Evaluation in “real world settings”…the success of complex health interventions like telehealth is dependent on human behaviour, program adoption, level of participant activation or engagement, and other contextual factor present where intervention is implemented. Randomized controlled trials are the gold standard method for conducting rigorous evaluation. However, this is not always the rule in telehealth evaluation; introducing again the debate on the positivist versus naturalist approach. Mixed methods, an emerging and evolving research methodology combining quantitative plus qualitative approaches could be the answer as pointed out by Martin-Khan and cols. in her paper “Mixed methods for telehealth research”. J Telemed Telecare. 2016.