Telemedicine is part of
the expanding use of communications technology in health
care, or "telehealth," being used in prevention, disease
management, home health care, long-term care, emergency
medicine, and other applications. The diversification of
such applications and continued advances in communications
technologies, including the Internet, are raising
expectations for telemedicine. However, the considerable
attention focused on the technological aspects of
telemedicine during the last decade has been accompanied by
a lack of validated or well-demonstrated approaches for
evaluating telemedicine. For program funding and policy
making, there is increasing need to develop and adapt
evaluative frameworks for telemedicine.
In the mid-1990s, the National Library of Medicine (NLM)
requested that the Institute of Medicine (IOM) develop a
broad framework for telemedicine evaluation. In 1996, based
on the deliberations of a 15-member expert committee, the
IOM released its report, Telemedicine: A Guide to Assessing
Telecommunications in Health Care. The report presented a
framework built upon five main evaluation elements: 1)
quality of care and health outcomes, 2) access to care, 3)
health care costs and cost-effectiveness, 4) patient
perceptions, and 5) clinician perceptions (IOM 1996).
Since 1996, the field of telemedicine has continued to
evolve and mature. Recently, the DHHS Office of the
Assistant Secretary for Planning and Evaluation (ASPE)
contracted with The Lewin Group to assess current approaches
to evaluating telemedicine. In particular, ASPE requested
that Lewin extend or otherwise update the 1996 IOM framework
for telemedicine evaluation as it applies to
teleconsultations.
The
Center for Telemedicine Law (CTL) is a non-profit entity
founded by organizations committed to providing high-quality
patient services through the use of telemedicine systems
throughout the United States and the world. CTL is a leader
in the gathering and analysis of information related to the
legal and regulatory aspects of telemedicine. Because
uncertainty about legal and regulatory issues often serves
as a deterrent to the maximum utilization of telemedicine,
CTL seeks to identify and clarify the legal and regulatory
barriers and to offer solutions for overcoming these
barriers. |
