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Trends in Telemedicine
This study was conducted to better understand the trends affecting the use of telemedicine. The widespread adoption of telemedicine, like virtually all high technology innovations, is particularly dependent on meeting the needs of end-users. More than 500 members of The Science Advisory Board's Clinical Panel participated in this project and offered their opinions and insights on a technology undergoing great transformation.

Although the definition of telemedicine may vary, the concept is not new. From its inception, the goal of telemedicine has been to overcome the time and distance barriers that separate the caregiver from the patient. While the proponents of telemedicine have promoted its potential to revolutionize healthcare, widespread adoption of the technology has been hampered by a number of technological, regulatory and other barriers. Interest in telemedicine, however, has been re-ignited by remarkable developments in computers and telecommunications. Until very recently, text, sounds, pictures, and video have been disseminated independently of each other over separate media, and have been controlled by separate industries. Due to the phenomenon known as digital convergence previously distinct industries and technologies are evolving, interconnecting, and merging in completely new ways.

The impact of convergence is forcing radical rethinking and restructuring of many traditional paradigms in the practice of telemedicine. Convergence is presenting both practitioners and vendors with a vast array of new opportunities. Innovations such as computer-based patient records, remote consultations, hospital information systems, computer-based decision support tools, community health information networks, and new ways of distributing health information to professionals and consumers are supported by, and in some cases reliant on, the widespread use of networked telemedicine technologies. Exploiting the opportunities of convergence, however, will require close collaboration between visionary healthcare professionals and innovative companies to creatively combine new and existing technologies to produce cost-effective solutions.

Among the study's major findings:

• 34% of users report their organization's telemedicine program has been in existence between 1 and 2 years, and almost 20% report their program has been in existence for 5 years or longer.
• Supporting "Continuing Medical Education" is the most common way in which telemedicine is used, followed closely by "clinical consultations".
• "Text documents" are the most frequently transmitted type of medical information transmitted between locations, while "real-time motion video" is transmitted least frequently.
• A desire to "deliver quality care to rural/under-served areas" was cited by users as the most important reason their organizations decided to implement a telemedicine, but non-users claim the "availability of affordable technology" would be their primary motivation.
• "Access to medical databases" was considered the most valuable clinical telemedicine application cited by users.
  87% of those using telemedicine report that their organization provides them with access to the Internet.
• Slightly more than a third of those using telemedicine report that their organization "occasionally" uses telemedicine to assess a patient at a remote location, while almost half "occasionally" use an interactive technology to consult with a remote caregiver.
• "Lack of funding" was by both users and non-users as the greatest impediment to the growth of telemedicine. Budgets for the majority of new telemedicine programs (less than one year old) appear to have increased by 50% or more from 1997 to 1998. However, budgets for the majority of older telemedicine programs (5 years or more), have remained the same for the majority of the respondents.
• Non-users indicated that having access to medical databases and the ability to transmit medical images would be the two most valuable telemedicine capabilities.

75% of the participants are located in North America, 14% in Europe, and the remaining 11% in Australia/New Zealand, Latin America, Asia and Africa. 54% of the participating members work in hospitals, 24% in academic medical centers, 10% in private practice, and the remainder in a variety of commercial, government and private institutions.

Two different questionnaires were completed by members of the Clinical Panel. One questionnaire was designed for those with "hands-on" experience with telemedicine, while the second was designed to measure the perceptions of those professionals who have yet to use the technology. The results of this study show an overwhelmingly positive disposition toward telemedicine and a remarkable similarity between the experiences of "users" and the perceptions of "non-users."

To read selected members' comments, please click here.

To request information on purchasing the full report, please contact Karen Blaine at The Science Advisory Board.

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