eHealth systems and emergency situations
Telemedicine presents a framework for evaluating patient care applications of telemedicine. The book identifies managerial, technical, policy, legal, and human factors that must be taken into account in evaluating a telemedicine program. The committee reviews previous efforts to establish evaluation frameworks and reports on results from several completed studies of image transmission, consulting from remote locations, and other telemedicine programs.
Classical medicine and eHealth integration
Telemedicine--the use of information and telecommunications technologies to provide and support health care when distance separates the participants--is receiving increasing attention not only in remote areas where health care access is troublesome but also in urban and suburban locations.
Telemedicine: A New Health Care Delivery System
Drawing from a widely cited 1990 IOM report, the committee agreed that quality of care is "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge" (IOM 1990c, p. 21). Consistent with the concepts set forth in a 1993 report (IOM, 1993a), the committee defined access as the timely receipt of appropriate health care. Costs measure the value of resources expended for an activity or objective. They are generally measured in dollars but are sometimes expressed in other units (e.g., travel time, days lost from work, treatment delays) without monetary conversion. These concepts and related evaluation topics (e.g., cost-effectiveness) are discussed further in later chapters of this report.
Telehealth is sometimes discussed interchangeably with telemedicine
For purposes of this report, an evaluation criterion is a measure, indicator, standard, or similar basis for describing outcomes or making judgments. Examples of criteria in common use in evaluations include mortality, hospital length of stay, and patient satisfaction. The committee focused on the set of basic concerns about the quality, accessibility, and cost of health care that lie at the core of most health services research and technology assessments. Because a comprehensive presentation of specific criteria appropriate for the heterogeneity of telemedicine applications was beyond the committee's resources, this report sets forth criteria in the form of questions with examples of the kinds of measures or standards that would be applied to particular telemedicine applications.