Abstract
Objectives: To assess the effectiveness of a statewide telemedicine and eHealth program in California and its impact on reducing barriers to health services for rural and underserved populations. Methods: Data were collected via surveys, site visits, document reviews, and informal interviews over a four-year period by an external evaluation team. Results: Medical consultations in 33 medical specialties were provided in 22 counties. Patients and providers were satisfied with telemedicine services, and the technical support and education provided was rated as being of high quality. Many policies and barriers exist that impede full deployment and sustainability of telemedicine programs. Provider recruitment is a challenge; consumer demand was lower than expected. Trial and error for program planning and implementation was the norm for this pioneering effort. Although technological and communicative networking among the grantees was initially minimal, it increased over time. Conclusions: Telemedicine can improve access to medical care for people who reside in rural populations and underserved markets. We speculate that a systematic statewide telemedicine program with a few regional telemedicine centers may be a better approach than numerous stand-alone programs.
Highlights
Telemedicine is the use of telecommunications and information technologies for the provision of healthcare at a distance (California Telemedicine & eHealth Center [California Telemedicine and eHealth Center (CTEC)], 2006)
Telemedicine is the use of telecommunications and information technologies for the provision of healthcare at a distance (California Telemedicine & eHealth Center [CTEC], 2006)
The grantees indicated that training materials related to business models and legal issues are needed along with updated information about reimbursement policies
Summary
Telemedicine is the use of telecommunications and information technologies for the provision of healthcare at a distance (California Telemedicine & eHealth Center [CTEC], 2006). This service-delivery method may be as simple as two health professionals discussing a case over the telephone or as complex as using videoconferencing equipment or satellite technology to conduct a real-time consultation between medical specialists in two different countries. Telemedicine has the potential to improve health care by bridging geographic gaps and mitigating service barriers, because it allows patient access to specialists who are practicing hundreds of miles away. Its use is not statewide due to a lack of an organized and shared infrastructure, public knowledge, provider participation, as well as lagging policy
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