Abstract
Telemedicine is an application of information technology that provides the means to deliver healthcare services at a distance. Interest in telemedicine by the healthcare community has been highly variable since its beginnings in the early 1960s, in part due to the failure to quantitatively demonstrate its cost-effectiveness in delivering healthcare services. Although once again on the upswing, we argue that telemedicine will not fulfill its advertised promises unless the community adopts a new paradigm for its development and evaluation. The paper thus summarizes the prevailing approach—technology driven, retrospective evaluation, little planning—and describes a new one which is based on capability requirements and the use of models for prospective analysis and planning. A new program to develop structural models of the healthcare delivery system for this purpose is presented, including the program's modeling criteria, major components and processes of the healthcare system being considered, the development strategy being pursued, and the structure of specific models being developed.
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