Navy Telemedicine: Current Research and Future Directions

Abstract

Abstract : The ongoing war on terrorism makes medical surveillance and remote access to medical care for deployed forces pressing concerns. The potential for chemical and biological terrorism on U.S. soil adds an urgency for Navy medical technologies to respond to Homeland Defense concerns. An assessment of Navy telemedicine as a complex healthcare support system is needed to demonstrate how current practices, training, equipment, and expenditures measure up to the emerging needs of the Fleet. This report reviews military and civilian models for evaluating telemedicine systems in order to determine future directions for Navy telemedicine research within the current funding environment. How can we calculate the level of technology to implement for the most productive return on investment across varying treatment settings? A literature review of military and civilian telemedicine was conducted in September 2001 to determine what types of evaluative models are currently being advocated by telemedicine practitioners. A review of current models for evaluating telemedicine yielded seven categories for evaluation: tools and equipment; outcomes; cost; treatment settings, task domains; participant satisfaction; and human factors. Using this literature review as a baseline, the authors developed a conceptual model for assessing the structure of Navy telemedicine. The model describes how each of the seven components affect the implementation of telemedicine in Navy and civilian settings. Finally, the authors recommend how short-term, narrowly-focused studies could form the basis for a model for correlating level of technology suites to level of care across treatment settings. Results: An analysis of models for evaluating telemedicine indicates that there is currently no workable model for evaluating telemedicine as a complex and multi-level system, either in military or civilian research.