Institute of Medicine committee calls for further study of telemedicine
As interest in using telemedicine to expand healthcare options grows, both its effectiveness and cost need to be evaluated, according to a report by an Institute of Medicine (IOM) committee.
“It’s technology unlike others because there’s a huge human component,” said John R. Ball, MD, JD, president and chief executive officer of Pennsylvania Hospital in Philadelphia, who chaired the committee.
Telemedicine is used in a variety of ways in patient care, education, research, administration, and public health. Applications can range from the ordinary, such as 911 calls, to the experimental, such as telesurgery, during which a surgeon guides robotic instruments at a distant site to perform surgery.
According to Ball, telemedicine could prove beneficial to nurse practitioners in rural settings, who could use it to provide their patients better access to higher technology.
“People have very different expectations and abilities,” Ball said. “The bottom line is [each telemedicine application] needs to be evaluated because of its specific differences.”
The IOM report spells out a framework for evaluating telemedicine to help decision-makers judge whether an application is effective, sustainable, and amenable to improvement. Ball said a clear business plan is needed to assess a program’s cost-effectiveness.
“This gives [health professionals] a road map to follow,” Ball said. “It gives people the sort of questions they need to ask. It provides a way to make evaluations fairly consistent.”
The committee recommended research that systematically compares telemedicine with alternatives. Areas to be examined include the clinical process of caregiving; the patient’s status or health outcome; access to care; costs for patients, payers, providers; and society; and the satisfaction of patients and clinicians.
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