Telemedicine

Telemedicine refers to the use of communications technology to help deliver medical care regardless of the distance that separates doctor and patient. Collectively, the public and private sectors have funded hundreds of telemedicine projects that could improve, and perhaps change significantly, how health care is provided in the future. The total amount of the investment, however, is unknown. GAO identified nine federal departments and independent agencies that have invested upwards of $646 million in telemedicine projects during fiscal years 1994 through 1996. The Defense Department is the largest federal investor with $262 million and considered a leader in developing this technology. Opportunities exist for federal agencies to share lessons learned and exchange technology, but no governmentwide strategy exists to ensure that the maximum benefits are gained from the many federal telemedicine efforts. Telemedicine technology today is not only better than it was a decade ago, it is becoming cheaper. However, the expansion of telemedicine is hampered by legal and regulatory, financial, technical, and cultural barriers facing health care providers. The questions facing telemedicine today involve not so much whether it can be done but rather where investments should be made and who should make them. The solution lies in the public and private sectors' ability to devise a way to share information and overcome barriers. The goal is to ensure the creation of an affordable telecommunications infrastructure and that the true merits and cost benefits of telemedicine are attained in the most appropriate manner.

GAO found that: (1) collectively, the public and private sectors have funded hundreds of telemedicine projects that could improve, and perhaps change significantly, how health care is provided in the future; (2) however, the amount of the total investment is unknown; (3) 9 federal departments and independent agencies invested at least $646 million in telemedicine projects from fiscal years 1994 to 1996; (4) DOD is the largest federal investor with $262 million and considered a leader in developing this technology; (5) state-supported telemedicine initiatives are growing; (6) estimates of private sector involvement are impossible to quantify because most cost data are proprietary and difficult to separate from health care delivery costs; (7) opportunities exist for federal agencies to share lessons learned and exchange technology, but no governmentwide strategy exists to ensure that the maximum benefits are gained from the numerous federal telemedicine efforts; (8) the Joint Working Group on Telemedicine (JWGT) is the first mechanism structured to help coordinate federal programs; (9) however, its efforts to develop a federal inventory, a critical starting point for coordination, have been hampered by definitional issues and inconsistent data; (10) in addition, DOD and other federal departments do not have strategic plans to help guide their telemedicine investments, assess benefits, and foster partnerships; (11) telemedicine is an area in which public and private benefits converge; (12) many anecdotal examples demonstrate how telemedicine could improve access and quality to medical care and reduce health care costs; (13) however, comprehensive, scientific evaluations have not been completed to demonstrate the cost benefits of telemedicine; (14) the expansion of telemedicine is hampered by legal and regulatory, financial, technical, and cultural barriers facing health care providers; (15) some barriers are too broad and have implications too far-reaching for any single sector to address; (16) telemedicine technology today is not only better than it was decades ago, it is becoming cheaper; (17) consequently, the questions facing telemedicine today involve not so much whether it can be done but rather where investments should be made and who should make them; (18) the solution lies in the public and private sectors' ability to jointly devise a means to share information and overcome barriers; and (19) the goal is to ensure that an affordable telecommunications infrastructure is in place and that the true merits and cost benefits of telemedicine are attained in the most appropriate manner.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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