An MD&DI April 1997 Column
Rural use of telemedicine has only begun to take hold, but already health-care providers are looking for ways to add more routes onto this medical branch of the information superhighway.
According to panelists in a session on telemedicine at the Medical Design and Manufacturing West conference held in Anaheim, CA, February 1013, new communications technologies are enabling health-care providers to share medical resources and research data with greater ease and efficiency than ever before. But a number of concerns still need to be addressed if the field of telemedicine is to realize the potential that many have envisioned for it.
A special presentation sponsored by FDA, the session brought together panelists from a number of organizations that are working with the agency to expand the use of telemedicine technologies, including the Health Care Financing Administration, the Agency for Health Care Policy Research, the Office of Rural Health Policy, and the Commission of the European Union.
According to Dena Puskin, of the Office of Rural Health Policy, a study recently conducted by that office indicated that the use of telemedicine is still relatively new in rural areas. Of the telemedicine programs surveyed, more than 40% had been in operation for a year or less. But the study also suggested that the use of telemedicine is growing fast, and many of those surveyed reported plans to expand their telemedicine capabilities.
However, the panelists pointed out that there are still several obstacles to the growth of telemedicine. The absence of standards for the recording and transmission of medical data, for instance, could slow the penetration of new technologies. To help develop such standards, FDA's Center for Devices and Radiological Health is working with standards-writing organizations such as the American National Standards Institute and the European Committee for Standardization's technical committee on medical informatics. The device center is also concerned with the development of regulations for the devices involved in telemedicine, such as imaging systems and software.
The panelists also discussed the difficulty involved in handling reimbursement for services involving telemedicine. At present, for instance, Medicare requires the actual presence of a physician for many services that it covers. Similarly, the absence of uniform standards for state licensing or for local coverage policies may lead to problems when telemedicine consultations are performed across state lines.---Leslie Laine