What do we really know about the cost-effectiveness of telemedicine?

Abstract

Telemedicine is still in its infancy, but undergoing rapid development. It is very difficult to evaluate telemedicine. We performed a literature survey (Medline). During the period 1990-8, over 1500 articles on telemedicine were published. Of these, 246 mentioned economic aspects in the abstract (16%). We selected 29 studies although few had demonstrated cost-effectiveness. Benefits for the patients in the form of reduced travel and waiting time must often be weighed against increased provider costs. Up to now, telemedicine in general has not had any significant effect on medical practice, or the structure and organization of health-care. In order to utilize the potential of telemedicine, its integration with traditional health-care is very important. There are country-specific variations in the health systems that make it difficult to generalize the results from one country to another.

Approaching the management of hospital units with an operation research technique: The case of 32 Greek obstetric and gynaecology public units

“…This can be used not only to store and transfer patient information but also to improve decision making, to improve institutional efficiency, to promote better health behaviour, and to enhance more rational management of resources [38][39][40][41]. The essence of telemedicine lies in transferring expertise and not the patient [39].…”

Flexible Homes, Flexible Care, Inflexible Organisations? The Role of Telecare in Supporting Independence

“…While summative data about individual telemedicine interventions tend to present a picture of clinical and cost effectiveness, as well as high levels of patient satisfaction, systematic reviews demonstrate 446 J. Barlow et al that many study designs are in fact methodologically inadequate (Håkansson & Gavelin, 2000;Hersh et al, 2001;Mair & Whitten, 2000;Whitten et al, 2002;Williams et al, 2002). This is especially problematic given the culture within which these innovations are being introduced, which places great emphasis on high standards of proof of efficacy before new products and innovations are adopted.…”

Social Exclusion and Information Systems in Community Healthcare

“…Others argue that telecare allows greater flexibility and responsiveness, for example, enabling the elderly to be cared for at home, providing safety, security and health benefits (Coyle et aI., 1995;Sixsmith, 2000;Whitten et aI., 1998), and a means of interacting in a client-centred manner, promoting patient autonomy through education and improved communication (Warner, 1997). We must also recognise that in the research literature these claims are not well documented (Collins et aI., 2000;Hakansson and Gavelin, 2000;Mair and Whitten, 2000;Roine et aI., 2001). Others note that such moves may change the nature of health services and the practice of medicine, resulting, for example, in a medicalisation of essentially social questions (Fisk, 1995;Gott, 1995).…”