Terry L. Huston
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Index Terms
- Is telemedicine a practical reality?
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Reviews
James Cecil Hammerton
Telemedicine is a new word, at least to most of us. Without much ado, we can imagine a doctor, or even a group of doctors, sharing an information system and seeking the cause of an illness. Even a larger scenario of multiple patients, not necessarily suffering from the same disease, is not totally confusing. Potential problems begin to multiply at a startling rate, however, when we consider the impact on our system of having multiple patients: doctors will be interested in seeing the cumulative “picture of a plague.” At this point (or close to it), we will be forced to consider the impact on our telemedicine system of paying for the system. The technical problems may well seem minor compared to the potential difficulties of working out a fair system of reimbursement. This article presents some of the immediate issues. One, which illustrates the difficulties facing the system, is how to compensate the doctors involved. This problem has received considerable attention lately. On the one hand, HMOs are regarded with suspicion because they have considered a payment scheme that appears to involve holding back a portion of whatever monies are extracted from the patient, or making payment to the doctor on the basis of how much he or she bills the patient. Somewhere in all of this, there is a suspicion that the doctors are gaining an illegitimate advantage over the patients. So, in answer to the question asked in the title to the article, telemedicine is a reality. As to whether it is a “practical reality,” a change of thinking is involved. More than the way people interact is affected. So press on, but beware.
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