The sustainability of telemedicine projects

Although there are instances where the provision of health care is successf ully driven by the profit motive, in most countries it is considered a publ ic service. The provision of telemedicine services assuredly meets an impor tant social need to extend health care to remote and rural areas in develop ing countries. While there are potential advantages and benefits from telem edicine, the evidence of its cost-effectiveness and sustainability is meagr e. Telemedicine undoubtedly yields cost savings in certain circumstances, b ut few service providers have found a way to recover their costs (and make a profit) from those to whom they provide their service. With their low exp enditures per person, developing countries face a daunting challenge in mak ing such public services sustainable. Pilot projects should be a first step in demonstrating the cost-effectiveness and benefits of telemedicine, but such projects should also be sustainable. Sponsors of such pilot projects m ust have a clear plan from the start about how the project can continue aft er the sponsorship comes to an end. This paper examines ways in which telem edicine services can be made sustainable.