STAFF PERCEPTIONS OF EMERGENCY AND HOME-CARE TELEMEDICINE

The utilization of a low-bandwidth telemedicine system for emergency a nd for home-care patients was studied in a pilot trial. The emergency setting was the emergency department of a small urban hospital and its emergency medical service (EMS); the home-care setting was the home-h ealth agency affiliated to the hospital. Utilization data were obtaine d through baseline and follow-up interviews with EMS technicians, emer gency department and home-health nurses, and the project coordinator. The results indicated that initial enthusiasm for the use of the telem edicine system was not followed by a commitment to the system's utiliz ation during the trial by the relevant administrations. Barriers to op timum utilization were identified, but the actual value of the system to patient care could not be determined. We conclude that the value of a telemedicine system to patient care cannot be realized unless there is an organizational commitment from the top to system utilization.