An assessment framework for telemedicine applications

Pressures for the adoption of telemedicine place increased demands on purch asers to assess applications of the technique. Assessment principles are he lpful in defining an evaluation framework for use at the local level. We su ggest an assessment approach that includes five specific elements: specific ation; performance measures; outcomes; summary measures; and operational an d other considerations. The approach described here was developed to assist with the needs of individual health authorities and institutions within th e health-care system of Alberta. Aspects of the approach are illustrated us ing a telepsychiatry example under the assumptions made. Conventional psych iatry (where the patient visited the psychiatrist) was most expensive for t he patient. The alternatives, telepsychiatry and outreach psychiatry (where the psychiatrist travelled to the patient), cost about the same from the s ervice provider's perspective (and from that of society as a whole); they w ere both much cheaper for the patient. At higher volumes, telepsychiatry wo uld be cheaper than outreach.