Telemedicine: Emerging e-medicine

This paper reviews the emergence of telemedicine and its recent expansion a nd use within the healthcare industry. Through this review, several example s of telemedicine within a variety of applications provide a broad context to discuss the challenges and opportunities facing the emergence of e-medic ine. These examples provide snapshots of a teleradiology system used by the military, teleconsultations used in neurosurgery and hemodialysis, and hom e telemedicine used in diabetes care. Based on the discussion of telemedici ne's history and expansion and the examples provided, a framework is offere d for understanding the evolution of telemedicine applications through four stages. These stages include: (a) development of basic technological capab ilities, (b) development of relevant applications, (c) the integration of t echnical applications within a complex environment, and (d) transformation of the operating environment. Implications for this framework are discussed .