Development of a telemedicine program

objective To examine the financial and organizational characteristics, dema nd for services, and satisfaction outcomes of a growing telemedicine progra m serving both urban or suburban and rural populations. Design Retrospectiv e review of 1,000 consecutive telemedicine consultations in the University of California (UC) Davis Telemedicine Program. a Setting Telemedicine video conferencing units, used to integrate care in the UC Davis Health System am ong the UC Davis Medical Center and several urban or suburban primary care clinics, rural hospitals, and clinic affiliates. Subjects A total of 657 co nsecutive patients who consented ro a telemedicine consultation. Main outco me measures Demographic information about the patient population, rhs rural and urban or suburban clinics, the types of specialty consultations, and t elemedicine equipment used in the UC Davis Health System. Patient and physi cian satisfaction were measured on a 5-point Likert scale. Results Patients and primary care physicians reported high levels of satisfaction. Rural cl inics requested more and a greater variety of specialist consultations than urban or suburban clinics. Conclusion Although referring physicians and pa tients indicate a high level of satisfaction with telemedicine services and insurers are negotiating reimbursement policies, additional research must investigate the reasons why some payers, patients, and providers resist par ticipation in these services.