Elements for assessment of telemedicine applications

Objectives: As an initiative of the International Network of Agencies for H ealth Technology Assessment, an approach to assessment of telemedicine appl ications was prepared to assist decision makers who are considering introdu ction and use of this technology. Methods: Review and commentary drawing on published assessment frameworks a nd reports of primary evaluations of telemedicine, with particular referenc e to experience in Finland and Canada. Results: Elements of the approach included development of a business case ( considering population and services, personnel and consumers, delivery arra ngements, specifications and costs); subsequent evaluation of the telemedic ine application; and follow-up (covering the domains of technical assessmen t, effectiveness, user assessment of the technology, costs of telemedicine, trials, economic evaluation methods, and sensitivity analysis). Conclusions: Decision makers should link introduction of new and often cost ly technology to appraisal of its feasibility, followed by evaluation of th e application, including longer term consideration of its sustainability an d impact on the healthcare system. As the effectiveness and efficiency of t elemedicine applications will often be strongly influenced by local issues, results of assessments may not be generalizable.