What are the pros and cons of TM/videoconferencing (from patient and provider perspective)?
 

• Pros include enhanced access to specialty care for patients and elimination of travel time and expense. Providers who travel to see their patients will also benefit from cutting out travel time and will also enjoy greater efficiency in delivery of care. Telemedicine provides opportunities for providers to educate patients, medical students, residents and other providers from a remote location, increasing dissemination of information to a broader audience than may otherwise be possible.
• Cons may include initial lack of ease about using telemedical equipment or communicating remotely, transmission problems that interrupt a videoconference, inability to touch the patient, limitations to physical exam if special equipment is needed that cannot transmit electronically.

How difficult is the equipment to use?

• A TRC facilitator will be present to set up the videoconferencing equipment and to troubleshoot any problems that are encountered during the conference. Training is available for any interested provider on the use of the equipment and pointers on how to interact with the patient/consulting provider via videoconference.

What are the limitations of TM/videoconferencing?

• Available bandwidth may be a limiting factor in achieving optimal transmission of images and sound.
• Transmission problems across phone lines occasionally interrupt videoconferencing sessions.
• While images are usually very clear and allow for visual examination of the patient, some providers may find the lack of ability to physically touch the patient during examination a limitation.

Is there evidence that seeing patients via telemedicine is effective and reliable?

• Research has been conducted showing that telemedicine is a cost-effective means of delivering healthcare. Large savings over traditional methods of care delivery have not been realized, however, due to equipment and transmission costs.
• Outcomes studies have shown reliability and overall satisfaction on the part of both patients and providers when using telemedicine.

Can I participate in a demonstration/trial run before seeing my patient?

• Yes, the TRC will be happy to arrange a demonstration and provider orientation prior to a patient appointment.

Have certain specialties been proven to be more or less amenable to telemedicine than others?

• Telemedicine services are most commonly used for radiology, dermatology and pathology due to the ease of transmitting high-quality images with store-and-forward technology. However, all specialties may benefit from telemedicine. Provider comfort with the technology is a large factor determining use of telemedicine. As equipment becomes more sophisticated, technological limitations will be decreased, enhancing ease of use and quality of telemedicine transactions. There have been no specialties identified as unamenable for delivery via telemedicine in the research to date.

Are certain populations particularly in need of telemedicine services?

• Rural areas have been targeted by funding agencies as most in need for telemedicine services due to lack of access to specialty care. Rural patients are not the only ones who may benefit from telemedicine though. Any patient with access problems or for whom travel is inconvenient and/or difficult may benefit. So too may providers who travel long distances to see certain patients or to hold periodic clinics.

How much advance notice does the TRC require to schedule a videoconference?

• Given the JCAHO requirements regarding credentialing/privileging of providers involved with a telemedicine consultation and the services being delivered/received, the more notice the TRC has the better. At least 24 hours advance notice is requested if possible. If necessary, however, the TRC is able to accommodate telemedicine needs on very short notice.