Authors' objectives:

This study aims to systematically review assessment and implementation aspects in telemedicine, in order establish the criteria that are used and how they are measured, from security to satisfaction and accessibility, across outcomes of efficacy, effectiveness and efficiency.

Authors' recommendations: Safety: 1. Telemedicine does not produce direct harmful effects on patients or professionals who deal with it. Technical quality of the systems: 2. The reception quality is in general good in all telemedicine applications. 3. Today, any type of information can be transmitted: voice, data, static images or in movement, in real time or previously stored, existing various information transmission means. The most used in telemedicine studies is the ISDN line, maybe because of good performances coupled to a reasonable price, but, above all, because at start of the studies included in this review, the possibility of the use of an ADSL line was not taken into account yet. 4. The utilized communication infrastructure determines the bandwidth and, thus, the transmission time and the need of information compression that finally can affect the image quality. Diagnostic accuracy: 5. Telemedicine has a high diagnostic accuracy compared to traditional care systems. The small differences in favor of traditional medicine are neither clinical nor statistically significant, except for radiology in which there is a dispute on the statistical significance. 6. The use of more modern technology, along with major bandwidth and more advanced visualization systems with higher spatial and image resolution, has allowed the diagnostic accuracy in telemedicine to increase, approaching traditional medicine and disappearing the statistical significance of teleradiology. Health outcomes: 7. The use of telemedicine reduces unnecessary transfers of patients who can be examined in their Community. It facilitates the examination of patientsin programmed consultations, home care or admissions in residential homes for elderly persons. 8. Telemedicine facilitates the early treatment of critical patients, previous to the arrival of the emergency teams or their transfer in traditional ambulance, above all, in cases of ischaemic cardiopathy with the sending of electrocardiogram from the ambulance. Satisfaction and accessibility: 10. Patients and professionals present a high degree of satisfaction with telemedicine. 11. Telemedicine contributes to a more equitable access to the healthcare services. Evaluation of telemedicine: 12. Is there an agreement between researchers on what has to be evaluated in telemedicine in terms of safety, effectiveness, efficiency and satisfaction. Legal-ethical aspects: 13. Is there an international commitment in order to safeguard the intimacy and to maintain the confidentiality of the transmitted information, as well as an interest in creating and regulating laws for the protection of data.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.juntadeandalucia.es/salud/aetsa

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: Andalusian Agency for Health Technology Assessment (AETSA)