An assessment framework for telemedicine applications.

Pressures for the adoption of telemedicine place increased demands on purchasers to assess applications of the technique. Assessment principles are helpful in defining an evaluation framework for use at the local level. We suggest an assessment approach that includes five specific elements: specification; performance measures; outcomes; summary measures; and operational and other considerations. The approach described here was developed to assist with the needs of individual health authorities and institutions within the health-care system of Alberta. Aspects of the approach are illustrated using a telepsychiatry example under the assumptions made. Conventional psychiatry (where the patient visited the psychiatrist) was most expensive for the patient. The alternatives, telepsychiatry and outreach psychiatry (where the psychiatrist travelled to the patient), cost about the same from the service provider's perspective (and from that of society as a whole); they were both much cheaper for the patient. At higher volumes, telepsychiatry would be cheaper than outreach.