Telehealth in Western Australia: the challenge of evaluation.

Between 1996 and 2003, a network of 85 telehealth videoconference sites was implemented in Western Australia (WA), together with 19 teleradiology facilities. Telehealth services have been growing steadily, and in 2002 there were over 30,000 teleradiology transmissions and 1250 clinical occasions of service via videoconference. The funding bodies, and in particular the WA Department of Health, need to know whether the aims of the project have been achieved. They must also decide whether investment should continue. A process of progressive evaluation has been implemented to identify progress to date, the benefits achieved and the potential for further development. However, it is difficult to evaluate a broad range of programmes in rural and remote locations for such an embryonic service. These difficulties are compounded by the lack of a strategy at national level to ensure consistency and compatibility not only of infrastructure, equipment and standards but also of data capture and evaluation methodologies for telehealth. This would allow comparisons across regions and states, which in turn would provide opportunities to learn from others and thus improve health-care nationally.