Increasing access to care via tele-health: the Arizona experience.

The Arizona Telemedicine Program (ATP) is a large, multidisciplinary, university-based program that provides telemedicine services, distance learning, informatics training, and telemedicine technology assessment capabilities to communities throughout Arizona. The types of teleconsultation services available include real-time and store-forward consultations, continuing medical education, and patient information sessions. Since the inception of the ATP, there have been 97,722 telemedicine events. The most frequently used telemedicine service is teleradiology, comprising 85,728 teleconsults. Next in frequency are teledermatology and telepsychiatry consultations. Results of patient satisfaction surveys indicate high levels of patient satisfaction with both real-time and store-forward consultations. Three studies of the efficacy of telemedicine services are discussed. One study of the efficacy and diagnostic accuracy of utilizing telecolposcopy, revealed a positive predictive value of the telecolposcopic impression of between 81% and 82%, while the positive predictive value of an in-person impression was 80%.