Research findings and strategies for assessing telemedicine costs.

With varying degrees of enthusiasm, researchers and decision-makers support the use of telemedicine. Forms of telemedicine are appearing in health-care delivery, and are often integral to transforming health-care information technology. Despite this, the appropriate role of telemedicine in the delivery process remains ambiguous, at least partly because of its uncertain impact on costs. Cost savings and benefits are often suggested by the logic of its impact on health care and by the promise of technology, but definitive information on the costs and benefits remain elusive. The objectives of this paper are to review the state of telemedicine cost research, to examine major issues affecting the yield from this research, and finally to recommend strategies for improving future research. As this paper demonstrates, the productivity of telemedicine cost studies suffers from an under-utilization of appropriate program evaluation and economic methods. This review of telemedicine cost literature will appraise telemedicine cost studies and their findings within a broad analytic framework. Telemedicine cost studies will be assessed on their methods of statistical inference, use of critical economic concepts, and contextual definition for the determination of costs and benefits.