A systematic review of technical evaluation in telemedicine systems.

We conducted a systematic review of the literature to critically analyse the technical evaluation and assessment frameworks that have been applied to telemedicine systems. A total of 47 articles met the inclusion criteria. Subjective methods were predominantly used for technical evaluation (59%), e.g., Likert scale. Those including objective measurements (41%) were mainly restricted to simple metrics such as network time delays. Only 3 papers included a rigorous standards-based objective approach. Our investigation has been unable to determine a definitive standards-based telemedicine evaluation framework that exists in the literature that may be applied systematically to assess and compare telemedicine systems. We conclude that work needs to be done to address this deficiency.