Telemedicine system evaluation and a collaborative model for multi-centered research.

Evaluating telemedicine systems and services is a complex task. Safety and efficacy must be measured in a relatively controlled laboratory environment, while measurement of clinical utility and medical effectiveness requires extensive field testing. The need for large clinical trials to demonstrate utility and effectiveness presents a dilemma. Substantial numbers of cases are needed to achieve statistically valid results, yet most telemedicine programs are based in rural settings with small patient populations. One potential solution is to pool data from multiple programs by using common data collection instruments and protocols. A promising model for the performance of multi-centered collaborative telemedicine research is described. The Clinical Telemedicine Cooperative Group (CTCG) is based on the successful use of collaborative research by clinical oncology research groups such as the Southwest Oncology Group (SWOG).