Telemedicine: caring for patients across boundaries.

Telemedicine combines computer, video and telecommunications to provide healthcare to patients at distant sites. With the improved camera and transmission technologies of the 1990s, telemedicine can be used in a variety of situations. There are two basic technological systems: live interactive video and still image ("store and forward"). Potential users include patients who live in rural or difficult to reach geographic areas, who are confined (i.e. prison inmates), Telemedicine can allow ambulatory patients to continue living at home rather than moving into costly nursing facilities. Home telemedicine also allows greater responsiveness and higher frequency of visits by home care nurses, potentially reducing future hospital visits and costs. Two home telemedicine models are the personal telemedicine unit and the enhanced personal telemedicine module with pc-based video. Telemedicine technologies developed by the military for use on the battlefield that could be adapted for civilian use include medical simulations, individual monitoring devices and biosensors, portable retinal display monitors, life support for trauma/transport, and diagnostic ultrasound imagery. Ultimately, the benefits of telemedicine will be consistency of care, easy access to specialized consultants, higher responsiveness to patient needs, and lower overall healthcare costs.