The economics of telemedicine.

Despite a large number of telemedicine trials, little information has been published on its economic costs and benefits. Most telemedicine initiatives have been funded as special projects which were not subject to normal budgeting procedures. A framework is needed to enable decision makers in health-care delivery to analyse the potential effects of telemedicine applications on the activities, functions and roles of the different parties involved, such as hospitals, consultants, general practitioners, nurses and other health-care workers, and the different costs and benefits for each of these groups. In many countries, telemedicine projects have been introduced within special closed groups, such as in prisons, for military or space operations, or in disaster zones. However, some commercial services providing international telemedicine have also begun. Telemedicine costs are strongly related to patient volumes, but issues such as protocols for reimbursement need to be resolved before large-scale implementation is likely to be achieved.