Delivery of Health Care to the Underserved: Potential Contributions of Telecommunications Technology

To evaluate the potential uses of telecommunications in medicine (telemedicine), determine the most important principles in designing telemedicine applications, decide what research questions to address, and identify potential barriers to full use of telemedicine. A consensus conference on telemedicine was convened in October 1993 to assemble a wide variety of participants with the assigned task of addressing the objective. Consensus was achieved on several key principles for implementation of successful telemedicine. Two of the most important principles will be (1) to focus on the needs of the underserved people more than on the capabilities of the available technologies and the regional centers and (2) to use the least expensive but appropriate telecommunications technology for any specific application. Greater professional connectivity between providers of health care in underserved areas and colleagues in tertiary medical centers is expected to minimize professional isolation in underserved areas. Telecommunications technologies have considerable potential for improving health care to the rural and underserved populations, but a systematic approach to implementation, which takes into account the identified key principles, is needed.