Health Care Goal Team

The Health Care Goal Team formulated these 6 key questions, hoping that they could be answered in the OTFC process. In an effort to help the team answer those questions, we searched the Internet for resources and assembled the following list. This list is by no means exhaustive, but provides us with a way to fill in some background information, and point to what others have done as examples.

With a subject as broad and important as health care, in general, and telemedicine, in particular, it's hard to know where to start. Fortunately, many other states and organizations have travelled this road before and information about this subject abounds on the Internet. What follows are several places where you can read about the efforts of others, the questions they asked, and some of the projects that resulted.

Some of the sites delve more into the medicine, rather than the tele, but are still useful and interesting. The point of view presented in the sites varies - some come from the community networking perspective, others from the health-care provider perspective. Both perspectives add important assets to the discussion.

Whenever you come across a page with valuable/interesting information on it, you can go to the File menu in your browser, and select Save As... This allows you to save the page as text on your computer, and you can then 'copy out' text later so that you can organize the information for future use.Create a folder on your hard drive called medicine, and save all these documents there.

A great document for some telemedicine background and specific questions for assessing efficacy and pointing out challenges can be found at the National Academy Press page. The writing style is decidedly academic, but provides lots of sample questions to get you thinking about telemedicine from both the provider and patient points of view. (Brought to you by the National Academy of Sciences.)

The Western Governors' Association Telemedicine Report, lays out the barriers to telemedicine and some (rather vague) actions to take to overcome them. This should be of particular interest to OTFC participants in answering question #1, since this group had identified problems similar to those identified by the Health Care Goal Team.

Assessment

Standards

For standards of telemedicine, it might be worth contacting the American Telemedicine Association. There's not much on this page, but it gives an e-mail link for more information. Perhaps the organization has some printed materials it could send out...

There is a section in the government's Telemedicine Report that's definitely worth looking at."The use of advanced telecommunications technology to deliver health care brings with it a host of concerns about safety and effectiveness. For instance, does a cardiologist at an urban medical center, using an electronic stethoscope, get the proper sound resolution to effectively make a proper diagnosis during a teleconsult with a patient in a rural clinic? Will a technology that works for one specialty be equally safe for use in another specialty?...."

Training

Policies

The federal government has recently (Jan.31,1997) released a document called the (TRC). There is a section of the report that deals"The current lack of payment for telemedicine services is considered to be one of the major barriers to telemedicine's rapid deployment. For example, most third party payers have taken a "wait and see" approach toward telemedicine payments. On the Federal government side, Medicare and Medicaid, which are wholly or partly administered by the Health Care Financing Administration (HCFA), have varying policies covering telemedicine...."

The above government report has a tough-on-the-eyes summary, which has been much improved for readability by the Benton Foundation on a page. The page is full of specific recommendations and is a must-read.

For lots of specifics on licensure, take a look at the section of the TRC. Subsections of this document include; history, legal foundation, alternative approaches to licensure, legal and regulatory issues, liability, and specific reform proposals.

Again, the TRC has a lot to say about"New technologies have vastly improved the ability to electronically record, store, transfer and share medical data. While these new advances have potential for improving health care delivery, they also create serious questions about who has access to this information and how it is protected. Additionally, this technology is threatened by potential unauthorized intrusion, such as computer hackers who have been known to tap illegally into private information on computer networks."

Access

This emphasizes rural health. It's a small part of , Applied Rural Telecommunications. ("AeRie provides rural communities the tools they need to apply telecommunications to meet their community and economic development goals.") On their, you'll find, among other things, lists of applications and opportunities for planning like;