Skip Navigation U.S. Department of Health and Human Services
Agency for Healthcare Research Quality
Archive print banner

Telemedicine, Update

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to for current information.

Full Title: Telemedicine for the Medicare Population—Update

February 2006

View or download Report

Structured Abstract

Context: Telemedicine services are increasingly utilized by patients, clinicians, and institutions. Although private and Federal insurers are covering some telemedicine services, the rationale for these coverage decisions is not always evidence-based.

Objectives: The goal of this report was to assess the peer-reviewed literature for telemedicine services that substitute for face-to-face medical diagnosis and treatment that may apply to the Medicare population. We focused on three distinct areas: store-and-forward, home-based, and office/hospital-based services. We also sought to identify what progress had been made in expanding the evidence base since the publication of our initial report in 2001 (AHRQ Publication No. 01-E012).

Data Sources: Ovid MEDLINE®, reference lists of included studies, and non-indexed materials recommended by telemedicine experts.

Study Selection: Included studies had to be relevant to at least one of the three study areas, address at least one key question, and contain reported results. We excluded articles that did not study the Medicare population (e.g., children and pregnant adults) or used a service that does not require face-to-face encounters (e.g., radiology or pathology diagnosis).

Data Extraction: Our literature searches initially identified 4,083 citations. Using a dual-review process, 597 of these were judged to be potentially relevant to our study at the title/abstract level. Following a full-text review, 97 studies were identified that met our inclusion criteria and were subsequently included in the report's evidence tables.

Data Synthesis: Store-and-forward services have been studied in many specialties, the most prominent being dermatology, wound care, and ophthalmology. The evidence for their efficacy is mixed, and in most areas, there are not corresponding studies on outcomes or improved access to care.

Several limited studies showed the benefits of home-based telemedicine interventions in chronic diseases. These interventions appear to enhance communication with health care providers and provide closer monitoring of general health, but the studies of these techniques were conducted in settings that required additional resources and dedicated staff.

Studies of office/hospital-based telemedicine suggest that telemedicine is most effective for verbal interactions, e.g., videoconferencing for diagnosis and treatment in specialties like neurology and psychiatry.

Conclusions: There are still significant gaps in the evidence base between where telemedicine is used and where its use is supported by high-quality evidence. Further well-designed and targeted research that provides high-quality data will provide a strong contribution to understanding how best to deploy technological resources in health care.

Download Report

Telemedicine for the Medicare Population—Update

Evidence-based Practice Center: Oregon
Topic Nominators: Centers for Medicare & Medicaid Services

Current as of February 2006


The information on this page is archived and provided for reference purposes only.


AHRQ Advancing Excellence in Health Care