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Computers in Medicine

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Conference attendees review the state of the art in telemedicine and telehealth

A symposium entitled "State-of-the-Art Telemedicine/Telehealth: An International Perspective," was convened in August 2001 with support from the Agency for Healthcare Research and Quality (HS10936) and many other government and nongovernment sponsors. Invited participants represented private, public, and military sectors of telemedicine, as well as diverse international interests. The purpose of the symposium was to assess the state of the art in telemedicine and to develop recommendations and action plans to advance telemedicine at the regional, national, and international levels.

A recently published symposium report covers topics ranging from an assessment of clinical telemedicine applications and the role of telemedicine in public health and medical education, to development of telemedicine network models and the diffusion of telemedicine. In an introductory chapter, Rashid L. Bashshur, Ph.D., of the University of Michigan Health System, discusses the promise of the federally sponsored Next Generation Internet (NGI) or Internet 2 (I2), Department of Defense Intelligent Integration of Information (I*3) system, and the European Community's Intelligent Information Interfaces (i3). These systems either expand the storage for large data sets needed for certain diagnostic and clinical applications; speed information transfer, acquisition, and integration; and/or develop interactive capabilities and embed computing power into everyday objects to develop vertically and laterally "connected communities."

Despite these innovations, problems related to access, quality of service, and security remain. Many projects have been funded only for the short-term. The lack of mature telemedicine programs prevents adequate and definitive cost-benefit analysis. Also, with certain exceptions, such as teleradiology and telepathology, health providers and health administrators have not embraced telemedicine enthusiastically. The success and progress of telemedicine are being met, in the United States at least, by State-based protectionism and inconsistent Federal policies and financing regulations. Internationally, legal, ethical, economic, cultural, and logistical challenges have yet to be overcome.

More details, including a brief review of contents addressed in the symposium report, are in "State-of-the-art telemedicine/telehealth: An international perspective," by Dr. Bashshur, Salah H. Mandil, Ph.D., and Gary W. Shannon, and "Telemedicine and health care," by Dr. Bashshur, in the Telemedicine Journal and E-health 8(1), pp. 3-4 and 5-12, 2002.

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