Telemedicine - is the cart being put before the horse?

Armfield, Nigel R., Edirippulige, Sisira K., Bradford, Natalie and Smith, Anthony C. (2014) Telemedicine - is the cart being put before the horse?. Medical Journal of Australia, 200 9: 530-533. doi:10.5694/mja13.11101

Author Armfield, Nigel R.
Edirippulige, Sisira K.
Bradford, Natalie
Smith, Anthony C.
Title Telemedicine - is the cart being put before the horse?
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2014-05-19
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.5694/mja13.11101
Open Access Status Not yet assessed
Volume 200
Issue 9
Start page 530
End page 533
Total pages 4
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing Company
Language eng
Formatted abstract
Telemedicine, the use of information and communication technology to deliver clinical services at a distance, although perceived as an innovation, has been discussed in peer-reviewed literature for over 40 years.1 While many articles describe the successes and failures of telemedicine, the evidence base for its use is weak. The common view is that it can benefit patients and clinicians, extending services into places where none previously existed. Here, we reflect on the shortcomings of telemedicine research and implementation, and suggest ways to strengthen the quality of evidence in relation to telemedicine. 

• A large literature base on telemedicine exists, but the evidence base for telemedicine is very limited. There is little practical or useful information to guide clinicians and health policymakers.
• Telemedicine is often implemented based on limited or no prior formal analysis of its appropriateness to the circumstances, and adoption of telemedicine by clinicians has been slow and patchy.
• Formal analysis should be conducted before implementation of telemedicine to identify the patients, conditions and settings that it is likely to benefit.
• Primary studies of telemedicine tend to be of insufficient quality to enable synthesis of formal evidence.
Methods typically used to assess effectiveness in medicine are often difficult, expensive or impractical to apply to telemedicine.
• Formal studies of telemedicine should examine efficacy, effectiveness, economics and clinician preferences.
• Successful adoption and sustainable integration of telemedicine into routine care could be improved by evidence-based implementation. 
Keyword Medicine, General & Internal
General & Internal Medicine
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
Queensland Children's Medical Research Institute Publications
School of Medicine Publications
Centre for Online Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 28 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 19 May 2014, 23:02:12 EST by Burke, Eliza on behalf of Centre for On-Line Health