Chapter 7: The Diffusion of Telemedicine

HIS CHAPTER DESCRIBES general trends in the growth and diffusion of telemedicine worldwide. It begins with a description of the diffusion in the United States, and is followed by examples from a range of other countries. A theoretical model is then presented that con- tains factors that affect the adoption of new technologies, particularly in a free market economy and with a high degree of profes- sional autonomy. Attention is then focused on the analysis of important factors slowing the spread of telemedicine on several different lev- els. Analyzing the diffusion of telemedicine and telehealth is complicated by virtue of the com- plexity and inclusiveness of the field. Although telemedicine or telehealth refers to the deliv- ery of medical or health services at a distance, there is no single and uniform telemedicine or telehealth service as such. As well, there is no specific, fixed, or uniform technology that enables telemedicine or telehealth. Instead, telemedicine and telehealth encompass a full range of diagnostic, clinical, and educational services and activities aimed at the promotion of health, the prevention of disease, and the treatment of illness. The technology of tele- medicine also is variable; design configuration, transmission, and equipment are all develop- ing quickly, with much of it becoming obsolete almost as quickly. Hence, it is neither possible nor perhaps appropriate to postulate a target or desirable rate for the diffusion of telemedi- cine as a whole, in isolation from a host health care system, the specific applications of telemedicine, or the alternative means of pro- viding the same services.