I. Telemedicine: History and Description
Perednia and Allen (1995) reported that the telemedicine concept was first applied in 1959, when physicians ôused a microwave link for telepsychiatry consultations between the Nebraska Psychiatric Institute in Omaha and the state mental hospital 112 miles away. In the same year, à teleradiologyö was used in Montreal to transmit ôtelefluoroscopic examinations over coaxial cable. In the 1970s and 1980s, limited telemedicine projects were instituted at several sites in North America and Australia, including the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) project of the National Aeronautics and Space Administration (NASA) in southern Arizona, a project at Logan Airport in Boston à, and programs in northern Canadaö (p. 484). Perednia and Allen (1995) reported that, with ôthe exception of the 20-year old telemedicine program at Memorial University of Newfoundland, St JohnÆs, none of the programs begun before 1986 has survived. Although data are limited, the early reviews and evaluations of those programs suggest that the equipment was reasonably effective at transmitting the information needed for most clinical uses and that users were for the most part satisfied. However, when external sources of funding were withdrawn, the programs disappeared, indicating that the single most important cause of their failure was the inability to justify these programs on a cost-benefit basisö (p. 485).
Various definitions of telemedicine have been offered (Woottin, 1996). The most general definitionùômedicine at a distanceùcovers the whole range of medical activities, including treatment and education. There are many successful examples of distance education in medicine, including the continuing medical education program run by the Mayo Clinic and delivered by satellite and the teaching of surgery to undergraduates by means of the Super-JANET network in the Unit...