Summary: Telemedicine refers to the use of communications technology to help deliver medical care regardless of the distance that separates doctor and patient. Collectively, the public and private sectors have funded hundreds of telemedicine projects that could improve, and perhaps change significantly, how health care is provided in the future. The total amount of the investment, however, is unknown. GAO identified nine federal departments and independent agencies that have invested upwards of $646 million in telemedicine projects during fiscal years 1994 through 1996. The Defense Department is the largest federal investor with $262 million and considered a leader in developing this technology. Opportunities exist for federal agencies to share lessons learned and exchange technology, but no governmentwide strategy exists to ensure that the maximum benefits are gained from the many federal telemedicine efforts. Telemedicine technology today is not only better than it was a decade ago, it is becoming cheaper. However, the expansion of telemedicine is hampered by legal and regulatory, financial, technical, and cultural barriers facing health care providers. The questions facing telemedicine today involve not so much whether it can be done but rather where investments should be made and who should make them. The solution lies in the public and private sectors' ability to devise a way to share information and overcome barriers. The goal is to ensure the creation of an affordable telecommunications infrastructure and that the true merits and cost benefits of telemedicine are attained in the most appropriate manner.
