Telemedicine: Information Can Help Cure

Telemedicine is the use of telecommunications and computers for information to support medical decision making, signal processing, and the arrangements to practice medicine at a distance. The u m q t encompasses everythmg from the use of standard telephone service to high speed, wide bandwidth transrms * sion of digitized signals in conjunction with computers, fiber optics, satellites, and other sophisticated peripheral equipment and software. The growth of the National Informaton Infkastructure and the increasing access to highspeed computers and communications by co~~sumefs, health care providers, public health professionals, and basic, clinical, and health services researchers will have a i ” e n d effect on health and human seMces throughout the nation and the world. The major research and evaluation issues, of interest to NLM, arising tiom the current and future application of this technology include: the impact of telemedicine on the health care system as a whole and on cost, quality, and access to m e for specific populations; 0 the benefits of integrated access to practice guidelines, expert systems, bibliographic databases, electronic publications, and other knowledge-based informaiion from within computer-based patient record systems and other automated systems that suppoa research and practice; the maintenance of patient confidentiality as increasing amounts of electronic health data are transmitted via telecommunications during health care and aggregated for important public health and research purposes; and the development of data standards and d o r m practices for effective transmission, aggregation, and integration of health care, public health, and research data. The National Library of Medicine is sponsoring projects which evaluate the impact of the National I&ormation In fkas t~~cm on health care, research, and public heal^, test methods to preserve the privacy of individual health data while also providhg efficient access for legitjmate health care, research, and public health purposes; and assess the utility of emerging health data standards in health applications of advanced communications and computing technologies.