Digital free marketplace [telemedicine]

The author discusses some of the larger implications of what is being done in the Department of Defense (DOD). To do that, one needs to look at some of the issues at the federal government level. There is discussion on how the American society is going to achieve the goals of health care reform. These goals are to improve access and reduce costs, while improving quality. Telemedicine potentially offers a way to achieve these three seemingly mutually exclusive objectives. Telemedicine is so new, that the government and the American society are still trying to determine exactly what the government's role in this should be. And when the author says government, the author means government with a big "G"; this is beyond the purview of the DOD. One of the big questions being asked is, "Who is going to pay for what?" There is a great deal of money that needs to be going into building the national information infrastructure and providing all of the services that one would like to have. There is a tremendous amount of investment needed within people's homes. The real impact of telemedicine will occur when one can get into people's homes and keep them healthy. But who decides what services are going to be available, and what kinds of investments are going to be made? The author gives a perception of how some of these questions might be addressed as society moves forward. The author thinks that one is going to see new kinds of marketplaces emerging. As a result, organizations are going to change, and one will need to change one's thinking about how one manages those organizations.