Assessing technological barriers to telemedicine: technology-management implications

Telemedicine, the use of information technology to deliver health care from one location to another, has the potential to increase the quality and access to health care and to lower costs. This growth of telemedicine installations is occurring even as the utilization rates for installed telemedicine projects are falling well below expectations. Drawing on data collected from three operational telemedicine projects involving different clinical telemedicine applications, we examine how the technological barriers to telemedicine are impacting telemedicine utilization rates. Addressing technological barriers is a necessary but not sufficient condition if telemedicine is to fulfil its promise, and it is predominantly only after such barriers are addressed that the other barriers-professional, legal, and financial-come to the fore. Our findings support end-user and technical training as major barriers but do not support the quality of the video, system reliability, or the perceived inconvenience for physicians to use the equipment as barriers to telemedicine. The mismatch between the sophistication of the technology and end-user requirements for clinical activities and patient confidentiality and privacy issues were supported as barriers, but how they impacted telemedicine utilization was different than expected. Finally, unsatisfactory sound quality of the telemedicine equipment was identified as a frequent and unexpected barrier to telemedicine utilization rates.