Telemedicine in Europe - the TELEPLANS project

Telemedicine has proliferated throughout much of the industrialized world. Initially, telemedicine was considered simply as an enabling technique for increasing access to health-care in remote or isolated regions and as a valuable tool for health-care emergencies. Nowadays, telemedicine is maturing, moving beyond the proof-ofconcept stage towards use as a tool for routine health-care delivery. Increasing access to and quality of care seemto be the main objectives in deploying telemedicine in Europe, as elsewhere. Moreover, telemedicine is moving towards home-care applications, especially for elderly and chronic patients (‘dehospitalization’). However, there are problems connected with the use of telemedicine. Besides the technical barriers, such as different telecommunication infrastructures and standards, there is still a paucity of assessments of telemedicine applications. Telemedicine activity in existing projects is low, reliable cost-effectiveness analyses are difficult, and its financial and economic consequences are still unclear. In addition, the medical profession is often resistant to the changes produced by telemedicine, and organizational and management changes are needed (e.g. financial reimbursement and the surmounting of medicolegal issues4). At present there are no clear laws that govern telemedicine activity or specify professional liability, or that ensure the privacy, security and confidentiality of medical data. Another theme of major importance concerns the education and training needed to overcome barriers generated by inexperience and cultural resistance to change. The TELEPLANS Project was a ‘Concerted Action’ funded by the European Commission DGXIII. Its objectives were to describe the European scenario for telemedicine and to establish a forum to bring together national health-care authorities, key decision makers and users of telemedical applications.