title: Telemedicine, rural elderly, and policy issues.
abstract: Historically, rural America has had a difficult time providing health care to its residents, particularly its frail elderly population. Rural health care is often faced with a shortage of health care specialists, facilities with inferior equipment, and insufficient resources compared to health care in more urban areas. It is anticipated that the use of telemedicine will help address many of the problems facing the delivery of health care services to rural elderly. This paper reviews some innovative projects delivering services to the elderly. Also, the paper discusses several issues that need to be addressed before telemedicine can reach its full potential in improving access to health care, including reimbursement policies, patient and provider liability and confidentiality, and the infrastructure supporting telemedicine. Although telecommunications has tremendous potential to address the care needs of frail isolated elderly, without comprehensive reimbursement policies, guidelines for ethical conduct of a teleconsultation, acceptable security measures of patient records, and adequate as well as compatible infrastructure, that potential cannot be completely realized.
authors.affiliation: West Virginia University, Center on Aging, Department of Community Medicine, P.O. Box 9127, Morgantown, WV 26506, USA. rtg@wvu.edu
authors.forename: R T
authors.initials: RT
authors.lastname: Goins
authors.forename: U
authors.initials: U
authors.lastname: Kategile
authors.forename: K C
authors.initials: KC
authors.lastname: Dudley
mesh_terms: D000368:Aged; D003219:Confidentiality; D003695:Delivery of Health Care; D016330:Frail Elderly; D006291:Health Policy; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D016365:Liability, Legal; D008004:Licensure; D012423:Rural Health; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine; D014481:United States