Telemedicine in an international context: definition, use, and future.
OBJECTIVE
Use of telemedicine is increasingly prevalent in order to provide better access to expert care, and we examine telemedicine use internationally.


METHODS
Using Donabedian's structure, process outcome framework, we conduct an analysis of published studies in the United States, Europe, and Asia to examine the uses, conditions treated, barriers, and future of telemedicine.


RESULTS
We identify several similarities and challenges to telemedicine use in each region. We find use of videoconferencing between providers or providers and patients for the treatment of acute and chronic conditions. Studies in the United States are more likely to identify applications for the use of chronic conditions, whereas studies in Europe or Asia are more likely to use them for acute access to expertise. Each region reported comparable challenges in reimbursement, liability, technology, and provider licensing.


CONCLUSIONS
We compare available research articles from three diverse regions, and many of the articles were merely descriptive in nature. Furthermore, the number of articles per region varied.


CONCLUSIONS
Barriers to telemedicine use include a lack of reimbursement, language commonality, technological availability, physician licensure or credentialing, trained support staff and patient privacy, and security assurances. Practitioners and policy makers should work to address these barriers.


CONCLUSIONS
Through this work, a summary of the research to date describes telemedicine use in the United States, Asia, and Europe. Identification of use and barriers may provide impetus for improving access to care by finding ways to increase telemedicine use through standardization.
Department of Health Care Leadership and Management, Medical University of South Carolina, Charleston, SC, USA.
Abby Swanson
AS
Kazley
Amy C
AC
McLeod
Karen A
KA
Wager
D001208:Asia; D004059:Diffusion of Innovation; D005060:Europe; D005544:Forecasting; D006801:Humans; D038622:Internationality; D013673:Technology Assessment, Biomedical; D017216:Telemedicine / Q000706:statistics & numerical data* / Q000639:trends*; D014481:United States