Elements drawn from the recent literature, including those concurring with the IOM framework and those that may augment the IOM framework, provide an initial understanding of the current state of knowledge regarding evaluation of telemedicine. Based on the recent literature, the IOM framework may be augmented in the following ways. (These are incorporated into the present report.)
- Take account of the maturity of the program (pilot vs. steady state) in evaluating any telemedicine program.
- Integrate into any telemedicine evaluation a specific cost-effectiveness analysis.
- Apply an appropriately rigorous methodology to the evaluative process to ensure that the data gathered are useful to the health care community and those that it serves, and to provide evidence-based findings that can be used to support coverage decisions as appropriate.
- Take a staged approach to evaluation of telemedicine programs to account for the maturation of telemedicine technologies over time and the resulting effects on outcomes.
There has not been a substantial amount of new information on telemedicine evaluation since publication of the IOM report. This outcome was not unexpected, however, given that the IOM framework is rather extensive, includes an in-depth review of the pertinent literature, and was developed relatively recently. In designing future evaluations of telemedicine activities, evaluators should consider carefully the IOM framework and the supplemental evaluation aspects identified in the present report.