individual telemedicine projects and evaluation approaches will vary, general adoption of an evaluation framework that includes the elements specified here would strengthen the rigor and cumulative value of telemedicine evaluations and results.

As noted at the beginning of this chapter, more rigorous evaluations of some telemedicine applications will produce positive findings that will, in turn, encourage wider adoption of these applications. In other cases, the results may be disappointing, yet they may also stimulate further technical innovation and more attention to user needs and circumstances. Thus, even negative results can be viewed as opportunities. The task for evaluators is not to justify telemedicine as such but to provide the credible and relevant information that people need to make immediate decisions and plans for the future. The framework presented here is offered in that constructive spirit.