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Older health care providers in small groups and solo practices, and

Health care providers in remote locations.

If the technology proves to be cost effective, the increase in managed care organizations should expedite the use of the NII for patient care, medical research and education, and health care administration. Though the primary factors relative to ramp-up expectations and determinants are outside the health care environment, government actions regarding Medicare and Medicaid will affect investments in technologies intended for health care markets.

Public and Private Sector Responses

Since health care is uniquely the purview of both the public and private sectors, such an application of NII technology is affected by government and industry. Acceptance by health care providers and related organizations in terms of cost-effectiveness and utility is affected by both political and economic considerations.

Recommendations

A comprehensive evaluation based on a realistic demonstration should be conducted to identify the factors related to the utilization of the NII by health care providers and related organizations. The evaluation should be based on stringent criteria that focus primarily on patient care issues such as quality and access, and that measure selected key parameters related to technology, economics, and legal/regulatory and social/cultural factors. The project will require the participation of industry, academia, and government in cooperation with health care providers to develop the evaluation criteria, design the study, and conduct the demonstration of cost-effective systems that will support telemedicine, medical research and education, and health care administration. It is intended that this white paper will provoke serious consideration of health care applications on the NII.

Reference

1. Perednia, D.A., and A. Allen. 1995. "Telemedicine Technology and Clinical Applications," Journal of the American Medical Association 273:483–488.



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