Telemedicine is a rapidly evolving modality of health care delivery. New developments in information technology provide a continually expanding array of tools for the implementation of telemedicine applications. In addition to technological innovations, there are numerous legal, political, and financial issues that continue to unfold with the implementation of telemedicine initiatives in widely varying settings. It is often suggested that one day the practice of telemedicine will be as commonplace as the use today of the telephone in the delivery of care. Until then, it is exciting to witness the resolution of both technological and social issues related to telemedicine.
The Handbook of Telemedicine represents “a collaborative European endeavor to establish the minimum requirements for the safe practice of telemedicine” (p. vii). Thirteen researchers and clinicians from across the European Union have contributed to this effort to formulate a uniform body of knowledge (BoK) for telemedicine. The contributors provide a European perspective on the history of telemedicine, telemedicine-related technologies, applications in specialties of care, privacy, legal issues, and economic justifications for telemedicine. There are more than a dozen appendices, the most helpful of which describes the development of telemedicine standards in the European Union. This book will be most helpful for those who have a special interest in European telemedicine initiatives. Readers with a broader interest in telemedicine will be better served by other recent publications.
A challenge facing all authors in the arena of information technology is the rapid obsolescence of their subject matter. Any attempt to codify a body of knowledge for the technologies associated with telemedicine in a monograph is doomed to a similar fate. The Handbook's treatment of technological issues soon will be of limited value.
More immediate limitations include the Handbook's cursory treatment of issues related to reimbursement and evaluation. The contributors point to the need for additional policy development related to reimbursement, but do not provide a vision of how this policy may take shape. The chapter on the evaluation of telemedicine applications also has notable limitations. The author of this chapter, one of the text's editors, provides a brief overview of quantitative approaches. The quantitative approaches discussed are limited to statistical procedures such as Cohen's Kappa coefficient and ROC curves. Discussion of qualitative methods and triangulation is missing.
Compounding the limitations in its content, the Handbook has typographical errors and evidence of limited editorial assistance on almost every page. The frequency of these more minor faults creates a substantial obstacle for the reader.
Readers interested in an overview of telemedicine are better served by Telemedicine: Theory and Practice (1977) edited by Bashur, Sanders, and Shannon. Likewise, the Institute of Medicine's Telemedicine: A Guide to Assessing Telecommunications in Health Care (1966) endures as a thoughtful treatment of evaluation methods. Apart from its European perspective, the Handbook of Telemedicine's BoK offers little beyond the contributions of these previous works.