Sustainability--the Holy Grail of telehealth?

The sustainability of a telehealth programme is one measure of its success. However, the term 'sustainable telehealth' has almost become an oxymoron. Many telehealth programmes are initiated in good faith and are based upon well founded principles. Unfortunately, the initial funding cycle is rarely long enough to enable the programme to reach maturity and become integrated into the health-care system. Telehealth does not critically depend on technology; change management is much more important and it takes time for personnel to adopt new modes of practice. In addition, a telehealth programme needs a threshold number of installations before it can be deemed fully operational. In many cases an evaluation carried out at the conclusion of the pilot phase will fail to recognize the initial goals. As a consequence, the criteria used to justify further financial support are often at odds with the original goals and aspirations of the project initiators, and this leads to dissatisfaction by all parties concerned.