Telemedicine service use: a new metric

Policy makers and funding agencies require relevant information on current practices of the use of telemedicine infrastructure and services. Several metrics have been used to describe average use of telemedicine services. None are adequate.

To identify and assess a new metric-consultations per site per week (C/S/W).

To determine existing usage, all papers and abstracts published between January 2005 and December 2009 in the Journal of Telemedicine and Telecare and Telemedicine Journal and eHealth were reviewed. Pilot studies, research projects, services reporting less than one year's data and teleradiology services were excluded.

In total, 210 reports of telemedicine services were identified, 77 of which provided sufficient data to calculate C/S/W. Average use was low, 1.8±3.5 (median 0.7) C/S/W, with 61% of services reporting less than 1 C/S/W and 71% reporting 2 or fewer C/S/W. Studies reporting on data from 2006 to 2009 showed less use (average 1.5±2.3; median 0.7 C/S/W) than earlier reports from 1996 to 2005 (1.7±2.5; median 0.7 C/S/W).

The use of this new metric, C/S/W, is proposed as a standard measure of telemedicine service use. The generally low results opens debate about how well current clinical services are used.