Telemedicine can be defined as the “delivery of healthcare and sharing of medical knowledge over a distance using telecommunications systems.” This simple definition is rapidly evolving into a rich and diverse set of clinical, educational, and research applications underwritten by an equally diverse set of technologies. However, there is now enough collective experience with telemedicine to look at the challenges facing the field from the point of view of healthcare quality and cost rather than from a technological point of view. Telemedicine and teleradiology will become important in clinical practice to the extent that they solve real unmet medical needs to improve quality, and do so in a cost-effective way. Technical innovation will create more and more opportunities for telemedicine applications, but technology must be thought of as part of the enabling infrastructure and not an end in itself. This is a lesson learned repeatedly in the world of medical imaging. As noted by one reviewer of telemedicine, “The literature is characterized by an array of approaches and technologies, with no replications or cross validation studies” (Grisley et al. 1995).
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