TELEMEDICINE: In the Shadow of eHealth
Despite venture capitalists' love affair with "e-anything," particularly companies pushing health care technology and related ehealth, telemedicine has failed to inspire a similar enthusiasm, Evan Rosen, principal of Impact Video Communication and author of "Personal Videoconferencing," writes in the February Issue of Telemedicine Today. While ehealth firms are viewed by venture capitalists (VCs) and other investors as "potential big ponies," telemedicine companies have gained a reputation as "small snails," Rosen says, explaining that many VCs "feel that reimbursement issues, regulatory concerns, economic barriers to entry and slow adoption have rendered telemedicine at best a slow return-on-investment, and at worst a losing proposition." According to Rosen, telemedicine simply means "practicing medicine at a distance," whereas "ehealth is more about informing patients, electronic billing and mining patient data." This points to a key difference in required funding, since "managed care companies and others can fund ehealth from the operating budget," but must fund telemedicine from the capital budget. Linda Weaver, chief technical officer for the Canadian "telehealth" firm Techknowledge, said, "The whole ehealth environment becomes a hosted service environment. People are buying a service, rather than a bunch of equipment. ... Ehealth is more about access. It's a network and community model while telehealth is about control and structure."
Not Dead Yet
But some experts say predictions of the death of telemedicine are premature and the debate over differences between the field and ehealth moot. David Balch of Eastern Carolina University School of Medicine said, "Who cares? All of this will blend into one thing. They're complimentary to each other. Most traditional telemedicine programs have not incorporated ehealth, but they will." He added that ehealth Web sites will also move in the direction of telemedicine, branching into direct patient care and telemedicine programs. Tom Key, chief of telemedicine and videoconferencing technology at St. Jude Children's Research Hospital in Memphis, agreed. He views ehealth as "one element of telemedicine, as is teleradiology or telesurgery," and believes that most in the field, particularly medical professionals, will come to see them all under the same "umbrella" (2/00 issue).