The main purpose of this chapter is to discuss the place of telemedicine in the modern medicine, its present and future application in the clinical medicine. It covers aspects of clinical telemedicine practice, technical advances, principles and practices, health policy and regulation, and health services research dealing with clinical effectiveness, efficacy, and safety of telemedicine and its effects on quality, cost, and accessibility of care. The diabetic foot problem was chosen as a suitable model to examine whether the use of telemedicine technology will improve the quality of medicine and reduce medical costs.
According to the American Telemedicine Association, telemedicinetelemedicine is the exchange of medical information from one site to another using electronic communication, such as telephone, Internet or videoconference to improve patients’ health status [1]. Related with telemedicine is the term “telehealthtelehealth ,” which covers a quite broader definition of remote healthcare, being more focused on other health-related services that do not always involve direct patient clinical services. Telemedicine practices allow for specialist consultation, direct patient consultation, patient monitoring, and medical education.
Although the term telemedicine is a relatively recent one, since 1970s, medicine has long made use of various communication technologies dating back to 1906. Wilhelm Einthoven, inventor of the electrocardiograph, created the “telecardiogram,” which transmitted electrocardiograms via telephone from the clinic to his office, enabling him to monitor his patients’ condition at a distance [2]. In the early 1990s, telemedicine experienced a considerable progress due to rapid advancements in information and telecommunications technologies and digital data transmission. Since then, the interest in the use of telemedicine procedures and the number of related publications had rapidly increased. A search of MEDLINE in 1990 found six publications on telemedicine; while by February 2009 there were more than 10,700 entries under the search term “telemedicine.”