It's a rapidly evolving field. Doctors want it on the desktop and a lot of the technology is not ready for prime time. Also, nagging questions remain about reimbursement. Telemedicine can work within a capitated system. No claims for reimbursement The acceptance of telemedicine as a reimbursable service is expected to increase dramatically in the near future.
Observers blame a lack of awareness and poor compliance with the telemedicine law.
At the federal level, the Health Care Financing Administration issued rules that allow for reimbursement of telemedicine services rendered to Medicare patients beginning in 1999, although Perednia says that the agency has not indicated whether telemedicine will be paid at the same level as in-person services. As managed care companies are squeezed by competition, telemedicine may become part of financial planning. Bruce Goldfarb, a resident of Baltimore, frequently writes about health care issues.