The Doctor is In: Telemedicine – ‘Next Big Thing’ or ‘Chronic Underachiever’?

Dr. Robert Cuyler

Telemedicine is a sweepingly broad term for the electronic delivery of healthcare.  The landmark book “History of Telemedicine” grapples with definition but settles on the following: “the delivery and receipt of personal health services via electronic information and communication technology.”  In this blog series, we will look at the emerging world of telemedicine and focus on what is working well and not so well in the translation from concept to actual practice, as well as featuring new applications and trends in the field.

Telemedicine holds enormous promise in the future of healthcare.  Until we start cloning and mass-producing doctors and nurses, we will increasingly depend on porting services and information electronically to consumers, rather than depending on those consumers to travel, whether that’s across the street, the state or the globe. At the same time, the field has moved in fits and starts in the journey from grant-based, research and publicly-funded organizations to routine practice.

In my work in healthcare management and consulting, I’ve seen too many promising telemedicine projects under-perform or close. More often than not, the telemedicine technology works perfectly, but planning and implementation fails to take into account just how many other systems must work in sync to make a successful telemedicine project.  We’ll be highlighting those critical systems, which range from big picture organizational vision and strategy to nitty-gritty details of practitioner training.

If you have heard the following statements uttered in your healthcare organization, you may be headed on a difficult implementation road ahead:

  • “Ooh, ooh, we can get a grant for bandwidth and telemedicine equipment!”
  • “We have a telemedicine champion, one of our doctors wants to do this!”
  • “Wow, we can actually talk to a doctor over the television, we’re ready to go!”
  • “We’ll get senior management on board later.  In the meantime, just get IT talking to the doctor.”

  • “Training? We just need to show the doctor and nurses how to turn on the equipment.”

If you find yourself or someone else in your organization sharing those thoughts, stay tuned to this series and we can guide you through the proper way to implement telemedicine in your healthcare  organization, and avoid some of the common pitfalls.

Have a question about telemedicine that you would like Dr. Cuyler to answer in his series, “The Doctors is In”? Submit them in the comment box below.

Robert N. Cuyler, PhD is President of Clinical Psychology Consultants Ltd, LLP, a consulting firm focused on telemedicine strategy and implementation.  He and Dutch Holland, PhD are co-authors of the book ‘Implementing Telemedicine: Completing Projects on Target On Time On Budget’.  He can be reached at

3 Responses to “The Doctor is In: Telemedicine – ‘Next Big Thing’ or ‘Chronic Underachiever’?”

  1. Elizabeth Burton

    I’ve worked with many healthcare organizations who have procured grant funding to start-up, expand, and sustain telemedicine programs. Specifically in underfunded urban and rural areas, where telemedicine can provide healthcare to those that may not have access otherwise, grants help to support the equipment, networks, training and people. I do not view obtaining grants as a pitfall to those wishing to step forward in the telemedicine arena. Even funders like HHS and CMS recognize the role they can play in this area.

    • Robert Cuyler, PhD

      Elizabeth, thanks. I certainly don’t see grant as pitfalls. I’ve seen problems when projects are launched with too narrow a vision. The presence of grant dollars or a telemedicine champion are relied upon too heavily, and the many human and organizational systems are under-estimated. In your experience, what are the key success factors in the programs that are sustainable and productive?

  2. Cliff Stepp

    There are recent changes in California’s rules and regulations that have made tele-health solutions easier to adopt, at least from a legal perspective. The appropriate technology, training and administrative mindset issues remain as challenging as ever. But, looking back, I remember dragging a client kicking and screaming into deploying an e-commerce website in 1995. Their direct quote, “Why would we wanna do that?” Six months later it accounted for nearly 20% of their business.


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