Telehealth: the promise of new care delivery models.

Telehealth possesses a significant potential to revolutionize healthcare delivery processes by challenging some of the long-held assumptions about healthcare delivery and by creating innovative alternative models. Those assumptions relate to the location-linked nature of healthcare and its episodic nature. Telehealth can challenge the assumption that healthcare is inextricably linked to the provider's location. Numerous models involving such approaches as interactive videoconferencing and store-and-forward technologies already exist. Telehealth also challenges the episodic nature of care. One example is provided by the models evolving from the convergence of three technologies: remote monitoring, electronic health records, and clinical decision support systems. Telehealth-based models of care can also lead to a reduced demand for services and greater efficiencies in the care process. These telehealth-enabled care delivery models have the potential to reduce the costs of care, improve quality, and mitigate provider shortages. However, the achievement of these goals is not straightforward. The current healthcare financing system is not designed to support such new models, and the existing healthcare culture is deeply ingrained within workflow processes and provider attitudes. A great deal of work remains to be done before the benefits of telehealth-based care delivery models are fully realized. Change is inherently risky but we must have the courage to assume the risk in order to create telehealth-driven innovations that lead to better and more cost-effective medical care for all.