Telemedicine effects: cost, quality, and access.

Following a brief review of lessons learned from first generation telemedicine projects, an analytical framework for assessing the potential effects of telemedicine on cost, quality, and accessibility of health care is provided. It is proposed that the effects of telemedicine on cost, quality, and accessibility are interconnected, and a comprehensive assessment should incorporate all three aspects, each considered from the perspectives of clients, providers, and society.