Telephones, telemedicine, and a technologically neutral coverage policy.

Health care must be understood in a way that facilitates a rational, consistent coverage and payment policy. Telephone care, telemedicine care, and in-person consultation are all useful ways of providing health care services. Because improved health and reasonable costs are the universally desired outcomes of medical consultations, reimbursement policies should favor the most efficient means of providing care. This view suggests that health care reimbursement should be made technologically neutral. That is, a covered service should produce the best clinical outcome at the lowest possible cost, irrespective of the technology used. The logic and implications of technological neutrality and its application to telemedicine are discussed.