Telemedicine: Problems, Promise, and Future

Background: Telemedicine, the application of information technology in order to provide health care at a distance, has been heralded as a solution for a wide range of administrative and technical health care challenges, from remote surgery to health care reform. Despite the excitement, it has only been applied in limited settings. In order to understand why the expectations of telemedicine have not been met, I propose to investigate how it has been invoked as a domain of technological promise and a source of a variety of medical solutions. Methods: Using the search term ‘telemedicine’, a Web of Science search was conducted for articles published between 1995 and 2010. The results of the search were randomly sampled and analyzed for content using Latent Semantic Analysis (LSA).  A term co-occurrence analysis was then conducted to uncover trends within the results of the search. Results: Of the articles that the Web of Science search identified, the associated terms provided a visual semantic representation along with how the use of particular terms have changed over time.  These terms covered a wide-range of topics, from robotic surgery to improvements in access to health care. Trends show that the peak in usage of the term ‘telemedicine’ occurred in 2000, with a leveling off thereafter, while use of terms increasing the strength of relationship for promises of telemedicine were used in the same period. Conclusions: The stabilizing usage of the term ‘telemedicine’ within the literature minimally suggests a shift in terminology.  Is it the case that ‘telemedicine’ has been co-opted and subsumed within a recent trend in the medical literature towards a diversity of terms related to information storage and transmission?   More research needs to be conducted in order to answer this question.