Several definitions of telemedicine were advanced both in print and in everyday usage. Jeffrey Bauer and Marc Ringel found that no single meaning was clearly dominant. Listed below are a few of the typical definitions that illustrate the field's meaning over the past few years. They are arranged by Bauer in sequence by year of publications to demonstrate the expansion of telemedicine.In addition, the definitions of telehealth and telenursing as prepared by the American Nurses Association are included below.
Telemedicine is:...a system of healthcare delivery in which physicians examine distant patients through the use of telecommunications technology.
...the use of telecommunications for medical diagnosis and patient care.
...the use of telecommunications and information technology to provide healthcare services to persons who are at some distance from the provider.
...new uses of information and technologies that are emerging, as well as the ability to move the caregiver and information to where the patient is rather than moving the patient to centralized places to deliver health services and information. Today's telemedicine model is evolving to "teleconsultation," where a physician consults with other specialists or a patient, using high-quality video-conferencing, with that consultation enabled by online information access.
...remote communication of information to facilitate clinical care and includes voice, images, elements of a medical record, and commands to a surgical robot.
...the use of telecommunications technology, including satellite links, dedicated line connections, interactive television systems and Internet connections, to provide healthcare services to patients at some location separate from the provider.
...a composite term for health-related activities, services, and systems, carried out over a distance by means of information and communications technologies, for the purpose of global health promotion, disease control and healthcare, as well as education, management, and research for health.
Defining Telemedicine for the Future:Bauer and Ringel state that the above definitions are somewhat static and do not capture the accelerating dynamism of the interface between communications, computers, information, and healthcare. They state emphatically that telemedicine will be the great equalizer, forging new relationships between patients and all types of practitioners, and attaining true consumer empowerment.
The historical definitions fail to incorporate related changes that are taking place in other dimensions of healthcare delivery. For example, most attempts to explain telemedicine are cast either explicitly or implicitly in the context of a doctor-patient relationship. This physician-centric perspective misses one of the most significant long-term effects of the telemedicine revolution-the expanding clinical powers of nonphysician practitioners and of patients who will use telemedicine to access a knowledge base that has been controlled by medical doctors.
The 21st century model of healthcare will see patients make decisions with assistance from a variety of practitioners (including physicians) and electronic decision-support tools. This empowerment of consumers is perhaps the most dramatic change that will be propelled by the revolution in healthcare communications. The futuristic definition prepared by Bauer and Ringel, below, places telemedicine in its proper perspective as one of the most powerful forces shaping a new, different, and better health system for the twenty-first century:
"Telemedicine is the combined use of telecommunications and computer technologies to improve the efficiency and effectiveness of healthcare services by liberating caregivers from traditional constraints of place and time and by empowering consumers to make informed choices in a competitive marketplace."