President of the Senate

Speaker of the House of Representatives

Dear Mr. President and Mr. Speaker:

It is my pleasure to present to Congress a report on the use of Advanced Telecommunications Services for medical purposes. Telemedicine has the potential to make a difference in the lives of many Americans. In rural areas where a patient and the closest health professional can be hundreds of miles apart, telemedicine can provide access to health care where little had been available before. In emergency cases, this access can mean the difference between life and death. In particular, in those cases where fast medical response time and specialty care are needed, telemedicine availability could be critical.

In addition, telemedicine can improve the delivery of health care to Americans by bringing a wider range of services, such as cardiology, dermatology and mental health services, to the underserved. It can also help attract and retain health professionals in rural areas by providing ongoing training and collaboration with other health professionals.

Given telemedicine's potential, Congress directed the Department of Commerce, in consultation with the Secretary of Health and Human Services, to report on the activities of the Joint Working Group on Telemedicine (JWGT) -- a Federal interagency group -- as well as findings from federally-funded telemedicine studies and demonstrations. This report provides information on the state of telemedicine across the country and discusses many of the technical, legal and political issues to be resolved in order for telemedicine to be a successful health care delivery option.

Key issues that must be settled before telemedicine can proliferate include: the licensure of telemedicine health professionals who work across state lines or who provide services on a multi-state basis; telemedicine safety and standards issues relating to the relative lack of standards in this field; the lack of insurer payment for telemedicine services; privacy and security issues unique to telemedicine; and the telecommunications infrastructure cost and accessibility for telemedicine use.

This report not only presents you with a needed overview of Federal telemedicine activities but also clarifies the next steps that we must take for our nation to remain at the forefront of health care delivery. In the coming year, among other things, the Joint Working Group plans to organize further discussions around cross-state licensure, stimulate the development of quality, scientific evaluation studies on telemedicine, and encourage the establishment of telemedicine technical standards and clinical guidelines.

I look forward to working with the Congress, the Secretary of Health and Human Services, health care professionals, and the public to pursue ways to improve health care delivery in the United States, using telemedicine and advanced telecommunications technologies.

Michael Kantor