By Bryan M. Gold | Contributing Editor

New legislation and renewed federal interest in telemedicine may help put an end to the outdated laws and regulations that have kept it from going prime-time.

Telemedicine is still a fairly new phenomenon. But this method of delivering health care and exchanging health care information using telecommunications technology is so popular that Congress may pass a telemedicine package before passing any of the other popular technology bills that lay before them.

In May, legislation was introduced that would simplify federal regulations and enhance the delivery of telemedicine services targeted to senior citizens living in rural areas.

"In remote rural areas, where a patient and the closest health professional can be hundreds of miles apart, telemedicine can mean access to health care where little had been available before," said Sen. Jim Jeffords, R-Vt., who authored S. 2505, known as the Telehealth Improvement and Modernization Act of 2000. "This legislation streamlines federal regulations to help hospitals and patients better utilize telemedicine programs. By better utilizing technology, we should not only be able to increase the quality of health care, but also increase efficiency and see cost savings. My legislation will ensure that the federal government is a leader, not a follower, when it comes to telemedicine."

The bill is picking up steam. Last summer, a number of U.S. senators added their names as cosponsors of the bill, joining the original 15. The issue has become one of significance, as there are several bills in the House that are companions to the Senate bill.

"Jeffords legislation is extremely important to eliminate the barriers that are there with the federal government," said Jonathan D. Linkous, executive director of the American Telemedicine Association, which is based in Washington, D.C. "The federal government has lagged behind the private sector and the rest of the world. Medicare reimbursement is not there, so we need to have legislation that encourages [this]."

The Office for the Advancement of Telehealth, based in Rockville, Md., said various technologies are used in telehealth, such as videoconferencing, the Internet, store-and-forward imaging, streaming media, satellite and wireless communications. "[They] already exist, but are not yet part of the regular landscape for our nations rural and urban underserved peoples," said officials of the Rockville office, echoing the sentiments of Jeffords and Linkous.

Tele-tale Signs

The federal government is a key player in the growth of telemedicine. The 1990 Farm Bill authorized the Distance Learning and Telemedicine (DLT) Grant Program to provide grants to rural schools and health care providers. The 1996 Farm Bill reauthorized the DLT, which helps rural schools and health care providers invest in telecommunications facilities and equipment to bring educational and medical resources to rural areas.

From its inception in 1993 through fiscal year 1999, the DLT funded 306 projects in 44 states and two U.S. territories totaling $83 million. For fiscal year 2000, the DLT is capitalized with $20 million in grant funds with $130 million available through the loan program.

Not to be outdone, the Department of Veterans Affairs Veterans Health Administration has national telemedicine initiatives that include the management of a satellite television network with two-way audio that provides the capability for all 173 VA medical centers and outpatient clinics to receive education and information via satellite.

The equipment is also used by individual VA medical centers to receive programming from organizations, including the American Hospital Association, the Joint Commission on Accreditation of Healthcare Organizations and the Healthcare Informatics Telecom Network.

In October 1996, Health and Human Services Secretary Donna E. Shalala announced that the National Library of Medicine, a part of the National Institutes of Health, was funding 19 telemedicine projects affecting rural, inner-city and suburban areas with a total budget of $42 million.

"The projects we are supporting will evaluate the