Some important milestones in the history of telemedicine and telehealth in the US demonstrate a long series of efforts to bridge geographic distance and address health disparities.
In April 1924, the magazine Radio News had a cover of a “radio doctor” predicting that technologies will arise whereby doctors will link to patients not only by sound but also by a live picture. This was a time when radio had just started reaching the American households and the TV as a commercial product was not available yet.
Radiologic images were transmitted by telephone between West Chester and Philadelphia, Pennsylvania at a distance of 24 miles, successfully demonstrating the potential of store and forward telemedicine.
Clinicians at the University of Nebraska used two-way interactive television to transmit neurological examinations and other information across campus to medical students. In 1964, a two-way link between the Psychiatric Institute and Norfolk State Hospital, 112 miles away, was established.
Massachusetts General Hospital (MGH) established a telecommunications link with a medical station staffed by nurse clinicians at Boston's Logan Airport to provide occupational health services to airport employees and to deliver emergency care and medical attention to travelers.
This was a demonstration project that was initiated in 1971 which explored the potential of satellite video consultation to improve the quality of rural health care in Alaska.
The STARPAHC (Space Technology Applied to Rural Papago Advanced Health Care) project was launched as a collaboration between NASA, the US Indian Health Service and the Lockheed Company to demonstrate the value of satellite-based communications in providing medical services to astronauts and residents of a rural underserved reservation. This project lasted for about 20 years and was one of the first comprehensive telemedicine-based community level health care delivery demonstration projects.
Section 254(b) of the Act provides in part that “(2) Access to advanced telecommunications and information services should be provided in all regions of the Nation, and (3) Consumers in all regions of the Nation, including low-income consumers and those in rural, insular, and high cost areas, should have access to telecommunications and information services.”
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, promoted the adoption and meaningful use of health information technology in general, and telemedicine more specifically, as a way to engage patients and families especially in underserved areas.
On September 25, 2013, the FDA issued the “Mobile Medical Applications Guidance for Industry and Food and Drug Administration Staff” that explains the agency’s oversight of mobile medical apps as devices. The FDA emphasizes that they focus only on the apps that present a greater risk to patients if they don’t work as intended and on apps that cause smartphones or other mobile platforms to impact the functionality or performance of traditional medical devices.
