Promoting Telemedicine Implementation in Europe: Between Public Policies and Private Interests

Contemporary health systems are facing challenging transformations due to increasing ageing population and mounting incidence of chronic-degenerative diseases. To address these challenges, a growing part of the literature call on to the implementation of ‘telemedicine’, which comes from the intersection of telematics and medicine, and has been firstly conceived in the 60’s as a fundamental means to provide medical assistance in natural disasters or space missions. Nonetheless, starting from the 90’s, the increased reliability of transmission devices has overturned this ‘residual ratio’ of telemedicine. Nowadays, thanks to the widespread availability of wireless networks and portable devices, telemedicine offers patients a huge range of care services accessible from home, which is meant to avoid unduly transfers to the specialist centres and reduce length of the hospitalizations. In parallel to this development, a public discourse has begun to sustain the implementation of telemedicine into the EU health systems. According to their proponents, telemedicine would improve quality and wide access to healthcare, allowing public health systems to save financial resources. Nonetheless, though telemedicine services are often presented as ready-to-use and without risks, available evidences on cost-effectiveness and clinical acceptability are scarce and inconsistent, and many questions still need to be addressed for a coherent spread of these services in daily practice. In such a scenario, it is fundamental to assess whether the innovative models are intended to cover real needs of chronic patients, or to induce new ones matching the economic interests of private stakeholders and telemedicine vendors.