Telemedicine is the use of electronic information and communication technologies to provide and support health care when distance separates the participants. Because of hyperspecialisation and multidisciplinarity, the technical medical environment has profoundly transformed in recent decades. The area of telemedicine is relevant for the treatment of ill-health and for the provision of medical consultation. Existing wisdom from decision makers and psychiatric consulters evaluates clinical applications of telemedicine, including the quality and accessibility of health care (US Congress, 1990). Two assessments contributed to the evaluation. One focuses on the acceptability of medical care and perceptions of patients and clinicians (Puig-Junoy et. al, 1998). The other concentrates on the financial effect of telemedicine in rural health care networks (Bashshur, 1995).
Research conducted by Berman & Fenaughty (2005) on rural Alaskan health services revealed that such new health care technology may increase patient benefits. Similar concerns about accessibility can be applied to Taiwan, a small heavily-populated land area with many mountains and isolated islands. Chen et al. (2001) performed a brief review of the telemedicine system in Taiwan and found that high quality medical care is difficult to access and medical resources are unequally distributed in rural areas. Due to geographic barriers, several archipelagos are deficient in specialist clinicians and medical resources are under-distributed. Primary healthcare is not emphasized and consulting a family physician is not encouraged. Telemedicine services were introduced in 1995 with a particular focus on providing healthcare in rural areas, continuing medical education (CME) for physicians in these areas, and special medical services for the elderly, the handicapped, and terminal ill patients at home. Online CME, one of the important functions of the telemedicine system, leads to a reduced sense of isolation for physicians and enhances the confidence of medical staff and patients.
Based on technically sound for society concern, Brodie et al. (2000) and Autor (2001) found that access to online services can mean better information about jobs, education, and health. This finding can also be applied to service industries, including health care, manufacturing, transportation, government and education. Health care provisions and relevant medical education through telecommunication is perhaps related to increasing social welfare and the development of new health services. Telemedicine systems offer new ways to practice medicine and "are technologically based innovative systems for the remote delivery of personal health services, continuing medical education, and patient health education." (Bashshur, 1995, p. 22) This research then investigates the educational, medical, and economic prosperity of government expenditure in infrastructure and health service in the context of telemedicine diffusion.
There are currently no studies that discuss the welfare concepts of telecommunication health services within the managed care environment or the influence of online CME on such health management. To address the relevant effects of access to care for rural residents, while facilitating the continuation and consolidation of positive effects on service delivery and utilization, this research makes an effort to provide an empirical base for evaluating the current operations of health care provisions, and to assess its potential replicability.
Drawing on literature from the health care and the educational technology fields, we measure and value the relevant environment and consequences from multiple perspectives. A better understanding of concerns from all affected factors will help establish the quantitative significance for possible medical interventions or programs. Investigation results serve as paradigms for selecting areas to maximize welfare in health care provisions. …