Telemedicine evaluation in the Pacific: overview and status of the AKAMAI Evaluation Initiative

Project AKAMAI is a federally funded program designed to augment health care delivery to the Department of Defense (DoD) and beneficiaries in the Pacific Basin using telecommunications technology. The AKAMAI Evaluation Initiative is a systematic evaluation of the potential contribution of telemedicine in a health care delivery system. In this study, patients are randomly allocated to usual care (UC) or telemedicine care (TC) for routine dermatology or orthopedic consultations between a primary care outpatient clinic and a tertiary care center. The automation infrastructure employs a thin client-server design and integrates existing hospital legacy systems and image servers on a secure network. The overall study investigates four areas of interest (clinical outcomes, patient/provider satisfaction, organizational impact, and cost/effectiveness). The objective is to provide healthcare policy-makers with scientific and technical information and provide a tested methodology for future evaluation of deployed DoD telemedicine systems in the Pacific.