Telemedicine is now made more feasible with the advent of modern information and telecommunication technologies. Telemedicine is used in a variety of medical situations in several countries. Its use is widespread. However these systems need to be evaluated so as to know how they are performing in comparison to the traditional ways of offering health care services. Health care providers and policy makers need to know the efficiency and effectiveness of these systems so that the available resources are used in efficient and cost effective alternatives of health services. People around the globe have been using different frameworks to evaluate telemedicine systems. Most people are evaluating telemedicine on ad hoc basis. Not one methodology or framework is popular or is widely used for evaluations. Hence the results are not comparable. There is clearly a need for standard methodology or a framework. Lack of evaluation standards can impact the costs, effectiveness, access and efficiency of care provided to patients. As a result this paper proposes a unified framework by synthesising existing methodological frameworks. The proposed framework provides various measures and criteria for evaluating various telemedicine applications. The framework also provides key indicators at a base level for each criterion. The most important measures in this framework are access, cost, effectiveness and acceptability of care. It is expected that this framework will be a step towards standardisation of frameworks and it will help new and experienced evaluators, health care providers and policy makers. The proposed framework is broad so that it can be applied to any application of telemedicine and depending on the setting in a given organisation; application specific base indicators may be added or deleted for each criterion.
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