Despite being separated by a big body of water and quite a few language barriers, there are few shared struggles in healthcare between the US and Europe. An Economist article highlighting the rise of telemedicine in the European Union calls attention to the issue of reimbursement and implementation in its member countries.

As the article puts it:

Member states do not agree on whether to pay for care that is administered remotely; some, including Germany, rarely pay for it at all.

It’s almost comforting that despite the potential of telemedicine to assist different aspects of healthcare, figuring out the balance between doctors and insurers is an issue beyond the US as well. It also calls attention to the need to figure out the best fit for it. Some doctors wrestle with the implications of telemedicine.The article interviewed Norwegian doctor, Nils Kolstrup, who said some physicians are worried that  it may lessen their authority by making it easier for patients to seek advice elsewhere. He also said patients may feel like they’re getting an inferior service.

Interestingly, the article doesn’t get into the context of when telemedicine is used apart from  highlighting the Cleveland Clinic’s work with several African countries to examine tumors to cope with the shortage of oncologists in places like Rwanda.

It seems like implementation is a stumbling block in places like China, which is investing billions in reforming its healthcare system with telemedicine as the focus, as the article points out.

“If you have a chaotic system and add technology, you get a chaotic system with technology,” says Peteris Zilgalvis, a health official at the European Commission. Telemedicine may even increase costs if it is added to old routines rather than replacing them. There is little evidence of its cost-effectiveness, says Marc Lange of the European Health Telematics Association, because studies simply lump it on top of standard care.

As with a lot of Economist articles, the comments section offers insights almost as interesting as the article. One reader expresses concern that telemedicine will focus physicians attention on the parts visible on the computer screen. “If you can’t see the whole body of someone you are missing something.” The same reader also expresses concern that not all screens and cameras do the same color processing and wonders whether this could affect a diagnosis.  Another reader calls attention to a success story using telemedicine for eye exams at the Aravind Eye Care Center in India.

As the American telemedicine market continues to grow, one report by BCC Research published this week said teleservices to outpatients is a category that is projected to rise from $6.5 billion in 2013 to nearly $24 billion in 2019.

BCC Research healthcare analyst Andrew McWilliams said, “The growing adoption of telemedicine services is expected to significantly impact larger markets such as healthcare, health insurance, home care, telecommunications (telecom), networking, disease management, e-health, and healthcare IT.”