Standards and Guidelines Development in the American Telemedicine Association

Background

There have been efforts towards establishing standards and guidelines for telemedicine practice prior to the formal establishment of the ATA Standards and Guidelines Committee. For example, radiology has a number of technical and practice guidelines in place for digital image acquisition, storage, transfer and display via Picture Archiving and Communications Systems (PACS) and teleradiology (Seibert, et al., 2004; Van Moore, et al., 2005; Siegel, et al., 2006; Williams et al., 2007; Krupinski et al., 2007); and the Society of American Gastrointestinal and Endoscopic Surgeons has guidelines for the Surgical Practice of Telemedicine (SAGES, 2004). The first set of guidelines from the ATA actually pre-dated the formation of the Standards and Guidelines Committee, and was created for Telepathology in 1999 (ATA, 1999).

In 2004 Richard Bakalar, MD and the ATA Ocular Telehealth Special Interest Group developed and published the first truly formal set of ATA practice guidelines. The guidelines specifically addressed diabetic retinopathy telehealth clinical and administrative issues and provided guidelines for designing and implementing a diabetic retinopathy ocular telehealth care program (ATA, 2004). This document established the general framework for future efforts in terms of addressing technical, administrative and clinical aspects associated with a particular clinical specialty using telemedicine as a means to deliver patient care. A very important precedence was established in the creation of these guidelines. Early in the development process the decision was made to contact the National Institute of Standards and Technology (NIST) for help and guidance regarding the accepted means by which standards and guidelines are produced and approved. Since then, NIST and the ATA have collaborated extensively in the guideline development process.