Catching Up With the Digital Age: The Concept, Scope, and Boundaries of Telemedicine

Abstract

Abstract Rapid advancements in digital health technologies have led to fundamental changes in the delivery of healthcare services, and telemedicine has emerged as one of the core components of this transformation. By enabling the provision of healthcare services through information and communication technologies in cases where distance is a critical factor, telemedicine supports the continuity of care, particularly in regions where access is limited. In this review, the conceptual framework of telemedicine, its historical development, its prevalence at global and national levels, and its current areas of application are addressed. While telemedicine offers significant advantages such as increasing access to healthcare services, reducing costs, and improving patient comfort; it also encompasses various challenges such as physical examination limitations, data security risks, technological infrastructure requirements, and disparities in legal regulations. Nevertheless, the increasing integration with artificial intelligence, big data, and mobile health technologies will allow telemedicine to provide more predictive and personalized healthcare services in the future. It is not possible for healthcare services to remain behind this transformation in the face of the requirements of the digital age. The fact that telemedicine does not remain merely a technological innovation but becomes an integral part of the healthcare system depends on seamless digital infrastructure, inclusive legal regulations, and the adoption of this practice by healthcare personnel. In this regard, providing training is essential to foster adoption and increase awareness among healthcare professionals. Otherwise, the adaptation of healthcare systems to digital transformation will not be sustainable.

Keywords

• telemedicine
• digital health
• telehealth
• medical education
• artificial intelligence

Dijital Çağı Yakalamak: Teletıp Kavramı, Kapsamı ve Sınırları

Abstract

Özet Dijital sağlık teknolojilerindeki hızlı gelişmeler, sağlık hizmetlerinin sunumunda köklü değişimlere yol açmış ve teletıp bu dönüşümün temel bileşenlerinden biri haline gelmiştir. Teletıp; mesafenin kritik olduğu durumlarda bilgi ve iletişim teknolojileri aracılığıyla sağlık hizmetlerinin sunulmasını sağlayarak, özellikle erişimin kısıtlı olduğu bölgelerde bakım sürekliliğini desteklemektedir. Bu derlemede, teletıbbın kavramsal çerçevesi, tarihsel gelişimi, küresel ve ulusal düzeydeki yaygınlığı ile güncel kullanım alanları ele alınmıştır. Teletıp, sağlık hizmetlerine erişimi artırması, maliyetleri azaltması ve hasta konforunu iyileştirmesi gibi önemli avantajlar sunarken; fiziksel muayene sınırlılıkları, veri güvenliği riskleri, teknolojik altyapı gereksinimleri ve yasal düzenlemelerdeki farklılıklar gibi çeşitli zorluklar da barındırmaktadır. Bununla birlikte, yapay zekâ, büyük veri ve mobil sağlık teknolojileri ile entegrasyonunun artması, teletıbbın gelecekte daha öngörücü ve kişiselleştirilmiş sağlık hizmetleri sunmasına olanak sağlayacaktır. Dijital çağın gereklilikleri karşısında sağlık hizmetlerinin bu dönüşümün gerisinde kalması mümkün değildir. Teletıbbın sadece teknolojik bir yenilik olarak kalmayıp, sağlık sisteminin ayrılmaz bir parçası haline gelmesi; kesintisiz bir dijital altyapının, kapsayıcı yasal düzenlemelerin ve sağlık personelinin bu uygulamayı benimsemesine bağlıdır. Bu doğrultuda sağlık çalışanlarının bilinçlendirilmesi ve eğitim süreçlerinin güçlendirilmesi kritik önem taşımaktadır. Aksi takdirde, sağlık sistemlerinin dijital dönüşüme uyum sağlaması sürdürülebilir olmayacaktır.

Keywords

• teletıp
• gigital sağlık
• telesağlık
• tıp eğitimi yapay zeka

References

1. 1. WHO guideline Recommendations on Digital Interventions for Health System Strengthening Geneva: World Health Organization; 2019
2. 2. Telemedicine: opportunities and developments in Member States – report on the second global survey on eHealth Global Observatory for eHealth series – Volume 2 Geneva: World Health Organization; 2010
3. 3. Cannon P, Lumsden L, Wass V. An innovative and authentic way of learning how to consult remotely in response to the COVID-19 pandemic. Educ Prim Care. 2022;33(1):53-8.
4. 4. American Medical Association. Statement of the American Medical Association to the House Committee on Energy and Commerce Subcommittee on Health, RE: Telemedicine. https://searchlf.ama-assn.org/letter/documentDownload?uri=/unstructured/binary/letter/LETTERS/statement-sfr-telemedicine-congressional-review.pdf. Published May 1, 2014.
5. 5. Stoltzfus M, Kaur A, Chawla A, et al. The role of telemedicine in healthcare: an overview and update Egypt J Intern Med. 2023;35:49
6. 6. Kane CK, Gillis K. The use of telemedicine by physicians: still the exception rather than the rule. Health Aff (Millwood). 2018;37(12):1923-30.
7. 7. Lucas JW, Villarroel MA. Telemedicine Use Among Adults: United States, 2021. NCHS Data Brief. 2022;(445):1-8.
8. 8. Saigí-Rubió F, Borges do Nascimento IJ, Robles N, et al. The Current Status of Telemedicine Technology Use Across the World Health Organization European Region: An Overview of Systematic Reviews. J Med Internet Res. 2022;24(10):e40877

9. 9. Pratama CG, Nurlianti R, Herstatt C, Goeldner M. Telemedicine Adoption for Managing Chronic and Rare Diseases in Indonesia During and Beyond the COVID-19 Era: Qualitative Study. J Med Internet Res. 2026;28:e83462.
10. 10. Statista Telehealth adoption rate in the Asia-Pacific region in 2019 and 2021, with a forecast for 2024, by selected country 2024.
11. 11. Kapur V, Boulton A, Angus D, Sukhrani D Asia-pacific telemedicine is here to stay [homepage on the Internet] Bain & Company; 2024 [cited 19 Feb 2026] Available from: www.bain.com/insights/asia-pacific-telemedicine-is-here-to-stay-snap-chart
12. 12. Gerçeker K, Erdem R. Türkiye’de uzaktan sağlık hizmetleri ve uzaktan muayene. Sdü Sağlık Yönetimi Derg. 2024;6(2):143-66
13. 13. Önal S, Kaya UHG. Pandemi Sürecinde Uzaktan Hasta Takibi Uygulamalarında Tele-Tıp Ve Birinci Basamaktaki Yeri. Klinik Tıp Aile Hekimliği. 2020;12(3):98-106.
14. 14. Ak S. Tele-sağlık hizmetlerinin Türkiye sağlık politikalarındaki yeri ve geleceği: Swot tabanlı bir değerlendirme. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Derg. 2025;11(2):122-37.
15. 15. Dilbaz B, Kaplanoğlu M, Kaya D. Teletıp ve telesağlık: geçmiş, bugün ve gelecek Eurasian. J Health Technol Assess. 2020;4(1):40-56.
16. 16. Uzaktan Sağlık Hizmetlerinin Sunumu Hakkında Yönetmelik TC Resmî Gazete 10 Şubat 2022; Sayı: 31746
17. 17. Sağlık Uygulama Tebliği (SUT)’nde Değişiklik Yapılmasına Dair Tebliğ TC Resmî Gazete 21 Nisan 2024; Sayı: 32524
18. 18. Hurst EJ. Evolutions in telemedicine: from smoke signals to mobile health solutions. J Hosp Librariansh. 2016;16(2):174-85
19. 19. Cipolat C, Geiges M. The history of telemedicine. Curr Probl Dermatol. 2003;32:6-11
20. 20. Bashshur R. History of Telemedicine: Evolution, Context, and Transformation New Rochelle, NY: Mary Ann Liebert; 2009
21. 21. Hyder MA, Razzak J. Telemedicine in the United States: An Introduction for Students and Residents. J Med Internet Res. 2020;22(11):e20839
22. 22. Jagarapu J, Savani RC. A brief history of telemedicine and the evolution of teleneonatology. Semin Perinatol. 2021;45(5):151416
23. 23. Murphy RL Jr, Bird KT. Telediagnosis: a new community health resource Observations on the feasibility of telediagnosis based on 1000 patient transactions Am J Public Health. 1974;64(2):113-9.
24. 24. Naughton J. The evolution of the internet: from military experiment to general purpose technology. J Cyber Policy. 2016;1(1):5-28
25. 25. Shawwa L. The use of telemedicine in medical education and patient care. Cureus 2023;15(4):e37766
26. 26. Baker J, Stanley A. Telemedicine technology: a review of services, equipment, and other aspects. Curr Allergy Asthma Rep. 2018;18:60
27. 27. Dhediya R, Chadha M, Bhattacharya AD, Godbole S, Godbole S. Role of Telemedicine in Diabetes Management. J Diabetes Sci Technol. 2023;17(3):775-81.
28. 28. Ma Y, Zhao C, Zhao Y, et al. Telemedicine application in patients with chronic disease: a systematic review and meta-analysis. BMC Med Inform Decis Mak. 2022;22(1):105.
29. 29. World Health Organization Consolidated telemedicine implementation guide Geneva: World Health Organization; 2022
30. 30. Su Z, Li C, Fu H, Wang L, Wu M, Feng X. Development and prospect of telemedicine. Intelligent Medicine. 2024;4(1):1-9. ISSN 2667-1026.
31. 31. Birinci Ş. National Healthcare Technology Initiative. Türkiye Bilimler Akademisi (TÜBA). İçinde: Ulusal Teknoloji Girişimi Kitabı. Ankara: TÜBA Yayınları; 2022. s. 17-25. Erişim adresi: tuba.gov.tr [Erişim Tarihi: 21 Mayıs 2026].
32. 32. Yellowlees P, Odor A, Patrice K, et al. Disruptive innovation: the future of healthcare? Telemed J E Health. 2011;17(3):231-4.
33. 33. Pruitt LD, Luxton DD, Shore P. Additional clinical benefits of home-based telemental health treatments. Prof Psychol Res Pr. 2014;45(5):340-6.
34. 34. Massone C, Brunasso AM, Campbell TM, Soyer HP. Mobile teledermoscopy: melanoma diagnosis by one click? Semin Cutan Med Surg. 2009;28(3):203-5.
35. 35. Farahani N, Pantanowitz L. Overview of Telepathology. Surg Pathol Clin. 2015;8(2):223-31.
36. 36. Binkhuysen FB, Ranschaert ER. Teleradiology: evolution and concepts. Eur J Radiol. 2011;78(2):205-9.
37. 37. Whited JD. Accuracy and reliability of teleophthalmology for diagnosing diabetic retinopathy and macular edema: a review of the literature. Diabetes Technol Ther. 2006;8(1):102-111.
38. 38. Choi PJ, Oskouian RJ, Tubbs RS, Choi PJK. Telesurgery: past, present, and future. Cureus. 2018;10(5):e2717.
39. 39. Ajami S, Lamoochi P. Use of telemedicine in disaster and remote places. J Educ Health Promot. 2014;3:26.
40. 40. Wilson LS, Maeder AJ. Recent directions in telemedicine: review of trends in research and practice. Healthc Inform Res. 2015;21(4):213-22.
41. 41. Valentino LA, Skinner MW, Pipe SW. The role of telemedicine in the delivery of health care in the COVID-19 pandemic Haemophilia 2020;26(5):e230-1.
42. 42. Smith AC Telemedicine: challenges and opportunities. Expert Rev Med Devices. 2007;4(1):5-7.
43. 43. Daragó L, Jung Z, Ispán F, Bendes R, Dinya E. A telemedicina előnyei és hátrányai [Benefits and disadvantages of telemedicine]. Orv Hetil. 2013;154(30):1167-71.
44. 44. Almathami HKY, Win KT, Vlahu‐Gjorgievska E. Barriers and facilitators that influence telemedicine‐based, real‐time, online consultation at patients' homes: systematic literature review. J Med Internet Res. 2020;22(2):e16407
45. 45. Mubaraki AA, Alrabie AD, Sibyani AK, et al. Advantages and disadvantages of telemedicine during the COVID-19 pandemic era among physicians in Taif, Saudi Arabia. Saudi Med J 2021;42(1):110-5.
46. 46. Keshvari H, Haddadpoor A, Taheri B, Nasri M. Determining the Awareness and Attitude of Employees in Deputy of Health of Isfahan University of Medical Science toward Telemedicine and its Advantages. Acta Inform Med. 2015;23(2):97-101.
47. 47. Ansarian M, Baharlouei Z. Applications and Challenges of Telemedicine: Privacy-Preservation as a Case Study. Arch Iran Med. 2023;26(11):654-61.
48. 48. Boxer RJ, Ellimoottil C. Advantages and utilization of telemedicine. Mhealth. 2019;5:12.
49. 49. Ramgobin D, Vo M, Golarmari R, Jain R, Jain R. Congestive heart failure clinics and telemedicine: The key to reducing hospital readmissions in the United States. Cardiol J. 2022;29(6):1013-9.
50. 50. Scalvini S, Vitacca M, Paletta L, Giordano A, Balbi B. Telemedicine: a new frontier for effective healthcare services. Monaldi Arch Chest Dis. 2004;61(4):226-33.
51. 51. Bokolo Anthony Jnr. Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. J Med Syst. 2020;44(7):132.
52. 52. Barbash IJ. Connecting the Docs: telemedicine support during in-hospital cardiac arrest resuscitation. Ann Am Thorac Soc. 2020;17(3):278-9.
53. 53. Al-Qirim N. Realizing telemedicine advantages at the national level: cases from the United Arab Emirates. Telemed J E Health. 2007;13(5):545-55.
54. 54. Klingler AM. Is telemedicine your cup of tea? J Am Acad Physician Assist. 2018;31(9):11-2.
55. 55. Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sens Int. 2021;2:100117.
56. 56. Brall C, Schröder-Bäck P, Maeckelberghe E. Ethical aspects of digital health from a justice point of view. Eur J Public Health. 2019;29(Supplement_3):18-22.
57. 57. Acharya RV, Rai JJ. Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services India. J Family Med Prim Care. 2016;5(4):798-803.
58. 58. Sirintrapun SJ, Lopez AM. Telemedicine in cancer care. Am Soc Clin Oncol Educ Book. 2018;38:540-5.
59. 59. Kruse S, Karem P, Shifflett K, et al. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. 2018;24(1):4-12.
60. 60. Guryleva M, Nezhmetdinova F. Telemedicine: advantages and risks. Medical Ethics. 2022;10(1):15-22.
61. 61. Chunara R, Zhao Y, Chen J, et al. Telemedicine and healthcare disparities: a cohort study in a large healthcare system in New York City during COVID-19. J Am Med Inform Assoc. 2021;28(1):33-41.
62. 62. Flumignan CD, Rocha AP, Pinto AC, et al. What do Cochrane systematic reviews say about telemedicine for healthcare? Sao Paulo Med J. 2019;137(2):184-92
63. 63. Kaspar BJ. Legislating for a new age in medicine: defining the telemedicine standard of care to improve healthcare in Iowa Iowa. Law Rev. 2013;99:839-65.
64. 64. Li YH, Li YL, Wei MY, Li GY. Innovation and challenges of artificial intelligence technology in personalized healthcare. Sci Rep. 2024;14(1):18994
65. 65. Pennic F. Survey: 83% of consumers are interested in receiving virtual care, but only 17% have access to it [homepage on the Internet] HIT Consultant; 2019 Available from: hitconsultant.net/2019/05/22/survey-83-of-consumers-are-interested-in-receiving-virtual-care-but-only-17-have-access-to-it
66. 66. Moore MA, Coffman M, Jetty A, et al. Family physicians report considerable interest in, but limited use of, telehealth services. J Am Board Fam Med. 2017;30(3):320-30.
67. 67. Bertelsmann Stiftung Video Sprechstunden [homepage on the Internet] 2015 [cited 22 Nov 2017] Available from: www.bertelsmannstiftung.de/fileadmin/files/BSt/Publikationen/GrauePublikationen/SpotGes_VideoSprechstunde_dt_final_web.pdf
68. 68. Lustig TA. The role of telehealth in an evolving health care environment: workshop summary Washington, DC: National Academies Press; 2012
69. 69. Waseh S, Dicker AP. Telemedicine training in undergraduate medical education: mixed-methods review. JMIR Med Educ. 2019;5(2):e12515
70. 70. Kay D, Pasarica M. Using technology to increase student (and faculty) engagement in medical education. Adv Physiol Educ. 2019;43(3):408-13
71. 71. Pathipati AS, Azad TD, Jethwani K. Telemedical education: training digital natives in telemedicine. J Med Internet Res. 2016;18(7):e193
72. 72. Jonas CE, Durning SJ, Zebrowski C, Cimino F. An interdisciplinary, multi-institution telehealth course for third-year medical students. Acad Med. 2019;94(6):833-7
73. 73. Basu A, Seaton P, Kirk R, et al. Review of the effectiveness of educational tools for teaching telehealth care 2010. Available from: www.academia.edu/2822595/Review_of_the_effectiveness_of_educational_tools_for_teaching_Telehealth_care
74. 74. Stovel R, Gabarin N, Cavalcanti R, Abrams H. Curricular needs for training telemedicine physicians: A scoping review. Med Teach. 2020;42(11):1234-42
75. 75. Warshaw R. From bedside to webside: Future doctors learn how to practice remotely [homepage on the Internet] AAMC; 2018 Available from: news.aamc.org/medical-education/article/future-doctors-learn-practice-remotely
76. 76. Muntz MD, Franco J, Ferguson CC, Ark TK, Kalet A. Telehealth and medical student education in the time of COVID-19-and beyond. Acad Med. 2021;96(12):1655-9.
77. 77. Association AM. AMA encourages telemedicine training for medical students, residents. 2016. Available from: https://www.ama-assn.org/press-center/press-releases/ama/encourage/telemedicine/training/medical/students/residents