When the staff of the Telemedicine Research Center (TRC) began in early 1994 to research what was known about telemedicine, it became readily apparent that a fair amount of information existed. However, it was scattered across a wide variety of resources, including online databases, private collections, government agency reports, and journals and newsletters not usually indexed in standard medical literature. In addition, since there were far fewer Web sites in 1994-1995, much of the material was still only available in print format. The director and staff of the TRC decided that a Web site that would collect and display this widely scattered information would be a valuable contribution to those with an interest in telemedicine. We decided to name it the Telemedicine Information Exchange, or TIE, to indicate that the site was to provide an exchange or clearinghouse of information, and provide a method for interaction for its users. Construction of the TIE began accordingly. We decided to gather and keep current information in the following subject areas:
Early work on the TIE commenced with financial support from the Health Care Financing Administration (HCFA) and in-kind assistance from Oregon Health Sciences University (OHSU). The TIE was first introduced to users in the form of a computer bulletin board (BBS) in February 1995. A toll-free number was initially used for access, but was discontinued in June 1996 for financial reasons. A National Science Foundation (NSF) Internet Connection proposal submitted in the fall of 1994 was ultimately funded and the TIE was launched on the Web in May of 1995.
We included the sections described above, as well as some additional sections for Legal information, links to other Web sites and business information. Over the next one and a half years we added other sections that experience suggested would be useful or were recommended by users. As telemedicine became more widespread and TIE visits increased substantially, it became clear that we would not be able to continue to maintain the TIE with limited staff and resources.
In 1997, discussion with staff at the National Library of Medicine (NLM) led to an invitation to submit an unsolicited proposal. "Upgrading, Expanding and Maintaining the Telemedicine Information Exchange" was submitted on August 15, 1997; the contract was approved and work began on September 3, 1997.
With NLM support we were able to begin creating a more sophisticated site as well as to diversify and substantially increase the amount of information offered, with full time staff including the project director, a programmer, research associate, Web developer, and an administrative/data entry person. The addition of a dedicated programmer allowed migration of the TIE from a Perl-script flat file format to a relational database format, as well as a total redesign of the site. Research personnel focused on content research and updates; a Web developer hired in 1998 made significant changes in upgrading the site's usability and standardizing its design; administrative help greatly increased the number of citations added to the Bibliographic database and maintained the office infrastructure. The five years of NLM support has created a unique resource that is relied upon worldwide for credible, up-to-date telemedicine information.
In December 2005, the TRC's contract with the NLM was terminated due to budget cutbacks. In July 2006, the Association of Telehealth Service Providers (ATSP), took over the the management, hosting, and updating responsibilities of the TIE. The Association of Telehealth Service Providers (ATSP) was founded in 1996 to support and grow the telemedicine industry and ensure that the tools needed to provide remote care are in place. The ATSP plans to make no changes to the TIE's operations and believes that managing the TIE is a perfect way to help achieve its mission of expanding the telehealth industry.
"As an almost daily user of the TIE," stated Will Engle, Executive Director of the ATSP, "I'm pleased to be able to support the continuation of this valuable resource for our members and the entire telehealth industry."
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