Procedural Telementoring in Rural, Underdeveloped, and Austere Settings: Origins, Present Challenges, and Future Perspectives

Annu Rev Biomed Eng. 2021 Mar 26. doi: 10.1146/annurev-bioeng-083120-023315. Online ahead of print.


Telemedicine is perhaps the most rapidly growing area in health care. Approximately 15 million Americans receive medical assistance remotely every year. Yet rural communities face significant challenges in securing subspecialist care. In the United States, 25% of the population resides in rural areas, where less than 15% of physicians work. Current surgery residency programs do not adequately prepare surgeons for rural practice. Telementoring, wherein a remote expert guides a less experienced caregiver, has been proposed to address this challenge. Nonetheless, existing mentoring technologies are not widely available to rural communities, due to a lack of infrastructure and mentor availability. For this reason, some clinicians prefer simpler and more reliable technologies. This article presents past and current telementoring systems, with a focus on rural settings, and proposes a set of requirements for such systems. We conclude with a perspective on the future telementoring systems and the integration of artificial intelligence within those systems. Expected final online publication date for the Annual Review of Biomedical Engineering, Volume 23 is June 2021. Please see for revised estimates.

PMID:33770455 | DOI:10.1146/annurev-bioeng-083120-023315