Can telemedicine be used to improve communication between primary and secondary care?

BMJ 1996;313:1377-1380 (30 November)

Information in practice

Can telemedicine be used to improve communication between primary and secondary care?

Robert Harrison, research fellow telemedicine,^a William Clayton, project coordinator,^a Paul Wallace, professor of primary care ^a

^a Department of Primary Care and Population Sciences, Royal Free Hospital, University College Schools of Medicine, London NW3 2PF

Correspondence to: Mr Harrison (email virtual{at}rfhsm.ac.uk).

Abstract

Objective: To test feasibility and acceptability of teleconferencingroutine outpatient consultations.
Design: Exploratory trial of teleconferenced outpatient referralsof general practitioners.
Setting: An inner city teaching hospital and surrounding generalpractices.
Subjects: Six general practices linked to hospital outpatientclinics.
Main outcome measures: Levels of participants' satisfactionmeasured with self administered questionnaires.
Results: 54 teleconsultations were performed in 10 differentspecialties. Few serious technical problems were encountered,and high levels of satisfaction with the consultations werereported by patients, hospital specialists, and general practitioners.
Conclusions: Teleconferenced consultations for routine outpatientreferrals with joint participation of general practitioner werefeasible. These may have an important potential benefit forimproving communication between primary and secondary care.

Key messages

Teleconferencing would allow doctors to achieve joint consultations through sound and video links without having to leave their usual workplace
In our preliminary trial we used low cost, PC based, videoconferencing equip- ment to connect six general practices to 10 specialties in a hospital
Few serious technical problems were encountered, and high levels of satisfac- tion were reported by the patients, hospital specialists, and general practitioners who participated in the consultations
The feasibility of teleconsultations should now be tested in a full scale trial

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