Impact of telemedicine must be defined in developing countries

doi:10.1136/bmj.324.7328.47a

BMJ 2002;324:47 ( 5 January )

Letters

Impact of telemedicine must be defined in developing countries

The first 150 words of the full text of this article appear below.

EDITOR $---$ The editorial by Edworthy shows the dangers of external commentary on what is most useful for developing countries.¹How can we measure the comparative impact of teleconsultationin Uzbekistan or Cambodia with teleconsultation in snowbound northernCanada, telemetry in Norway supporting elderly people at home,or teleradiology avoiding long painful journeys in remote partsof the British Isles? What values do we use $---$ economic, social,quality adjusted life years, consumer feedback, political position,or providersatisfaction?

More importantly, how do we measure the impact of telemedicine on the health systems of developing countries? Will strengtheningsecondary care for a few disadvantage basic primary care or environmentalhealth for the many? Will investment in the required rural telecommunicationsbe at the expense of providing drinkable water? Will developingcountries too be seduced by the expensive impact of technologyled tertiary care for the few, while ignoring the endemic impact. . . [Full text of this article]