Intended for healthcare professionals

Education And Debate

Telemedicine: lessons remain unheeded

BMJ 1995; 310 doi: (Published 27 May 1995) Cite this as: BMJ 1995;310:1390
  1. Paul McLaren, senior lecturer in psychiatrya,
  2. C J Ball, senior lecturer in old age psychiatryb
  1. a United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London SE1 9RT
  2. b Academic Department of Psychiatry, London Hospital Medical College, London E1 1BS
  1. Correspondence to: Dr McLaren.
  • Accepted 1 May 1995

Telemedicine, the delivery of health care with the patient and health professional at different locations, has been around for over 30 years. Its driving force has been developments in communications technology, and as new communications systems are developed health applications are proposed such as supporting the delivery of primary health care to geographically remote areas or regions underserved through the maldistribution of professional expertise. Despite rapid technological advances, evaluations of such systems have been largely superficial, and more thorough evaluations have failed to show significant advantages for more advanced and expensive technology over older technology such as the telephone. Methods for evaluating the impact of particular technologies on the health care system need to be developed and clearer benefits shown in terms of improved standards of care.

The development of high speed data transmission links on the information superhighway has stimulated a new burst of activity in the field of telemedicine. The prefix, from the Greek telos, implies only distance, but telemedicine has been defined more recently in terms of advanced communications technology. “Telecommunication that connects a patient and a health care provider through live two-way audio, two-way video transmission across distances and that permits effective diagnosis, treatment and other health care activities.”1 This preoccupation with the latest technology is a symptom of the malaise that has afflicted the field since its inception, and much of the work presented at the Telemed 94 international conference in London last November revealed that the subject is still dominated by advanced communications technology looking for health applications.

Telemedicine, however defined, is not new; early reports appeared in the …

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