Intended for healthcare professionals

Rapid response to:


Use of telemedicine will double in next decade, report predicts

BMJ 2010; 340 doi: (Published 23 March 2010) Cite this as: BMJ 2010;340:c1634

Rapid Response:

Telemedicine: Less competition, more empowerment

J Zarocostas highlights an important obstacle to any potential
adoption of telemedical services in primary care. Namely, some general
practitioners “regard telemedicine as competition” (BMJ 2010;340:c1634).
There is, however, a growing body of evidence to the contrary. Referring
as an example to telecardiology (telemedicine that informs the diagnosis
and management of cardiac disease, in both the acute and chronic setting),
research suggests that telemedicine enables and empowers GPs to manage
more of their own patients than otherwise possible. This is principally
due to two factors:

1. Avoidance of unnecessary referrals to the secondary care level. In
an Italian study, a cohort of 200 GPs were provided with a telecardiology
service, resulting in the GPs managing their own chest pain patients in
74% of cases[1].

2. Development of GPs’ cardiac care expertise. It has been postulated
by some that bridging the gap between primary and specialist care via a
telecardiology service actually improves the GPs’ own knowledge-base, thus
improving the standard of cardiac care provided[2-3].


[1]. Scalvini S, Zanelli E, Conti C, Volterrani M, Pollina R,
Giordano A, et al. Assessment of prehospital chest pain using
telecardiology. Journal of Telemedicine and Telecare 2002;8(4):231-6.

[2]. Molinari G, Valbusa A, Terrizzano M, Bazzano M, Torelli L,
Girardi N, et al. Nine years' experience of telecardiology in primary
care. Journal of Telemedicine and Telecare 2004;10(5):249-53.

[3]. Scalvini S, Glisenti F. Centenary of tele-electrocardiography
and telephonocardiography - where are we today? Journal of Telemedicine
and Telecare 2005;11(7):325-30.

Correspondence to:

Competing interests:
WB worked temporarily (summer 2009) in a clerical capacity for Broomwell Healthwatch telemedical services.

Competing interests: No competing interests

12 April 2010
Warren D Backman
medical student
Daniel Bendel, medical student, University College London
University College London