Telemedicine is here to stay and with the falling costs and increasing capabilities of computers, imaging systems and the internet it holds real promise for missionary doctors in remote areas wanting to seek specialist advice, as well as those working in the NHS.
The NHS Plan states that, 'The NHS will have the most up-to-date information technology systems to deliver services faster and more conveniently for patients'. As a result of this NHS Plan there will be, 'electronic booking of appointments', 'access to electronic personal medical records', 'electronic prescribing of medicines' and 'facilities for telemedicine by 2005'. However, Lilley, Navein and Frank Burns (the author of the foreword) are deeply critical of the NHS' attempts to-date in utilising new technology.
Following the authors advice to 'flip through the pages' (all 185), I was both impressed and confused by the scope of the book. Topics, which are poorly indexed, include buying a computer system, NHS Direct, the history of the Internet, electronic patient records, digital x-ray storage and voice recognition software. In its favour, the book takes a relaxed look at telemedicine while enabling the reader to think through the issues raised. It takes a sensible approach in challenging us to ensure telemedicine projects are well planned (twelve strategic steps are included) and to use them as a stimulus for positive changes in practice. The technical section does provide useful information, which should help the reader to become familiar with the technology.
Assuming they can be found, there are a number of sections which provide an aspiring telemedic with useful discussions of techniques such as Store, Forward and Real Time Data Transmission. Having some experience of running a telemedicine project, however, I was disappointed with the discussion of patient confidentiality and medico-legal issues.
In summary, I would recommend that anyone beginning to think about using telemedicine in clinical practice should browse through a library copy of this book. If you can find the relevant sections, it will inform and challenge your thinking.
- British Medical Journal 2000: 321:465-6 (19 August)
- The NHS Plan