Is there a future for telemedicine?

• Published in: The Lancet (British edition) 2002-06, Vol.359 (9322), p.1957-1958
• Main Authors: Rinde, Eivind, Balteskard, Lise
• Format: Article
• Language: English
• Subjects: Female; Future; Humans; Instrumentation; Male; Telemedicine; Telemedicine - trends
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(02)08845-1

In today's Lancet, Paul Wallace and colleagues report a randomised trial of joint teleconsultations for patients referred by their general practitioner for a specialist opinion compared with routine referral for a hospital appointment. The investigators randomised a large number of patients (1000 per group) and conclude that virtual-outreach consultation resulted in a reduction in the number of tests ordered and higher satisfaction among the patients, but a greater number of offers for standard outpatient appointments in the telemedicine group. This difference probably depends on incomplete examination in the telemedicine group but the foundation for follow-up appointments in the two groups is hardly comparable. Follow-up rates in the study were increased, especially in ear, nose, and throat medicine and in orthopaedics. This difference is probably because general practitioners do not use peripheral devices such as fibreoptics or other instrumentation in their consultations and the receiving specialists do not get sufficient visual information from the consultation. If the clinical examination is incomplete, telemedicine cannot give diagnostic adequacy and would be useless.