A broad term used to describe medicine at a distance through a communications link. Such techniques for education, diagnosis and treatment have been successfully used. In teleradiology, radiographic images are transmitted to a distant site for interpretation by a radiologist. Ambulance paramedics can transmit an electrocardiogram to the receiving hospital. A telepathologist can look down, and in some cases control, a microscope located several hundred miles away. In a teleconsultation, the doctor and patient are in different places, joined by a link such as videoconferencing. In its simplest form, this kind of telemedicine uses the telephone, but also two-way video and audio links are used. Telesurgery, combining televisual and robotic techniques, is also increasingly available

Telemedicine is useful for remote locations, such as the Antarctic, or on board ships, or aeroplanes, where it may be difficult or impossible to get a doctor to the patient. It can also speed up the referral process, reduce unnecessary referrals and improve communication between professionals. It has potential value in pilot projects of ‘hospital at home’ care.

‘Smart’ technology developments include an ELECTROCARDIOGRAM (ECG) interpretative tool embedded in a smartphone to help analyse test results via an app; inhalers, as used in asthma, which detect, store and transmit information on each activation as well as information about coincident air pollution and location; smart-pills that, when swallowed and the active ingredient released, transmit that information to treating clinicians so that they can check adherence to the prescription regime; and even digital therapy, with which patient information can be entered and a course of tailored COGNITIVE BEHAVIOUR THERAPY (CBT) uploaded. With the rapidly escalating costs of medical care, it is likely that more use will be made of these techniques.