Over the last three years, there have been major advances in the development of telehealth systems - both in developed and developing countries. Telehealth has benefits in both rural and urban areas. In rural areas, remoteness places a barrier to access to medical services. In urban areas, many social groups experience immobility which limits their access to medical treatment. Telehealth can help provide a solution to both sets of problems as well as better integrating both rural and urban health provision within localities, regions and nations.
Telehealth systems vary from the simple provision of diagnostic information through the development of regional health clearing house facilities and electronic record keeping to the performance of operations through remote technology. Journeys can be reduced and resources pooled to produce a more effective global health system. Currently doctors on remote Pacific islands make use of information communication technology to obtain specialist diagnoses of patients who are unable, either because of physical or economic reasons, to bodily present themselves to specialists.
Technologies which enable detailed image to be conveniently transmitted in real time over distance and which enable the manipulation of technology through remote facilities dramatically alter the traditional relationship of face to face doctor-patient interaction. Most tele-health systems are of a lower order of remote technological manipulation but the potential for on-line treatment is clearly already present.
In terms of an ageing society, one important development is that of the diffusion of home medical monitors which capture vital signs and transmit these into the monitoring medical agency - e-nursing, in fact. This enables older persons to remain in familiar and friendly environments whilst still receiving appropriate levels of care and assistance. Similarly, at home monitoring is now available to pregnant mothers in a number of locations.
Reducing the dependence on residential medical facilities in favour of home based arrangements has important cost reduction consequences as well as important logistic dimensions. Ensuring priority status for medical vehicles and designing residential areas in such a way as to accommodate medical servicing by mobile staff are early candidates for consideration.
Scotland has already begun its own experiment with and development of telemedicine.
On line programs, materials and data bases:
On line working papers and strategy documents:
Margaret Grieco
Professor of Transport and Society
Transport Research Institute, Napier University
66 Spylaw Road, Edinburgh EH10 5BR
e-mail at m.grieco@napier.ac.uk