Review

Dial M for medicine

THE TELEMEDICINE TOOLKIT: A workbook for NHS doctors, nurses and managers
Roy Lilley and John Navein
Radcliffe Medical Press, 2000

This book has number of good points. It is timely, with Labour’s NHS white paper requiring health authorities to consider telemedicine in their health improvement programmes, and the publication of Information for Health. It also emphasises that technology alone is unlikely to yield benefits: work practices must also change for real service improvements to be seen. It does stress the fact that ‘telemedicine’ is a group of technologies, employable across a wide variety of settings. For example, most doctors actually use telemedicine every day — talking to colleagues on the phone — and the telephone is frequently an appropriate technology for such discussions, with more expensive technologies, such as video conferencing, being a ‘sledgehammer to crack a nut’. The format is also effective, with exercises, ‘think boxes’ and tips making it accessible. It is possible to dip into the book: indeed, this may be the best way to read it.

On the negative side, it fails to address the lack of scientific evidence of genuine clinical benefit resulting from telemedicine applications. It also glosses over technical issues and difficulties, and so it is too superficial to really be a ‘toolkit’. For example, problems with digital camera range and resolution get only a few lines. There is scant attention to the ubiquitous Web and the technology on which it is based, which could now form the platform for many forms of electronic communication. Many of the humorous asides are likely to be seen as patronising or offensive by one or other of the intended audiences. Some material seems irrelevant and the book feels about twice as long as it needs to be.

So this is a book that you will either love or hate, largely because of its style. Although it sets out to be provocative (and what else would we expect of Roy Lilley?), many will dislike the style, perhaps intensely. Borrow it before you decide to but it.