Classically a rural general practitioner or nurse will consult with specialist colleagues using the interactive television facilities of a local hospital. A range of ancillary devices can be connected such as blood-pressure, heart rate, oxidimetry, blood chemistry, etc. There appears to be little hard data on the effectiveness of conventional teleconsultations and even less on tele-home care although claims are made for patient and carer satisfaction. Lack of reimbursement for such consultations is a significant impediment to wider practice. A telestethoscope can also be used for auscultation.
Physician satisfaction seems likely but patient satisfaction is unclear.
Tele-echocardiology is technically demanding but has been applied to the emergency evaluation of chest pain, etc. Diagnostic accuracy is not yet adequately established 1 . 1. Acute Health Division, Victorian Government Department of Human Services, 1998. Teledermatology can serve as a good model for other telemedicine specialties. In particular, a key element in making a dermatological diagnosis, visual inspection of the skin, can be readily transmitted via telemedicine techniques.