The implementation of telemedicine systems in Australia is now feasible due to developments in communications and computer technology.

Telemedicine involves the linking of doctors, nurses, patients and specialists using telecommunications with additional facilities such as slow scan television and voice conferences. Computer based systems can also provide access to diagnostic images and pathology reports as well as computer based information retrieval systems.

The use of telemedicine systems would raise significant legal and security issues. There will be a need for community discussion of these matters before systems are introduced.

Telemedicine has a potential to impact on both medical education and clinical support systems. However, before these developments can proceed there will be a need for agreement on standards  to be adopted for the coding and dissemination of medical information.  There are opportunities for developing Australian modules for medical education which could be distributed internationally.

Aspects of telemedicine are already being implemented in Australia, including teleradiology systems and direct reporting of pathology results to general practitioners.

New technologies are emerging in the use of telemedicine for home monitoring activities. Given the prevalence of conditions such as cardiac disease in the population, there is a need for further study of these developments.

Interested parties, including Federal and State health authorities, RACGP and specialist colleges, university research departments, legal representatives and consumers, should confer to ensure that the benefits offered by telemedicine are co­ ordinated in a manner which will be satisfactory to the Australian health system and to the community, possibly under the sponsorship of the Australian Medical lnformatics Association (AMIA).

A number of telemedicine pilot projects are currently proceeding in Australia and it would be desirable for the projects to be evaluated in a co-ordinated manner.

While telemedicine appears promising, it should be subject to evaluation as regards costs and benefits before widespread introduction in Australia.