A role for tele-education in the centralization of accident and emergency services

Experience-based guidelines for the implementation of telemedicine services

Many telemedicine projects fail to survive beyond the funded research phase. A review of seven Scottish telemedicine services was conducted to identify successes and failures. Qualitative interviews were conducted with key individuals in each project. All projects were partly successful. The main reasons associated with partial failure were: the service was not needs-driven; there was no commitment to provide the service; there was no suitable exit strategy after research funding expired; there was poor communication; there was a lack of training; there were technical problems; work practices were not updated; the protocols for use were poor or non-existent. Based on this, guidelines that might improve the chances of success in future projects were drawn up.

Tele-education in emergency care

The use of telemedicine is becoming routine and accepted in certain limited areas such as electrocardiogram and radiograph/computed tomographic scan telemetry. Tele-education has thus far had limited applications although in emergency medicine it has been shown to be an effective medium for the education of senior house officers and emergency nurse practitioners in remote or peripheral units. Despite apparent clinical and cost benefits and government support, the full potential of two way video conferencing and tele-presence has yet to be realised by the clinician, educator and manager.