EDITORIAL

TELEMEDICINE NEW GENERATION

 

It is a great honour for France to play host to an International Conference on TeleMedicine for the second time in five years. This new medical practice - as evidenced in the very prolific literature on the subject - has gone through major developments which illustrate the potential and efficacy of TeleMedicine in our Society. The issue is to assess if it has reached the limits of implementing, at a lesser cost, all the current capabilities made available to the Citizens by the health sector.

The indications of TeleMedicine- improvement of remote rescue and care of people living in distant places or in isolated areas, aid and support in case of natural disasters - have expanded thanks to the transmission of still and live images to medical consultations and training between hospital specialists. The results obtained have hardly been appraised so far, and available assessment criteria make their interpretation rather difficult. In our Global Information Society, in which the unity of time has replaced unity of space and where proximity mainly depends on accessibility, progress is fast and " brutal ". Studies on standards cannot be easily controlled. Large bandwidth networks have stopped developing. The high cost of space techniques make it difficult to use satellite.New higher quality products are being marketed at a lower price and are constantly upgraded so that it is impossible to fix costs once for all. Moreover, one has to take into consideration the fear of users concerning confidentiality, the risks inherent to insecure transmissions and the medico-legal or ethical issues. One cannot ignore that TeleMedicine has mainly developed in Health institutions and very often in the structures equipped with the best technical platforms : this has favoured the collaboration between medical doctors and trained researchers with a view to improve specialized care and research.

Our behaviour and our culture do not keep up pace with the generated technological breakthrough. Quite obviously, TeleMedicine has not reached its maximal potential. It has neither reached its " cruising speed ". It is not sufficiently incorporated into the setting-up of health and care networks whose development and running largely depends on the involvement of such a medical practice on the ground. This raises high expectations among decision-makers, especially in small cities and rural areas. Developing countries are in financial difficulties to use Tele-Medicine. We are in a Society in which Man expects the implementation of new facilities and services for the benefit of all. The modern technologies of Information and Communication are far too much used by traditional services and do not result in access for a larger number of users, some classes of citizens being more and more excluded from quality care.

Our conference will deal with all the scientific, legal, financial and technical aspects of TeleMedicine. TeleMedicine will only reach its goal if it is fully integrated into the building of the Universal Health Services providing equal access to care for all throughout the world. Its prerequisite is the introduction of new services to the benefit of citizens. Needs do exist and answering those needs is possible. I am full of hope when it comes to TeleMedicine new generation and its dynamism as the program of the conference shows.

Professeur Louis LARENG

Chairman of the Conference

Director of the Institut Européen de TéléMédecine

President of the European Society of TeleMedicine