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The Telemedicine Tool Kit; A workbook for NHS doctors, nurses and managers.
  1. Jonathan Benger
  1. Research Fellow in A&E Telemedicine, Tewksbury

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    By Roy Lilley and John Navein. (Pp 185; £30.00.) Radcliffe Medical Press, 2000. ISBN 1-85775-4808.

    This is a 180 page A4 softback book with lots of big type, boxes and icons that aims to “demystify the subject . . . and help you implement your own telemedicine projects”. The authors are well qualified, combining expertise in management, remote health care and real life telemedicine projects, which gives them a credibility sometimes lacking in other writers on this subject. As they freely admit, to produce a book on telemedicine is a little anachronistic, but while a CD ROM might seem more appropriate the book actually has the feel of an electronic publication, both in its style and the use of various symbols, text boxes and layouts.

    The Telemedicine Tool Kit is written from the perspective of medicine in general, rather than accident and emergency (A&E), though most of the content will be directly relevant to developments in A&E, and there are even one or two appropriate examples, such as call to needle times. It is designed to stimulate thought and debate with colleagues, rather than be prescriptive about the way in which telemedicine should be implemented. This makes it very different to the other major UK book on the subject,1 which provides a solid introduction and factual approach. The Telemedicine Tool Kit does contain facts, but these are selected to engage and challenge the reader, rather than cover the topic comprehensively.

    In attempting to engender enthusiasm and stimulate debate this publication is likely to succeed. It also takes care to emphasise some important principles that are essential to the implementation of telemedicine and touches on a number of related topics, such as current telecommunications and the internet. Most importantly, it devotes a large section to describing a series of steps that can be followed to develop a thriving telemedicine initiative.

    Despite all this, the style of the book is somewhat off putting. In an attempt to achieve readability and humour it sometimes seems just a little too smug. It seems doubtful that readers will find themselves filling in the “exercise” boxes that pepper the text, or making a coffee when they are told to. For telemedicine enthusiasts the endless upbeat character may reinforce a feeling that telemedicine is obviously right and easy, but the unconvinced may be discouraged by subheadings such as “risk management for technophobes and sceptics”. Constant references to “propeller heads” (presumably men with technical expertise and pony tails) and an unremitting jocularity acts to obscure rather than emphasise the underlying message.

    Does telemedicine need a tool kit, or indeed a workbook? The latter concept has too many schooldays connotations to appeal. There is, however, no doubt that telemedicine requires good publications to help those who are thinking of adopting the technique in their own practice. This book is useful, thought provoking and well informed, yet its attempts to simplify and enthuse actually detract from its ultimate readability. It is easy to dip into but harder to read; at best it will inform and enthuse, at worst it will irritate and alienate.

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