BOOKS

Taking health telematics into the 21st century Edited by Michael Rigby, Ruth Roberts and Michael Thick Radcliffe Medical Press 217 pages£35

E-health, particularly telemedicine, can do one of two things: support the traditional care-giving process or enable a new healthcare model, centred around the patient.

Based on the outcome of an expert working meeting on telematics, sponsored by the Nuffield Trust in December 1998, this book looks at both options and raises many clinical and ethical issues.

Presented as a series of contributions from a wide range of health professionals, it stands back from the rapid drive towards modernisation and takes stock of the issues and major problems involved in the move to e-health and new ways of working.

It considers the need for changes to clinical culture and organisation, the way health professionals interact with patients, and examines concerns over quality of care and 'technophobia'.

Consideration is given to how we can predict where telemedicine is likely to be useful and the need for clinical controls and data protection.

Case studies from Britain, Sweden and Norway are used to illustrate the complex issues that e-health brings to patients and health professionals.

In particular, the nursing case study supplied by Lorraine Gerrard, Adrian M Grant and J Ross Maclean, provides valuable insight into the procedural issues of telemedicine and highlights the importance of location, training and competence and support for nurse and patient.

Telemedicine from the patients' perspective is not overlooked, and the report supplied by Frances Presley of the community health councils provides an objective view of the benefits for patients.

Although telemedicine is an exciting subject, this book is not an exciting read and suffers from its dry, academic style. Its other weakness stems from the fact that it was produced from a meeting held over two years ago, which gives it a distinctly dated feel. E-health and NHS modernisation has moved on.

That being said, the book does provide valuable discourse around the fundamental problems facing us as we embrace e-health.

It places emphasis on the special characteristics of healthcare and the need to protect and manage the personal patient-health professional dialogue.

Most important, it makes the point that people need to be at the centre of the introduction of telemedicine and their needs must be considered.

E-health is not just about technology, it is about human values and needs.