As the two founding members of the Institute of Health Services Management's telemedicine and telecare programme, we were pleased to see your wide-ranging comments on telemedicine ('Telly addicts?' IT Update, 18 March).

The telemedicine and telecare reference group referred to arose from our study on telemedicine and telecare's impact on healthcare, which pointed to the need for partnership between government, health services, the professions, and industry. The group contains a spectrum of opinion, and aims to stimulate discussion of key issues.

Few such groups include hospital and primary care clinicians, health service managers, academics, researchers and suppliers, and the areas of agreement are more significant than the areas of disagreement.

The group is not trying to do the work of the four health departments, nor is it writing any framework document. It exists to provide links and advice based on practical experience, and this includes offering an input to the framework.

There is, rightly, a lively debate about the best way of evaluating the benefits, but there is agreement on the urgent need to undertake some large-scale trials taking a whole-system approach to healthcare delivery. These will provide realistic opportunities for evaluation, as well as providing a basis for the wider health community - patients, carers, the NHS and suppliers - to learn more about using technology to modernise services.

This way of working may provide a useful model for introducing other far-reaching innovations into the NHS.

As the reference group facilitators, we hope to be able to get the working group reports (referred to in your article) published for a wider audience. For readers who would like to know more about the wide range of applications already working and being developed, there are several one-day conferences planned. Copies of the IHSM report, Telemedicine and Telecare: impact on healthcare are available for£12. Further information can be obtained from either of us.

Keith Clough and Ian Jardine

15 Sutton Wick Lane



Oxfordshire OX14 4HH

Tel: 01235-521105

Fax: 01235-531144