Despite high expectations, telemedicine and telehealthcare systems, which enable doctors to interact with patients many miles away via video, digital imaging and electronic data transmission, have had only limited impact on the National Health Service, according to a study sponsored by the ESRC.
The expected revolution in medicine, overcoming problems of access to specialist care and speeding up referrals and diagnosis, has simply not happened, say researchers led by Professor Carl May, of the University of Newcastle upon Tyne.
"Telemedicine" is disappearing, in stark contrast to the apparent success of telephone services on which clinical staff decide the urgency of patients' injuries or illnesses, and advice lines such as NHS Direct.
Resistance from professionals is often blamed, but the real reason is often a failure to think through the organisational problems involved in integrating new technology into everyday NHS activity.
Telemedicine lets doctors deal remotely with patients over a live video-conferencing link where a face-to-face consultation may be difficult or time-wasting, such as when patients live in isolated rural areas. And it makes it easier to share pictures and data with experts in different parts of the UK or, potentially, other countries.
But while "telemedicine" is on the wane, new portable "telecare" systems for monitoring people with illnesses such as diabetes, asthma, and respiratory and cardiovascular disorders, are under development.
These new systems connect patients with the NHS using mobile or fixed phones to send data about health problems, enabling early intervention when needed, and potentially reducing hospital admissions. But they face similar problems of integration in a health service which is not a single organisation, but rather a federation of more than 700 NHS trusts, each with its own procurement and management structure.
Professor May said: "We were struck by the strong claims made about the promise of telemedicine. But we found that despite significant support in policy documents and very active champions of the cause in the clinical world, these systems have largely failed to become integrated in routine healthcare delivery."