Abstract
A focus group of 12 persons who had been the subject of telemedical consultations met four times to discuss what changes to the health service they expected to result from the widespread introduction of telemedicine. There was general agreement about four main themes. First, rationalization of care would occur. For example, health-care spending would have to take into account the need for local care and there would be more primary care, with telemedicine providing easy access to specialists. The implementation of home care would be facilitated. Second, there was an expectation that costs would be controlled, for example by the use of multi-skilled personnel and by having fewer, smaller, newer and different hospitals. Third, quality control would be introduced (e.g. the widespread use of evidence-based medicine). Fourth, it was agreed that a change of professional attitudes would be needed, particularly among doctors (e.g. more openness, less bluster and less hierarchy). Telemedicine is likely to be a great driver of change in the health service. The changes relating to the location and type of work are fairly predictable, but the changes in relationships are likely to be profound.