ABSTRACT
AcrossEuropetherearemovestoimprovethedeliveryandqualityofcare butatthesametimetotryandcontaintheescalatingcostsofdeliveringthese servicesbyremovingthemanybarriersthatexistbetweentheprovisionof institutionalhealthcare,careinthecommunityandprimarycare.Present structuresareseennotonlytobeinefficientbutalsonottoprovideseamless care.Movementofhealthcaredeliverytowardstheprimarysectorandthe homesettingcanresultinsubstantialbenefitsintermsofhealthoutcome, socialprovision,cost-effectivenessandresourceutilization,particularlyin relationtothemanagementofchronicdisease.However,itiswidely recognizedthatachievementofsuchasystemofcareishighlydependenton telematics(informationandcommunicationstechnologies)fortheoptimal transferofclinical,demographicandadministrativeinformationbetweenthe differentprovidersofservicesinthehealthsector.Itisinthiscontextthat thereisagrowinginterestintelemedicine;aninterestarisingpartlybecause oftechnologicalpushanddrivenbyadvancesintelecommunications.But telemedicineisnowemergingfromitsresearchanddemonstrationstageand asitmaturesisprovidingwaysinwhichitcouldbeanimportantadjunctin thefutureforimprovedaccesstocareinthecommunity,particularlyinrelation tothemanagementofchronicdisease.The'hospitalwithoutwalls'concept couldthusberealized.
