Eleven years of experience with low-bandwidth telemedicine in a nurse-led rural clinic in Scotland.

A pilot trial of telemedicine in primary care began in the village of Letham in 1998. The service provided conventional consultations with the district nurse, plus teleconsultations with a general practitioner (GP) at the health centre in Forfar, a few km away. In the first year, the videoconferencing link was used by 14 patients, all aged over 65 years.

Feasibility of a telemedicine 'booth' for supporting remote care in Scotland.

Access to health care in remote settings is becoming increasingly difficult in Scotland. We have investigated the feasibility of a telemedicine 'booth'. Two telemedicine booths were constructed for display at the Royal Highland Show in Edinburgh.

Mortality in general practice: problems concerning deaths in institutions.

Following the provision of all general practitioners in Grampian with data on their practice death rates, the experience of death rates at institutions in the region was examined. Nursing homes are more likely to be situated in less deprived areas and their age-specific death rates are generally higher than those experienced by residents from non-institutional settings. For residents in non-institutional settings in Grampian, higher death rates generally parallel increasing deprivation.

Proposed telemedicine booth.

Change is inescapable. For the rural and remote population the world over, changes to society's view of doctors, and to doctors' view of their role and place in society have lead to a decline in the number of rural practitioners. This personal view of change, and the impact of technology on change, comes from the Grampian area of Scotland, where the traditional remote community of villagers, school, doctor, bank and church is in rapid decline.

Monitoring mortality in general practice in Grampian, Scotland.

Information on the distribution of mortality and morbidity in general practice is scarce, and not easily accessible either by health authorities or individual general practices. Although the assessment of population mortality is a standard public health measure, colleagues in public health, information sciences and general practice rarely undertake such activity related to general practice populations. Mortality information can be used for various purposes.