[Adapted from UKeHA web-site; with changes]

Early telemedicine took the form of verbal and written communication.
Telemedicine is not new. Once medical care began to be provided to individuals outside a small community, such as a village, so the need to cope with distance became apparent. The simplest and earliest form of telemedicine required no technology at all. When an individual was too ill to travel to a healer, a family member or friend would go to the healer, describe the illness and take the advised therapy back to the distant sufferer. This approach has been described in many societies and is still current in some remote areas.

Messengers were also used to provide advice and medications to armies, as these were frequently located away from easy provision of medical care. Verbal messages became supplemented with written information, such as advice on treatment of specific conditions. A variety of messaging systems developed for general communication (mirrors, fires, flags, etc) were adopted for medical use by military and naval forces and subsequently in civilian medicine. At an early stage there emerges a pattern of telemedicine evolving by use of technologies developed for general purposes.

Postal and telegram services became routine in medicine, allowing advice to be delivered over much greater distances at greater speed. Use of the telephone and fax machine continued this trend. Early telephone-based medical consultations date back to as early as 130 years ago [49]. These improved methods of communication allowed more interaction than earlier approaches and advice became both more timely and better informed. Information could be shared more widely, allowing for second opinions to be obtained and offering an opportunity to educate.

The integration of computers with telephony, initially by use of modems, is a more recent example of medicine adopting general communication technology. Increasingly medicine is utilising electronic exchange of information, as is society generally. Telephony and computing are increasingly merging to deliver information and communication technologies (ICTs) such as videoconferencing with real time data transfer. Now the term eHealth is used to reflect the merging of technology whilst the scope of usage and benefits expand.

Telemedicine has evolved with societies, utilising ever more competent technologies as these have been developed. Aspects of telemedicine may be narrowly focused, but the underlying development has been non specific. eHealth is seen as broadening the scope of what was known as telemedicine. New deployments of telemedicine are occurring with increasing rapidity. Telemedicine will be part of the movement towards a model of care based around the individual, rather than around institutions.