Theory and Application
Edited by Debra Howcroft and Eileen M. Trauth
Chapter 18: Competing Rationalities: A Critical Study of Telehealth in the UK
Ela Klecun Introduction Telehealth offers an interesting, rapidly changing field to study that encompasses a wide range of health services delivered at a distance and, more speciﬁcally, over various telecommunication networks. The history of telehealth is chequered, with the majority of early projects failing to survive the end of funding and being unable to move from projects to sustainable services. Yet, increased pressure on the health services in many countries and advances in technology brought renewed interest in telehealth in the 1980s and 1990s (Perednia and Allen 1995; Darkins and Cary 2000). So far, in the UK, the majority of telehealth services are provided by pilot, small scale projects (May et al. 2001; Klecun-Dabrowska and Cornford 2002). These tend to be funded as research as much as operational systems. They differ in scale, type of services offered and application area (in terms of medical speciality and geographical scope), and they employ different technologies and target diverse users, reﬂecting the heterogeneous nature of telehealth (Klecun-Dabrowska 2002). Nevertheless, large government initiatives, which could be classiﬁed under a broad umbrella of telehealth, are gaining momentum. For example, a nurse-led triage telephone system (NHS Direct) is in operation throughout the country, electronic bookings systems are being piloted, and the Integrated Care Records Service (ICRS), a portfolio of services covering the generation, movement and access to health records, is one of the four key deliverables set out in the new National Health Service (NHS) information technology (IT) procurement strategy (DOH 2002). Health...
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