Twelve months' experience with telemedicine for the British armed forces.

In 1998, a low-cost telemedicine system was established for the British armed forces in Bosnia. It involved a digital camera, computer, e-mail and a telephone link between the remote site and the UK. Images were transferred to a PC and forwarded to specialists in the UK, who replied within 24 hours. In the first 11 months of use, there were 60 referrals from one remote site. Clinical management following specialist advice was significantly altered in a third of these cases, with additional reassurance offered in 13% of cases. When other sites were connected the usage of the service doubled. This inexpensive system provided effective care to our patients, irrespective of location.