Telematics and patients Over last years we have seen progresses in all sector brought by the innovations in technology. Within ten or twenty years, which further progresses will be on disposal of men, who knows? The same is worthy for the advances in medicine. Indeed who among us, the physicians, does not employ therapy instruments as the ultrasound scanning, the TAC or the RNM?  Who does not acknowledge nowadays the worth of remote surveys thanks to the employ of telematics or the importance of remote consultation or scientific conferences? Provided that, a question becomes natural: does the patient, undergoing tests ever more sophisticated and often on distance, still have the right relationship with his doctor and/or specialist? The relationship physician/patient has always been the dilemma of the medicine profession. Unfortunately the growth of technical innovations, essential to border rightly the pathology, has placed second the delicate balance patient/doctor. The coming of telemedicine, that is the coming of the possibility to carry on remote diagnosis and therapy if on a hand enriches the endless space of possible interaction, on the other hand submits the patient to the risk of becoming an entity without a real identity. So it is required that the main responsible for the patient, that is the family doctor, takes personally again the rôle of co-ordinator of the diagnostic and therapeutic process. The right information carried out with patience and respectfully of the humanity of the patient becomes essential when the technologic development trends to neglect the practice of the art to privilege the technocratic aspect of the medical profession. It's evident that this new scientific reality sets remarkable problems for the physician regarding behaviours and ethics. Which the approach? Which the solution? Not only one but many variables constitute the therapeutic process and to one of them it must be given its own place within the diagnostic “puzzle”, eased by new technologies. In details all the means involving a not direct survey of the pathological condition may convince that the patient is ever more alone in his disease, but it isn't so. That does not mean nevertheless that the relationship between patient and physician must move in favour of equipment in damage of the human relationship, basic to individuate therapy and its success. As for all other revolutions and changes in human life, whichever sector they refer to, it is necessary to give an ethic- philosophic value to the purpose and the effective usefulness of telemedicine. So we can assert that any new introduction in whatever sector isn't but a mean to go beyond, breaking the previous limits to face new ones. This way and not another, it must be deemed the coming of telemedicine. The purpose is not to have a “Remote relationship “ with patient, but to get deeper acknowledgement of the disease and its state of evolution. Telemedicine too is a mean of acknowledgement, it's a consequence of the relationship between physician and patient, it's neither a mean of cure nor a mean of diagnosis. It's ever more a logic consequence of that activity, only belonging to humankind, that is the cure. 

Piergiorgio Spaggiari
Direttore Generale
Azienda Ospedaliera "Eugenio Morelli"
Sondalo