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A questionnaire was sent to the chief surgeons at 141 Swiss hospitals to evaluate their knowledge and acceptance of telemedicine in surgery. The response rate was 69%. Ninety-three per cent of all surgical departments used computer technology, 85% regularly used the Web and 88% had an internal hospital network. ISDN lines were used in 58% of the participants' hospitals. While 35% of respondents had participated at least once in networking, only 8% regularly used telemedicine. The opinion was that access to therapeutic advice (87%) was a better use of telemedicine than was obtaining a primary diagnosis (24%), although the majority accepted the principle of making (91%) and receiving (94%) a remote diagnosis. The survey suggested that surgeons are interested in telemedicine and open to its development, although their experience and knowledge are limited. Therefore, telemedicine in surgery may be advanced by creating surgical networks for teleconsultation and tele-education. [ABSTRACT FROM AUTHOR]

Unlabelled: Scientific journals currently face challenges including cost pressures caused by economic constraints, increasing rivalry among competitors, limited market potential of non-english speaking journals, increasing medical specialization with resulting market fragmentation, and internet-based competition. We therefore analyzed strategic opportunities of the journal Swiss Surgery on the basis of customer surveys and of a market analysis., Results: Swiss surgeons expressed their interest in the continuation of the journal but also indicated their support for changes in its concept and for an increased use of electronic media. An international market analysis points-out the difficulties of national, non-english speaking journals in gaining impact points and in attracting authors and readers of scientific medical articles. Therefore, a journal such as Swiss Surgery should identify and use publication niches., Recommendation: The demand for a concept addressing surgical training including continuous postgraduate education was confirmed by the customers of Swiss Surgery. A corresponding offer does not presently exist in the area and could become the new focus of the journal. This change of concept may have a number of consequences: A journal focusing on surgical training and education should use the results of readers' surveys rather than impact point assignment to evaluate quality. The journal should increasingly use electronic services including data bases, pictures, videos and closed user groups to supplement the print version. At short term, however, the printed version should be continued and not be substituted by the electronic version in order to maintain the established brand "Swiss Surgery".

The potential of electronic communication in medicine is assessed based on an analysis of a pilot project pertaining to internet based communication among referring and hospital physicians. Advantages of electronic data exchange in medicine pertain to speed and capacity for data transfer, availability of data and data integration, ultimately enabling consistent medical case management. Quality requirements of electronic communication of medical data are related to safety, availability, data integration, potential for case management and system qualities. Medical efficiency can be increased by use of electronic communication only if complex functions beyond the substitution of conventional mail by e-mail are implemented and an exhaustive use of the technology can be achieved.