Published work in telemedicine has been surveyed in order to consider the range of current research, highlight some pitfalls and point out areas where it seems that more work is required. This article deals with tests of the safety and efficacy of telemedicine systems. This work can be seen as moving through three phases: first, identify the technical specification of equipment required for the particular telemedicine application; second, test that this is appropriate in particular settings; third, establish a set of standards and guidelines to ensure that the telemedicine system is used to the best advantage. Work in teleradiology seems to be in the second phase. Work in teledermatology, for example, is still in the first phase. Telemedicine is an important and growing area of academic research. The quality of the research ought also to be increasing. While there have been a number of well designed, robust studies with clear conclusions that show the value of telemedicine in certain settings, much more remains to be done.