This study will capitalise on the ICT research opportunities arising from a major randomised trial of telemedicine currently underway. In addition to the main trial measures, it is desirable to evaluate the educational processes and the organisational arrangements likely to critically affect the implementation of new types of service.  A maximum variability sample of GPs will be selected. Analysis of recordings will be supplemented by semi-structured interviews with general practitioners and hospital consultants. Interview transcripts will be analysed using framework analysis1. A 100% sample of consultants will be interviewed. Half the GPs will be interviewed about educational issues and half for behavioural and organisational issues. A sample of patients whose interviews were recorded will be interviewed using a semi-structured format.