While we would all like to think people in regional areas will one day get the same access to emergency and other medicine as people in metropolitan areas this is never going to be the case.

There are however situations where advances in medical technology and communication mean that a rapid remote diagnosis is possible.

This is the principle behind the pre-hospital lysis program which allows a cardiac specialist to assess the condition of a heart attack patient while they are still being transported to hospital.

A common ECG test of the electrical activity of the heart, conducted by a paramedic, can allow the cardiologist to make an assessment and prescribe treatment while the patient is still in the ambulance.

Together with advances in medical imaging, video conferencing and improvements in internet communication with the rollout of the NBN, pre-hospital lysis is another way patients in rural and remote areas can have access to specialist care.

For heart attack patients the technology is not a substitute for a face-to-face assessment by a specialist, it is the initial assessment until the patient reaches a facility where further testing can be done.

As with most traumatic injuries, it is the speed with which treatment can begin which has an enormous impact on the outcome for a heart attack patient. This ability to conduct a remote diagnosis and begin treatment quickly can be expected to save lives and reduce permanent heart damage.

The technology also has implications for smaller hospitals where nursing staff can administer drugs on the instruction of specialists who may be hundreds of kilometres away. This goes some way in bolstering the role of these hospitals which are in danger of being bypassed because their high level of nursing care is not accompanied by specialist knowledge.