We appreciate the letter by Rosario Pacahuala et al. regarding our consensus document of the Spanish Society of Cardiology on telemedicine consultations.1

By enabling adaptation to the new situations associated with medical modernization, telemedicine has become established as a form of care of both the here and now and the future. Telemedicine consultations permit a different form of health care that can be a source of stress for both medical staff and patients. Thus, satisfactory telemedicine consultations must be rewarding and reassuring, produce a positive feeling for both physicians and patients, and avoid generating stress, anxiety, and discomfort.2

Accordingly, the telemedicine consultation must be optimized to maximize performance. Efficient consultations rely on soft skills focused on empathy, warmth, and trust. These skills underlie and enrich hard skills centered on abilities and scientific knowledge. Indeed, the combination of both skill sets is key to high-quality telemedicine. Such consultations must guarantee confidentiality, stressing privacy and data protection, and be efficacious and safe.

As highlighted by the authors, the role of nursing staff is crucial in this context, as well as probably that of pharmacists and other individuals involved in health care, such as caregivers. A consensus document on the telemedicine consultation for nursing staff would be highly valuable, with a special focus on the management and monitoring of lifestyle habits and control of risk factors. As one would expect, all components should be coordinated with primary care. The involvement of other professionals would facilitate the optimization of resources in telemedicine3 to offer health care that is at least as rewarding as face-to-face consultations. This coordination work regarding continuity of care could be organized, at least partly, by the Working Group on the Integration of Cardiology and Primary Care of the Clinical Cardiology Association.