However, specific challenges of distance follow-up have also become painfully clear and need creative solutions.2 For example, it is more difficult to estimate whether a newly referred patient or his or her family can recognise signs and symptoms, such as leg oedema in heart failure patients, or whether they are able to decide if it is necessary to come to the hospital. In addition, in patients with visual or auditory impairments, it can be difficult to change medication by phone, especially when a patient does not have email or cannot read very well. For patients who are very lonely and feel socially isolated, and/or elderly patients, extra telephone contact with the clinic can be very important to ask questions and help to solve problems.