Dear user, our repeated request to you again. Telemedicine projects are usually supported if they provide evidence of the improvement of the health situation in the partner countries. So far only the total numbers of users and groups as well as the increasing monthly case numbers of predominantly individual projects such as SHCH Cambodia, Mazar E Sharif and the open forums, such as dermatopathology cytopathology and histopathology have been considered. However, the case numbers are dependent on numerous non-medical factors, among others on the "marketing interests" of the peripheral partners, but so far there are no criteria which describe the influence on the medical situation in the partner countries. The success of telemedicine can only be documented and at the same time the quality of telemedicine can be improved by the feedback of the clinician the user sending back this information to the consulting partner (experts). Unfortunately, about 60% of all requests from the "experts „were not answered and only 20 % of additional information in the form of supplementary images of further clinical information was send to the experts so that a discussion of difficult cases usually remains open and the diagnosis remains vague . The frequently used polite phrase “thank you” is not sufficient to document the influence of tele diagnosis on therapy. In future cases, please add the following information as feedback to the case later. 1 clinician accepts tele diagnosis Yes/No 2 clinicians implement the diagnosis in their therapy concept Yes/ No 3 clinicians report short-term follow up on improvement of symptoms or cure Yes / No Despite the additional effort, the measure can contribute to the general improvement of the medical situation and document the success of telemedicine. We ask for your feedback best regards Dr Gerhard Stauch