TELEMEDICINE AND THE NATIONAL INFORMATION INFRASTRUCTURE - ARE THE REALITIES OF HEALTH-CARE BEING IGNORED

Health care is shifting from a focus on hospital-based acute care towa rd prevention, promotion of wellness, and maintenance of function in c ommunity and home-based facilities. Telemedicine can facilitate this s hifted focus, but the bulk of the current projects emphasize academic medical center consultations to rural hospitals. Home-based projects e ncounter barriers of cost and inadequate infrastructure. The 1996 Tele communications Act as implemented by the Federal Communications commis sion holds out significant promise to overcome these barriers, althoug h it has serious limitations in its application to health care provide rs. Health care advocates must work actively on the federal, state, an d local public and private sector levels to address these shortcomings and develop cost effective partnerships with other community-based or ganizations to build network links to facilitate telemedicine-generate d services to the home, where the majority of health care decisions ar e made.