objective To examine the financial and organizational characteristics, dema
nd for services, and satisfaction outcomes of a growing telemedicine progra
m serving both urban or suburban and rural populations. Design Retrospectiv
e review of 1,000 consecutive telemedicine consultations in the University
of California (UC) Davis Telemedicine Program. a Setting Telemedicine video
conferencing units, used to integrate care in the UC Davis Health System am
ong the UC Davis Medical Center and several urban or suburban primary care
clinics, rural hospitals, and clinic affiliates. Subjects A total of 657 co
nsecutive patients who consented ro a telemedicine consultation. Main outco
me measures Demographic information about the patient population, rhs rural
and urban or suburban clinics, the types of specialty consultations, and t
elemedicine equipment used in the UC Davis Health System. Patient and physi
cian satisfaction were measured on a 5-point Likert scale. Results Patients
and primary care physicians reported high levels of satisfaction. Rural cl
inics requested more and a greater variety of specialist consultations than
urban or suburban clinics. Conclusion Although referring physicians and pa
tients indicate a high level of satisfaction with telemedicine services and
insurers are negotiating reimbursement policies, additional research must
investigate the reasons why some payers, patients, and providers resist par
ticipation in these services.