| Abstract | Health care is shifting from a focus on hospital-based acute care toward prevention, promotion of
wellness, and maintenance of function in community and home-based facilities. Telemedicine can
facilitate this shifted focus, but the bulk of the current projects emphasize academic medical center
consultations to rural hospitals. Home-based projects encounter barriers of cost and inadequate
infrastructure. The 1996 Telecommunications Act as implemented by the Federal Communications
commission holds out significant promise to overcome these barriers, although it has serious limitations in
its application to health care providers. Health care advocates must work actively on the federal, state,
and local public and private sector levels to address these shortcomings and develop cost effective
partnerships with other community-based organizations to build network links to facilitate
telemedicine-generated services to the home, where the majority of health care decisions are made. |