The notion of using telecommunications in the healthcare industry goes back to the early 1900's. There had been experiments using radio telecardiology (from the 1910s), telephone-mediated telestethoscopy (from the 1920s), and radiology image transfer and videophone experiments (from the early 1950s).

The first generation of telemedicine using video conferencing began in the late 1950s with Dr. Cecil Wittson's microwave-mediated rural telepsychiatry program in Omaha, Nebraska, and with Dr. Albert Jutras' cable-mediated teleradiology program in Montreal. Telemedicine's second generation was based on the use of digital compression and transmission technologies in the late 1980s, allowing point-to-point interactive videoconferencing to and from anywhere that had access to T1, fractional T1, or ISDN lines.

Since the mid-1990s, telemedicine programs have become common throughout the world in nearly every specialty and area of healthcare -- radiology, pathology, continuing education, homecare, emergency care, mental health, rehabilitation, cardiac monitoring, and every medical and surgical specialty. Technologies have ranged from high-band with interactive video to low-bandwidth wireless.

In recent years, growth in the use of telemedicine has been facilitated by several important factors:

• Lower cost and more widely available communications
• Lower cost, higher performance computers
• Greater public confidence in the use of computer technology,
• Greater acceptance of the technology by medical professionals, and
• Emerging global standards in communications, video conferencing, and medical disciplines