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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Support for this project was provided by the National Library of Medicine and the Health Care Financing Administration, U.S. Department of Health and Human Services, under Contract No. N01-OD-4-2139. Additional support for dissemination of the report was provided by GTE. The views presented are those of the Institute of Medicine Committee on Evaluating Clinical Applications of Telemedicine and are not necessarily those of the funding organizations.

Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee on Evaluating ClinicalApplications of Telemedicine.

Telemedicine: a guide to assessing telecommunications in health care / Committee on Evaluating Clinical Applications of Telemedicine, Division of Health Care Services, Institute of Medicine; Marilyn J. Field, editor.

p. cm.

Includes bibliographical references and index.

ISBN 09-309-05531-8

1. Telecommunications in medicine—Evaluation. 2. Telecommunications in medicine—United States—Evaluation. I. Field, Marilyn J. (Marilyn Jane) II. Title.

[DNLM: 1. Telemedicine—standards—United States. 2. Program Evaluation—methods. W 84 AA1 I4828t 1996]

R119.9.I56 1996 First Printing, October 1996

362.1'028—dc20 Second Printing, November 1997

DNLM/DLC

for Library of Congress 96-30101

CIP

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Copyright 1996 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America



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