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16. Blue Cross-Blue Shield plans in Iowa, Kansas, and Montana have already developed payment policies for some forms of telemedicine, and North Dakota has announced payment plans that include telemedicine, but even these policies may need to be revised as new applications emerge (Goldberg, 1999).

17. For further elaboration on these points, see Tracy et al. (1999).

18. This summary of coverage rules is derived from Goldberg (1999) and from HCFA (1999).

19. For a discussion of the history and challenges of evaluating telemedicine applications, see Institute of Medicine (1996) and Strode et al. (1999).

20. Additional information on the NLM's telemedicine programs, including descriptions of funded projects, is available online at <>.

21. The Department of Defense has investigated technologies for remote treatment of soldiers and developed telemedicine systems for military personnel and their families, and the Veterans Administration has developed technologies for sharing medical records among its health care facilities. In addition, NASA has invested in technologies for remote consultation and treatment of astronauts.

22. Margarate Hamburg, DHHS, presentation to the committee on March 1, 1999, Washington, D.C.

23. Further information on the pilot can be obtained from either <> or <>.

24. William Yasnoff, associate director for science and acting director, Information Network for Public Health Officials in the CDC Public Health Practice Program Office, in his presentation to the committee on March 1, 1999, estimated that $200 million would be needed, in addition to the $28 million already appropriated, to get the Health Alert Network up and running.

25. Of the $120 million in computer science research funding from DHHS, $110 million came from the NIH and $10 million came from the AHRQ.

26. In 1999, research funding for the Departments of Defense, Energy, and Commerce and for the NSF totaled $4.1 billion, $4.1 billion, $808 million, and $2.7 billion, respectively. These figures include funding for basic and applied research but not development (NSF, 2000, Table C-22).

27. Thomas Kalil, National Economic Council, presentation to the committee on March 1, 1999, Washington, D.C.

28. Two forthcoming reports from the CSTB will address issues of structuring federal and nonfederal support for mission-driven information technology research: Meeting Society's Needs: Expanding the Scale and Scope of Information Technology Research and the final report of the CSTB Committee on Computing and Communications Research to Enable Better Use of Information Technology in Government. For additional information on these projects, see <>.

29. Gauging the supply of and demand for information technology workers is a difficult task, and several analysts have noted faults in data given out by industry groups and the Department of Commerce. The CSTB has initiated a study of information technology workers that is expected to shed more light on this subject.

30. Information on the CSTB project workforce needs in information technology is available online at <>.

31. Insight into the scope of an expanded definition of computer literacy can be gleaned from a report by the CSTB (1999b).break

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