ABSTRACT
The first recorded use of telemedicine dates back to a 1957 Nebraska project that allowed doctors and patients to interact over a closed circuit television link. In another early and notable telemedicine project, STARPHAC, health care was delivered to residents in the Papago Indian Reservation in the US. The STARPHAC project was eventually discontinued on the grounds of organisational problems,11 although other difficulties experienced include the reluctance of the Medicare health insurers to reimburse physicians for technologically mediated consultations,12 an issue resolved in 1997. In the 1970s and 1980s,13 other limited telemedicine projects were developed in the US and Canada. With the exception of the 20 year old telemedical project at the Memorial University of Newfoundland, St John’s, which was based on the telephone network as the core technology supporting audio conferencing and the transmission of electro-encephalograms, none of the programmes commenced before 1986 appears to have survived.
