One commonly discussed benefit of broadband access in rural America is the potential for telemedicine visits that allow rural residents to take advantage of urbanized medical services. While the primary benefit of telemedicine is often viewed as improved health care access, the availability of these services also offers significant economic contributions to the local community. Site visits to 24 rural hospitals of varying size over a four-state area in the Midwest provide information to develop a methodology for estimating telemedicine's economic impact. Using this technique, telemedicine services contribute between $20,000 and $1.3M annually to these local economies, with an average of $522,000.

in 1997 the teleradiology facilities at princess margaret hospital swindon were upgraded to a modern dicom compliant system. we describe the practicalities rather than the technical issues of setting up and running a teleradiology system that can send images to the radiologists' homes on call obviating the need for them in many cases to attend the hospital. we list the initial doubts and concerns voiced by both radiologists and radiographers and describe the means of overcoming the problems that arose. from these reflections we have obtained a deeper insight into the use of teleradiology in a district general hospital (dgh) setting. our conclusions are described.