also likely assume an increasing responsibility for many other functions such as prophylactic care, public health, patient education and patient support. Smaller numbers of physicians will be able to oversee the care of larger numbers of patients with the aid of real-time clinical data and two-way telecommunications systems. Such systems have been used successfully in the intensive care setting, enabling specialists to remotely monitor the status of patients at multiple intensive care units (Breslow et al. 2004). Some experts have speculated that physicians will assume more specialized roles as medical care becomes increasingly dependent on technology, and that patients will only see physicians for "high-tech" specialty care. Shifting Directions in Medical Care ICT, together with other advances in medical technology, will undoubtedly have a major impact on the nature of medical care provided for a wide range of medical conditions over the next two decades. Advances in genetics, proteomics, robotics, nanotechnology, biomaterials and biophotonics are expected to dramatically change the ways in which we diagnose and treat illness. The following is a brief summary of some of the major technological advances we can expect within the next 20 years: Improved medical and surgical robotic systems that will allow for the performance of more precise and technically challenging procedures, less invasive surgical procedures (smaller and fewer incisions), pre-programmed tasks and real-time intraoperative imaging Advanced imaging techniques that will identify pre-cancerous cells, and imaging systems that will be used to target treatments specifically to diseased tissues (e.g., cryotherapy for cancer treatment) Implantable