Good communication with your 'remote' sites is crucial to the development of a strong telemedicine program. Build on existing partnerships and affiliations when you plan a telemedicine network . It's difficult to maintain a telemedicine relationship when you don't have other mutual interests. For example, patient referrals, shared economic perspectives, and primary care training opportunities for academic medical centers might be some of the common goals that unite hospitals of disparate size and budgets. Use the least bandwidth possible in developing your network, without compromising the speed and resolution you need to provide optimal patient care.
Telecommunications is still the major expense for many telemedicine programs.
Build a network that is scaleable, flexible, adaptable. Networks should be able to adapt themselves to changes in applications and telecommunications technologies. Utilization will depend upon how well your target groups have been oriented and trained. Keep your end-users in mind with every decision you make. Work at the state and national level on policy issues relating to telemedicine.