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Telemedicine had its beginnings in the United States in the 1960s as a means of providing specialty consultation using closed circuit interactive television.1) With the explosion of interest in telemedicine over the past five or six years there has been an increase in the use of telecommunications technology. At present telemedicine is used by a growing number of health providers and home health care services.2) But it's use in long-term care has not been explored. Correspondence: Jung-Yong Park, Department of Family Medicine, 01105-C PFP 200 Hawkins Drive University of Iowa Iowa City, Tel: 319-353-5552, E-mail: jung- yong-park@uiowa.edu By the early 1990s, dramatic improvements in information and communications technology heralded the dawn of a new era for telemedicine. It is 10 years since the resurgence of interest in telemedicine. The technology has undergone considerable development: the cost of equipment and communications has declined substantially; a wide range of applications has been deployed; telemedicine has been used in a variety of unique and extreme environments; the quality of the published literature on telemedicine has improved; and administrators have more realistic ideas about how to plan and use the technology. Even with these improvements, there has been slow progress in the areas of payment coverage and for services.3)