Opportunities for the use of broad-band packet-switched data networks for direct patient care

A few of the changes occurring in the relationship between primary care physicians and their consultants, as well as changes which are occurring as major medical centers respond to competitive pressures, are outlined. The primary care environment and the medical center environment are described. Previous attempts to use electronic means to transmit and store information in the health care delivery environment, which have largely been focused on single specialities, are discussed. It is argued that none of these systems has been comprehensive enough to have a major impact on primary care and that the geographic dispersion of health care will require new communication systems and new information storage systems. Development of integrated computer and communication systems based on high-speed digital and broadband fiber optics technology should improve the quality of medical care and should enhance the efficiency of the health care delivery process. Metropolitan area network, SONET, and BISDN systems are discussed as possible new approaches