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Dentistry has faced the same access issues that have spurred telemedicine development in other fields. However, until recently dentistry has lagged behind in adopting telemedicine. The findings of the Association of Telemedicine Service Provider's (ATSP; www.atsp.org) 1998 Report on US Telemedicine Activity, done collaboratively with Telemedicine Today Magazine, are instructive. Of over 40,000 teleconsults among 139 U.S. programs performed in 1997, only 200 were dental teleconsults--all done by one program. Although that figure represents a significant increase over the 4 dental teleconsults reported in 1996, teledentistry has a long way to go. The first steps are now being taken. At the schools of dentistry at the University of California at Los Angeles and the University of Bristol in Bristol, England, two different approaches to teledentistry are being actively explored. Telemedicine Today spoke with lead researchers at each school to discuss these programs.

Tele-home health care is expanding, and it is easy to say why. There are about 1.5 million home health visits each day in the U.S. For the substantial fraction of these that are staffed by a Registered Nurse, the average cost/visit is nearly $90. Several small studies have shown that the cost per visit for a tele-home visit is about $20-$30--that is, one third, or less, the price of an onsite visit. This is due, of course, to the substantial overhead in an on-site visit: the automobile and the time spent driving and parking. The same nurse that can visit only 5 or 6 patients in their homes each day can see 15-25 patients daily using telenursing technology. Increasingly, this efficiency is starting to compel the attention of strategic planners in healthcare. Tele-home nursing uses a variety of video and telemonitoring technologies. These can be configured to connect the patient to a nursing call center or to a specific practitioner. In the past we've reviewed tele-home nursing and call-center services extensively, most recently in our December 1997 issue. With this story we take a close look at individual companies and the way they are integrating new technologies into service-delivery programs.