Taiwan is a heavily populated country, with a small land area and many mountains and
isolated islands. Because medical resources are unequally distributed, high quality
accessible medical care is a major problem in rural areas. Medical personnel are unwilling
to practice in rural areas because of fear of isolation from peers and lack of continuing
medical education (CME) in those areas. Telemedicine provides a timeless and spaceless
measure for teleconsultation and education. The development of telemedicine in Taiwan
began under the National Information Infrastructure (NII) Project. Distance education
and teleconsultation were the first experimental projects during the initiation research
stage. The cost and effectiveness of the hardware and network bandwidth were evaluated.
In the promotion research stage, applications in different medical disciplines were
tested to promote multipoint videoconference, electronic journals and VOD. Investigation
of user satisfaction put on more emphasis on improving application functions. In 1998,
a new Cyber Medical Center (CMC) international collaboration project was begun, integrating
technologies of multimedia, networking, database management, and the World Wide Web.
The aim of the CMC is to create a multimedia network system for the management of
electronic patient records, teleconsultation, online continuing medical education,
and information services on the web. A Taiwan mirror site of Virtual Hospital and
two international telemedicine trials through Next Generation Internet (NGI) were
done at the end of 1998. In the future, telemedicine systems in Taiwan are expected
to combine the Internet and broadband CATV, ADSL, and DBS networking to connect clinics,
hospitals, insurance organizations, and public health administrations; and, finally,
to extend to every household.