Next Generation Internet
The Internet has dramatically changed the way America communicates and does business. Between 1991 to 1999, the number of domain names with an IP address rose from almost zero in 1991 to by 45,000,000 by 1999.1 From the consumer's standpoint, the Internet offers the ability to interact with health practitioners online and easily access health-related information. It's no wonder, then, that more people use the Internet to gather information about health-related topics than any other subject.

However, there are numerous barriers that might inhibit telehealth growth on the Internet, including growing delays, costs, and lack of security, reliability and availability on a worldwide basis. The development of Internet2 might help address some of these barriers. Internet2 is a joint venture by academia, the federal government and industry. This group is using a new high-speed backbone network with a core subnetwork consisting of a 2.4-Gbps, 13,000-mile research network to test Internet applications (for example, Internet Protocol (IP) multicasting, differentiated service levels, and advanced security). It will also allow researchers to test and resolve problems such as bandwidth constraints, quality and security issues.

In the telehealth industry, wireless technology is most commonly used for telemetry and emergency medical services. However, in countries that have adapted to digital wireless phone systems faster than the United States, the future of wireless technology is already available. For example, in Japan, Nippon Telephone & Telegraph will provide Internet e-mail access via its wireless phone services to 1 million customers. This year, Japanese companies will also introduce a mobile videophone to its local markets that can transmit live video at 32 kbps. In the Netherlands, Nokia has already introduced the Nokia 9110 Communicator, which can link to a digital camera; store images, and then e-mail them. Nokia's Communicator will be available in the United States within in the next year, but mobile videophones may not be for several years.

Companies in the United States have already have introduced wireless handheld computers, such as the Palm Series and its competitors. More recently, mobile phone providers, such as Sprint PCS , have introduced products with the ability to access limited Web pages for text information but direct access to the Web and its graphics is not yet possible without appropriate technical standards. However, a standard called the Wireless Application Protocol (WAP) is already under development. WAP is a way of converting information on Internet Web sites into a form that can be displayed on a mobile hand-held phone device.

The advent of so-called microbrowsers may still be a few years away, because mobile systems currently do not have the capacity to support high-speed connections with the Internet. Once faster speeds are available, WAP proponents believe that consumers will be able to get message notification and call management, electronic mail, mapping and location services, weather and traffic alerts, sports and financial services, address book and directory services, and corporate intranet applications on their hand-held devices.