Telemedicine is not new. It began in the 1920s. The current period of rapid growth began almost a decade ago. Although comprehensive telemedicine research and evaluation still is lacking, examining the history of telemedicine reveals a number of lessons. Applications seem to have fluctuated between complex technologies and applications and extremely simple ones. Fully integrated telemedicine will require high bandwidth and robust technologies. Store-and-forward applications transmitted through the Internet appear elegantly basic. The same societal challenges to implementation remain, regardless of technology.