National and international telecommunication infrastructures have been set up through Europe to facilitate the movement of information. One major benefactor of the improved communication infrastructures is the health care community. The accessibility and interoperability of medical information systems is one of the grand challenges for the 21st century. Within Europe current developments in the application of telemedicine are being defined in separate initiatives. There are a number of pilot actions concentrating on various aspects of telemedicine. These actions involving the introduction of new technology or working practices rarely fail for technology related problems. However, in order to fully assess the likely take-up of telemedical technologies it is vital that all the aspects including non-technical are also addressed. This paper describes how a complete pilot telemedical information society will be set up which facilitates to support secure and standardised remote diagnosis, teleconsultations and advanced medical facilities in a number of sectors covering a crucial spectrum of those required to support a complete telemedical information society. This pilot testbed will then be assessed in the context of a European environment identifying a business plan for its extension to other member states therefore promoting a truly international telemedical information society for the 21st century.