This application was written for eight rural hospitals (Davenport, Ephrata Grand Coulee, Moses Lake, Odessa, Othello, Quincy and Ritzville) and two tertiary hospitals (Empire Health Systems and Sacred Heart Medical Center) in Eastern Washington. The application proposed a Telemedicine system to more effectively and efficiently coordinate patient care and provide interactive physician consultation and patient education. This application was built on the foundation for a "seamless" health care delivery system that provides quality patient care. This plan optimized provider communication to ensure continuity of care along the health care continuum from primary care to speciality care and back home for follow up. This plan provided monitoring of patient progress in the care plans mutually developed with the rural primary care practitioner, the patient and the urban consultant physicians. The plan also identified shared centers of Teleradiology and a rural wide area network to share a physician based diagnostic expert system.