k between Atlanta and St. Petersburg in Russia has allowed American doctors to advise Russian surgeons. Equipment was provided by UNM (United Medicine Network), a direct dial videoconference network created for global telemedicine. In INFRASTRUCTURE TO 2030: TELECOM, LAND TRANSPORT, WATER AND ELECTRICITY - ISBN 92-64-02398-4 © OECD 2006 2. TELECOMS INFRASTRUCTURE TO 2030 France, a panel of six specialists reviews patients suffering specific skin diseases all over France in one afternoon, so patients get six opinions, not one, using video links and a consensus on treatment can be reached. Promptness of essential care from a specialist whenever necessary for emergency cases, with the facility for local doctors to obtain an expert opinion not physically present. For instance, when a three-year-old child fell off the refrigerator and opened up a deep wound with no bleeding, a remote nephrology consultant was requested. The specialist carried out an interactive video examination at the local clinic and found transport was safe for the specialist surgery required (source: American Telemedicine Association). Avoidance of travel for treatment for patients, saving lives, cutting costs and preserving beds in remote hospitals. Also, increased efficiency is possible for medical staff by avoidance of travel; they may work from wherever is convenient and serve more patients in a given time. For situations of health security, telemedicine provides the isolation necessary, for quarantine cases and for remote mental institutions. Remote hospital care in-home, for the sick, aged and infirm, with surveillance and advice on self-medication, etc., where possible, or advice to local helpers present, with monitoring by alarms and video perhaps combined with the concepts of the "smart house". This development will be essential to cope with an ageing population as expenditure on health care increases with age. Table 2.17. Portion of health expenditures for over-65s is increasing In per cent Sweden Belgium Japan 1. "Health for all in the 