1. A method for transmission of digital medical data between at least two geographically separate locations connected by data paths of limited bandwidth, the method comprising the steps of: separating said medical data arriving at one of said locations into at least bulk content and metadata; associating said bulk content with a content identifier; transmitting said bulk content to at least one other of said locations and storing it; extending said metadata to comprise said content identifier and a list of all of said locations where said bulk content has been and stored; and transmitting said extended metadata to at least one of said locations and storing it.