While debates continue over the effectiveness of innovative communication technologies to bring information and services to populations that have been underserved by such new technologies, a federally-funded program at the University of Vermont and Fletcher Allen Health Care (FAHC), Burlington, Vermont, has enabled trauma specialists to link with rural emergency room health care providers through a synchronous videoconferencing (telemedicine) network. Analysis of patient histories and surveys completed by the participating physicians after each use of the computer conferencing system as well as interviews and observations indicate that the FAHC consulting trauma specialists and the remotely located physicians felt the linkups do not interfere with standard ER procedures, that communication was at least adequate for all consultations, and that the consults improved the quality of care, for over half of the cases. Furthermore, interviews with rural ER physicians indicated that they saw the program operating as the first stage of FAHC's management of a patient to be transferred to that facility.