The modern trend in Medicare is for the out placement of expertise and facilities to the local practitioner away from the large centralised hospital. But the MD seldom has the range of experience and ability to cope with all situations and in the extreme, remote locations can be devoid of adequate emergency or even basic medical facilities. It is to telepresence technology that people are now looking to find a solution to this growing problem. If only we could teleport the expert, the specialist, the human being with that vital experience and information to the point of application, then a growing area of difficulty could be overcome. The combination of telecommunications, computers, miniature cameras and display units, offers a practical solution. The first viable product and service available has recently been launched by BT and ABB Nera, under the name CAMNET. By using a sub miniature television camera mounted on a pilot's headset together with a miniature display unit to be viewed by one eye, it is possible for a remote observer to see precisely what the wearer sees and to transmit visual images, text and schematic information back to the wearer to guide their activities. In this way it is possible for a doctor or paramedic to literally have an expert sat on their shoulder, guiding them through the diagnostic and other medical procedures.

The first purchasers of this system were the Aberdeen Survival Centre who are responsible for the provision of medical and survival support for the oil industry in the North Sea. In simulated accidents and difficulties it has been proven to be possible for a remote medical practitioner to accurately diagnose ailments from the correct action when supported by a paramedic wearing CamNet. The system can be operated over a mobile satellite link that is conveniently packed into two suitcases for transportation. The system can also be used over the ISDN, which is the digital interface to the switched telephone network operating over copper pairs, optical fibre, radio and satellite circuits. By these means CamNet can be operated anywhere in the world to provide services in the remotest regions and locations.

Extensions of this technology are now being investigated and include the use of two cameras on a binocular mount above the eyes of the wearer, along with miniature microphones over each ear. At a remote location a virtual reality headset is worn with screens in front of both eyes and headphones for each ear So it is now possible for you to "see what I see" and "hear what I hear" at any distance. A surgeon operating in London can thus have, stood inside him looking out, hundreds of students world-wide, all experiencing the operation, the ambience of the operating theatre, the correct depth of field and perception enjoyed by the surgeon and his team in the actual operating theatre. Contrast this future situation with that of today where it is only possible for one or two people to stand and peer into an incision of alternatively a handful to view from a gallery, or on a remote television screen with a camera that gives no perception of death.

The next obvious, but most difficult, extension of this technology will see the introduction of a glove that will create a sense of feel at a distance. Today, such a technology exists but is extremely crude. But the basic elements exist for us to feel pressure, temperature along with some prosthetic manipulation realistically mimicking some distant hand. A critical feature of all of these elements in this telepresence technology is delay. The human sensory system is evolved to realise a reasonable delay period between action and reaction, eye and hand. If this delay is exaggerated then we experience great difficulty in functioning correctly and being able to manipulate with any degree of accuracy. For International applications, it is optical fibre that enables such technologies to be realised by virtue of their speed of operation. On a satellite circuit across the Atlantic, we experience a delay of one third of a second. This introduces a considerable difficulty for human speech, let alone touch and manipulation. On an optical fibre cable, a photon can span the Atlantic in less than a tenth of this time. This is comparable to the time it takes the signal created by a pin prick at the end of our finger to travel to the brain and give us the feeling of pain. So in the literal sense, our eye, our ears and our hands can be extended half-way around the world with little more than a doubling of the natural delay built into the nervous system of the human body.

Our senses of sight and sound can be effectively teleported half-way around the planet today. Within the next fifteen years we can expect that facility to be extended to our sense of touch. We will literally be able to be teleported into real environments, or even computer generated environments, at that distance. The implications for the medical and other professions are quite immense. It will mean expertise and consultation on demand anytime, anywhere. The best of the best can be on tap and be teleported to any location on demand.

The arrival of this technology will satisfy and answer an unnoticed but growing need for an increasing number of specialists coping with a smaller, but deeper range of activities. This is inevitable as our breadth of knowledge increases and our need for true understanding grows. Training and education might also be expected to rely on such technology to realise our means of imparting knowledge and experience at a far at an increasing rate and depth than has been necessary so far.