The authors would like to acknowledge the cooperation and insights gained from warfighters, especially from LCDR Dennis McCartin of Third Fleet, and LCDR Marquez Campbell of SPAWAR Systems Command, who made sure this study focused upon the important issues from the perspective of field personnel. Our thanks to Dr. Carla Salinas, of Kaiser Hospital, who provided a perspective toward how civilian health care professionals use telemedicine in their daily experience, and Mr. Edwin Dela Santos, a medical technician at San Diego Children's Hospital, who provided information about how intrahospital communications work. Thank you also to Greg Adams (SSC San Diego D8501) and Bill Pugh (Naval Health Research Center) for providing references to previous naval telemedicine work and to Mark Lasher (SSC San Diego D853) for helpful suggestions and comments at our team meetings.Finally, thank you to the many personnel from codes within the D80 Communications Department at SSC San Diego who contributed visibility into all the intricate pieces of the DoD land-based and afloat communications infrastructure, and ensured a clear identification of the edge where capability ends and development must start.Windows NT® is a registered trademark of the Microsoft Corporation Virtual Naval Hospital ™ is a trademark of the University of Iowa. SB EXECUTIVE SUMMARY OBJECTIVEThis study defines the specific communications capabilities of U.S. Navy ships and identifies operational problems and technical barriers prohibiting telemedicine on a wide scale. This information is needed so the transmission of medical data can be managed in conformance with shipboard capabilities and contingencies can be developed for the potential degradation of those capabilities. While communications requirements for telemedicine in the civilian sector continue to be defined and implemented on a limited basis, the Department of Defense (DoD) must also supply similar needs in hostile environments. SCOPEThis report evaluates the effect current technology has upon the telemedicine aboard U.S. Navy ships while underway. The focus of this report covers current capabilities aboard U.S. Navy vessels for communication operations and for interfacing to existing infrastructure and future technologies. Identifying these capabilities will benefit the acquisition community and those who conduct requirement synthesis where technology proliferates and develops rapidly. This report identifies the communication assets of the fleet infrastructure ashore and at sea, and provides details of functional and technical requirements and possible near-and long-term solutions, enhancements, and recommendations. • Medical Administration. Patient demographic data and basic health information must be stored and tracked and available for recall as patients move geographically.• Radiation Health. All periods of radiation monitoring for exposure must be documented and tracked.• Occupational and/or Environmental Health. All occupational health elements are to be documented as required by DoD and Depa...