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Health care delivery was measurably improved by teleconsultation; however, the use of television did not significantly improve upon the e8ectiveness of the two-way audio consultations between doctors and aides.Two major field experiments in the use of communications technology to improve the delivery of rural health care services have recently been carried out in Alaska. Both used high-powered satellites that can communicate with small inexpensive ground stations, and both provided teleconsultation services in which the expertise of a physician was used by a remotely located, less highly trained health care professional. In one experiment, a two-way voice-only link was used; in the other, the communication was accomplished over a one-way black-and-white television channel with two-way voice. This article describes the projects and their evaluations and draws some conclusions about the importance of satellites for health care delivery. The rural Alaskan environment presents special problems for delivery of health care services.A total population of only 350,000 occupies an area of 500,000 square miles. About 55,000 are Indians, Aleuts, or Eskimos, a large proportion of whom live in Dennis R. Foote is a communications specialist at the Academy for Educational Development in Washington, D.C., where he advises the Agency for International Development on applications of satellites and other communication technology to the problems of developing nations. He participated in the evaluations of both the ATS-1 and the ATS-6 Alaska health care experiments while he was at Stanford University's Institute for Communication Research.The research reported here was carried out under contracts with the Lister Hill

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Its technical success illustrates that large-scale rural applications of satellite broadcasting are possible; the evaluation of its efectiveness raises important considerations for future programming.Ever since two-way and broadcast communication by satellite to inexpensive terminals became technically and economically feasible, people have been speculating and experimenting with possible applications that take advantage of the particular capabilities of this technology. Initial speculation focused on programs for primary school education, sometimes involving several nations. Subsequent experimental projects concentrated on support of professional activities and continuing education. SITE is the first application to include education of a mass rural population as a major component. Furthermore, it is the first use of satellites for social development on such a large scale.In this article we consider aspects of the project which may have not been measurable or even visible, but which are important in understanding both the internal dynamics of the project and its implications. We first examine SITE'S Clifford Block is Associate