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The geography of Russia and the complex structure of the Russian health-care system make telemedicine systems especially appropriate. The telemedicine project described here deploys a telemedicine system in Nizhny Novgorod with further integration into the Privolzhsky District telemedicine network. It started with the creation of a telemedicine center with high-speed dedicated communication links to various medical institutions in Moscow, interregional telemedicine centers, and several district hospitals in rural areas of the Privolzhsky district. In addition to this specialized network, training by telemedicine specialists from the Space Biomedical Center at Moscow State University was provided along with teleconsultations with specialists from the most advanced medical institutions in Moscow. Consultations were carried out via the interregional telemedicine center on a contractual basis. The regional telemedicine network linked nearly 78 medical sites. This system provided approximately 500 teleconsultations and 100 educational sessions within the past 3 years.