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During Space Shuttle missions, telemedicine is used daily to ensure the health and productivity of the crew. NASA has incorporated telemedicine into routine space operations since the beginning of the space program, utilizing its experience in advanced satellite communications to assist in providing terrestrial health care during several telemedicine projects. Telemedicine is a technology with promise for improving access to health care on Earth, and numerous terrestrial telemedicine programs are currently underway. NASA and the terrestrial health care community have important roles to play in telemedicine technology development, and each stand to benefit greatly from the other's telemedicine experiences.