The practice of space medicine is fraught by several unique challenges, including limitations in spacecraft resources and limited medical training opportunities. The great distance separating the astronauts from their doctors on Earth further confounds managing their health. NASA uses computer and telecommunication technology to bridge this distance and practice telemedicine. Since the beginning of the U.S. space program, NASA flight surgeons have relied on two-way radio communication and limited biomedical telemetry to remotely assist the crew in managing crew health matters. More recently, the capability for bi-directional video transmission was added, to enable the crew to speak virtually face-to-face with their doctors. However, for the International Space Station (ISS), additional capabilities must be provided. This paper presents a vision for delivering telemedicine in the ISS era.