Introduction

In attempting to understand what is perceived to be the relatively slow take-up of broadband, governments in OECD countries are increasingly turning to the demand side of the equation for answers. However, a recent OECD report suggested that some believe that there is currently no 'killer application' that can be expected to result in a surge in demand for broadband.

The consultations undertaken for this paper would suggest otherwise. At least in the health sector, it appears that compelling content and applications already exist and that there is considerable latent demand for broadband services.

Transformational benefits are possible in the health sector through a networked system with a capability to deliver a range of applications. That is, embracing the full range of clinical, educational, professional development and administrative applications.

Modern health services are increasingly enabled by technology - it is not a new concept. Health professionals have been using a range of computer and telecommunications applications to deliver improved health outcomes and reduce costs for over twenty years. However, much of the delivery of online health services in Australia to date has been achieved using narrowband platforms. This is severely limiting and delivers sub-optimal results compared to what is possible using broader bandwidth platforms. Health professionals in Australia have been forced to adopt a 'make-do' attitude in terms of bandwidth availability at an affordable price. Our consultations suggest that this is the key reason for the latent demand, although the paper canvasses a range of other impediments.

The national action plan for the health sector, Health Online, was released in November 1999 to provide a basis for a national strategic approach to health information, involving new ways of delivering health services. Health Online includes the aim that in Australia's future health care system:

Customers and providers, whether in cities or in regional Australia, have online access to medical records, clinical advice, specialist referrals, diagnostic test results, and other telehealth services.

Health Online has already had a significant impact in promoting a nationally uniform approach to using information and communications technologies in the health sector. However, future progress could be limited and the objective stated above cannot be achieved without widespread access to high bandwidth connections.

The paper gives an overview of a number of the initiatives in health, ranging from the brave new world of the haptic work bench to the more commonplace telepsychiatry or the emerging challenge of electronic patient records. Some of these applications are extremely bandwidth-hungry and ultimately will require broadband. Health applications have two critical requirements that are distinct from other sectors: the technology must be reliable and synchronous to deliver optimum benefits. The availability of broadband at an affordable price would encourage more widespread use, deliver greater productivity gains and better health outcomes.