Consider the following scenarios: A 64-year-old woman with congestive heart failure has recently moved to a new city. She checks in with her doctor - who is hundreds of miles away - for their biweekly consultation, but she never has to leave her home. Through an interactive videoconference over the Internet, the doctor helps the woman install an electronic diary through which she will track her daily salt intake. The diary, in turn, will automatically update her electronic medical records.

A two-year-old child wakes his parents in the middle of the night with a raspy cough. The parents, recent immigrants who speak little English, belong to a health plan that supplied them with Internet access over their television set and a home health kit containing a digital thermometer, a heart-rate monitor, a stethoscope, and a video camera. The parents call their pediatrician, who checks the child through videoconference. The doctor's instructions are supplied with instantaneous closed captioning in the parents' native language. Meanwhile, the pediatrician recalls that a rash of respiratory problems have been reported in the area and logs onto the latest information from the local public health department.

Sounds like science fiction, right? It shouldn't. Most of the technologies exist to make both of these cases possible. But because of some remaining barriers, the health care industry hasn't been able to tap into the Internet's full potential. The World Wide Web has the ability to revolutionize the health care sector by connecting people, information, and services from anywhere across the country and even the world. It's time for the health and information technology industries to work more closely together to ensure that the Internet evolves in ways that support health care services.

In some respects, consumers already are ahead of the health care industry in recognizing the Internet's potential. People are turning to health-related services on the Internet in record numbers. In 1999 an estimated 30 million Americans searched the Internet for health-related information. Some 32 percent of online users shopped for health products on the Web, spending hundreds of millions of dollars on prescription drugs and other health products. And yet the Internet has not penetrated many of the areas of health care that show promise for significant transformation. For example, remote medical consultations are available only from specialized facilities that use dedicated network connections, which makes such consultations less accessible and more expensive. Only a handful of hospitals currently utilize the Internet to locate health information that might indicate problems, such as searching the medical records of emergency-room patients for potentially hazardous drug interactions. And public-health officials still typically receive information from testing labs via regular mail or fax, increasing the risk of delayed or lost test results.

To be sure, there are technological barriers to overcome if the Internet is to become an integral part of health care services. For example, better security is needed to protect sensitive medical information that is exchanged electronically and to guard against "denial of service" attacks such as those that recently paralyzed some popular Web sites. Moreover, quick, immediate access via cable modems, digital subscriber lines, and wireless communications are not available in many of the places that need them most, such as rural areas or inner-city neighborhoods, and on-demand bandwidth is not available on the Internet at all.

But often what prevents the Internet from being used widely is more than just technical barriers. Despite the growing field of "e-health," health care organizations have been slow to adopt the Internet. In an era of declining profitability, many health systems are unable to devote resources to untested, unproven Internet health-related projects. And most health plans do not cover virtual office visits or other Internet-based services.

The federal government should take the lead in fostering needed partnerships between health and technology organizations. One way is to fund pilot projects that link multiple organizations to the Internet to exchange health information. Project evaluations would provide the health and information technology industries with more accurate information for developing strategic plans that incorporate Internet-based programs. But pilot projects cannot substitute for continued efforts to resolve policy debates that impair the ability of organizations to adopt Internet applications. For example, regulations governing the protection of electronic records have yet to be finalized. These types of issues must be addressed for the Internet to reach its full potential.

We have the tools literally at our fingertips to revolutionize the way health care services are delivered. Let's take the steps that are needed to make the Internet an integral part of our health care system.