In the EC project TELEMED (R1086) the feasibility of digital image communication for remote expert consultation in radiology is investigated. Three modes are considered: batch mode (normal case), interactive mode (emergency case), and mixed mode (teaching situation). To allow short transmission and response times for the voluminous data files, 2 Mbit/s networks and 384 kbit/s ISDN are employed to interconnect eight European university hospitals. A set of requirements was derived, and software has been developed for image and text communication, for image display and manipulation, and for synchronization of remote workstations. From the experiences gained during experimentation regarding the appropriate design of networks, transmission rates and data throughput, user acceptance, integration and standardization, recommendations for future routine application could be concluded.