The EuroMedNet results achieved by TelBios as telemedicine service provider, represent the point of the iceberg and the first plateau of a long journey. The point of the iceberg because they are the positive end points of a lot of effort, of economical resources invested by TelBios and as income from client.

• TelBios has started to provide the Italian Minister of Defence for his telemedicine activities of access to the WUP and installed a teleradiolgy system based on iPACs to the Italian Field Hospital in Pec, Kossovo. This will allow the physicians at the Policlinic Celio to perform second opinion activities on diagnostic studies DICOM 3.0 compliant. (March 2003).

• TelBios S.p.a. has been certified that the quality system operated in his two operative units of Milano and Roma, is in compliance with the standard UNI EN ISO 9001: 2000 concerning the following activities: design and provision of telemedicine and e-learning services. (April 2003).

• The activity of telemedicine among the San Raffaele Hospital and the site in Tirana, to support the surgical follow-up and second opinion, is still continuing this year. Bi-weekly teleconsultation involving also physicians from other hospitals in Lombardia, will continue up to the end of 2003. These activities are sponsored by the Lombardia Region and a NGO, AISPO. The clinical specialty involved is mainly orthopaedics in paediatrics. (April 2003).

• Design and development and realization of a teleradiology network for emergency on trauma, using iPACs in 4 clinical sites in Siciliy, named ReSPeCT. The are 4 spokes clinical sites: Sant'Agata Militello, Taormina, Barcellona, Lipari. The Policlinic of the University of Messina is the hub. The network is operating since May 2003. Telemedicine and e-learning project in Palestine: TelBios in cooperation with an NGO, AISPO in Milano, has won a contract for the design, development and the provisioning of telemedicine and e-learning services to 6 clinical sites in Palestine, and one in Siria. (June 2003).

• TelBios S.p.a. has won an open industrial bid issued by the Istituto Superiore Sanità www.iss.it for the design, development and the provisioning of a service based on the WUP and multipoint videoconference service for 6 sites simultaneous for the Italian Transplant network. The network will link more than 20 clinical sites across Italy. (July 2003).

• The CARDNET network update: to the new organization of CARDNET managed by TelBios under in collaboration with the Lombardia Region, 14 hospitals has already signed the formal agreement to participate. The agreement involves three parties: the hospitals, the Lombardia Region and TelBios. Of these 14 sites, 10 are new sites. The agreement is a formal and administrative framework, where the hospital commits himself deciding to invest for the procurement of a telemedicine facility and systems designed by TelBios (ISDN telemedicine terminals). The 10 new sites are due also the commercial network that TelBios has set up mainly through local agency representatives. In this initiative TelBios is sponsored by the pharmaceutical company Amersham. (July 2003). (www.hoise.com/vmw/03/articles/vmw/LV-VM-07-03-16.html; and www.sanita.regione.lombardia.it).

• TelBios has been awarded by Fondazione Istituto G. Gaslini of Genova of a contract for the provisioning of a DESNET satellite terminal to increase the operational capability of a medical and logistic mobile unit to be deploy in IRAQ. TelBios is in charge of the telemedicine services and systems. The experience done in EuroMedNet and Telemedicare have been essential for the success of the project. (July 2003).

• TelBios is starting a joint project with a CRO company (Clinical Research Organization - www.opis.it) in order to set up practical guidelines in telemedicine for the application of the 'best practice' in telemedicine. The expected outcomes go well behind the scope of EuroMedNet and will strongly commit TelBios and his partner up to spring 2004. Telemedicine malpractice starts appear in the literature. TelBios has started an internal project on 'Security'. The aim is to submit for the ISO UNI 17799 by the end of 2004. The scope of the project is to assess what are the vulnerabilities within the actual infrastructure and the risks associated with the critical processes of teleconsultation. This will end in September 2003. For TelBios the issue of 'Security' together with topics like liability, ethic and law, is an important asset as the infrastructure, the organization and the clinical competences.