Council Directives 92/29 and 93/103 establish the “use of long distance medical consultation” for the protection of the safety and health of maritime workers and distant or isolated populations of the EU. In response to these needs, MERMAID will set up an integrated 24-hour multilingual, telematic, around-theworld, medical emergency service that will transfer medical expertise via satellite and ground based ISDN networks when and where necessary. Since, (a) voice medical teleconsultation is obsolete, (b) videotele-phony has introduced “face-toface” medical teleconsultation and remote visual inspection and (c) telemedical interventions, (which are critically dependent on local paramedic skills), can now receive multimedia support on medical procedure, MERMAID will develop: (1) A locally $\underline(resident \ multimedia \ medical \ guide \ for \ ships)$ to serve both for training and as a reference during emergencies. (2) $\underline(A \ system \ of \ INMARSAT-A \ (ship \ to \ shore) \ links)$ (for transfering images, sounds, text / patient anamnesis and signals), $\underline(which \ is \ feeding \ into \ an \ ISDN \ network \ that links \ together \ the \ MERMAID \ health \ service \ providers)$. (3) $\underline(The \ telematic \ means \ for \ the \ medical \ teleconsultant \ to \ remotely \ interact \ with \ the \ local \ multimedia \ medical \ guide)$ and efficiently demonstrate health care procedures to local paramedics. Requests for help, broadcast over MERMAID INMARSAT-A links will be routed to one or more specialists depending on type of help needed, language(s) required for efficient communication, proximity to the site of emergency etc. Thus MERMAID, relying on telepresence and combining locally stored multimedia reference material with remote consultation, it proposes a viable solution to the problem of missing medical expertise for isolated populations. It is significant that the MERMAID pilot users represent 1% of the world merchant marine, a size that guarantees the validity of its outcome and is a good start for disseminating the MERMAID results.