When a topic so synonymous with advanced technology as telemedicine needs a written history, perhaps a discipline has come of age. Telemedicine has had an oral history among visionaries and technophiles over the last thirty years or so. Tales of grand projects, technical failures and fabulous successes abound at telemedicine meetings. One is reminded of the film footage of early efforts at flight where extravagant engineering approaches failed time and time again until the elegant solution of the Wright brothers took to the air on the beach at Kitty Hawk in December 1903. It is hard to imagine the frustration and excitement of initial efforts at telemedicine or manned flight when current expectations are for information on demand and on time departures. However, from very early efforts in telemedicine the vision was consistent: overcome the huge liability of distance in patient care by creating an electronic continuum between the site of need and the site of expertise. The vision continues to strive toward technical transparency and clinical results, which assure a patient that no matter who, no matter where, no matter when medicine will care for you with consistent professionalism. Technology took us from the patient home to the technology-rich hospital. Perhaps technology will transfer the majority of patient management back to the comforts of home, convenience of workplace or the exigencies of travel and mobility.