Use of the Internet for multimedia conferencing began in the early 1990s. Multimedia conferencing allows people at multiple, distributed locations to communicate using audio, video and shared workspace programs; the Multicast Backbone of the Internet (MBONE) provides the technical solution to make the most efficient use of the limited Internet bandwidth for such interactions. The scope for using this technology in medical applications was recognised by the MICE project which, in November 1994, used Sun SPARC workstations connected to the MBONE to send video and commentary of live operations from Sweden and San Francisco to a workshop held in London. These sessions were marred by severe congestion experienced on the networks on the day, but the consensus of those organising and attending the workshop was that the exercise was worthwhile. The main lessons learnt from this first transmission were the need to provide better quality links and to ensure confidentiality. In December 1995, the MERCI project, funded by the European Union under the TELEMATICS for Research programme, began work to refine and further propagate the use of the multimedia conferencing software. Part of this work is to provide these improved facilities to transmit operations to two more workshops scheduled for 1997. MERCI will offer confidentiality through encryption facilities built into the conferencing programs, improved programs which cope better with adverse network conditions, use of the new high-speed JAMES network and access to a multimedia server from which recordings of operations and medical instrumentation can be delivered to the workshop participants. (C) 1997 Elsevier Science B.V.
