The term `telemedicine' refers to health care and health education transmitted over large distances via computer with interactive audio and video capabilities. Over the past decade, telemedicine has been widely hailed as a means of administering health care to rural areas where doctors are scarce. Most research on the subject emphasizes technological, regulatory, and utilitarian aspects of telemedicine. This study, however, develops a cultural studies perspective in order to examine how social relationships are negotiated with regard to telemedicine in a particular context. The contextual focus is South Dakota - a state where telemedicine has rapidly developed in response to an ongoing crisis in health care access. An overview of economic and health care conditions in South Dakota is followed by examinations of network structures through which telemedicine operates in the state and an analysis of how telemedicine is rhetorically constructed in the state's leading newspaper. Concluding sections discuss the hegemonic nature of telemedicine in South Dakota and raise questions about telemedicine in other contexts.
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