Emphasizing primary care, this handbook focuses on the application of specific types of telecommunications technology to the process of information exchange within a rural health care system. Its purpose is to provide guidance to health care planners who want to consider the potential of telecommunications technology for improving quality, accessibility, and efficiency of care. Taking a functional, applications-oriented approach, it integrates the issues and recommends a decision-making process. The range of technologies discussed includes not only the expensive and exotic but also the rather inexpensive, everyday technologies that should be available in many parts of the country. Content includes background material on health care and information exchange; the concept of a network and the distinction between telecommunications links and end-instruments; functional applications of telehealth systems (patient care management, administration, education); technical components of telehealth--transmission (narrowband, telephone, radio, broadband, networks), end-instruments (audio, telemetry, data/record, video, slow-scan television, patient-viewing video devices); process for assessing feasibility of telehealth in a specific setting; paying for telehealth. More than 50 current and planned telehealth projects and references for additional information are briefly described. (RS)