Alpena General Hospital is the only hospital serving 100,000 people in a six-county region of 3,567 square miles in northeastern Michigan. Winters are long and hard: 170"""""""" of snow fell between October and April in 1997 making driving 110 miles to the closest comparable facility difficult. The demands on the health care system have been large due to closure of the two other hospitals in the area in the past 10 years and a population that is elderly and growing. The Internet is a powerful communications tool through which Alpena General Hospital can connect remote medical clinics to the hospital and each other for rapid access to and interchange of medical information within and without the region. This request is for finding for Phase I of a four-phase plan. Phase I begins the linkage by connecting three AGH remote sites to AGH?s main campus. Requested funds are for the firewall software for secure Internet access, the Internet Information and proxy servers, frame relay setups, DCU/CSUs, and routers. AGH will match this request with funds to purchase the Internet and firewall servers, and for first year and ongoing frame relay lease fees at all Sites. AGH will provide technical support and user training at the main and three remote sites. Completion of this pilot project will enable other area primary health care provider sites within and without the region to connect to the Internet through AGH in Phases II - W. The main sites of the region?s primary care health system, all included in this four phase connectivity plan, are: a) Alpena General Hospital?s main campus and six remote sites; b) two rural public Community Health Centers with a total of five sites; and c) 39 physicians in private practice at 18 sites. It is the mutual objective of these facilities to strengthen the entire regional medical system by Internet connectivity through Alpena General Hospital to 1) gain access to medical databases and the National Library of Medicine?s resources 2) share and exchange medical information, 3) improve access to patient care, 4) provide increased access to Continuing Medical Education programming, and 5) reduce costs of providing care.