Increasingly, telecommunications and advanced information technologies are being used for a variety of activities: clinical, administrative, and education/research. These activities are undertaken with the expectation that health care delivery will be improved. To validate this expectation, a number of investigations have been undertaken to assess the effectiveness and efficiency of the activities. Unfortunately, many of these investigations have either been incomplete or have applied inappropriate techniques in the evaluation process. This is especially true in the attempts to evaluate the cost effectiveness of various telecommunication technologies and service delivery. The model presented here provides a systematic framework that can be used in evaluating the effectiveness, efficiency, and feasibility of telemedicine. The model delineates the different aspects and characteristics of an evaluation across three dimensions-focus (cost, quality, access), level (individual, community, society), and activities (clinical, administration, education/research). These dimensions are interrelated, making comprehensive evaluation difficult.