shorten: When considering telemedicine, many organizations immediately recognize the need for the underlying audio-video technology on which it's deliveredand the ensuing costs thereofas a primary challenge. This is why many grants have been made available to facilitate the purchase of such technology.But the initial acquisition costs for the technology are only the tip of the iceberg. There are always ongoing support and maintenance costs associated with the technology that need to be considered. To address this, many technology vendors have moved to lease or service-based contracting models, where a single monthly fee not only gets you access to the technology, but its routine monitoring, maintenance, and upgrades. This can all be covered by one of the available grants if you're fortunate enough to be awarded one. Even then, there are far larger expenses to be considered. The actual ongoing management of the telemedicine program itself is likely to be an even bigger expense than the technology, and is oftentimes overlooked when an initial, small-scale pilot project is conceived