Abstract
In the United States, the public is accessing the Internet to provide information and deliver services, and to interact with citizens, business, and other government agencies (Bimber, 1999; Pardo, 2000; West, 2003, 2004). As with any change between citizen-government interactions, e-government is accompanied by speculation on its impact to both citizen and government. E-government capability of continual service delivery can make government efficient and transparent to the public (Norris, 1999; West, 2003), and more responsive to public needs through fast and convenient communication options (Thomas & Streib, 2003). It permits quicker material update than traditional distribution methods (Pardo, 2000). However, other literature suggests e-government will not live up to these prospects. A separation exists among citizens that use and do not use the Internet. This separation is based on a number of factors, including inequalities in Internet access “digital divide” and technological skills, along with psychological and cultural barriers. Literature extensively shows the differences in United States Internet use to fall along important socioeconomic and demographic factors, such as age, race, education, and income (Mossberger, Tolbert, & Stansbury, 2003; Neu, Anderson, & Bikson, 1999; Pew Internet & American Life Project, 2003c; U.S. Department of Commerce, 2002; Wilheim, 2000). E-government may create inequalities in the delivery of government information and services. Telehealth is a specific form of e-government aimed at improving the accessibility and quality of healthcare, and reducing service costs (Schmeida, 2004a). It relies on electronic information and telecommunication technology innovation (H.R. 2157, 2001). As nations contend with expensive healthcare, the promise of better healthcare service delivery at a reduced cost has made teleheath an increasingly attractive policy option in the United States and internationally.