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Gulden Ophthalmics has been appointed the sole distributor of Image Consultant systems. This partnership brings together one of the leading telemedicine/tele-education systems on the market with Gulden's name recognition and marketing network. Since 1994 Image Consultant has established a national multi-faceted telemedicine network that goes beyond the traditional hub and spoke telemedicine network. The network is being built with the ultimate goal in mind that the ideal network would be seamlessly integrated into all aspects of health care providing connectivity between all health care providers. In addition, experience has shown that tele-education is intimately associated with telemedicine, so the network has a high concentration, and is in fact, largely structured through a tele-education expansion plan. Network Development Philosophy A hub and spoke telemedicine concept has many limitations to expansion. Any telemedicine system design has hub and spoke components due to the fact that traditional medical referral patterns tend to create hubs and spokes. Historically, the primary driving force for this system has been geography. Telemedicine technology reduces or often eliminates geography as a factor in providing the best possible care. The reality is that if telemedicine technology had preceded our current health care design, there is a good possibility that hub and spoke would not have been the form that dominates health care today. As such, hub and spoke telemedicine design may be a good example of making new technology "work the way we always did things" instead of maximizing its potential benefit. Hub and spoke implementation of telemedicine may be the biggest inhibitor to telemedicine expansion.