A system for remotely programming a programmable medical apparatus, comprising a digital interactive communications network including an encrypted VPN tunnel interconnecting respective computers and video conferencing devices at a programming site and a remote programmed site, with VNC linkage of the interconnected computers, wherein the computers are arranged for programming the programmable apparatus from the programming site, with at least 1 megabit/second connection in both directions of interconnection, whereby audio and video signals are synchronized for the programming the programmable apparatus
