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Four months have passed since Kevin Rudd nudged the Communications Minister, Stephen Conroy, to the edge of the stage and announced plans to build a $43 billion national broadband network.

Although the project seems to be moving at glacial speed – deadlines have been pushed back and details are scant – we can discuss with more confidence how high-speed broadband will change the lives of millions of Australians. Thomas Watson, chairman of IBM, allegedly said in 1943: "I think there is a world market for maybe five computers."

The authenticity of the quote has been vigorously disputed, but the underlying lesson holds true today. It is easy to underestimate the leaps technology can make in a short period of time. Senator Conroy is evangelical about e-health, the use of broadband to improve remote diagnosis, in-home monitoring, file-sharing and emergency and disaster response.

"Studies show that remote patient monitoring could reduce emergency room visits by up to 40 per cent and the length of hospital stays by up to 60 per cent," he said recently. But it is difficult to grab the public's imagination with predictions of speedier medical file transfer or improved remote education.

Somebody once said that what drove take-up of the internet was games, girls and gambling. To paraphrase, it is not the pointy-headed stuff that excites people, but the entertainment possibilities, things they can visualise in their lounge rooms, such as television. It should be noted that predicting what the national broadband network could mean for people is like finding your way through a darkened room: You can feel the outlines of the objects nearest you, but only guess at what lies ahead.

The one thing everybody agrees on is that Internet Protocol TV (IPTV) will be the centrepiece of the proposed broadband network. So first, an explanation of what IPTV is not. It is not watching high-definition YouTube videos or downloading movies over the internet, both of which are sometimes confusingly labelled internet TV.

Broadly speaking, IPTV delivers a guaranteed quality of service and allows the service provider to offer various interactive add-ons. It allows you to watch programs shown earlier without having to record them, choose camera angles for sporting events and use a split screen to channel surf while watching a program. On a recent visit to Australia, the vice-president of the IP division at the broadband builder Alcatel-Lucent, Kevin Maculuso, told BusinessDay that IPTV offered a lot of flexibility for other applications.

"You could have a little screen within your TV and you're essentially having a video conference with your friends, and you're all watching the same thing and you can talk about it as if you're in the same room. Those are applications that don't exist so far." Another recent visitor, Pacnet's chief executive, Bill Barney, said in his home town of Hong Kong IPTV was "as common as free-to-air", allowing him to watch any American sport live on a pay-per-view basis.

The national broadband network will also change the way we buy access to broadband. Internet service providers (ISPs) such as Telstra, Optus and iiNet will have to adapt to the new landscape. The fundamental tenet of the national broadband network is that it is a wholesale network, the owner of which – the Federal Government – is not allowed to sell services in competition to other providers.

This is to avoid replicating the situation at present, in which Telstra owns the network and is in constant conflict with rival companies that rent capacity from it (Telstra is obliged by law to lease the capacity). Rod Tucker, who sat on the expert panel that advised Senator Conroy to adopt the national model, said broadband users would have a far greater ability to pick and choose service providers according to their needs.

"You won't necessarily need to have an ISP in the traditional sense. If you want to connect your computer to the national broadband network and download pages from the web, then an ISP is the perfect provider for that," he said. "But instead of that you might have, for instance, an IPTV provider, and that can be totally independent of the ISP. You might choose entirely not to use the web, and have no ISP. The elderly person next door might have some sort of health monitoring system and that's all they want."

Professor Tucker, who is the driving force behind Melbourne University's new Institute for a Broadband Enabled Society, said sociologists at the institute were investigating ways in which the national network can enhance the satellite communities being built further from city centres. "There's really a need to develop communities outside capital cities that have the sort of environment that can capture something you might have had in the city. Maybe super-high-definition distribution of events that go on in the city; sporting events, or events that take place at the Arts Centre, distributed to large screens in the communities."

The question that usually follows 'what can I get?' is 'what will it cost?' And as with the first question, the answer to the second is 'we don't really know'. Since the Prime Minister sent eyeballs spinning by announcing his Government would build the network, highly intelligent people all over the country have been developing a panoply of cost estimates. The rough consensus seems to be about $200 a month, much more than many existing broadband plans.

But even if this were accurate, say advocates, it doesn't take into account what services the money will buy. Professor Tucker said someone recently told him they would refuse to pay $200 a month for access to the network, but when invited to add up how much he paid for each of the individual services the network could provide, the figure was closer to $500 a month. It is the IPTV-driven features that will deliver economic benefits and could change our lives. State-of-the-art teleconferencing (also known as telepresencing) had the potential to transform how we work, and was environmentally friendly, said Telstra's chief technology officer, Hugh Bradlow.

Telstra treads warily around the subject of the national network (its involvement with the network is still to be determined), but it is upgrading its high-speed hybrid fibre co-axial cable network in Melbourne to deliver 100 megabits per second, matching the network. "It's not about just entertainment any more, it's about high-definition video conferencing – telepresence systems that allow you to start changing behaviours," Dr Bradlow said.

"If I could do telepresence from home, I could change my work hours dramatically, because I would avoid rush-hour commuting. I'd do more from home, so I may not commute at all on certain days, but I wouldn't lose any productivity, or, more importantly, that personal interaction that is important in terms of normal working relationships. "There is still work to be done on the end systems, the actual in-home devices, because you don't yet have a sufficient proliferation of the flat screens. But if you think of a world in which this technology becomes really low cost, where you can literally paper the walls with it, you can literally create a telepresence room in your study."

Teleconferencing is environmentally friendly because it lessens the amount of air and ground travel, curbing emissions. Another green technology that will be enhanced by the network is smart grids. Smart electricity meters in homes and businesses communicate through networks, exchanging information about energy consumption and appliance operation. Advanced smart grids can enable appliances to be activated and adjusted remotely, and their ability to monitor energy flows in all directions offers the possibility of greater energy efficiency.

But before we get too excited about smart grids, e-medicine and interactive TV, we have to understand that we are in a state of limbo and will remain so. The Government has said it will take eight years to build the network, which will pass 90 per cent of homes and provide speeds of up to 100 Mbps, but that could be charitably described as an aspirational timeframe, rather than a rock solid commitment (the other 10 per cent will be reached by wireless and other technologies). In a recent report entitled Navigating the Path to Australia's NBN, a Goldman Sachs JB Were telecommunications analyst, Christian Guerra, predicted the network roll-out would not begin until 2011, and by 2017 it would pass only 50 per cent of homes.

Mr Guerra thinks the Government's target of 90 per cent will not be achieved until 2025. For now, Senator Conroy is able to deflect questions by pointing out that an implementation study is under way, and that it is impossible to discuss the finer points of the network, such as who, where, when and even what. That study, by McKinsey & Company and KPMG, is expected to be finished by February and will address network design, governance, ownership caps and ways to attract private sector investment. Because of a number of factors, including geography, infrastructure and the readiness of the state power company to begin the build, Tasmania was nominated as first cab off the rank.

But the first trenches have not been dug, despite Senator Conroy's claims that Tasmanians could be on line by March. Also generating furious perplexity is the question of overhead versus underground cabling. Attempts have been made to divine the Government's intentions, but the only hint has been a Tasmanian Government request for tender that specified vastly more overhead than underground cabling.

The Government knows the cable TV roll-out war in the 1990s left many people with a jaundiced view of aerial cabling, as Telstra and Optus strew thick, unsightly cable on power poles. But aerial fans say the cable for the national network would be much slimmer and less obtrusive. It is also much cheaper to install.