Volume 5, Number 3 May/June 1997
Telemedicine
ARGE MEDICAL CENTERS IN URBAN AREAS
can support small and medium-sized facilities in small towns and rural areas because of
today's advanced communications technologies. Advanced communications satellites, such as
Lewis Research Center's Advanced Communication Technology Satellite (ACTS), help provide
quality medical diagnosis and information services to remote facilities in a faster, more
cost-effective manner.
ACTS, the world's first processing Ka-band satellite, is pioneering new communications initiatives that apply to telemedicine. It uses small, low-cost portable antennas with affordable high-data-rate (up to T1—1.544 megabytes per second) transmission of medical records, images and live video. A number of experiments have explored the telemedicine applications of ACTS.
AMT Telemedicine Experiment
The University of Washington Department of Radiology's ACTS Mobile Terminal (AMT)
Experiment, outfitted in a news-gathering van, was interfaced to a computer and a magnetic
resonance-imaging device to provide medical-imaging files and remote diagnosis, respectively.
The mobile terminal traveled throughout Washington State, with the fixed station at the Jet
Propulsion Laboratory (JPL). The experiment demonstrated and evaluated a full-duplex voice,
data and slow-scan video communications link for remote medical-imaging applications and
characterized the K/Ka-band land-mobile propagation channel.
Telemammography Using Satellite Communications
This experiment demonstrated technologies and methods to deliver high-quality,
high-resolution mammography images from rural to urban sites using low-cost, high-access
global satellite networks. Digital image compression, satellite link performance
requirements and satellite-to-terrestrial network interoperability must be developed
while maintaining diagnostic accuracy and low system cost. The Cleveland Clinic and
the University of Virginia are affiliated with the project.
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This display is a digitized mammogram recently transmitted over ACTS. The area of interest is magnified to assist the radiologist in the diagnosis. |
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Advanced Applications to Validate ACTS Technologies
Several collaborative telemedicine, image-processing and educational projects, plus equipment
checkout prior to the availability of an ACTS high-data-rate Earth station in Hawaii, were
involved. Medical imagery files were exchanged with the University of Washington Medical
School, and a prototype PC-based telemedicine terminal was checked out with Georgetown
University. Other partners were the Pacific Space Center, the University of Hawaii, the
State of Hawaii and GTE Telephone Company.
Application of Small Earth Stations in Conducting
Telescience and Telemedicine
This Johnson Space Center (JSC) experiment showed that the satellite is an acceptable
transmission medium to provide medical diagnosis on long-duration space flights. Fifty-three
patients were viewed from another site in Houston, where physicians tried to accurately
diagnose their ophthamological conditions with minimal questions. The patients previously
received extensive eye exams. The only information provided for diagnosis was the patient's
age, an eye problem synopsis and a telemedicine Fundescope eye examination. Doctors
diagnosed 50 patients correctly and one incorrectly; two need further examination. KRUG
Life Sciences Inc., the University of Colorado Health Sciences Center and Fitzsimmons Army
Medical Center were involved.
EMSAT: Advanced Technology for Emergency Medical Services
JPL and EMSAT successfully demonstrated the use of the AMT for emergency medical
communications. The experiment evaluated the feasibility of mobile satellite communications
for better pre-hospital communications than are available with current terrestrial radio
technologies. It assessed the transmission and reception of satellite digital voice for
two-way, pre-hospital communications, one-way transmission of patient data from field
paramedics to the base hospital and telemetry of patient assessment data to the base
hospital. The trials simulated communication with paramedics at the accident scene and
en route to the hospital.
Medical Service Triage Support and
Radiation Treatment Planning
This experiment combined telemedicine and supercomputing to compare teleradiology via the
Internet or ACTS by digitally transmitting vast amounts of medical information and images.
It also performed distributed radiation treatment planning, optimization, remote medical
access and imaging for remotely computed dose calculations and volume visualization. The
results were disseminated in real time for collaboration and treatment. Goddard Space
Flight Center, University of Hawaii, Ohio Supercomputer Center and Georgetown University
were involved.
Prototype Multimedia Telemedicine Testbed:
Alaska as a Model (Project Ravencare)
This experiment demonstrated telemedicine for remote patient care. T1 VSATs linked Mt.
Edgecumbe Hospital in Sitka, Alaska, to Georgetown University in Washington, D.C. The
network was tested to ensure its provision of safe, reliable and optimized remote patient
care for patients. One experiment included the transmission of digitally encoded x-rays
for remote consultation. Interactive video, audio and text were integrated into the
platform to provide enhanced consultation capabilities.
Medicine in an Integrated Group Practice
This Mayo Clinic Foundation investigation assessed the feasibility of delivering the
diagnostic modalities necessary for high-quality health care, telemedicine's acceptance
by providers and consumers, the seamless integration of new communications technologies
into existing infrastructure and the rapid access and archiving of medical information
by transparent repositories. An ACTS high-data-rate Earth station in Arizona was connected
to Phoenix Children's Hospital and the Mayo Clinic in Scottsdale, Arizona. The Mayo Clinic
in Rochester, Minnesota, was connected terrestrially to Sprint's MAGIC fiber optic network
and linked to its Arizona counterparts over ACTS from the high-data-rate Earth station and
MAGIC in Kansas City, Kansas.
Application of ACTS to the Practice of Medicine
in an Integrated Group Practice
This Mayo Clinic Foundation experiment involved remote telemedicine studies and training
using a variety of techniques, primarily with commercial T1 video teleconferencing equipment.
It verified the value of T1 rate video and medical data telemetering for certain medical
consultations and for continuing medical education and training classes.
ACTS Montana Telemedicine Demonstration
This demonstration used a modified version of the ACTS Ultra Small Aperture Terminal (USAT)
with the portable Telemedicine Instrumentation Pack (TIP) developed by KRUG Life Sciences
for JSC. The TIP, a briefcase-sized medical diagnostic system used in Space Shuttle missions,
with USAT and ACTS can provide basic medical capability to any location. Others involved
were St. Vincent's Hospital, Crow-Northern Cheyenne Hospital and Exxon's Billings Refinery.
| In a staged telemedicine emergency situation at a remote Exxon refinery, a medical technician transmits vital information to St. Vincent's Hospital in Billings, Montana. |  |
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VAMA VSAT Access to Medical Image Archives
The National Library of Medicine and the University of California at San Francisco Medical
School developed and evaluated a system for remotely accessing medical records and image
databases, including the Visible Human collection and x-ray images collected as part of the
National Health and Nutrition Surveys. Multisocket image retrieval software is being
developed to use full T1 satellite channel speed while maintaining Internet compatibility.
Contact Shaik Mazharullah at the National Technology Transfer Center
for individual project contacts.
Call 800/678-6882, or visit
http://www.nttc.edu/ telemed/lewis.html
Please mention you read about it in Innovation.
