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Military telemedicine developments are a test for future applications

The BBI Newsletter - February 1, 1997

Continued from page 1.

An example of such cooperation was assembly of the Primetime III Telemedicine task force, with triservice representatives, Department of Defense, Defense Information Systems Agency, Defense Advanced Research Projects Agency (DARPA), and academic and commercial partners, including GTE Government Systems (Chantilly, Virginia), Northrop Grumman (Los Angeles), Madge-Teleos Communications (Reston, Virginia), among others. The systems developed supported 384k/bit per second data rates for 30 frames/second of real-time interactive video conferencing. Georgetown University provided a mini-PACS subsystem able to handle filmless radiology and CT images, and full-color Doppler ultrasound images. The resulting Primetime III capabilities will include: video" conferencing, teleradiology, high-resolution still imaging, Internet access and e-mail, dentistry support, Doppler ultrasound, telesurgical mentoring and support for hospital information systems and electronic records.

Primetime III was developed and will be deployed in four phases. The first supported broadband communications to hospitals in Hungary and Bosnia for MASH operations, and equipped at least one naval vessel. The system linked sites there with support facilities in Germany and stateside. During Phase 2, field medical units were deployed in Bosnia, each highly mobile, but with limited troop support capacity. The capabilities in Phase 2 included lower bandwidth communications, adequate for video conferencing, high-resolution still images and medical information systems support. Phase 3 will provide telemedicine for additional operational base medical units with turnkey systems. In Phase 4, new technologies will be integrated, including the transportable electronic medical record for field soldiers (a sort of electronic "dog tag") named MEDITAG, upgrades for 3-D ultrasound and integration of the Life Support for Trauma Transport (LSTAT) system components. Ultimately the Primetime system will link Landstuhl Regional Medical Center, the USS George Washington, the 212th Army Mobile Surgical Hospital and the 67th Combat Support Hospital (Hungary), as well as dozens of field medical support units in Bosnia, with fixed triservice medical facilities located in the U.S.

In addition to actual treatment, the military is focusing on medical simulation and virtual reality prior to actual combat operations. This allows them to consider infectious diseases in an area, medication availability, the medical support skills of personnel deployed, vaccinations of military personnel who will enter an area, and threats posed by chemical and biological warfare weapons.

The links created by this global telemedicine presence can be used during non-engagement periods as a medical educational and support platform for distance learning and medical videoconferencing. It can even be extended to civilian medical personnel in a region to foster good will and help develop the medical skill of the local medical personnel.

Telemedicine is growing and beginning to thrive. Technological evolution to RTP, changes in the basic Intel Pentium architecture to support multimedia, the openness of the Internet, continued growth of managed care, and changing state medical requirements are all stimulating the market for telemedical solutions. The market will see dramatic growth, but that growth most likely will be around companies offering the newest and most cost-effective technologies to the medical marketplace.

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