Bosnia Puts Telemedicine to First Real Test

Previously confined to prototypes, Defense Department telemedicine projects now have a real-life theater to test their technologies

P> In Bosnia, 20,000 American soldiers battle the harsh climate and the remote, mountainous terrain of the war-torn region. For the medical personnel sent to handle the health care of these soldiers, the rugged topography and the presence of active mine fields make the job of setting up field hospitals and clinics doubly difficult. In fact, the medical challenge has been likened to lifting half the population of a city the size of Frederick, Md., and displacing it to the Rocky Mountains while maintaining a superb level of health care.


But advances in information technology and communications, and the explosion of the Internet are bridging the gap.

At a recent conference, the U.S. Department of Defense, private companies, national laboratories and others unveiled technology supporting telemedicine initiatives. Exhibitors at the National Forum II: Global Telemedicine and Its International Implications demonstrated transmitting X-ray images from military clinics in Bosnia to the conference site by Internet.

Highlights of the three-day conference included using standard PCs and World Wide Web browsing tools to transmit the first digitized patient X-ray images from Bosnia. The Imaging Science and Information Systems team at Georgetown University Hospital participated in the project in cooperation with the Analogic Corp. of Peabody, Mass.

"Our ability to transport images from remote locations using standard commercial, off-the-shelf tools and networks means that cost-effective teleradiology is a reality," said Army Col. Fred Goerringer, director of the Medical Advanced Technology Management Office at Fort Detrick, Md. MATMO funded the Web-based X-ray transmission project.

For the past three years, the Department of Defense conducted wide-ranging tests of telemedicine projects, including teleradiology, telesurgery, ultrasound diagnosis and desktop videoconferencing. But until the Bosnia deployment, much of the new technology was developed as prototypes.

"The military's telemedicine program has really accelerated in Bosnia. The Bosnia theater has provided the Defense Department a real opportunity to implement and test the latest telemedicine technology," Goerringer said.

The telemedicine conference was organized partly to enable the Department of Defense to advance military and civilian use of telemedicine. Navy Cmdr. M.A. Greenauer, an official in the DoD Telemedicine Test Bed project, said the Defense Department is sharing information with businesses and civilian government agencies to spur telemedicine use and development. The Test Bed initiative resulted from Vice President Al Gore's push to re-engineer government processes.

Greenauer said tests of some projects already show promising results. During a six-month period, a teleradiology system aboard a Navy aircraft carrier helped reduce emergency medical evacuations for the carrier group by 37 percent. In one instance, a teleradiology diagnosis of an Antarctica-based U.S. Naval station employee, stricken with a kidney stone, saved the U.S. government $1 million when an emergency evacuation of the employee was averted, according to Greenauer.

Several companies based in the Washington area, such as Pulsar Data Systems Inc. of Lanham, Md., exhibited their products at the telemedicine conference. Pulsar developed and installed computer support systems for ultrasound systems aboard a Navy aircraft carrier.


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