Military Telemedicine & Medical Advanced Technology & Medical Advanced Technology Military...

Military TelemedicineMilitary Telemedicine

& Medical Advanced Technology& Medical Advanced Technology


& Medical Advanced Technology& Medical Advanced Technology

Spanish American War; 1899Spanish American War; 1899

Haiti; 1995Haiti; 1995

Medical Advanced TechnologyMedical Advanced Technology

Management OfficeManagement Office

Command BriefingCommand Briefing

Medical Advanced TechnologyMedical Advanced Technology

Management OfficeManagement Office

Command BriefingCommand Briefing

Reengineering Health Care DeliveryReengineering Health Care Delivery

MeditagMeditag

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

QuickTime™ and aPhoto - JPEG decompressor

are needed to see this picture

Medical Telepresence . . .. . . Projecting Specialty Care Support in Far-Forward, Difficult-to-Serve Areas.

Medical Telepresence . . .. . . Projecting Specialty Care Support in Far-Forward, Difficult-to-Serve Areas.

Information in “Technology Savvy” Organizations has evolved . . .

Information in “Technology Savvy” Organizations has evolved . . .

Ad HocraticAd HocraticAd HocraticAd Hocratic

The basis for our strategy . . .The basis for our strategy . . .


HierarchicalHierarchicalHierarchicalHierarchical

TofflersTofflersParadigm Paradigm ShiftShift

TofflersTofflersParadigm Paradigm ShiftShift

Spokes:Spokes:

Hubs:Hubs:

a “grid-based” matrix . . .

People who needPeople who needHealth CareHealth CarePeople who needPeople who needHealth CareHealth Care

People who can provide Health CarePeople who can provide Health Care

S x H

Difficult to ServeDifficult to Serve

Expensive-to-serveExpensive-to-serve

UnderservedUnderserved

Difficult to ServeDifficult to Serve

Expensive-to-serveExpensive-to-serve

UnderservedUnderserved

S1

S2

S3

S4

S5

H'H2 H3 H4 H5 H6

Ad-hocratic organizations can be task-organized into . . .

"Bob, what do you think about this ankle ?

Should we evachim or not ?”

. . . facilitates time and distance independentmedical decisions

Multimedia Informatiuon

Realtime Tele-Imaging . . .

Telemedicine Test Bed Vision:

Telemedicine projects world-class health care to patients and providers, anywhere, anytime.

“I want to take the very best of Army Medicine to the front!”

General Max Thurman

DoD Telemedicine Overview DoD Telemedicine Test Bed MATMO Projects/Funding MC4 Medical Communications for Combat

Casualty Care Accomplishments and Future Vision

Telemedicine Test Bed Strategic Principles

Readiness Orientation Patient Focus Rapid Prototyping and Process Re-engineering Outcome-based Metrics Open and Integrated System Architecture Leveraged Development Sound Business Practices

Telemed-PMTelemed-PMUsers GroupUsers Group

AF Centers of ExcellenceAF Centers of Excellence

Navy Centers of ExcellenceNavy Centers of Excellence

Army Centers of ExcellenceArmy Centers of Excellence

AF & Navy, Academia, AF & Navy, Academia, IndustryIndustry

CG, MRMCCG, MRMCChief Op OffChief Op Off

Army TSGExec Agent

T-Med StakeholdersT-Med Stakeholders

LAM / Battle Labs /ARPALAM / Battle Labs /ARPA

AMEDD AMEDD C&SC&S

AF & Navy SG’s

Army Digitization OfficeArmy Digitization Office. . .Test-Bed Operations

Test-Bed Oversight . . .DOD (HA)DISA, DDRE

Tri Service T-Med Test-Bed Structure . . .

Medical Advanced Technology Management Office (MATMO)

Testbed Management and Administration at USAMRMC

Coordinates testing, integration, and prototype deployment of telemedicine technologies

DoD telemedicine project clearinghouse

Physicians

Medical Physicist

BiomedicalEngineer

Systems &Telecom

Health Care Admin/Log

Imaging Tech

Army

Air Force

Navy/Marine Corps

DoD Civilians

Academia

Contractors

Joint Telemedicine Project TeamWhen you play baseball you don’t pick 9 shortstops ...

The T-Med ProgramThe T-Med Program

Mobile Medical Mentoring(M3) VehiclesMobile Medical Mentoring(M3) Vehicles

6 Program Thrust Areas . . .6 Program Thrust Areas . . .

Far-Forward T-Med AppliquesFar-Forward T-Med Appliques11

22

33

Expert Host Medical Center AppliquesExpert Host Medical Center Appliques44Digital Field Hospital AppliquesDigital Field Hospital Appliques

55 ARPA InsertionsARPA Insertions

66 Telecom SustainmentTelecom Sustainment

. . . consistent with Force XXI & Army’s Digitization Strategy . . . consistent with Force XXI & Army’s Digitization Strategy

. . . totally integrated -- . . . totally integrated -- foxhole to specialty care Medical Centerfoxhole to specialty care Medical Center

. . . open systems --. . . open systems --scaleable, interoperable, upgradeablescaleable, interoperable, upgradeable

6 Program Thrust Areas:6 Program Thrust Areas:6 Program Thrust Areas:6 Program Thrust Areas:

Far Forward TelemedicineFar Forward Telemedicine

in the Maneuver Battalion areain the Maneuver Battalion area

or in deployments like Macedonia, Croatia or in deployments like Macedonia, Croatia

& Somalia, or Haiti & Somalia, or Haiti

Far Forward TelemedicineFar Forward Telemedicine

in the Maneuver Battalion areain the Maneuver Battalion area

or in deployments like Macedonia, Croatia or in deployments like Macedonia, Croatia

& Somalia, or Haiti & Somalia, or Haiti

1

The T-Med ProgramThe T-Med ProgramThe T-Med ProgramThe T-Med Program

NEWNEWSatellite & VTCSatellite & VTC

- 6 cubic feet- 6 cubic feet- 117 lbs.- 117 lbs.- $58K- $58K

ORIGINALORIGINALSatellite & VTCSatellite & VTC

- 30 cubic feet- 30 cubic feet- 332 lbs.- 332 lbs.- $148K- $148K

Sincgars able to supportSincgars able to support Medical ImageryMedical Imagery

Medical Situational Awareness-Medical Situational Awareness- Great ValueGreat Value

Digital Moulage--Digital Moulage-- Training EnhancerTraining Enhancer

Far-Forwrd Casualty Mgmt--Far-Forwrd Casualty Mgmt--greatly enhanced with Imagerygreatly enhanced with Imagery

Sincgars able to supportSincgars able to support Medical ImageryMedical Imagery

Medical Situational Awareness-Medical Situational Awareness- Great ValueGreat Value

Digital Moulage--Digital Moulage-- Training EnhancerTraining Enhancer

Far-Forwrd Casualty Mgmt--Far-Forwrd Casualty Mgmt--greatly enhanced with Imagerygreatly enhanced with Imagery

Major Findings . . .Major Findings . . .

Desert Hammer . . .Desert Hammer . . .

Time to treatment reduced 28%Time to treatment reduced 28%Time to treatment reduced 28%Time to treatment reduced 28%

Comfort TelemedComfort Telemed


Build & Deploy M3 Vehicles:Build & Deploy M3 Vehicles:

Build & Deploy M3 Vehicles:Build & Deploy M3 Vehicles:

22

““EMS-T-Med” for telemedicineEMS-T-Med” for telemedicine““EMS-T-Med” for telemedicineEMS-T-Med” for telemedicine


““Hardware Downscaling” Hardware Downscaling” from MITTfrom MITT Commercial MedicalCommercial Medical Software PackageSoftware Package

““Hardware Downscaling” Hardware Downscaling” from MITTfrom MITT Commercial MedicalCommercial Medical Software PackageSoftware Package

Developmental Overview . . .Developmental Overview . . .Developmental Overview . . .Developmental Overview . . .

2 Basic Scenarios:2 Basic Scenarios:

Dockable hostDockable host

Forward deployed Forward deployed EMS T-Med EMS T-Med

2 Basic Scenarios:2 Basic Scenarios:

Dockable hostDockable host

Forward deployed Forward deployed EMS T-Med EMS T-Med

T-Med M3 ConceptT-Med M3 ConceptVehicle atVehicle atFort Sam HoustonFort Sam Houston4 Oct 944 Oct 94

T-Med M3 ConceptT-Med M3 ConceptVehicle atVehicle atFort Sam HoustonFort Sam Houston4 Oct 944 Oct 94

Digital Field Hospital Prototype-Digital Field Hospital Prototype-

Filmless & “Wireless” CapabilityFilmless & “Wireless” Capability

Digital Field Hospital Prototype-Digital Field Hospital Prototype-

Filmless & “Wireless” CapabilityFilmless & “Wireless” Capability

33

Field CT-Field CT- Trauma SupportTrauma SupportField CT-Field CT- Trauma SupportTrauma Support

Desert StormDesert StormSomaliaSomaliaHaitiHaiti

Desert StormDesert StormSomaliaSomaliaHaitiHaiti

Deployable Digital MTFDeployable Digital MTF

35 acres andno phones !!!35 acres andno phones !!!

MCW

ICW

ICW

ICW

ICU

ICU

ICU

ICU

EMT

MCW

ICW

ICW

CMS OR

SURGERY OR

OR

PH CT

XRAY

LAB TMED

TOC CDR

CONF

You are here . . .

. . . you need to talk to someone here !

DINS (Digital Imaging Network Systems)DINS (Digital Imaging Network Systems)DINS (Digital Imaging Network Systems)DINS (Digital Imaging Network Systems)

1111

2222

3333

Wireless TelecommunicationsWireless TelecommunicationsWireless TelecommunicationsWireless Telecommunications

4444 HIS (Hospital Information Systems)HIS (Hospital Information Systems)HIS (Hospital Information Systems)HIS (Hospital Information Systems)

Deployable Digital MTF...Deployable Digital MTF...Deployable Digital MTF...Deployable Digital MTF...

Four Subsystems...Four Subsystems...

... a template for any size deployable MTF which integrates Telemedicine and hospital information and communications technologies

... a template for any size deployable MTF which integrates Telemedicine and hospital information and communications technologies

Distributed VideoDistributed VideoDistributed VideoDistributed Video


Digital “Catcher’s Mitts”Digital “Catcher’s Mitts”

Global Grid Demo Project- Global Grid Demo Project- MDIS & ATM Capable HostMDIS & ATM Capable Host

Digital “Catcher’s Mitts”Digital “Catcher’s Mitts”

Global Grid Demo Project- Global Grid Demo Project- MDIS & ATM Capable HostMDIS & ATM Capable Host

4444



ARPA Technology InsertionsARPA Technology Insertions

e.g. LSTAT , 3D Ultrasound, e.g. LSTAT , 3D Ultrasound,

Lensless MicroscopyLensless Microscopy

ARPA Technology InsertionsARPA Technology Insertions

e.g. LSTAT , 3D Ultrasound, e.g. LSTAT , 3D Ultrasound,

Lensless MicroscopyLensless Microscopy

5555


UpgradeableUpgradeable

ScaleableScaleable

Inter-operableInter-operable

UpgradeableUpgradeable

ScaleableScaleable

Inter-operableInter-operable

SatelliteSatellite56 Kbs56 KbsSatelliteSatellite56 Kbs56 Kbs

Voice Grade: Voice Grade: Voice Grade: Voice Grade:

T1 - T1 - 1.5 Mbs1.5 MbsT1 - T1 - 1.5 Mbs1.5 Mbs

Full VideoFull VideoReal-timeReal-timeStill VideoStill VideoHospital-LevelHospital-Level

Full VideoFull VideoReal-timeReal-timeStill VideoStill VideoHospital-LevelHospital-Level

Voice &Voice &Single ImagerySingle ImageryAid man levelAid man level

Voice &Voice &Single ImagerySingle ImageryAid man levelAid man level

Real-time MultimediaReal-time MultimediaWarfighter XXIWarfighter XXI

Real-time MultimediaReal-time MultimediaWarfighter XXIWarfighter XXI

DS3 /ATM: 45 MbsDS3 /ATM: 45 MbsDS3 /ATM: 45 MbsDS3 /ATM: 45 Mbs

Video & Video & Batch ImageryBatch ImageryAid stn levelAid stn level

Video & Video & Batch ImageryBatch ImageryAid stn levelAid stn level



6666 TelecomsTelecomsTelecomsTelecoms

Full Telemedicine SupportFull Telemedicine Support

Spoke to Hub Spoke to Hub

(Clinic to MEDCEN)(Clinic to MEDCEN)

Full Telemedicine SupportFull Telemedicine Support

Spoke to Hub Spoke to Hub

(Clinic to MEDCEN)(Clinic to MEDCEN)

Single ChannelSingle ChannelSingle ChannelSingle ChannelMultichannelMultichannelMultichannelMultichannel

Remote Spoke ClinicianRemote Spoke ClinicianRemote Spoke ClinicianRemote Spoke Clinician Hub ConsultantHub ConsultantHub ConsultantHub Consultant

PanamaPanama

CubaCuba HaitiHaiti

MacedoniaMacedonia& Croatia& Croatia KuwaitKuwait

SomaliaSomalia

KoreaKorea

GermanyGermany

Ivory Ivory CoastCoast

KwajaleinKwajalein

EgyptEgypt

Worldwide Telemedicine Rapid DeploymentsWorldwide Telemedicine Rapid Deployments in the past in the past

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Primetime III . . .Primetime III . . .Telemedicine Augmentationto Task Force EagleMedical Units in Support ofOperation Joint Endeavorin Hungary and Bosnia

. . .. . .

. . . the action spot today

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Primetime III T-Med Support Task Force

Med Adv Tech Mgmt Office - Support Task Force Chairman

Landstuhl / European HSSA

30th Med Brigade

AF MEDSITE

MEDCOM, DCS IM, NOD

HCSSA

Army DMIS

AMEDD C&S & Test Board

PASBA

ARPA

TRANSCOM

DoD (HA) DMIM

Navy Med Inf Mgmt Ctr

USUHS

DISA-USA

DISA-Europe

5th Signal

22th Signal

V Corps

EUCOM

USAFE

ASDC3I

USAMMCE

Coordinations to date:

Aid Stations

Clinics

MASH

Combat Spt Hospital

StatesideHospitals

USSGeorge

Washington

Quick Overview of Operation . . .

Up to 170 beds, 400 sick call/clinic visits per day200 X-Ray Exams, Up to 25 CT studies per day

Landstuhl

Hungary

Bosnia

ATHCroatia

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Five Major Task Force Eagle Customer Requirements

Patient Accountability

Minimize Evacuations

Specialty Medical Consultation

Rapid Trauma Response

Medical Situational Awareness

1

2

3

4

5

Video T-Med Imagery

Filmless Teleradiology

Digital CT Scanner /Ultrasound

Tele-Surgical Mentoring

Lab & Radiology Results (CHCS)

CHCS/TAMMIS/PARRTS/DMRIS

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Capabilities to Meet Requirements

FOB/BOB

15-16x

MASH

CSH

Landstuhl

IDNXCloud

WurzbergHeidelberg

Ft Sam Video Bridge

CONUS Med CensOverview:Primetime IIIT-Med Solution

Norfolk

USSGW

POP

FOB/BOB

4-5x

(Germany)

(Hungary)

(Bosnia)

An Army Aviator was unable to fly due to a cyst in his external ear...the flight surgeon needed a teleconsult...

...she established a link to an ENT specialist in Landstuhl and successfully removed the cyst...the Aviator was returned to duty... NO EVACUATION NEEDED!

67th CSH -- Tazar, Hungary

QuickTime™ and aPhoto - JPEG decompressor

are needed to see this picture.

67th CSH

Landstuhl Regional Medical Center

FOBBOB

MASH

CSH

LandstuhlCONUS Med Cens

CONUS Med CensPrimetime IIIPhase 4

Norfolk

USSGW

Transmittable and TransportableClinically Relevant Patient Record: “BOSMEDNET”, MARC--MEDITAG

EVALUATION STRATEGY

OBJECTIVES

Clinical ,Technical, and

Operational Effectiveness

COLLABORATIVE but INDEPENDENT

•Telemedicine Evalutation Working Group (TEWG)* - Clinical Effectiveness

•U.S. AMEDD Board *- Operational Evaluation/Data Collection

•Northrup Grumman - Technical Feasibility

*Vector Research Inc - Provides technical support

and economic analysis

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Croatia

Bosnia

Serbia

Macedonia

and Herzegovina

Montenegro

Vojvodina

SloveniaZagreb

Skopje

Sarajevo

Primetime III Task ForcePrimetime III Task Force

Testbed Challenges

Integration of Advanced Technology into Clinical Practices

“Make it Programmatic” (GEN Sullivan)Transition to Standards-based ArchitectureEvaluation and Outcomes AssessmentLegal Implications

Medical Communications for Combat Casualty Care (Army MC4 Program)

Far-Forward Telemedicine Digital Field Medical Treatment Facility Expert Tertiary Care Host Telemedicine Sustainment Integration of Emerging Technologies

Army Force XXI - 5 TMED Thrusts

MC4 Challenges

Flexibility - Shared Bandwidth Interoperability - With other systems, with other

Services: Army Digitization Office (ADO), Theater Medical Information Program (TMIP)

Technology Cycle (18 - 24 months) Transition from R&D Prototyping to Full

Deployment

Concept Exploration

AdvancedDevelopment

Fielding &Sustainment

Hard Transition

Hard Transition

OP & OM FundingR & D Funding

Rqmt/Doctrine

Traditional R&D

Concept Exploration

Advanced Development

Fielding & Sustainment

SoftTransitions

OP & OM Funding

R & D Funding

Rqmt/Doctrine

Rapid Prototyping R&D

“We must change the way we change ”

Emerging Evolutionary Principles . . .

DARPAAdvanced R&D

6.1. - 6/3

MC4Concept, Acquisition

Development & Deployment

6.5 -6/6

Devel

opm

ent

Tech

nolo

gies

MATMOCOTS Technologies

Prototyping and Integration

6.3 - 6.4

Coordination with DARPA

AWE Battle Labs

TMIPNAVY

AIR FORCE

MDIS Filmless Medical ImagingMDIS Filmless Medical Imaging

Ethernet BackboneEthernet Backbone

MRUltrasoundNuc Med

Digital Angio

CT Comp Rad (phos plate)

5 each

Image DisplayImage DisplaySubsystem Subsystem

Image Storage Image Storage SubsystemSubsystem

Optical Juke BoxOptical Juke Box

Laser ImagerLaser Imager

Image Acquisition SubsystemImage Acquisition Subsystem

Image Data Base Image Data Base SubsystemSubsystem

VMS VMS Db HostDb Host

Tele Rad Tele Rad GatewayGateway

Time to Find Historical Imagery

Lost Image Rates

5 10 15 20 250

Percentage5 10 15 200

Film: 20 MinutesDigital: 2.5 Minutes

Film: 17.5 %Digital: 1.5 %

- Korea Overview -Akamai Project Element - Korea Overview -Akamai Project Element

Joint Army and Air Force Telemedicine System for Radiologic Consults and Telemedicine

Joint Army and Air Force Telemedicine System for Radiologic Consults and Telemedicine

Consistent Quality of Care - All Locations

Integration of Diagnostic Expertise in "Real Time" VTC links at Tripler,

121 General Hospital,Walker and Casey

Same Day Diagnostic Capability- Remote Sites

Tertiary Care Consultation Capability Patient Evacuation Decisions Seriously Ill Patients Visiting Dignitaries

Deployable Remote Imaging for- Disasters Contingencies

121 Gen. Hosp.

Walker

Kunsan

Osan

Casey

Tripler

Project MediTagProject MediTag

Customer Customer RequirementsRequirementsRuggedRugged

Large Storage CapacityLarge Storage CapacityRapid Transfer RatesRapid Transfer RatesSecureSecureSimpleSimple

Allow data capture and delivery of a wide Allow data capture and delivery of a wide array of data types: X-rays, MRIs, EKGs, array of data types: X-rays, MRIs, EKGs, Sound, or up to 40,000 pages of text.Sound, or up to 40,000 pages of text.

Meeting the Meeting the NeedsNeeds

20-21 megabytes of LossLess Compressed Data 20-21 megabytes of LossLess Compressed Data

Ruggedized: 100% Weather Proof, Withstands 500 G forcesRuggedized: 100% Weather Proof, Withstands 500 G forces

Compatible with all types of Computer hardware Compatible with all types of Computer hardware

Securely Stores Text, Voice, Video and any form of Digital Data Securely Stores Text, Voice, Video and any form of Digital Data

Memory cells DO NOT require batteriesMemory cells DO NOT require batteries

Extensible: System will Evolve with TechnologyExtensible: System will Evolve with Technology

Project ProMedProject ProMed

•Developing uses for Handheld Devices

•Wireless Distributing Computing Networks

•Intuitive Interface Design

•Making Access to Information more Efficient.

•Developing uses for Handheld Devices

•Wireless Distributing Computing Networks

•Intuitive Interface Design

•Making Access to Information more Efficient.

Digital Mammography Mobile Digital Mammography Mobile LaboratoryLaboratory

• Dynamic, Modularized DesignDynamic, Modularized Design

• Intelligence Imaging Technology TransferIntelligence Imaging Technology Transfer

• High Capacity CommunicationsHigh Capacity Communications

• DoD, HHS, NIH, CIADoD, HHS, NIH, CIA

Consortium on TelepsychiatryConsortium on Telepsychiatry...Promoting Mental Health into the 21st Century...Promoting Mental Health into the 21st Century

• Consortium between the United States Consortium between the United States Department of Defense Telemedicine Test Bed Department of Defense Telemedicine Test Bed and Academic, Governmental, and Industrial and Academic, Governmental, and Industrial Partners.Partners.

• Further the practice of mental health care Further the practice of mental health care through the intelligent and programmatic through the intelligent and programmatic application of advanced technology.application of advanced technology.

Med College of Georgia

Med College of Georgia

Tertiary Care Telemedicine Georgia Triad--Military & AcademiaTertiary Care Telemedicine Georgia Triad--Military & Academia

Ga TechGa TechEisenhowerEisenhower

Rural TelemedNodes in GeorgiaRural TelemedNodes in Georgia

McPherson&

OtherArmy Signal School

McPherson&

OtherArmy Signal School

“Home house call”

“Home house call”

AugustaAugusta AtlantaAtlanta

CATV Broadband Topology

Headend

Distribution amp

70-mile radius

San Antonio “Medical ATM T-Med Grid”San Antonio “Medical ATM T-Med Grid”

4 Major Components4 Major Components

CHCS “Mothership”CHCS “Mothership”

Filmless MDIS System

Brooke T-Med Kiosk Host

USAA Towers

ATM Link to Wilford Hall

Filmless MDIS System

Brooke T-Med Kiosk Host

USAA Towers

ATM Link to Wilford Hall

Wilford Hall MDIS

new Brooke MDIS

The DoD Telemedicine Test Bed The DoD Telemedicine Test Bed World Wide Web PageWorld Wide Web Page

•Using the Internet for Using the Internet for Information ExchangeInformation Exchange

•WWW, eMail, Conferencing, WWW, eMail, Conferencing, File SharingFile Sharing

•A global communications A global communications infrastructureinfrastructure

•http://www.matmo.army.mil/http://www.matmo.army.mil/

What we have learned . . .6 lessonsWhat we have learned . . .6 lessons Primetime T-Med Network Payoffs. . .Primetime T-Med Network Payoffs. . .

Patient Exams - Projected Specialty SupportPatient Exams - Projected Specialty Support

Video Exam Notes- Patient RecordsVideo Exam Notes- Patient Records

Grand Rounds - QA, TeachingGrand Rounds - QA, Teaching

1

2

3

continued . . .continued . . .

3 Can we keep it scaleable, interoperable, & upgradeable ?

2 Is it effective clinically ?

1 Will it work technically ?

4 Is Clinical Multi-media valuable?

5 Is T-Med the “Glue” ?

Overarching Structure . . .Overarching Structure . . .Telemedicine Validation InitiativeTelemedicine Validation Initiative

Military Medicine can take Military Medicine can take good advantagegood advantage

of emerging telecoms- Long haul & localof emerging telecoms- Long haul & local

T-Med is especially attractive for ‘split-base’ T-Med is especially attractive for ‘split-base’

medical operationsmedical operations

ConclusionsConclusions

High bandwidth is still expensive - High bandwidth is still expensive -

but costs are coming downbut costs are coming down

Projects capability of Projects capability of

medical experts far forwardmedical experts far forward

Attractive rapid prototype opportunities existAttractive rapid prototype opportunities exist

Telemedicine will help shape future of military medicineTelemedicine will help shape future of military medicine

Four echelons of integrated medical Four echelons of integrated medical

capability--Stresses upgradeablity & capability--Stresses upgradeablity &

open technical approachopen technical approach

Summary, continuedSummary, continued

Military Telemedicine & Medical Advanced Technology & Medical Advanced Technology Military...

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