Learn to anaesthetise "Stan the Man" over satellite link

Bristol 02 November 1999The initial pilot phase of the Multimed project, part-funded by the European Space Agency and the British National Space Centre within the ARTES-3 Multimedia Initiative, is coming to an end. A team of five partners has united the principles of high fidelity simulation as applied in the Bristol Medical Simulation Centre (BMSC), of cutting-edge satellite communications, offered by the DirecPC service, and high-level Continuing Medical Education (CME) for health professionals in one powerful concept to bring to market an efficient methodology for the tele-training of medical procedures, specialities, and applications. During the 15-month test and implementation period, the Multimed team has focused on the remote training of anaesthesia scenarios in collaboration with ten pilot user sites within the United Kingdom.

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The leading part in the Multimed project is played by "Stan the Man" the human patient simulator (HPS), hosted at the BMSC in a mock operating theatre. This manikin-like simulator, which can also change sexes, has been developed at the University of Florida and is commercialised by Medical Education Technologies Inc. (METI). The computer-controlled HPS can be programmed to accurately mimic various human physiological states. Trainers in the adjacent control room, who are linked via radio headsets with the trainees in the operating theatre, can activate different real life scenarios allowing students, nurses, physicians, and medical support services staff to practise delicate techniques, such as cannulation, monitoring ECG or blood pressure, intubation, and ventilation.

DirecPC, an asymmetric, high bandwidth satellite data link, provided by HOT Telecommunications Ltd., enables BMSC to broadcast all training sessions to the ten distant hospital sites. The satellite service includes a 400kbs Internet connection, a 3Mbs file transfer mode, and streaming multicast multimedia. The end-user terminal consists of a multimedia-enabled PC, equipped with a special network card and connected via a coaxial cable to a 60 cm receiving dish. The service is transmitted from a satellite uplink, located in Griesheim, Germany. The Bristol site, where audio and video encoding as well as remote user interfacing to the HPS is handled, communicates with the uplink server over a high speed landline through a standard modem. The Multimed team as a result can download teaching modules in discrete chunks to intelligent data caches in the local user terminals.

Multimed offers four service levels for the remote user, consisting of two real time services and two off-line ones. At the start of each session, the user has the choice of the four service levels, which are on-line reference, evaluation, observation, and simulation. In practice, the student will select a particular topic and browse the database resources for relating literature reviews and professional news items. The third service level provides tailored courseware offering interactive specialist teaching programmes and built-in monitoring features, allowing the trainee to obtain awareness of medical simulation. The second service level is directed towards passive simulation enabling a trainee to participate in live sessions at the BMSC and communicate with the course leaders. At the first service level, remote users actively take part in the HPS sessions to influence the pre-set scenario.

The four components have been fully integrated into the Multimed project as to facilitate the transition between theory and practice without having to put real patients at risk. Following the pilot phase, the team hopes to extend the tele-education system for anaesthesia to other medical disciplines, as well as to remote locations all over the world. In this regard, project leader Esys will be responsible for the system design and the business analysis of Multimed's commercial potential. The Institute of Telemedicine and Telecare at Queen's University, Belfast will provide independent review of the courseware, market analysis, and evaluation of the service. Healthworks Limited in turn will take care of the medical reference material, as an expert in electronic publishing. To know more about Multimed, please also read the VMW article Advanced satellite technology brings simulated medical emergency scenarios "live" to the desktop. More details are available at the Multimed home page.


Leslie Versweyveld

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