U.S. National Library of Medicine is tracking down Telemedicine implementations for health care

Bethesda, 01 October 97 Within the U.S. National Institutes of Health (NIH), telemedicine represents an important topic of investigation. The NIH, celebrating its 100th birthday, is one of eight health agencies of the U.S. Public Health Service which, in turn, is embedded in the U.S. Department of Health and Human Services. The National Library of Medicine (NLM) constitutes one of the NIH's spearheads in the field of High Performance Computing and Communications (HPCC) and telemedicine in particular. According to Michael Ackerman, assistant director for HPCC at the NLM, the NIH strives to ensure privacy of information, completeness and correctness of content and wide availability of health care, using HPCC and the National Information Infrastructure (NII) network.

The NLM already has built a tradition in awarding research contracts. In February 1994, twelve projects were granted for Biomedical Applications of High Performance Computing and Communications. A lot of these studies had a telemedicine focus and they are no exception in the NLM activities. Other examples are on the one hand the Visible Human Project, a 3-D computerized cadaver and a detailed atlas of the human body, which serves as a resource for medical information, comparable to the European Euromed Virtual Medical Worlds, and on the other hand the DocView project which investigates end user access to the medical literature in the form of scanned pages of journals and other sources sent over the Internet, similar to the information handling by the European Health Telematics. Observatory.

In October 1996, the NLM decided to fund 19 telemedicine projects affecting rural, inner-city and suburban areas with a total budget of $42 million. The multi-year projects, located in 13 states and the District of Columbia, should serve a threefold purpose consisting in the evaluation of the telemedicine impact on cost, quality and access to health care; in the assessment of the confidentiality level height of health data transmitted via electronic networks and in the testing of emerging health data standards.

Let us remind here that the Euromed(-ETS) project has a similar goal adjusted to European needs.

Furthermore, the NLM also is the principal funder of two National Academy of Sciences studies which form a theoretical framework in order to review the projects on the basis of a set of objective criteria for efficiency and data security. The first study, issued by the Institute of Medicine, appears under the title "Telemedicine: a Guide to Assessing Telecommunications in Health Care" and the second, provided by the National Research Council is called "For the Record: Protecting Electronic Health Information".

The selected projects present a cross-section of the medical application field focusing either a physician/specialist or a hospital/patient relation. Some of them are involved with health prevention, others with direct support for infirm people in need of care but situated at a remote distance.

The NLM has chosen a variety of patient situations including a range from high risk new born babies as well as people suffering from cancer and chronic or mental illnesses to patients with renal dialysis or a bad heart condition. Sometimes, the project is mainly dealing with mutual information distribution; sometimes, the computer aided health care is directly affecting the improvement of quality in the emergency room or the trauma centre.

This differentiation must allow the NLM to create detailed and thoroughly profound vision on the telemedicine applications in order to chart the unsuspected possibilities the world of High Performance Computing and Communications is offering in the health care domain.

For more information about the NIH, please consult for instance the August 1997 issue of the RCI, Ltd. Newsletter. If you want to know more about the NLM funded projects, please check in at the NLM Web Site .

Leslie Versweyveld