March 1998

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ITIS98logo Visit the website of he first International Conference on the Telemedical Information Society (ITIS '98)

ITIS'98 - The final countdown has begun ...
An impressive list of expert speakers and a well-filled but nicely balanced programme. What more do you want to turn the First International Conference of the Telemedical Information Society into a success? As the starting date of ITIS'98 draws nearer, Virtual Medical Worlds Magazine is happy to present to you the final conference programme. We assure you it would be a real pity to miss this unique and futuristic event. So if you didn't register yet, what are you waiting for? Fill in your form and come to Amsterdam?

Microturbine and valve system remove arterial plaque from blood vessels
At the Forschungszentrum Karlsruhe a microturbine and a valve system are being developed to be integrated on cardiac catheters. Prototypes have been designed to open occluded coronary arteries and to test the in-vitro cutting of calcified arterial plaque. The research is being embedded in the Esprit project IMICS. The institute plans further research in close cooperation with hospitals for specific applications in order to optimise the integrated catheter system for commercial production.

Health care ATM network introduces telemedicine to the Middle East
The Hamad Hospital in Dubai has signed an agreement with both the Omnix Qatar Company and Fore Systems to organise the installation of a health care network based on Asynchronous Transfer Mode (ATM) technology. This network will enable the hospital to take up a pioneering role in providing innovative telemedicine solutions throughout the whole of the region for many years to come.

Studu shows that Minimally Invasive Heart Surgery is safer than open-chest procedures
Surgeons from seven major medical centres in the USA have prepared a study on analysed data from more than thousand patients at 121 medical centres to prove that the port-access minimally invasive approach is safer and shows an equally low incidence of complications than standard open-chest procedures for both coronary bypass and mitral valve surgery. This first report issued from the Port-Access International Registry (PAIR) supports the surgeons' earlier prediction that minimally invasive heart surgery would become the standard method of dealing with bypass and valve interventions.

Does teleradiology produce 'filmless' hospitals?
The recent development of teleradiology has experienced an increasing success amongst medical experts. There are still important administrative difficulties to overcome which makes it very unlikely that we will be able to talk of 'filmless' hospitals in the near future. A supplementary issue constitutes the present lack of international standardisation with regard to image file formats. A lot of mutual thinking has to be done before we can benefit to the full from the revolutionary advantages teleradiology has to offer. In the recent issue of the Journal edited by the European Health Telematics Observatory, the French Drs. Vincent Hazebroucq, Christine Hoeffel and Professor André Bonnin, explain their views.

Digital telecardiology system saves precious time in patient treatment
Although the 'filmless' hospital still seem a utopia, within the specific field of catheterisation procedures medical experts are making a growing use of digital angiography instead of cinefilm. In the Netherlands, an interesting telecardiology project has been set up in which referring hospitals execute catheterisation interventions and in due case present the patient's data to cardiologists and cardiac surgeons of the university hospital in order to decide on further treatment such as for instance coronary artery bypass grafting. Digital image transfer of the catheterisation between the two hospitals involved allows time sparing and more effective service towards the patient.

Dodge County Hospital: chronicle of a telemedicine pilot site
In November 1991, Dodge County Hospital, situated in the rural town of Eastman, Georgia, became the pilot site for an interactive patient examination system which was developed to eliminate distance in the provision of health care. Since then, the network has enabled hospital staff to offer definitive care to about 85 percent of patients with complex problems without them having to leave their own familiar doctor or community hospital. Georgia's pioneering telemedicine program resides under the responsibility of the Medical College of Georgia Telemedicine Centre in Augusta.

Infusion pump controls drug dosage
Many patients suffering from chronic disease need treatment with continuous drug application. Without exact control of dosage and frequency, side effects may be caused affecting the quality of the patient's life. Within the Esprit program, a modular microsystem for controlled medical drug release has been developed consisting of an implantable programmable infusion pump, an external processing unit, a telemetry device and a printer. At the European IT Conference Exhibition held in Brussels last November, MICROMEDES demonstrated a prototype with closed-loop application. The next step in the project will hopefully lead to a system's test in practice.

Comparative health care performance information provider delighted with data warehouse system change
The HBS International Company, based in Bellevue, Washington, provides comparative performance systems and data repositories enabling health care organisations to measure, benchmark and improve their results. HBSI has an urgent need for a high qualified data warehouse system in order to meet the severe demands it has imposed upon itself. Since the existing data warehouse no longer kept pace with the company's growth potential, HBSI recently entered into partnership with Red Brick Systems, a provider of relational databases, based in Los Gatos, California. Together, they transform data into information allowing hospitals to make strategic decisions in effective treatment as well as in cost management.

NASA selects ATL's HDI 5000 ultrasound system for telemedicine in space
In the year 2000, NASA will launch its International Space Station for ten years in orbit. In order to investigate human adaptation to spaceflight environment and to space exploration, the HDI ultrasound technology will be used to perform sophisticated medical diagnostic procedures aboard the space station. The transmission of these data in digital format from the orbiting spacecraft to earth will have immediate relevance for telemedicine initiatives on earth. Moreover, beyond the protection of the astronauts' health, the knowledge gained on cardiac functions will be applied to patients on earth suffering from heart failure.

AFP Imaging and DENT-X International acquire ProDen Systems
ProDen Systems Inc., based in Vancouver, Washington manufactures the advanced ProScope and ProScope VCT intraoral dental camera systems. The company constitutes a path to the dental office software market for AFP Imaging and its DENT-X International subsidiary. ProDen fits perfectly into AFP's strategy to expand into related dental hardware and software product line opportunities. The acquisition of ProDen means another step in the concentration on high tech dental industry.

Voice-controlled surgical robot ready to assist in minimally invasive heart surgery
The Automated Endoscopic System for Optimal Positioning (AESOP) is a description for designating a surgeon-controlled robotic arm capable of manoeuvring and positioning an endoscope in minimally heart surgery procedures. The device has been developed by Computer Motion Inc., a company based in Santa Barbara. It has recently has been cleared by the American Food and Drug Administration. At the 34th Annual Meeting of the Society of Thoracic Surgeons, the voice-controlled AESOP® 3000 surgical robot was launched with the ambition to try and overcome present human limitations in surgery by means of advanced technology.

Front-line Telemedicine and Virtual Reality in combat situation
The operating conditions for doctors in extreme combat situations can't be compared to those of their hospital colleagues. Virtual Reality techniques as well as telemedical implementations seem to include promising training perspectives for general practitioners allowing them to learn how to function efficiently in a hostile environment and how to face up to stressing and precarious work circumstances. Dr. Jean-Paul Papin offered a glance at the characteristics of front-line medicine missions in France and the training means for unit doctors at the International Symposium on Telemedicine in Brussels, last October. He illustrated his speech with a concrete example of virtual reality applied to the learning of elementary resuscitation gestures in an aggressive environment.

NIVEMES Telemedicine network puts focus on sailors and islanders
Within the Telematics Applications Programme, the European Commission approved in June 1995 a funding of 3.000.000 ECUs in favour of the NIVEMES project: Network of Integrated Vertical Medical Services Targeting Ship Vessels and Remote Populations. This three year project started out in January 1996 to develop an international network of telemedicine health care providers and telemedicine services, offered to individuals or groups in remote locations or emergency situations such as sailors and islanders. Prime contractor, the Greek technology provider ATKOSoft SA, is working together in a consortium with hospital partners from Sweden, Ireland, Portugal and Greece.

CEGETEL installs French health care computer network
The Times recently announced that CEGETEL has won a one billion FFr. contract to develop a national Internet based health care computer network in France.

Live telemedical demonstration at Scandinavian Network Expo 98
Göteborgs Posten reported on a real life telemedicine event at the Scandinavian Network Expo 98 which took place in Gothenburg. A dermatologist examined a patient in Borås fifty kilometres distance from Gothenburg. The connection between doctor and patient was provided through an Asynchronous Transfer Mode (ATM) link.

The UK National Health Service takes a hard look at IT strategy
Current developments in Information Technology offer the possibility to store medical information on electronic patient records (EPR) and smartcards. The National Health Service (NHS) in the United Kingdom hesitates to adopt these new solutions because several complicated issues need to be dealt with first. The NHS is embarking on a radically new IT strategy in which the balance between accurate information on the state of people's health and data confidentiality gets primordial attention.

Web technology makes Swedish hospital network run smoothly
The county council of Skane has decided to install the largest telemedical web system in Sweden. Physicians from different hospitals all over the region will use the network to organise virtual meetings and to discuss patient cases with each other at a distance.

Telemedicine offers permanent education and practical etiquette for doctors
As the Georgia Statewide Telemedicine Programme is being established, a growing need occurs amongst physicians to take away their uncertainties about treating real patients via the system. The Telemedicine Centre of the Medical College of Georgia (MCG) has developed a specific training course in order to give doctors a chance to examine "mock" patients via telemedicine and to learn typical telemedicine etiquette. For this mission, "patients" are being prepared to participate in the new Standardised Patient Programme that is funded by 1 million dollars made available through The Distance Learning and Telemedicine Act of 1992.

Three-dimensional eye surgery simulation with haptic feedback
Three commercial hardware developers and the Centre for Human Simulation at the University of Colorado School of Medicine have united forces to create a simulation tool allowing both doctors and students to practice delicate surgical procedures on a virtual human eyeball without having to cut any tissue. The Medicine Meets Virtual Reality Conference held at the end of January in San Diego, formed an ideal occasion to give a fascinating demonstration of this unique combination of technologies.

Enhanced speed and quality of Internet2 offers new telemedicine opportunities
In the autumn of 1996, thirty four American universities set up an ad hoc project, called Internet2. Their mission was to provide the desktop PC user with ever growing faster access to data. By October 1997, one hundred and sixteen universities and various information technology companies in the States were participating to develop applications that would benefit from the enormous increases in speed and bandwidth being created in a federally funded networking effort similar to the early days of the Internet. At present, the University Corporation for Advanced Internet Development constitutes the global organisation for the commercialisation of Internet2 technology. The next generation of the Internet will undoubtedly exercise a profound influence on the future implementations of the telemedicine concept.

Anatomic VisualiseR© provides students with fascinating Virtual Learning Environment
At the Learning Resources Centre (LRC) of the University of California San Diego (UCSD) School of Medicine, Professor Helene Hoffman and her colleagues have studied since 1995 the possibilities to implement Virtual Reality (VR) based simulation in the teaching and learning of human anatomy. This strategy has resulted in the prototype development of a flexible and extensible object oriented 3-D software architecture, called VisualiseR©. The educational application integrates 3-D anatomic models with supporting 2-D media such as diagnostic images, surgical videos and literature searches, as to create a VR-Multimedia Synthesis (VR-MMS) Environment. In the future, the Anatomic VisualiseR© will help medical students to establish a context for their acquired knowledge, skills and reasoning.

How to forge criteria for assessment of visual depth perception in Virtual Environments
On the last conference day of Medicine Meets Virtual Reality, which took place in San Diego at the end of January, Dr. Helene Hoffman, professor at the University of California (UCSD) School of Medicine, presented a well-defined concept for a behaviourally based method to obtain precise information on the impact of Virtual Environment (VE) design choices on perception and performance of perceptual-motor tasks. This experiment fits into a series of studies to elucidate the relative merits of VR-based teaching systems such as the Anatomic VisualiseR© prototype and the role of interface design on educational outcomes. Before the VisualiseR© will be implemented within UCSD's preclinical anatomy curriculum, the exact cost-benefit relation of the application should be determined.

PRIMEDIA and VHA join efforts for satellite delivered health care education and information
VHA unites more than 1600 leading community-owned health care organisations in the States in a nationwide network. To optimally serve its members, the company has closed a four-year deal with PRIMEDIA Workplace Learning in order to supply continuing education and training programs as well as relevant and up-to-date news directly to the participating medical facilities via satellite. This partner has been specialising in the production of flexible, customised distance learning solutions to professionals in a large variety of markets. The health care domain is one of the central areas in their policy.

Early telemedical intervention gets the best out of less fortunate children
The Telemedicine Centre of the Medical College of Georgia has set up an Early Intervention Programme called Satilla. The general idea is to gather health care specialists around children who are born tiny and prematurely, and who suffer from Down's Syndrome or cerebral palsy , or who are exposed to high risk factors such as an alcoholic mother. The development of the child's condition is being followed at regular times by telemedicine consult involving the whole team of specialists. The programme avoids the need for long distance travel to visit one care taker after another in a short time. In this way, the child doesn't get upset or restless since it can be examined in the familiar environment of the local health care department.