Telemedicine: The assessment of an evolving health care technology
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Reich, J. J.↗
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Telemedicine: An expanding new science on land and sea
Several medical and technical men in San Diego County are concerned with the need in many rural communities for a 24-hour day, 7-days a week access to adequate medical care. People isolated from urban areas by travel-times of 40-minutes tend to delay seeking early and effective medical care. The authors were able to assemble quality technology which permits narrow-band video-pictures, better known in the CB trade as ROBOT slow-scan television (SSTV), to be transmitted over telephone lines, by micro-wave, through satellite-bounce, or by HF-radio. These 'ROBOT' pictures can be accompanied with explanatory audio communication and with diagnostic signals from electronic instruments.
Jackman, K. R.↗
Medical informatics and telemedicine: A vision
The goal of medical informatics is to improve care. This requires the commitment and harmonious collaboration between the computer scientists and clinicians and an integrated database. The vision described is how medical information systems are going to impact the way medical care is delivered in the future.
Clemmer, Terry P.↗
Global considerations for implementation of telemedicine
In Dec. 1989, the United Nations proclaimed the Decade 1990-1999 as the International Decade for Natural Disasters Reduction (IDNDR). The Decade identified a number of research programs. IDNDR, provides a unique opportunity to explore the potential offered by the emerging technologies, and to promote, develop, and support those technologies deemed adequate to make the next century a safer one, especially in the poorest countries of the world. But all this improvement cannot be accomplished in a vacuum. We must begin now to eliminate pitfalls and illusions. A new attitude must emerge. In the scope of reducing human damages resulting from disasters, we must reconsider the cross-cultural understanding, and reach a real awareness which combines humility with a sense of relativeness. Promoting the right context is essential to the mandate of the Decade.
Lechat, M. F.↗
Use of satellite telecommunications for telemedicine
The use of space telecommunications facilities in the interests of medicine should establish a reliable and timely connection between the specialists involved and access for each of them to information sources the need. Since a certain global-scale program should be implemented for this goal to be achieved, one of the top-priority tasks is to determine appropriate orbital facilities for telecommunications as well as appropriate areas and countries for them, outlining the territories where portable data receive/transport records can be placed and stations that are cheap and simple enough to operate can be stored. Eventually the satellite telecommunications system should encourage health workers to unite in a world community on the basis of a regular and efficient information exchange with the goal of protecting the health of man and the peace of Earth. This goal could only be achieved by gradually removing differences in the domain of medical education and information in different regions over the globe, by providing a possibility of rapid and coordinated access to the information on medical problems of interest on the global scale, as well as by coordinating the discussion and solution of all problems associated with the development and progress of the satellite communications system.
Tamkovich, Gennady↗
The Use of the Discrete Wavelet Transform to Perform High Level Data Compression for Applications in Telemedicine
The document includes an executive summary of the program activities; questions regarding tiling that have yet to be addressed; and the impact of the grants received which include MDACC Infrastructure development, support of technology transfer, and the technical accomplishments of the program.
Schomer, Donald F.↗
Slow Scan Telemedicine
Originally developed under contract for NASA by Ball Bros. Research Corporation for acquiring visual information from lunar and planetary spacecraft, system uses standard closed circuit camera connected to a device called a scan converter, which slows the stream of images to match an audio circuit, such as a telephone line. Transmitted to its destination, the image is reconverted by another scan converter and displayed on a monitor. In addition to assist scans, technique allows transmission of x-rays, nuclear scans, ultrasonic imagery, thermograms, electrocardiograms or live views of patient. Also allows conferencing and consultation among medical centers, general practitioners, specialists and disease control centers. Commercialized by Colorado Video, Inc., major employment is in business and industry for teleconferencing, cable TV news, transmission of scientific/engineering data, security, information retrieval, insurance claim adjustment, instructional programs, and remote viewing of advertising layouts, real estate, construction sites or products.
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Keynote address. Second NASA/Uniformed Services University of Health Science International Conference on Telemedicine, Bethesda, Maryland
No abstract available
Telemedicine/trends↗
Technical Challenges in Providing Ophthalmic Telemedicine for Ocular Monitoring During Long-Duration Space Flight
No abstract available
Caputo, Michael↗
Medical Optimization Network for Space Telemedicine Resources (MONSTR)
No abstract available
Rubin, David↗
Medication abortion via digital health in the United States: a systematic scoping review
Digital health, including telemedicine, has increased access to abortion care. The convenience, flexibility of appointment times, and ensured privacy to abortion users may make abortion services via telemedicine preferable. This scoping review systematically mapped studies conducted on abortion services via telemedicine, including their effectiveness and acceptability for abortion users and providers. All published papers included abortion services via telemedicine in the United States were considered. Articles were searched in PubMed, CINAHL, and Google Scholar databases in September 2022. The findings were synthesized narratively, and the PRISMA-ScR guidelines were used to report this study. Out of 757 retrieved articles, 33 articles were selected based on the inclusion criteria. These studies were published between 2011 and 2022, with 24 published in the last 3 years. The study found that telemedicine increased access to abortion care in the United States, especially for people in remote areas or those worried about stigma from in-person visits. The effectiveness of abortion services via telemedicine was comparable to in-clinic visits, with 6% or fewer abortions requiring surgical intervention. Both care providers and abortion seekers expressed positive perceptions of telemedicine-based abortion services. However, abortion users reported mixed emotions, with some preferring in-person visits. The most common reasons for choosing telemedicine included the distance to the abortion clinic, convenience, privacy, cost, flexibility of appointment times, and state laws imposing waiting periods or restrictive policies. Telemedicine offered a preferable option for abortion seekers and providers. The feasibility of accessing abortion services via telemedicine in low-resource settings needs further investigation.
60 APPLIED LIFE SCIENCES↗
International Telemedicine/Disaster Medicine Conference: Papers and Presentations
The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.
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Communications satellites in the national and global health care information infrastructure: their role, impact, and issues
Health care services delivered from a distance, known collectively as telemedicine, are being increasingly demonstrated on various transmission media. Telemedicine activities have included diagnosis by a doctor at a remote location, emergency and disaster medical assistance, medical education, and medical informatics. The ability of communications satellites to offer communication channels and bandwidth on demand, connectivity to mobile, remote and under served regions, and global access will afford them a critical role for telemedicine applications within the National and Global Information Infrastructure (NII/GII). The importance that communications satellites will have in telemedicine applications within the NII/GII the differences in requirements for NII vs. GII, the major issues such as interoperability, confidentiality, quality, availability, and costs, and preliminary conclusions for future usability based on the review of several recent trails at national and global levels are presented.
Zuzek, J. E.↗
Medical care delivery in the US space program
The stated goal of this meeting is to examine the use of telemedicine in disaster management, public health, and remote health care. NASA has a vested interest in providing health care to crews in remote environments. NASA has unique requirements for telemedicine support, in that our flight crews conduct their job in the most remote of all work environments. Compounding the degree of remoteness are other environmental concerns, including confinement, lack of atmosphere, spaceflight physiological deconditioning, and radiation exposure, to name a few. In-flight medical care is a key component in the overall support for missions, which also includes extensive medical screening during selection, preventive medical programs for astronauts, and in-flight medical monitoring and consultation. This latter element constitutes the telemedicine aspect of crew health care. The level of in-flight resources dedicated to medical care is determined by the perceived risk of a given mission, which in turn is related to mission duration, planned crew activities, and length of time required for return to definitive medical care facilities.
Stewart, Donald F.↗
Performance of advanced trauma life support procedures in microgravity
BACKGROUND: Medical operations on the International Space Station will emphasize the stabilization and transport of critically injured personnel and so will need to be capable of advanced trauma life support (ATLS). METHODS: We evaluated the ATLS invasive procedures in the microgravity environment of parabolic flight using a porcine animal model. Included in the procedures evaluated were artificial ventilation, intravenous infusion, laceration closure, tracheostomy, Foley catheter drainage, chest tube insertion, peritoneal lavage, and the use of telemedicine methods for procedural direction. RESULTS: Artificial ventilation was performed and appeared to be unaltered from the 1-G environment. Intravenous infusion, laceration closure, percutaneous dilational tracheostomy, and Foley catheter drainage were achieved without difficulty. Chest tube insertion and drainage were performed with no more difficulty than in the 1-G environment due to the ability to restrain patient, operator and supplies. A Heimlich valve and Sorenson drainage system were both used to provide for chest tube drainage collection with minimal equipment, without the risk of atmospheric contamination, and with the capability to auto-transfuse blood drained from a hemothorax. The use of telemedicine in chest tube insertion was demonstrated to be useful and feasible. Peritoneal lavage using a percutaneous technique, although requiring less training to perform, was found to be dangerous in weightlessness due to the additional pressure of the bowel on the anterior abdominal wall creating a high risk of bowel perforation. CONCLUSIONS: The performance of ATLS procedures in microgravity appears to be feasible with the exception of diagnostic peritoneal lavage. Minor modifications to equipment and techniques are required in microgravity to effect surgical drainage in the presence of altered fluid dynamics, to prevent atmospheric contamination, and to provide for the restraint requirements. A parabolic simulation system was developed for equipment and procedure verification, physiological research, and possible crew medical officer training in the future.
Parabolic Flight↗
STARPAHC systems report. Volume 2: Operational performance
The Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) demonstrated the value and potential of telemedicine using physician's assistants for providing quality health care delivery to people in a remote area. Generally, the program's achievements were to: (1) establish the feasibility of the STARPAHC concept in the delivery of health care; (2) gain information for developing health care systems for future manned spacecraft; (3) determine the constraints and capabilities involved in the interaction between physicians and non-physician health care personnel; (4) determine effectiveness of the STARPAHC technique; and (5) define the additional developments that are needed and/or most valuable to improving telemedicine and its exportable potential.
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