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At least 55 records · Page 3
All sourcesNASA NTRSDOE OSTI
NASA NTRS1991

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.↗
NASA NTRS1991

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↗
NASA NTRS1984

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.

Source record↗
NASA NTRS1991

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.

Source record↗
NASA NTRS1996

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.↗
NASA NTRS1991

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.↗
NASA NTRS2002

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↗
NASA NTRS1977

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.

Source record↗
NASA NTRS2000

Bridging the Gap from Networking Technologies to Applications: Workshop Report

The objective of the Next Generation Internet (NGI) Federal program is threefold, encompassing development of networking technologies, high-performance network testbeds, and revolutionary applications. There have been notable advances in emerging network technologies and several nationwide testbeds have been established, but the integration of emerging technologies into applications is lagging. To help bridge this gap between developers of NGI networking technologies and developers of NGI applications, the NASA Research and Education Network (NREN) project hosted a two-day workshop at NASA Ames Research Center in August 1999. This paper presents a summary of the results of this workshop and also describes some of the challenges NREN is facing while incorporating new technologies into HPCC and other NASA applications. The workshop focused on three technologies - Quality of Service (QoS), advanced multicast, and security-and five major NGI application areas - telemedicine, digital earth, digital video, distributed data-intensive applications, and computational infrastructure applications. Network technology experts, application developers, and NGI testbed representatives came together at the workshop to promote cross-fertilization between the groups. Presentations on the first day, including an overview of the three technologies, application case studies and testbed status reports, laid the foundation for discussions on the second day. The objective of these latter discussions, held within smaller breakout groups, was to establish a coherent picture of the current status of the various pieces of each of the three technologies, to create a roadmap outlining future technology development, and to offer technological guidance to application developers. In this paper we first present a brief overview of the NGI applications that were represented at the workshop, focusing on the identification of technological advances that have successfully been incorporated in each application and technological challenges that remain. Next we present the technology roadmaps that were created at the workshop, summarizing the status of various mechanisms that are currently under development and forecasting when various advances are likely to occur within the next one-to-three-year time span. Then we identify issues that were raised at the workshop that might hinder technology development or that might impede integration into NGI applications. We also report some specific guidelines that were offered at the workshop to enable application developers to integrate and effectively use emerging NGI technology building blocks. Finally, we describe NREN activities to incorporate emerging technologies into NASA applications. These activities include support for other NASA High-Performance Computing and Communications Program areas such as IPG (Information Power Grid), support for NASA science enterprises such as Earth science and Mars program prototyping activities, support for satellite/terrestrial networking applications such as the TransAtlantic and TransPacific demonstrations and the Interplanetary Internet, support for NASA telemedicine applications such as the Virtual Collaborative Clinic, and participation in NGI advanced technology testbed initiatives such as the QBone and the NTON/Supernet. For each activity we highlight the primary technological challenge that is associated with it.

Johnson, Marjory J.↗
NASA NTRS2000

Real-time transmission of full-motion echocardiography over a high-speed data network: impact of data rate and network quality of service

With high-resolution network transmission required for telemedicine, education, and guided-image acquisition, the impact of errors and transmission rates on image quality needs evaluation. METHODS: We transmitted clinical echocardiograms from 2 National Aeronautics and Space Administration (NASA) research centers with the use of Motion Picture Expert Group-2 (MPEG-2) encoding and asynchronous transmission mode (ATM) network protocol over the NASA Research and Education Network. Data rates and network quality (cell losses [CLR], errors [CER], and delay variability [CVD]) were altered and image quality was judged. RESULTS: At speeds of 3 to 5 megabits per second (Mbps), digital images were superior to those on videotape; at 2 Mbps, images were equivalent. Increasing CLR caused occasional, brief pauses. Extreme CER and CDV increases still yielded high-quality images. CONCLUSIONS: Real-time echocardiographic acquisition, guidance, and transmission is feasible with the use of MPEG-2 and ATM with broadcast quality seen above 3 Mbps, even with severe network quality degradation. These techniques can be applied to telemedicine and used for planned echocardiography aboard the International Space Station.

NASA Discipline Cardiopulmonary↗
NASA NTRS1999

New approaches to virtual environment surgery

This research focused on two main problems: 1) low cost, high fidelity stereoscopic imaging of complex tissues and organs; and 2) virtual cutting of tissue. A further objective was to develop these images and virtual tissue cutting methods for use in a telemedicine project that would connect remote sites using the Next Generation Internet. For goal one we used a CT scan of a human heart, a desktop PC with an OpenGL graphics accelerator card, and LCD stereoscopic glasses. Use of multiresolution meshes ranging from approximately 1,000,000 to 20,000 polygons speeded interactive rendering rates enormously while retaining general topography of the dataset. For goal two, we used a CT scan of an infant skull with premature closure of the right coronal suture, a Silicon Graphics Onyx workstation, a Fakespace Immersive WorkBench and CrystalEyes LCD glasses. The high fidelity mesh of the skull was reduced from one million to 50,000 polygons. The cut path was automatically calculated as the shortest distance along the mesh between a small number of hand selected vertices. The region outlined by the cut path was then separated from the skull and translated/rotated to assume a new position. The results indicate that widespread high fidelity imaging in virtual environment is possible using ordinary PC capabilities if appropriate mesh reduction methods are employed. The software cutting tool is applicable to heart and other organs for surgery planning, for training surgeons in a virtual environment, and for telemedicine purposes.

NASA Discipline Neuroscience↗
NASA NTRS1998

Real-Time, Interactive Echocardiography Over High-Speed Networks: Feasibility and Functional Requirements

Real-time, Interactive Echocardiography Over High Speed Networks: Feasibility and Functional Requirements is an experiment in advanced telemedicine being conducted jointly by the NASA Lewis Research Center, the NASA Ames Research Center, and the Cleveland Clinic Foundation. In this project, a patient undergoes an echocardiographic examination in Cleveland while being diagnosed remotely by a cardiologist in California viewing a real-time display of echocardiographic video images transmitted over the broadband NASA Research and Education Network (NREN). The remote cardiologist interactively guides the sonographer administering the procedure through a two-way voice link between the two sites. Echocardiography is a noninvasive medical technique that applies ultrasound imaging to the heart, providing a "motion picture" of the heart in action. Normally, echocardiographic examinations are performed by a sonographer and cardiologist who are located in the same medical facility as the patient. The goal of telemedicine is to allow medical specialists to examine patients located elsewhere, typically in remote or medically underserved geographic areas. For example, a small, rural clinic might have access to an echocardiograph machine but not a cardiologist. By connecting this clinic to a major metropolitan medical facility through a communications network, a minimally trained technician would be able to carry out the procedure under the supervision and guidance of a qualified cardiologist.

Bobinsky, Eric A.↗