Sep. 13, 1997 Soon people who do not live in or near large cities with major medical facilities will have expert medical care readily available. Patients in remote or medically underserved areas of the country will benefit from an experiment in advanced telemedicine conducted jointly by NASA's Lewis Research Center, Cleveland, OH, and Ames Research Center, Moffett Field, CA, and James D. Thomas, M.D., FACC, of The Cleveland Clinic Foundation, Cleveland, OH.
Recently, a "patient" undergoing an echocardiographic examination at Lewis was "remotely" diagnosed by Dr. Thomas at Ames. He viewed a real-time display of echocardiographic video images transmitted over the broadband NASA Research and Education Network (NREN). Dr. Thomas interactively guided the technician administering the procedure through a two-way voice link between the two sites.
"I was very pleased with the diagnostic quality of the echocardiograms," said Dr. Thomas. "Digital echocardiographic equipment will be on the International Space Station when it is operational. Echocardiography is more practical for life in space than other imaging techniques, such as magnetic resonance imaging (MRI) because it requires less power, is noninvasive, is small and versatile, and is not magnetic or radioactive. The early results of our experiment support our belief that this technology holds great promise for use in space as well as use on Earth by means of telemedicine."
Echocardiography is a medical technique that applies the methods of ultrasound imaging to the cardiac system, providing a "motion picture" of the heart in action. A small, rural clinic may have access to an echocardiograph machine but not to a technician specially trained in its operation, or to a staff cardiologist. If the clinic were connected to a major metropolitan medical facility through a high-speed communications network, a minimally trained technician could carry out the procedure under the supervision and guidance of qualified echocardiography personnel.
While many telemedicine requirements can be satisfied by the transmission of still images (e.g., X-ray photographs), the challenge of procedures such as echocardiography is that high- resolution, moving images must be transmitted in real time. This requires a reliable broadband network and a robust data- compression mechanism.
"In the demonstration, we used the NREN to assess the clinical feasibility of conducting remote echocardiography, as well as the technical feasibility of supporting remote echocardiography, by determining the minimum network needed and the maximum video compression required to produce a transmission of high-resolution medical imagery," said Christine Falsetti, NREN project manager at Ames.
The NASA Research and Education Network is NASA's cornerstone project of the interagency Next Generation Internet (NGI) Initiative. In Oct. 1996, President Clinton and Vice President Gore announced their commitment to the NGI initiative based upon the strong research and development programs across Federal agencies.
"This experiment was a step toward reaching the goals of the NGI," said David A. Foltz, networking project manager at Lewis. "Pushing current networking technologies to the limit helps us understand how to design, build and operate a national communications network for the future."
Reaching these goals will affect health care on Earth and will pave the way for physicians on Earth to view the heart function of an astronaut aboard the International Space Station.
During the experiment, Lewis provided network engineering staff and hardware support to Dr. Thomas, while Ames provided overall network management of the NREN and related technical support to Lewis personnel. The Cleveland Clinic Foundation provided echocardiograph equipment and support personnel used to examine the volunteer "patient" at Lewis.
This experiment is a part of the cooperative agreement involving a two-year, $4 million grant to support the research and development of a digital echocardiography lab at The Clinic, that NASA announced earlier this year.
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