Telemedicine project integrates Rome Labs, Welch Allyn, SUNY Health Science Center, and U.S. Army

CNY Business Journal (1996+), Nov 11, 1996 by Wilson, Fred

Rome Laboratory, in collaboration with Welch Allyn, the U.S. Army, and the SUNY Health Science Center (HSC) at Syracuse, recently demonstrated the use of medical informatics on the battlefield. The technologies permit wireless transmission of vital medical information, both from the field and from a transport airplane, to a base hospital, where physicians interpret data and prescribe treatment to military medics at the patient's side. The demonstration was part of the U.S. Army's Global Yankee '93 tactical exercises at Fort Drum. Rome Laboratories communication software made possible the transmission of medical data acquired by Welch Allyn video-diagnostic equipment. Rome Labs and Welch Allyn co-sponsored the demonstration.

The Business Journal interviewed Welch Allyn's Tim Callahan and Rome Laboratory's Daniel Hague and Richard Metzger.

Question: How are these technologies used to treat patients on a battlefield?

Tim Callahan, Welch Allyn: A corpsman on the battlefield decides whether a wounded soldier can be healed within three days. If not, the soldier is evacuated -- moved from the "incident site" in the field to the "staging site," which is an air strip equipped with medical-diagnostic instruments. Here, medics immediately measure vital signs -- blood pressure, pulse, p02 (oxygen saturation), and temperature -- and forward this and, in some cases, other medical information, to the base hospital. This process continues on the aircraft so that, upon arrival, base medical personnel can immediate assign treatment priorities (triage).

Q: How and why was this project conceived?

Richard Metzger, Rome Laboratory: The Global Yankee '96 telemedicine application of Rome Laboratory communications software is one of a number of uses for this technology. We are primarily focused on "in-theater" trauma care. We had asked Dr. Robert Corona at SUNY HSC what medical information should be sent from an airborne C-130 transport plane to a ground station. Dan Hague and his communications group have been testing and developing high-speed networks and network-management technology. We looked at video teleconferencing, and the application to telemedicine became apparent.

Global Yankee '95 was the first such exercise in our wireless-video teleconferencing from the field to the main base at Fort Drum, then into NYNET and SUNY HSC. From this project, Global Yankee '96 emerged, requiring diagnostic instruments such as those made by Welch Allyn.

Q: What is NYNET?

Daniel Hague, Rome Laboratory: NYNET is a high-speed-network testbed which uses asynchronous-transfer-mode (ATM) technology and spans New York State. NYNET was installed by NYNEX and connects us at Rome Labs with Syracuse University, Columbia University, Cornell University, and other players, including SUNY HSC.

Q: How is the medical information transmitted?

Metzger: Our ground base has high-bandwidth radio links and fiberoptics infrastructure for full-motion video. We have only lower bandwidth resources in an airplane. We therefore take snapshots -- each is one frame of video -- and convert these into the digital domain, then send the high-resolution, full-color still images to base by wireless transmission. With this technology, medics on the aircraft can even send an electrocardiogram. At that point, the physician on the ground has all the medical intelligence he needs -- vitals, patient forms, history, electrocardiograms, and an image of the wound if necessary. This can all be done in a few minutes.

Q: What is the maximum range of transmission?

Hague: Our range is limitless because we can use satellites. Medical personnel need only transmit information to the ground, from which ground-based assets are available.

Q: What are the ground assets?

Hague: There is a range of 1,000 miles through which an airplane can send signals to the ground, using satellites. From there, data is converted to HTML for transmission to anywhere via the Web-based technology -- the Intranet concept.

Q: How does Rome Labs, a military organization, view this project?

Hague: Rome Labs is the U.S. Air Force superlab for command-and-control communications and intelligence technology. We view medical problems as command-and-control with a different set of information. Instead of pictures of tanks and trucks and the commander's headquarters, we transmit X-rays, an MRI, and vital signs. Instead of a commander making decisions, a physician makes the decisions.

Q: What other uses are there for this technology?

Callahan: Welch Allyn equipment was also used in the recent Olympics held in Atlanta. We placed the diagnostic equipment in Olympic Village for treating injured athletes and also at the equestrian events for treating animals. This permitted attending physicians to transmit images and other medical information over T-1 telephone lines to one of three or four U.S. hospitals for specialist consultation.

Q: What future projects do you envision?

Metzger: I would like to miniaturize some components, have greater bandwidth to accomplish more things, and explore Web-based technology.