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Telemedicine and International Disaster Response: Medical Consultation to Armenia and Russia Via a Telemedicine Spacebridge

Published online by Cambridge University Press:  28 June 2012

Bruce A. Houtchens*
Affiliation:
Department of Surgery, University of Utah, Salt Lake City, Utah
Terry P. Clemmer
Affiliation:
Director, Division of Critical Care, LDS Hospital, Salt Lake City, Utah
Harry C. Holloway
Affiliation:
Uniformed Services University of the Health Sciences, Bethesda, Md.
Alexander A. Kiselev
Affiliation:
Director, Soyuzmedinform, Moscow, Russia, CIS
James S. Logan
Affiliation:
Space Medical Services, Tulsa, Okla.
Ronald C. Merrell
Affiliation:
Associate Dean for Clinical Affairs, University of Texas Health Sciences Center at Houston, Houston, Tex.
Arnauld E. Nicogossian
Affiliation:
Chief Medical Officer, Office of Space Flight, NASA Headquarters, Washington, D.C.
Haik A. Nikogossian
Affiliation:
Office of the Director, Republic Diagniostic Center, Yerevan, Armenia, CIS
Russell B. Rayman
Affiliation:
Executive Vice President, Aerospace Medical Association, Alexandria, Va.
Ashot E. Sarkisian
Affiliation:
Department of Diagnostic Imaging, Republic Diagnostic Center, Yerevan, Armenia, CIS
John H. Siegel
Affiliation:
Director, New Jersey State Trauma Center, Chief, Section of Trauma Surgery, University of Medicine and Dentistry of New Jersey, Newark, N.J.
*
Department of Surgery, University of Utah, 500 Foothill Drive, Salt Lake City, UT 84132USA

Abstract

Introduction:

The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa.

Methods:

During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas.

Results:

Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47 and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent.

Conclusion:

These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

Type
Special Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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Footnotes

*

This paper was presented and discussed at the International Conference on Disaster Medicine, Moscow, U.S.S.R., 22–23 May 1990; International Symposium on Medical Aspects of Earthquake Consequences in Armenia, in Yerevan, Armenia, U.S.S.R., 9–11 October 1990; and Disaster Medicine Conference in Bethesda, Maryland, USA, 9–12 December 1992.

References

1. Pesola, G, Bayshtok, V, Kvetan, V: American critical care team at a foreign disaster site: The Armenian experience. Crit Care Med 1989:6:582586.CrossRefGoogle Scholar
2. House, AM, Roberts, JM: Telemedicine in Canada. Can Med Assoc J 1977:117:386388.Google Scholar
3. Watson, DS: Telemedicine. Med J Aust 1989:151:6271.Google Scholar
4. Gladston, I: What have radio and television to contribute to continuing medical education? J Med Educ 1954:29:2830.Google Scholar
5. Driver, SC, Shepherd, DU, Walpole, GRO: A comparison of three methods of using television for the continuing medical education of general practitioners. Brit J Med Educ 1972:6:246252.CrossRefGoogle ScholarPubMed
6. Fisch, A, Dwyer, TF. Interactive television in continuing education of foreign trained psychiatrists. J Med Educ 1972:47:912914.Google Scholar
7. House, M, Keough, E, Hillman, D, et al. : Into Africa: The telemedicine links between Canada, Kenya, and Uganda. Can Med Assoc J 1987:136:398400.Google ScholarPubMed
8. Scott, AA, Boehm, LA: Continuing education through telemedicine for Ontario. Can Med Assoc J 1988:138:1011.Google ScholarPubMed
9. O'Neill, JJ, Nocerino, JT, Walcoff, P: Benefits and problems of seven exploratory telemedicine projects [MTR-6787], Mitre Corporation, Washington D.C. 1975:1100.Google Scholar
10. Bashshur, RL, Lovett, J: Assessment of telemedicine: Results of the initial experience. Aviat Space Environ Med 1977:48:6570.Google ScholarPubMed
11. Gershon-Cohcn, J, Cooley, AG: Telegnosis. Radiology 1950:55:582587.CrossRefGoogle Scholar
12. Benschoter, R: Multipurpose television. Ann NY Acad Sci 1967:142:471478.CrossRefGoogle ScholarPubMed
13. Dwyer, TF: Telepsychiatry: Psychiatric consultation by interactive television. Am J Psychiatry 1973:130:865869.Google Scholar
14. Fuchs, M: Provider attitudes toward STARPAHC: A telemedicine project on the Papago reservation. Med Care 1979:17:5968.CrossRefGoogle Scholar
15. Higgins, LC: Rural docs: Narrowing the gaps. Med World News 1989:30:3238.Google ScholarPubMed
16. Castle, CH: Open circuit television in postgraduate medical education. J Med Educ 1963:38:255260.Google Scholar
17. Hays, RB: A training program for rural general practice. Med J Aust 1990:153:546548.CrossRefGoogle ScholarPubMed
18. Foote, DR. Satellite communication for rural health care in Alaska. J Commun 1977:27:173182.Google Scholar
19. Carey, LS, Russell, ES, Johnson, EE, Wilkins, WW: Radiographic consultation to a remote Canadian hospital using Hermes spacecraft. J Can Assoc Radiol 1979:30:1220.Google Scholar
20. Nicogossian, A, Kiselev, AA: Telemedicine in extreme situations (in Russian). Voen Med Zh 1990:8:4042.Google Scholar
21. Gravenslein, JS, Berzina-Moettus, L, Regan, A, et al. : Laser mediated telemedicine in anesthesia. Anesth Analg 1975:53:605609.Google Scholar
22. Staub, FJ: OR consultation by telemedicine. AORN J 1977:25:11691178.CrossRefGoogle ScholarPubMed
23. Bird, KT: Cardiopulmonary frontiers: Quality health care via interactive television. Chest 1972:61:204205.Google Scholar
24. Grundy, BL, Jones, PK, Lovitt, A: Telemedicine in critical care: Problems in design, implementation, and assessment. Crit Care Med 1982:10:471475.CrossRefGoogle ScholarPubMed
25. Southard, TE, Pierce, LJ: The application of digitized image transmission to forensic dentistry. Milit Med 1986:151:413415.Google Scholar
26. James, JJ, Grabowski, W, Mangelsdorff, AD. The transmission and interpretation of emergency department radiographs: Ann Emerg Med 1982:11:404408.Google Scholar
27. Solheim, K: Emergency medicine and telemedicine (in Norwegian). Tidsskr Nor Laeqeforen 1990:110:936937.Google Scholar
28. Dunn, EV, Conrath, DW: Primary care: Clinical judgment and reliability. NY State J Med 1977:77:748754.Google ScholarPubMed
29. Garden, JW, Knapp, CF, Sanders, JH: Biomicroscopic electronic imaging and data transfer. Arch Ophthalmol 1990:1008:637638.Google Scholar
30. Cunningham, N, Marshall, C, Glazer, E: Telemedicine in pediatric primary care. JAMA 1978:240:27492751.CrossRefGoogle Scholar
31. Riggs, RS, Purtilo, DT, Connor, DH, Kaiser, J: Medical consultation via communications satellite. JAMA 1974:228:600602.CrossRefGoogle ScholarPubMed
32. Weinstein, RS, Bloom, KJ, Rozek, LS: Telepathology and the networking of pathology diagnostic senices. Arch Pathol lab Med 1987:111:646652.Google Scholar
33. Wittson, CL, Affleck, DC, Johnson, V: Two-way television in group therapy. Ment Hosp 1961:12:2223.Google Scholar
34. Solow, C, Weiss, RJ, Bergen, BJ, Sanborn, CJ: 24-hour psychiatric consultation via TV. Am J Psychiatry 1971:127:16841694.CrossRefGoogle ScholarPubMed
35. Webber, MM, Wilk, S, Pirruccello, R, Aiken, J. Telecommunications of images in the practice of diagnostic radiology. Radiology 1973:109:7174.CrossRefGoogle Scholar
36. Page, G, Sylvestry, J, Roberge, FA, et al. : Narrowband teleradiology. J Can Assoc Radiol 1982:33:221226.Google Scholar
37. Gitlin, JN. Teleradiology. Radiol Clin North Am 1986:24:5568.CrossRefGoogle ScholarPubMed
38. Weinstein, RS, Bloom, KJ, Rozek, LS. Telepathology: Long distance diagnosis. Am J Clin Path 1989;91:S39S42.Google Scholar
39. Dongier, M, Tempier, R, Lalinec-Michaud, M, Meunier, D: Telepsychiatry: Psychiatric consultation through two-way television. A controlled study. Can J Psychiatry 1986:31:3234.Google Scholar
40. Revesz, G, Kundel, HL: Transmission of radiographic images via closed circuit and microwave television techniques. Invest Radio 1973:8:392395.CrossRefGoogle ScholarPubMed
41. Andrus, WS, Dreyfuss, JR, Jaffer, F, Bird, KT: Interpretation of roentgenograms via interactive television. Radiology 1975:116:2531.CrossRefGoogle ScholarPubMed
42. James, JJ, Fill, W, Mangelsdorff, AD, et al. : Interpretation of radiographic images transmitted via satellite. Milit Med 1982:147:288295.Google Scholar
43. Markivee, CR, Mahanta, B, Savci, S, et al. : Diagnostic accuracy of a teleradiography image transmission system. MD Comput 1989:6:8893.Google Scholar
44. Carey, LS, O'Connor, BD, Bach, DB, et al. : Digital teleradiography: Seaforth-London network. Can Assoc Radiol J 1989:40:7174.Google Scholar