Telemedicine Program
Telemedicine is the interactive transmission of medical images
and data to provide better health care for people in remote or
"medically underserved" locations. The concept has
been around since the 1920s and its general viability has been
demonstrated since the 1950s, but wide adoption was slowed by
high costs and technological shortcomings.
Today the technique is burgeoning under the impetus of snowballing
advances in computer, videoconferencing and digital imaging technologies
that offer potentially reduced costs along with greater efficiency
in transmission and display.
Dr. Terry Lightner transmits the sounds of a child's heart
beating to a physician 250 miles away.
Since the 1970s, NASA has been in the forefront of research
and demonstration in the field of telemedicine. NASA has an obvious
interest because of the potential of telemedicine in care of
astronauts operating beyond Earth orbit in the future. But the
agency has a broader interest because it has been mandated by
Congress to promote the transfer to the private sector of technologies
developed in the course of aerospace research, and many of the
technologies that make telemedicine possible were originally
developed for acquiring visual information from lunar and planetary
spacecraft. NASA is actively engaged in developing new technologies
applicable to both space and Earth telemedicine and in spurring
broader acceptance of telemedicine by conducting demonstrations
of the technique's potential in cooperation with local governments
and the medical and industrial communities.
A demonstration of particular interest is an ongoing program,
started in 1995 and planned as a permanent operation, in which
the University of Texas Health Sciences Center at San Antonio
(UTHSCSA) is linked with South Texas Hospital, Harlingen, Texas,
250 miles distant. The South Texas area is classified as medically
underserved, with a special problem in the lack of physicians
and nurses trained in oncologic (cancerous) diseases. Until the
program started, 80 pediatric oncology patients at South Texas
Hospital were able to see UTHSCSA cancer specialists only once
a month when the specialists visited Harlingen.
Now, via two-way audio/video linkage, UTHSCSA physicians can
see and talk with South Texas patients, review laboratory work
and consult with doctors providing primary care at South Texas
Hospital. They are also conducting 80 hours a month of "teleclinics"
and providing instruction in pediatric oncology nursing techniques
and family counseling. In addition, South Texas Hospital is getting
specialty help in treating the increasing number of tuberculosis
cases in the area.
From San Antonio, Dr. James Legler views a blood slide in
Harlingen, Texas by means of video relay.
The South Texas project is the result of a broad public/private
sector collaboration. In addition to UTHSCSA, South Texas Hospital
and the Texas Department of Health, participants include VTEL
Corporation of San Antonio, which donated two desktop videoconferencing
systems, maintenance and staff support, and made available two
MediaConferencing (MediaConferencing is a trademark of VTEL Corporation)
systems at cost; Sprint, Inc., Kansas City, Missouri, which is
providing the high speed fiber optic cable link between San Antonio
and Harlingen; and Healthcare Open Systems and Trials (HOST)
Consortium, Washington, D.C., an industry-based effort to provide
rapid application of information technologies to improve health
care quality.
NASA contributed expertise to the telemedicine system's design,
integration, verification and validation, and additionally provided
one-third of the funding to operate the system during its first
year. The NASA effort was coordinated by the agency's Office
of Space Access and Technology; Dryden Flight Research Center
led the effort to integrate off-the-shelf computer and networking
systems into the telemedicine link; and Johnson Space Center
contributed networking and systems design expertise.
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