Telemedicine goes to war

When the United States began attacking Iraq nearly two weeks ago, military forces deployed a new telecommunications system designed to support a hospital in a combat zone without the need for traditional paper forms and files.

The Navy's Fleet Hospitals hired GTSI Corp. to integrate the hardware and software to support a field hospital with operating rooms, ancillary services and up to 500 beds. The mobile system fits into four rugged cases, and two units already have been sent to the Middle East to support the war in Iraq.

The new technology is part of a proven strategy to treat the injured outside a traditional hospital setting during the "golden hour" when quick medical care may save a life.

Such "forward surgery takes the operating room out of the hospital, puts it into the forward environment, provides life-saving resuscitative surgery early and quickly," said Dr. John Mateczun, Joint Staff senior medical officer, in a recent briefing. "In fact, this strategy has been so successful that of those people who have made it back to forward surgical teams, all have survived."

Navy carriers have computer and teleradiology capabilities, but the GTSI system helps take medicine to new frontiers, according to Jeffrey Howell, who runs the Naval Telemedicine Business Office.

"X-rays can be sent anywhere in the world to be read," Howell said. "They get attention immediately. They get turned around in an hour around the clock."

This is possible because the system comes equipped with a satellite dish, folded into one of the heavy-duty cases, which allows the field hospitals to communicate with other military medical facilities in real time.

The system also comes equipped with Hewlett-Packard Co. servers, a public address system, Shoreline Communications Inc.'s Shoreline IP PBX phone system, more than 100 wireless Panasonic ruggedized notebooks, a secure network and medical software.

Twenty-eight vendors have provided software and hardware for the system. Microsoft Corp. provides communications software, and the Navy developed medical software that stores patient information on wounded personnel.

For the military, the compact system is a vast improvement from past methods, which required truckloads of equipment to set up a frontline hospital in a "M*A*S*H"-like setting. Once operational, the Fleet Hospitals will be able to abandon paper in favor of electronic communications and records.

"It is like night and day compared to the [first] Gulf War," Howell said. "Telemedicine has come a [long] way. We're running at a very fast pace."

Regardless of where the system is located, it can communicate with the outside world. In fact, the network uses local phone numbers so hospital workers do not have to dial long distance for phone, fax or computer hookups.

The telecom system is now being used for potential military casualties, but it also can be deployed for humanitarian missions, such as after earthquakes, forest fires or floods, according to Steve Valencourt, a network systems analyst at the Fleet Hospital Support Office in Williamsburg, Va.

"I designed the system with the goal of being as straightforward and as reliable as possible," Valencourt said. "We built in a great deal of reliability and redundancy. We used manufacturers who have a good record of performance."

Since Sept. 11, 2001, GTSI has turned its attention to "creating fast and mobile response solutions," said Dendy Young, GTSI's chairman and chief executive officer. "GTSI technology teams have transformed off-the-shelf products and services into a unique solution that lets the Navy quickly mobilize a complete paperless medical facility."

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What is telemedicine?

The Navy pioneered telemedicine as a way to help treat wounded servicemen and women close to the battlefield. Here are some key features of the technology:

* The technology is available on all large-deck military ships and in the field with mobile technology supplied by GTSI Corp.

* Medical personnel have instant access to ship- and land-based specialists using computer technology to transmit information around the clock.

* Doctors in the field can access hospital-based technology and transmit X-rays and other tests for diagnosis.

* The telemedicine system uses computer data-bases to maintain patient information rather than relying on a paper-based system.

* The system transmits information via a satellite line that operates at speeds similar to land-based T1 lines.