by Gregor Wolbring
08/31/08
NASA pioneered the concept of telemedicine in the 1960s to monitor the health of humans in space (Plush 2000). In 1997 the applications ranged from clinical consultations to interactive distance learning, electronic patient records and professional medical education (Clifton 1997). A full telemedicine theatre is being used in the city of Bagran in southern Afghanistan, which is linked to a U.S. Army hospital in Germany (Sinha 2003). Between 1993 and 2000, the military developed a Worldwide Telemedicine Rapid Deployment capability. Major user requirements included patient accountability, minimal need for evacuation, rapid trauma response, specialty medical consultation, and medical situational awareness (Industry Canada 2000). Currently, the United States and the United Kingdom have established at least two active telemedicine programs among the local national Iraqi providers (Guest Blogger 2008).
The UK’s program was established in 2004. It currently connects 37 Iraqi medical facilities and is serviced by over 387 volunteer medical consultants hailing from the USA, UK, Canada, Australia, and New Zealand. The U.S. Army tele-consult handled over 2,600 tele-consults since its inception in 2004. A low-cost, store and forward e-mail tele-consultation system is only available to the U.S. and coalition providers in Iraq. U.S. military providers located stateside answer consults (Guest Blogger 2008). The second, more costly telemedicine system, is for Iraq nationals and was initiated in 2006. It offers primarily educational opportunities (Guest Blogger 2008) . It makes long-distance lectures possible from 14 U.S.-based, venerable, civilian medical centers to the four large Iraqi hospitals in Baghdad, Mosul, Erbil, and Basra (Guest Blogger 2008).
The Tripler Army Medical Center located in Hawaii is the first military medical center to use telemedicine technology for long distance ICU care in Guam and Korea (Downey 2008). Two other projects are an automated medical treatment system that does not require onsite medical personnel on the front lines of battle, and is ready to receive, assess, and stabilize wounded soldiers during the critical hours following injury and a future generation of battlefield-based unmanned medical treatment systems, or "trauma pods," to stabilize injured soldiers within minutes after a battlefield trauma and administer life-saving medical and surgical care prior to evacuation and during transport. (SRI International 2005;Popular Mechanics.com 2007).
Military psychologists are using virtual reality systems to help treat Iraq war veterans suffering from post-traumatic stress disorder (Government HealthIT 2008;Pacific Telehealth & Technology Hui / TATRC 2008). The US Department of Defense investment in telemedicine for the years of 1993 – 1998 was 327 million dollars with over 192 projects(Reed and Army War Coll Carlisle Barracks PA 2002).
Today in the US the following military related agencies have activities in Telemedicine, Telehealth, and Health Technologies (Bloch 2008):
Health Affairs, Military Health Systems, Biological Research and Defense Systems, Defense Knowledge Online Portal, Global Expeditionary System, Electronic Surveillance Systems (ESSENCE), Defense Medical Epidemiology Database, Defense Occupational Environmental Health Readiness System, Defense Medical Surveillance System, Theater Enterprise Wide Logistics System, JMeWS, Joint Medical Logistics Automated System, Theater Medical Information Program, AHLTA, TRICARE, VA & DOD Joint Efforts University Collaborations, Programs to Study Military Health Care, Armed Forces Medical Intelligence Center
TATRC, Technologies Deployed in the Field, Walter Reed Army Medical Center Technologies, Walter Reed Army Institute of Research, Telemedicine Directorate, Neurosurgery Service, Telepathology, Medical Applications Center, Tripler Army Medical Center, Digital Programs, DOD/VA Interoperability Project, Pacific Telehealth and Technology HUI, Fort Gordon, Fort Sam Houston, Brooke Army Medical Center Institute of Surgical Research, Army SBIR Program
Teleradiology, Virtual Medical Clinics, Fleet Technology, Tactical Medical Coordination System, National Naval Medical Center, Naval Medical Information Management Center, Naval Telemedicine Business Office, Naval Medicine Online, Office of Naval Research, Naval Health Research Center, Naval Ambulatory Care Center, Medical Data Surveillance System, Bioterrorism and Biowarfare
Teleradiology, University of Pittsburgh and Air Force Effort, Equipment in the Field, Bioterrorism and Disaster Response, Wilford Hall Medical Center
Combat Medical Informatics Program; Defense Science Office, Advanced Biomedical Technology Program, Biological Sciences Program, Bio Materials, Information Technology; DARPA SBIR Program; DOD Science and Technology Dual Use Program
Uniformed Services University of the Health Services
Department of Biomedical Informatics, Medical Simulation Center and Patient Simulation Laboratory, Casualty Care Research Center, Center for Disaster and Humanitarian for Medicine
Information Technology Databases, Informatics Support for Chronic Illness Care and the Visually Impaired, Rural Health Initiatives, Patient Safety and Health Quality, Bar Code Medication Administration System, Telemental Health Research, Telehealth Program for Underserved and Native American Veterans, Office of Care Coordination, Veterans Health Activities and Services, Vista Office EHR System Collaborative Effort, Health Services Research & Development, Veterans Health Initiative
Biological and Physical Research Office, Health and Medical Office, National Space Biomedical Research Institute, International Space Station, Biomolecular Systems Research, Space Centers, Ames Research Center, Jet Propulsion Laboratory, Langley Research Center, Johnson Space Center, Marshall Space Flight Center, Medical Informatics and Technology Application
To just highlight one. The US Army Telemedicine and Advanced Technology Research Center TATRC has the following programs(US Army Telemedicine and Advanced Technology Research Center (TATRC) 2008)
Medical Robotics research projects aimed at adapting, integrating, or developing technologies to treat patients in fixed and mobile medical facilities and to locate, identify, assess, treat and rescue battlefield casualties.
Health Information Technologies - oversees all health informatics related programs within TATRC and is designated as the IM/IT research arm for the Military Health System (MHS) Joint Medical Information Program Office.
Medical Imaging Technologies research projects are organized into four distinct research areas: portable imaging and image guided therapeutics, advanced high performance imaging, computational methods and decision support in imaging, and optical/para-optical imaging techniques.
Computational Biology focuses on development and application of methods for analysis, interpretation, prediction and modeling of biological data. Recent developments in genomic research presents both challenges and opportunities to extract knowledge from large amounts of gene and protein data that could lead to early detection of biological threats and emerging infectious diseases, as well as the discovery of new drugs and treatment regimens.
Mobile Computing and Remote Monitoring - focuses on identifying and developing point-of-care medical technologies and support architectures to improve military health care through the application of wireless information and sensor technologies.
Simulation and Training Technology -Research is being conducted in four general categories: PC-Based Interactive Multimedia, Digitally Enhanced Mannequins, Part-Task Trainers and Total Immersion Virtual Reality. The strategy is to identify enabling technologies, mature them into components, integrate those components into simulation-based training systems, and validate them to determine the degree to which they transfer skills learned via simulation to the practice of enhancing training and/or patient care.
Chronic Disease Management - portfolio reflects the use of advanced medical technology in primarily Diabetes and Heart Disease. Current projects highlight the use of telemedicine, home care monitoring, evolving biosensor development, and advanced immunologic testing in vulnerable populations.
Medical
Logistics - dedicated to advancing the
practice of medical logistics via conceptualization and execution of
state-of-the-art prototype devices that are modular in concept and
multifunctional/multi-procedural in capability for implementation across the
spectrum of care within the Department of Defense, from the battlefield to its
tertiary care centers and into the industrial base.
Often we look for advances in health technology and their impact at civilian sources but the military deserve a lot of attention for what health technologies they develop and envision and what the impact of these advances and visions are outside of the military as it is to be expected that the health technology advances will diffuse towards the civilian sector
Gregor Wolbring is an ability governance,
science and technology governance,
disability studies and health policy scholar. He
is an Assistant Professor at the University of Calgary, Faculty of Medicine,
Department of Community Health Sciences, Program in Disability Studies and
Community Rehabilitation. He is a member of the Center for Nanotechnology and
Society at Arizona State University; Part Time Professor at Faculty of Law,
University of Ottawa, Canada; Adjunct Faculty, Critical Disability Studies,
York University, Toronto, Canada; Member CAC/ISO - Canadian Advisory
Committees for the International Organization for Standardization section
TC229 Nanotechnologies; Member: Review Board of the
Journal, Review in Disability
Studies; Member, International Editorial Advisory Board, Journal:
Studies in Ethics, Law and
Technology; Chair of the Bioethics Taskforce of
Disabled People's International; and
former Member of the Executive of the Canadian Commission for UNESCO
(2003-2007 maximum terms served). He publishes the
Bioethics,
Culture and Disability website, authors a
weblog on NBICS and its
social implications and is a regular contributor to the
What
Sorts of People blog.
Please contact the author for additional information
on this article or for other references at
gwolbrin@ucalgary.ca
© Gregor Wolbring, All Rights Reserved, 2008. Please contact the
author for permission to reprint.
Behavioral Health Care of Isolated Military Personnel by Videoconference TELEMEDICINE JOURNAL AND e-HEALTH Volume 10, Number 3, 2004
A Comparative Cost Analysis of an Integrated Military Telemental Health-Care Service
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CyberSightings Skip Rizzo CyberPsychology & Behavior. October 2006: 642-647.
The U.S. Army Telemedicine Program: General Overview and Current Status in Southwest Asia
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Telemedicine and e-Health. August 2006: 396-408.
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Brian J. Grady
Telemedicine Journal and e-Health. September 2002: 293-300.
A Prospective Evaluation of ENT Telemedicine in Remote Military Populations Seeking Specialty Care
Ted Melcer, Darrell Hunsaker, Bobbi Crann, Lisa Caola, William Deniston
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Darryl C. Hunter, Jennifer E. Brustrom, Brian J. Goldsmith, Laurie J. Davis, Mark Carlos, Eileen Ashley, Gilbert Gardner, Imre Gaal
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Jeffrey Stensland, Stuart M. Speedie, Maureen Ideker, James House, Theodore Thompson
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