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<TITLE>AKAMAI TELEMEDICINE PROJECT</TITLE>
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<p align="RIGHT">&nbsp;</p>
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<p align="RIGHT"><font size="2"><b><font face="Arial, Helvetica, sans-serif"><a href="#mandate">AKAMAI
Mandate</a></font></b></font></p>
<p align="RIGHT"><font size="2" face="Arial, Helvetica, sans-serif"><b><a href="#concepts">Program
Concepts</a></b></font></p>
<p align="RIGHT"><font size="2" face="Arial, Helvetica, sans-serif"><b><a href="#impacts" target="">Theater
Readiness Impacts</a></b></font></p>
<p align="RIGHT"><font size="2" face="Arial, Helvetica, sans-serif"><b><b><a href="#objectives" target="">Operational
Objectives</a></b></b></font></p>
<p align="RIGHT"><font size="2" face="Arial, Helvetica, sans-serif"><b><a href="#evaluation">Telemedicine
Evaluation</a></b></font></p>
<p align="RIGHT"><font size="2" face="Arial, Helvetica, sans-serif"><b><a href="#emerging">Emerging
Technology Investigation</a></b></font></p>
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<p><font size="2"><b><font face="Arial, Helvetica, sans-serif">SUBJECT:
AKAMAI Telemedicine Project <br>
</font></b> </font>
<p> <font size="2" face="Arial, Helvetica, sans-serif"><b>Points of Major
Interest:<br>
<br>
</b> </font> <a name="mandate">&nbsp;</a>
<p> <font size="2" face="Arial, Helvetica, sans-serif"><b>1. <u><b>AKAMAI
Mandate</b></u></b>: AKAMAI is a congressionally mandated Department of
Defense (DOD) telemedicine project designed to deploy and assess the value
of telemedicine and telecommunications technologies in the military's
Pacific region health care system. This is for the purpose of transferring
patient medical data (text, image, video) among facilities and all necessary
theater locations in peace and war.</font></p>
<p><font size="2" face="Arial, Helvetica, sans-serif"><br>
</font> <font size="2" face="Arial, Helvetica, sans-serif"> <a name="concepts">&nbsp;</a>
<b>2. <u><b>AKAMAI Program Concepts</b></u></b>: The prevailing AKAMAI
telemedicine concept is directing telemedicine and digital imaging operations
throughout the Pacific Region, including ships at sea. <i>Active telemedicine
operations are currently supporting:</i> <i>Micronesia, U.S. Coast Guard
Ships at Sea, 3<sup>rd</sup> Medical Group and Bassett Army Community
Hospital, Alaska, 15<sup>th</sup> Medical Group Hawaii, 121<sup>st</sup>
Evac Hospital, Republic of Korea, Madigan Army Medical Center, Washington,
and US Naval Hospital Guam as well as the Naval Hospital in Okinawa, Japan</i>.
AKAMAI is tasked to investigate clinically relevant applications of emerging
telemedicine related products, technologies, and services. This is to
include using already established bandwidth to pass patient information
back and forth. Further, the project seeks to evaluate telemedicine's
impact on the health care delivery system and military readiness. </font>
<p><font size="2" face="Arial, Helvetica, sans-serif"><br>
</font> <font size="2" face="Arial, Helvetica, sans-serif"> <a name="impacts">
<b>3. <u><b>AKAMAI Theater Readiness Impacts</b></u></b>: The AKAMAI project
enhances the health care delivery system and improves military readiness
in the Pacific Basin Region by projecting the medical specialty expertise
of Tripler Regional Medical Center (TRMC) to remote sites through the
use of advanced medical technologies and telecommunications capabilities.
Located in the Pacific Region the AKAMAI Project faces the challenge of
extreme distances and significant time zone differences. These obstacles
offer a unique opportunity to exploit existing and pre-existing network
capabilities down to the lowest level of care possible in a warfighting
environment. This project has significant readiness and humanitarian implications
in the Pacific Region.</a> </font>
<p><font size="2" face="Arial, Helvetica, sans-serif"><br>
</font> <font size="2" face="Arial, Helvetica, sans-serif"> <a name="objectives">
<b>4. <u><b>AKAMAI Operational Objectives</b></u><b>: </b></b>The following
list highlights the operation objectives of the AKAMAI Program.</a><br>
</font>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Digital Radiology/Sustainment</u>:
To maintain and update MDIS systems that are already in place throughout
the Pacific Basin.</font>
</ul>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Digital Radiology
at Elmendorf</u>: To establish MDIS technologies and equipment at the
3<sup>rd</sup> Medical Group at Elemendorf Air Force Base, Alaska.</font>
</ul>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Multimedia T-Med
System</u>: To install Multimedia Medical Systems with communications
and training to the following areas:</font>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif">Japan/Okinawa</font>
<li><font size="2" face="Arial, Helvetica, sans-serif">Guam/Pacific
Islands</font>
<li><font size="2" face="Arial, Helvetica, sans-serif">Korea</font>
<li><font size="2" face="Arial, Helvetica, sans-serif">Ships at Sea
Connectivity</font>
<li><font size="2" face="Arial, Helvetica, sans-serif">Deployable
Telepresence</font>
</ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Web-Paradigm
Solution</u>: To provide Store and Forward and real time/inter active
solutions that can be run on the Department of Defense Local Area Network
via the Intranet. This is done using Commercial Over the Counter Software
with already existing programs for health care delivery.</font>
</ul>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Deployable Telepresence
Unit</u>: A deployable radiology imaging system that can be used in
the future to assist forward deployed units and also used for humanitarian
assistance.</font>
</ul>
<a name="evaluation"></a>
<p> <font size="2" face="Arial, Helvetica, sans-serif"><b>5. AKAMAI Telemedicine
Evaluation: </b>Evaluations to integrate protocol user interface and evaluation
database with core telemedicine system pilot versions. Perform teleconsulting
operations and evaluations by assessing organizational impact; Protocols
by assessing outcomes of telemedicine encounters; and Human factors which
are relevant to the use of telemedicine equipment. Included in the evaluation
is assessing the technical functionality (IV&amp;V) and cost-benefit analysis
of telemedicine systems.</font>
<p><font size="2" face="Arial, Helvetica, sans-serif"> <br>
</font>
<a name="emerging">&nbsp;</a>
<p> <font size="2" face="Arial, Helvetica, sans-serif"><b>6. AKAMAI Emerging
Technology Investigation: </b>Provided below is a list of emerging technologies
being utilized by AKAMAI.<br>
</font>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>SETS Technology
(non-invasive)</u>: A means of performing non-invasive surgery by using
Hyperspectral Florescent Imagery to depict cancerous cells within the
body.</font>
</ul>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Remote Radiation
Therapy Treatment</u>: Establishing a partnership with Mallinckrodt
and Maui High Performance Computing Center to perform a study of Remote
Radiation Therapy Treatment.</font>
</ul>
<ul>
<li><font size="2" face="Arial, Helvetica, sans-serif"><u>Other Proposed
Projects</u>: Request the C3, Clinical Consulting Committee to prioritize
projects. This will be accomplished by using funding available after
providing funding for Congressionally mandated and previously committed
projects to perform other projects in priority order. </font><font size="2"></font><font size=2 face="Arial"><br>
</font>
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