akamai_telemed.html

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<title>In the Pacific Theater, Telemedicine is "Akamai"
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<h1>In the Pacific Theater, Telemedicine is "Akamai"
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<h3>Source:  <a href="http://www.dtic.dla.mil:80/afps/">American Forces Press Service</a></h3>
<p>
By Douglas J. Gillert
<p>
<a href="http://www2.tamc.amedd.army.mil">TRIPLER ARMY MEDICAL CENTER</a>, Hawaii
<p>
 Clever; smart; best

at something. That's a rough translation of the Hawaiian word

"akamai" and why planners chose the word as the title for a major

telemedicine project in the Pacific theater.
<p>
	Akamai is one of a roughly half-dozen telemedicine projects

Tripler and other components of the U.S. Pacific Command are

testing for the assistant secretary of defense for health

affairs. Air Force Lt. Col. Tony Gelish, project director, said

the primary goal of Akamai is "customer service, whether they are

health care providers or the patients" in areas of the theater

where health care is limited.
<p>

	"Tripler is reaching out and asking the question, 'How can

we improve our customer support?'" Gelish said. "'Telepresence

is a great way, because it's less expensive than moving patients

or assigning additional [health care] providers."
<p>
	Three objectives guide the project:
<ul>
<li>Conduct telemedicine and digital imaging throughout the

Pacific, including ships at sea;

<li>Evaluate telemedicine's impact on patients and health care

providers and on military readiness;

<li>Investigate applications of emerging telemedicine

products, technologies and services.
</ul>
<p>
	Currently, Akamai fields two basic services. The first is

teleconsultation. This uses full-motion, real-time video and

allows doctors to consult with other medical personnel in remote

areas. It is being used primarily on Kwajelein Island. The second

is a concept called "store and forward."
<p>
	The latter allows health care providers at distant locations

to store information by modem to a computer file, using the

Digital Satellite Network. Specialists at Tripler can then

retrieve the information and evaluate it, Gelish explained. They,

in turn, store the results of their evaluations and treatment

recommendations for later retrieval by the attending provider.

The concept eliminates barriers created by the Pacific Ocean's 10

time zones.
<p>
	"Over 24 months, we performed more than 300 telemedicine

consults," Gelish said. "About 95 percent of those could be done

by 'store and forward.'"
<p>
	The concept impacts military readiness, Gelish said. "For

example, with telemedicine we may be able to treat a sick crew

chief at Kunsan [Air Base, Korea] instead of evacuating him. That

means a lot to the commander trying to launch [fighter aircraft]

sorties.
<p>
	"Usually, all that doctors [at understaffed locations] need

is 'telementoring,' and their level of confidence goes up." With

Akamai's store and forward capability, he said, "an experienced

subspecialist is looking over your shoulder 24 hours a day."
<p>
	As a result, Gelish said, medical evacuations decrease, and

physicians can make smarter, earlier decisions about the level of

care their patients need. In this way, he said, the services and

the individuals both benefit.
<p>
	The ongoing telemedicine project supports operations in

Micronesia; Coast Guard ships at sea; Hickam Air Force Base,

Hawaii; and Madigan Army Medical Center, Wash., the next nearest

major DoD medical center. The project includes a deployable

telemedicine unit at Hickam, and technicians now are installing a

medical diagnostic imaging support system to provide picture

archiving and communications to support digital radiology at

Tripler and remote sites.
<p>
	The 15th Medical Group, Hickam, is using the first

deployable teleradiology unit in the world, said then-group

commander Col. Horace Carson. Teleradiology, Carson explained,

reduces the cost of obtaining X-rays by replacing expensive film

with basically free digital images. The process also saves time.
<p>
	"Before, couriers had to hand-carry film X-rays to Tripler

Army Medical Center (about a 30-minute drive from Hickam), where

radiologists could read them and provide evaluations," Carson

said. "Now, we have T-1 [telecommunication lines] directly to

Tripler and can transmit the images immediately."
<p>
	Master Sgt. James North, noncommissioned officer in charge

of radiology at Hickam, said the deployable telemedicine unit can

endure any field conditions. "Temperatures aren't a factor

because we don't have film to protect," he noted. Besides sending

digital images back to Tripler, he said, medics in the field can

print the image on normal bond paper.
<p>
	Akamai is in the fourth year of a five-year contract set to

expire in fiscal 1997. Three contractors are demonstrating their

equipment, Gelish said, and evaluators will determine which

products best suit the delivery of telemedicine in the Pacific

region. Since the contract began, he added, more than 300

consults have occurred.
<p>
	Early on, providers in the field resisted "outside advice,"

Gelish said. "But after using it awhile, they like it a lot."
<p>
	The project will expand to Okinawa and Guam this summer, and

then to Korea, he said. The main islands of Japan, which already

have a robust medical system, don't need Akamai, he said.
<p>
	With the Western Pacific lined up, Akamai is now also

pointing back toward North America. A new hospital currently

under construction at Elmendorf Air Force Base, Alaska, will be

completely digital, Gelish said. Akamai, he said, will help make

this next building block in military medicine "clever, smart and

best."


</body></html>
	<html>
	<head>
	<title>In the Pacific Theater, Telemedicine is "Akamai"
	</title>
	</head>
	<body bgcolor="#FFFFFF">
	<center>
	<h1>In the Pacific Theater, Telemedicine is "Akamai"
	</h1></center>
	<hr>

	<h3>Source: <a href="http://www.dtic.dla.mil:80/afps/">American Forces Press Service</a></h3>
	<p>
	By Douglas J. Gillert
	<p>
	<a href="http://www2.tamc.amedd.army.mil">TRIPLER ARMY MEDICAL CENTER</a>, Hawaii
	<p>
	Clever; smart; best

	at something. That's a rough translation of the Hawaiian word

	"akamai" and why planners chose the word as the title for a major

	telemedicine project in the Pacific theater.
	<p>
	Akamai is one of a roughly half-dozen telemedicine projects

	Tripler and other components of the U.S. Pacific Command are

	testing for the assistant secretary of defense for health

	affairs. Air Force Lt. Col. Tony Gelish, project director, said

	the primary goal of Akamai is "customer service, whether they are

	health care providers or the patients" in areas of the theater

	where health care is limited.
	<p>

	"Tripler is reaching out and asking the question, 'How can

	we improve our customer support?'" Gelish said. "'Telepresence

	is a great way, because it's less expensive than moving patients

	or assigning additional [health care] providers."
	<p>
	Three objectives guide the project:
	<ul>
	<li>Conduct telemedicine and digital imaging throughout the

	Pacific, including ships at sea;

	<li>Evaluate telemedicine's impact on patients and health care

	providers and on military readiness;

	<li>Investigate applications of emerging telemedicine

	products, technologies and services.
	</ul>
	<p>
	Currently, Akamai fields two basic services. The first is

	teleconsultation. This uses full-motion, real-time video and

	allows doctors to consult with other medical personnel in remote

	areas. It is being used primarily on Kwajelein Island. The second

	is a concept called "store and forward."
	<p>
	The latter allows health care providers at distant locations

	to store information by modem to a computer file, using the

	Digital Satellite Network. Specialists at Tripler can then

	retrieve the information and evaluate it, Gelish explained. They,

	in turn, store the results of their evaluations and treatment

	recommendations for later retrieval by the attending provider.

	The concept eliminates barriers created by the Pacific Ocean's 10

	time zones.
	<p>
	"Over 24 months, we performed more than 300 telemedicine

	consults," Gelish said. "About 95 percent of those could be done

	by 'store and forward.'"
	<p>
	The concept impacts military readiness, Gelish said. "For

	example, with telemedicine we may be able to treat a sick crew

	chief at Kunsan [Air Base, Korea] instead of evacuating him. That

	means a lot to the commander trying to launch [fighter aircraft]

	sorties.
	<p>
	"Usually, all that doctors [at understaffed locations] need

	is 'telementoring,' and their level of confidence goes up." With

	Akamai's store and forward capability, he said, "an experienced

	subspecialist is looking over your shoulder 24 hours a day."
	<p>
	As a result, Gelish said, medical evacuations decrease, and

	physicians can make smarter, earlier decisions about the level of

	care their patients need. In this way, he said, the services and

	the individuals both benefit.
	<p>
	The ongoing telemedicine project supports operations in

	Micronesia; Coast Guard ships at sea; Hickam Air Force Base,

	Hawaii; and Madigan Army Medical Center, Wash., the next nearest

	major DoD medical center. The project includes a deployable

	telemedicine unit at Hickam, and technicians now are installing a

	medical diagnostic imaging support system to provide picture

	archiving and communications to support digital radiology at

	Tripler and remote sites.
	<p>
	The 15th Medical Group, Hickam, is using the first

	deployable teleradiology unit in the world, said then-group

	commander Col. Horace Carson. Teleradiology, Carson explained,

	reduces the cost of obtaining X-rays by replacing expensive film

	with basically free digital images. The process also saves time.
	<p>
	"Before, couriers had to hand-carry film X-rays to Tripler

	Army Medical Center (about a 30-minute drive from Hickam), where

	radiologists could read them and provide evaluations," Carson

	said. "Now, we have T-1 [telecommunication lines] directly to

	Tripler and can transmit the images immediately."
	<p>
	Master Sgt. James North, noncommissioned officer in charge

	of radiology at Hickam, said the deployable telemedicine unit can

	endure any field conditions. "Temperatures aren't a factor

	because we don't have film to protect," he noted. Besides sending

	digital images back to Tripler, he said, medics in the field can

	print the image on normal bond paper.
	<p>
	Akamai is in the fourth year of a five-year contract set to

	expire in fiscal 1997. Three contractors are demonstrating their

	equipment, Gelish said, and evaluators will determine which

	products best suit the delivery of telemedicine in the Pacific

	region. Since the contract began, he added, more than 300

	consults have occurred.
	<p>
	Early on, providers in the field resisted "outside advice,"

	Gelish said. "But after using it awhile, they like it a lot."
	<p>
	The project will expand to Okinawa and Guam this summer, and

	then to Korea, he said. The main islands of Japan, which already

	have a robust medical system, don't need Akamai, he said.
	<p>
	With the Western Pacific lined up, Akamai is now also

	pointing back toward North America. A new hospital currently

	under construction at Elmendorf Air Force Base, Alaska, will be

	completely digital, Gelish said. Akamai, he said, will help make

	this next building block in military medicine "clever, smart and

	best."


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