The Telemedicine TeleInViVo Initiative

The computer system that this programme uses is supportive of a wide range of medical applications (from gynecology to abdominal scans). The integrated workstation uses techniques -- the Internet, ISDN, a phone line, and GSM -- that allow one physician to collect three-dimensional ultrasound data of a patient and to send this data to another physician who specialises in the particular disease that the patient has. This data transmission can occur online, that is, while both doctors are connected, or offline, for instance, overnight, through narrowband channels. In the latter case waiting times are minimised, whereas in the former case additional scans may be requested by the remote expert during the teleconsultation to hone in on the diagnosis. Only the actions introduced by one user are transferred to the remote location, so that the second workstation has to calculate only the corresponding image. That is, no bulky image data are transferred over the network, enabling the two doctors to see exactly the same image on their screens in real time. Any delay between two locations reflects the latency of the intermediate network.

Health, Technology.

Telemedicine involves provision of health care services through Information and Communication Technology (ICT). It supports health care service provision in areas in which the ratio of doctor- or health-worker-to-patient is too high to manage or where a particular specialty is lacking.

Currently, the Nakaseke Hospital has no telephone line and is completely isolated by both distance and communication channels from other health centres.

Two doctors from the Mulago Medical School were trained in June, 1999 in the use of TeleInViVo equipment in Coimbra, Portugal. They have in turn trained a number of doctors from Nakaseke and Mulago Hospital. Two technicians were also trained in servicing and back-up in Germany in September, 1999, when they worked to install TeleInViVo equipment at Mulago Medical School. Two young students are studying project developments: one from the Faculty of Technology (engineering department) and another from the Medical School (radiology department).

The device will be tested in different socioeconomic conditions and adjusted to meet the needs of developing countries and countries in transition. It currently comes in two versions: a fully portable, self-contained device, and a workstation version (a PC attached to an ultrasound scanner for internal hospital use). A fixed station for expert diagnosis support will be situated at the Coimbra University Hospital in Portugal. The field test sites include Azores and Canary Islands; UNESCO will evaluate EU-TeleInViVo in Uganda and Kazakhstan at two different sites for each country.

By the time of the project's completion, it is hoped that a medical teleconference emergency workstation will be available in Europe as well as in other regions of the world that provide health care services to underserved areas like ecological disaster areas, remote rural areas, and isolated islands.