TELESYNERGY(R) Medical Consultation WorkStation Environment

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The TELESYNERGY(R) Medical Consultation WorkStation (MCWS) development was initially begun by CBEL in the mid 1990s, and was first deployed in the Center for Information Technology (CIT) and NCI Radiation Oncology Branch (ROB) environments on the NIH campus in early 1997. Since the National Cancer Institutes Radiation Oncology Sciences Program (ROSP) is: (1) sponsor of a clinical outreach program (Partnerships in Science(TM), (2) participant in a residency training program jointly with the Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC), (3) participant in the NCI All Ireland Cancer Consortium (which combines the cancer treatment capabilities of Bethesda, Belfast, and Dublin in a five-year relationship aimed at a multilevel attack on cancer in Ireland), and finally, (4) supportive of the re-vitalization of the King Hussein Cancer Center (KHCC) in Amman Jordan, the TELESYNERGY(R) System quickly became a major IT component of these programs through NCI and CIT Collaboration. The MCWS, which was originally based upon Asynchronous Transfer Mode (ATM) network architecture, allows real-time multimedia conferencing between distributed sites, and the systems includes high-resolution electronic view boxes for the display of CT, MRI or chest film images. Also included is a high-resolution video link for the presentation of a view of the consultant, the display of video-taped medical images or live presentations, or the display of histopathology images obtained from remote-controlled microscopes. As a component of this project, a prototype high-speed medical image communication network was implemented, based on ATM switch technology, which allows 155 Mbit/sec multimedia communication between users. The MCWS System also allows ATM-Gateway access to remote/distant sites via high-speed ISDN Primary Rate Interface (PRI) telephone circuits. The NCI selected the TELESYNERGY(R) System as the enabling technology for their Partnerships in Science(TM) Program, and the first of these partnerships sites to be implemented with the TELESYNERGY(R) System was the Holy Cross Hospital, in Fort Lauderdale, Florida, during the Summer of FY00. A TELESYNERGY(R) System was installed at the WRAMC in April of FY01, and an upgraded version was installed during the last quarter of FY04. A second Partnerships in Science(TM) site, the Schiffler Cancer Center at the Wheeling Hospital, in Wheeling, West Virginia, had its TELESYNERGY(R) System installation completed during January of FY02. In addition, full TELESYNERGY(R) systems were implemented at the Belfast City Hospital in Belfast, N.I., U.K., and at the St. Luke's Hospital in Dublin, Republic of Ireland (ROI), during the summer of FY02. A second ROI system was installed at the Trinity College Dublin (TCD) at the School of Radiation Therapy in February of FY04. Full TELESYNERGY(R) Systems were installed at Cork University Hospital and the University College Hospital Galway during the winter of FY06. In addition, a simplified and upgradeable TELESYNERGY(R)-Lite System was installed at the same time, within TCD, as a sample for duplication at five smaller cancer centers in the ROI by TCD Staff. Since September 1999, we had planned for the installation of a TELESYNERGY(R) System within the King Hussein Cancer Center (KHCC) in Amman, Jordan, as part of an NCI-Jordan Cancer Consortium. The installation of this most advanced TELESYNERGY(R) System, was successfully completed during January of FY04. Another TELESYNERGY(R) System was installed in the Clinical Centers re-designed 11th floor Telemedicine Clinic during the summer of FY04. There are currently, a total of twelve TELESYNERGY(R) Systems installed worldwide, which are supported by CIT staff. An additional thirteen systems installed within the U.S., are supported by NCI staff. Completed during FY07, was the task of converting the TELESYNERGY(R) Software from its original Sun/Solaris workstation environment to the PC/Linux workstation environment. Also completed was the integration and packaging of all hardware components for the portable and ruggedized version of the TELESYNERGY(R) environment, including its Very Small Aperture Terminal (VSAT) Satellite Antenna System. During FY07, TAIS developed a small Telenephrology System on a mobile cart that provides Dr. Andrew Narva (NIDDK), the newly-appointed Director of the National Kidney Disease Education Program, with the ability to conduct regularly scheduled clinics with his previous renal patients at the Zuni PHS Hospital in Zuni, AZ. In addition, TAIS implemented an EENT Imaging System on a mobile cart for Dr. Hirsh Komarow (NIAID), Staff Clinician in the Laboratory of Allergic Disease, for his use in the Pediatric Allergy Clinic. Finally, planning was completed for the installation of a TELESYNERGY(R) System in the U.S. Armys Telemedicine and Advanced Technology Research Center (TATRC) at Fort Detrick, MD, with deployment scheduled for October 2007. An additional full TELESYNERGY(R) System was designed for installation at the Beaumont Hospital in Dublin, Republic of Ireland. This will be the sixth full TELESYNERGY(R) System installed in Ireland, as part of the NCI All Ireland Cancer Consortium. Commissioning is scheduled for November or December 2007. During FY08, efforts will center on the installation and configuration of the Linux version of the TELESYNERGY(R) software environment in the ruggedized, portable TELESYNERGY(R)System. Also, TAIS will initiate activities to expand the scope of the TELESYNERGY(R) architecture to increase medical capabilities and to streamline human-computer interaction.