TELESYNERGY(R) Medical Consultation WorkStation

美国国家癌症研究所的放射肿瘤学计划(ROSP)赞助一项名为“科学伙伴关系(TM)计划”的临床推广计划，以及与沃尔特里德陆军医疗中心(WRAMC)和国家海军医疗中心(NNMC)联合开展的住院医师培训计划。NCI也是NCI全爱尔兰癌症联盟的成员，该联盟结合了贝塞斯达、贝尔法斯特和都柏林的癌症治疗能力，建立了为期五年的合作伙伴关系，旨在对爱尔兰的癌症进行多层次的攻击。最后，国家癌症委员会支持重振约旦安曼侯赛因国王癌症中心。出于这四个原因，NCI和Rosp对高速医学图像通信和远程医疗系统感兴趣。因此，CIT和NCI在开发和实施先进的远程医疗技术方面进行了合作，特别是TELESYNERGY(R)系统。 TELESYNERGY(R)医疗咨询工作站(MCWS)最初由CBEL在20世纪90年代中期开始开发，并于1997年初首次部署在NCI Rob和CIT环境中的NIH园区。MCWS最初基于异步传输模式(ATM)网络体系结构，允许分布式站点之间的实时多媒体会议，该系统包括用于显示CT、MRI或胸片图像的高分辨率电子视频箱。还包括一个高分辨率视频链接，用于展示顾问的观点，展示录像医学图像或现场演示，或展示从遥控显微镜获得的组织病理学图像。作为该项目的一个组成部分，实现了一个基于ATM交换技术的高速医学图像通信网络原型，用户之间可以进行155Mbit/s的多媒体通信。MCWS系统还允许ATM网关通过高速ISDN主速率接口(PRI)电话电路访问远程/远程站点。 NCI选择TELESYNERGY(R)系统作为他们的科学伙伴关系(TM)计划的使能技术，其中第一个使用TELESYNERGY(R)系统实施的伙伴关系地点是位于佛罗里达州劳德代尔堡的圣十字医院。2001财年4月在WRAMC安装了TELESYNERGY(R)系统，并在2004财年最后一个季度安装了升级版本。位于西弗吉尼亚州惠灵市惠灵医院的希夫勒癌症中心是第二个科学伙伴关系(注册商标)网站，它的TELESYNERGY(注册商标)系统安装工作已于2002财年1月完成。 此外，TELESYNERGY(R)系统在2002财年夏天在英国新泽西州贝尔法斯特的贝尔法斯特市医院和爱尔兰共和国都柏林的圣卢克医院(ROI)实施。第二个ROI系统于2004财年2月在都柏林三一学院放射治疗学院安装。自1999年9月以来，我们一直计划在约旦安曼的侯赛因国王癌症中心内安装TELESYNERGY(R)系统，作为NCI-约旦癌症联盟的一部分。这一最先进的TELESYNERGY(R)系统的安装工作已于2004财年1月顺利完成。另一个TELESYNERGY(R)系统安装在临床中心-S在2004财年夏天重新设计了11楼的远程医疗诊所。目前，全球共安装了10个TELESYNERGY(R)系统，并得到CIT工作人员的支持。在美国境内安装的另外13个系统由NCI工作人员提供支持。 在2005财年期间，完成了基于ISDN的中央通信中心的设计和制造，以取代基于ATM的中央通信中心。最近启动了软件开发，以便将最初基于ATM的TELESYNERGY(R)环境的功能嵌入到新实施的基于ISDN的中央通信枢纽中。即将完成的任务是将TELESYNERGY(R)软件从原来的Sun/Solaris工作站环境转换到PC/Linux工作站环境。 TELESYNERGY(R)环境的便携式版本的开发是在2002财年期间开始的，目的是能够提供临时的高性能远程医疗解决方案，以应对大规模的医疗紧急情况。移动TELESYNERGY(R)系统内众多子系统的制造和组装工作将在2006财年完成，新设计和采购的双模甚小口径终端(VSAT)卫星天线系统也将完成。 最后，在2006财年期间，我们预计将在科克大学医院和戈尔韦大学学院医院的投资回报率内再实施两个功能齐全的TELESYNERGY(R)系统。此外，ROI内的支持癌症中心将安装多达五个较小规模的TELESYNERGY(R)系统。

The National Cancer Institute's Radiation Oncology Sciences Program (ROSP) sponsors a clinical outreach program, known as the Partnerships in Science(TM) Program, as well as a residency training program jointly with the Walter Reed Army Medical Center (WRAMC) and the National Naval Medical Center (NNMC). The NCI is also a 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. Finally, the NCI supports the re-vitalization of the King Hussein Cancer Center (KHCC) in Amman Jordan. For these four reasons, the NCI and ROSP are interested in high-speed medical image communication, and telemedicine systems. The CIT and the NCI have, therefore, collaborated in the development and implementation of advanced telemedicine technologies, in general, and the TELESYNERGY(R) System, in particular. The TELESYNERGY(R) Medical Consultation WorkStation (MCWS) development was initially begun by CBEL in the mid 1990s, and was first deployed in the NCI ROB and the CIT environments on the NIH campus in early 1997. 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, 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 at the School of Radiation Therapy in February of FY04. Since September 1999, we have been planning the installation of a TELESYNERGY(R) System within the King Hussein Cancer Center (KHCC) in Amman, Jordan, as part of the 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 Center?s re-designed 11th floor Telemedicine Clinic during the summer of FY04. There are currently, a total of ten 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 FY05, was the design and fabrication of an ISDN-based Central Communication Hub, as a replacement for the ATM-based Central Communication Hub. Software development was recently initiated to embed the functionality of the original ATM-based TELESYNERGY(R) environment within the newly implemented ISDN-based Central Communication Hub. Rapidly nearing completion, is the task of converting the TELESYNERGY(R) Software from its original Sun/Solaris workstation environment to the PC/Linux workstation environment. The development of a portable version of the TELESYNERGY(R) environment was begun during FY02, in order to be able to provide a temporary high-performance telemedicine solution in response to a large-scale medical emergency. The fabrication and assembly of the numerous subsystems within the Mobile TELESYNERGY(R) System will be finalized during FY06, with the completion of the newly designed and procured dual-mode Very Small Aperture Terminal (VSAT) Satellite Antenna System. Finally, during FY06 we expect to implement two additional full-featured TELESYNERGY(R) Systems within the ROI, at the Cork University Hospital and the University College Hospital Galway. In addition, there will be up to five smaller-scale TELESYNERGY(R) Systems installed at supporting cancer centers within the ROI.