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DistanceDoc and MedRecorder: New Approach to Remote Ultrasound Imaging
DistanceDoc™ and MedRecorder™ products are used by Henry Ford Health Services in a number of settings. The organization is at the leading edge of remote diagnostic research, pioneering programs such as remote-guided ultrasound diagnosis of the health of astronauts in the International Space Station. In its work with astronauts on ISS, the center quickly ran up against bandwidth and image quality challenges that made meaningful medical diagnosis difficult to impossible in such remote settings.
Jack Butler, IT program manager in the Department of Surgery at Henry Ford , explains: “To get ultrasound images from the space station to Earth, we were convolving the ultrasound signal into an S-video signal, then compressing it to downlink to a diagnostician headquartered in Houston.”
Actually, that is the very barrier that other attempts at remote medical diagnostics have encountered: it is almost impossible to obtain diagnostic-quality images due to multiple layers of image degradation that occurs during the capture and transmission of the data, either to storage devices or over networks. The center needed in its remote-guided ultrasound research an ultrasound imaging innovation. It has found this breakthrough with DistanceDoc and MedRecorder products.
Diagnostic-Quality Image Transmission
The center joined forces with GE, which is providing a number of its portable ultrasound machines—called GE LOGIQ Books—in support of a project conducted with the Olympic Training Facility in Colorado Springs and Lake Placid. Butler, for his part, needed to find a way to transmit both still and moving ultrasound images from the LOGIQ Books to the diagnosticians.
“We didn't want to have to send a radiologist to the site,” Butler explains. The point was to be able to provide rapid medical diagnosis of sports injuries even when a team of doctors was not onsite. “We wanted to be able to have someone onsite with minimal training to conduct the examination under the guidance of the remote expert back at the hospital, download the images and then let a radiologist do the analysis back home.”
When the video converter equipment that had been used to accomplish a similar goal on the space station was showed to the research team, it was generally agreed that it was far too complicated for use on Earth. It was also too cumbersome to pack around with sports teams the hospital is responsible for, and required too much expertise to setup and use.
With the VGA broadcasting solution DistanceDoc, and the accompanying archiving product, MedRecorder, the research team can now conduct realtime remote expert guidance of the ultrasound examination, download and transmit diagnostic-quality images and video sequences to experts almost as fast. It is possible to get exactly the same image that is seen on the ultrasound machine to an expert at the other end.
Dr. Scott Dulchavsky, Chairman, Department of Surgery at Henry Ford, adds, “While still in these early stages of our research, the image capturing and broadcasting system has been used by doctors to successfully remotely diagnose injuries to skaters and wrestlers. This is a huge step forward for our research, for GE and for the Olympic sports team.”
Opening Doors to New Applications
Together, Mediphan and physicians at Henry Ford Health Services are now working together to expand the applications of the solution. “There are so many ways to expand this technology and move it forward, now that we have diagnostic-quality images. We're in a whole different ballpark now,” Butler says. “S-video images are not even a consideration for us now—we're playing a whole new game now.”
The diagnostic-quality images that DistanceDoc captures include muscular-skeletal images (bones and joints), as well as soft tissue scans (organs, blood flow, corneas, etc.). “What we are proving is that medical diagnosis can be done from these images—there is now no doubt about this,” Butler says. “The images are exactly what a diagnostician needs to see to make diagnosis and recommendations in the heat of battle, during a game, or for astronauts in space.”
It brings the center a big step closer to its overriding mandate to apply its research to as broad a population as possible, including in underserved regions. “Our vision is that one day we'll be able to send out a kid on a bike with a portable ultrasound machine to scan the population of an entire village,” Butler says, “allowing us to determine exactly who needs to see a doctor. Thanks to DistanceDoc and GE's portable ultrasound technology, that vision looks all the more achievable today.”
This case study is also available in the following languages:
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