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New Remote Diagnostics Solutions Developed in Cooperation with NASA Researchers
On the International Space Station (ISS), the diagnosis of medical issues and injuries is problematic. First of all, X-RAY, CAT, and MRI machines are too bulky for transportation into space. Besides crew aboard the space station does not have substantial diagnostic training. And finally, the nearest doctors and hospitals are over 250 miles away on Earth.
However, the ISS does have an ultrasound machine on-board. It was used as part of experiments on the effects of microgravity on human health. During medical use, the ultrasound machine’s hand-held transducer emits high-frequency sound waves that partially reflect at points of differing density, such as between soft tissue and bone. The machine’s computer translates the echoes into a two- or three-dimensional video representation and outputs the video through a VGA port. On Earth, ultrasound is commonly used for imaging fetus development, abdominal conditions like gallstones, and blood flow in patients with arterial disease. Applications such as the diagnosis of broken bones or collapsed lungs are very difficult to do with ultrasound, given the high density differences of bone and air, which completely reflect the ultrasound waves and prevent clear images of deeper tissue.
In 2000, Scott Dulchavsky,M.D., Ph.D., chair of the Department of Surgery at Henry Ford Hospital in Detroit, was funded by the National Aeronautics and Space Administration (NASA) to develop a versatile ultrasound diagnostic technique for remote use on the ISS. Dulchavsky tested new ultrasound applications and found that, in many cases, such as with collapsed lungs, the technique worked better than X-ray imaging. He became lead investigator for the Advanced Diagnostic Ultrasound in Microgravity (ADUM) experiment, a collaborative effort between Johnson Space Center, Henry Ford Hospital, and Wyle Laboratories Inc. in Houston and was ultimately able to demonstrate the effectiveness of ultrasound as a remote and multipurpose diagnostic tool in space.
Dr. Dulchavsky's team encountered one major obstacle in keeping with NASA’s mandate to translate space technologies into applications for terrestrial use: there were no cost-effective, technologically viable methods for sending ultrasound scans over long distances without a loss of image quality. While high satellite uplink and downlink channels are available to NASA, most environments are limited by simple broadband Internet.
When he showed the research team the video converter equipment that had been used to accomplish a similar goal on the space station, it was generally agreed that it was a very complicated solution to 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.
“We have extensive satellite capabilities and telemedical support at NASA, but we don’t have these for common terrestrial use,” said Dr. Dulchavsky. The team needed practical and accessible video streaming and capture solutions to the field of medicine. The result came in the form of DistanceDoc™ and MedRecorder™ devices. Each device plugs into the VGA port of any standard ultrasound or medical machine and then connects to a computer or PACS server by a universal serial bus (USB) 2.0 or Local Area Network (LAN) Ethernet. A non-physician can, with minimal technical know-how, install Mediphan’s technology and use it to send medical imaging for consultation with experts. Coupled with the highly portable General Electric LOGIQ laptop ultrasound machine and the NASA-developed instructional software now modified for broader use, even the medically inexperienced can consult with doctors remotely to diagnose medical issues when and where they occur.
The technology is helping improve education, allowing a medical trainee on duty to share diagnostic information with an attending doctor elsewhere. Mediphan MedRecorder offers the ability to archive personal portfolios documenting proficiency in diagnostic techniques and provides an affordable way to store and maintain records. Both MedRecorder and DistanceDoc devices enable the remote ultrasound techniques developed for space to be employed on Earth. By capturing, transmitting, and storing diagnostic-quality ultrasound imagery and video, the devices allow doctors to diagnose injuries and other conditions while not in the same room, building, or even hemisphere as their patients.
Meanwhile, the United Nations Millennium Project, which has among its goals improved maternal care in underserved areas, plans to use the tele medical procedures in developing countries. Dr. Dulchavsky and his team are currently working to create a highly versatile, environmentally robust device that could serve as a kind of information node connecting patients in remote areas to distant experts via Mediphan technology. Then, Dr. Dulchavsky says, “we could utilize the techniques and technologies that we developed for use on the ISS to diagnose a wide variety of medical issues, such as traumatic injury, problematic pregnancies, and certain infectious diseases.”
When Dr. Dulchavsky was working at a distance with a NASA team in the Mars-like environment of Devon Island in northern Canada, he performed the first-ever remote guidance of a simulated appendectomy. One day, the same technique may be used to do the real thing in a village in Madagascar, on the slope of Everest, or on Mars itself.
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Des nouvelles solutions de diagnostic à distance développées en coopération avec la NASA
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