Internet as an "honest" management tool first experience in a national institute of health and social services in Argentina

The PAMI's website creation (www.pami.org.ar) has had the purpose of spreading its activities, the standards of medical care and administrative management, offering--at the same time--a honest channel of interaction with the community.

Wireless vital sign telemetry to hand held computers

Most physicians and other health care providers share/access patient information via hard copy chart records, telephone conversations, or through hospital computer networks. These modalities are cumbersome when physicians are away from the hospital and ground wiring infrastructure is not readily available. In a prior study, we used wireless in-flight telephony and the Internet to transmit vital signs from an airborne Boeing 757 to three remote locations on the ground. However, because all recipient stations relied on an institutional network to receive the information, it was not possible to transfer data to a given location beyond the hospital campus. We now propose an innovative system capable of transmitting telemetry information from any location in the globe to a single portable computer using Wireless Application Protocol (WAP) technology for the Internet. Medical data including blood pressure, pulse, respiratory rate, end tidal CO2, oxygen saturation and EKG tracings were transferred from a G2 (digital cellular) phone linked to a hand held computer to a remote hand held device and were viewed in real time using customized software. Cellular Digital Packet Protocols (CDPD) enabled data transfer speeds up to 19,200 bps. Advances including the Internet and wireless computer technology may revolutionize the way medical information is shared, making it possible for physicians and health allies to directly access patient data from anywhere at any time.

In-flight continuous vital signs telemetry via the Internet

BACKGROUND

Current methods available to assess a passenger's life threatening medical condition during in-flight emergencies are inadequate. Critical communication channels between the airplane and ground control rely only on voice communication via a two-way radio. The purpose of this study was to test the efficacy of cellular telephone technology via the Internet as a cost-effective way to obtain the "linking" pathway from an aircraft to a ground medical facility by conducting a simulated on line triage.

METHODS

On July 31, 1997, we transmitted vital signs from a Boeing 757, flying from Chicago to Los Angeles, simultaneously to: The Saddle Back Memorial, in Laguna Hills, CA; Hospital Santojanni in Buenos Aires, Argentina; and the Medical Department of American Airlines in Dallas/Fort Worth, TX. Three lead EKG, heart rate, BP, arterial oxygen saturation, end tidal CO2, respiratory rate body temperature and real time video images were collected from a passenger and transmitted to each facility from the aircraft via the Internet. Access to the Internet was gained via the cellular phone aboard the aircraft.

RESULTS

A total of 20 different simulated scenarios of an medical emergency condition were successfully transmitted, simultaneously, to all health care facilities. All data was received without any corruption with an average delay time of 1 s.

CONCLUSIONS

Close monitoring of the patient can lead to a better understanding and assessment of a medical condition, improve in-flight patient care, accelerate the decision making process by making an early diagnosis, and correct a life-threatening condition before the patient arrives at the destination.

Live interactive broadcast of laparoscopic surgery via the Internet

BACKGROUND

For the first time in the history of communications, we conducted live interactive broadcasts through the Internet (on August 29, and September 3, 1996).

METHODS

Successful transmissions were performed from Pontiac, Michigan, to Laguna Hills, California, and Buenos Aires, Argentina, and participants actively interacted in audio and video formats in real time.

RESULTS

Video images were transmitted at a rate of 1-2 frame/s and displayed in a 320 x 240 window at the remote sites. The loss of audio packets averaged 17% with a delay of 0.5-2 s. The broadcasting computer station was also able to receive real-time video and sound from the distant computers, allowing complete interaction between both parties over the duration of each transmission session. Average broadcast time was 1. 5 h +/- 30 min, and the cost of each transmission was equal to that of a regular local phone call.

CONCLUSIONS

Videoconferencing via the Internet is a viable method for transmitting information in real time allowing surgeons worldwide to work together during surgical procedures.

Videoconferencing as a medical educational tool: first experience in Argentinean public hospital

Authors present their experience with first medical videoconferencing program developed in a public Argentinean hospital. Both modalities--room and desktop videoconferencing--were used. The program was exclusively used for educational purposes. A total of twelfth videoconferencing were successfully made using all resources. They included surgical procedures, magisterial lessons, grand rounds, etc. The project proved that videoconferencing is a cost-effective medical education tool, even in developing countries.