NATO Telemedicine Interoperability Study TiOPS

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NATO Telemedicine Interoperability Study (TiOPS)

• David M. Lam, MD, MPH, University of Maryland
  Medical School, National Study Center for Trauma
  and EMS, Baltimore MD and U.S. Army Telemedicine
  and Advanced Technology Research Center, Ft.
  Detrick, MD
• Secretary, NATO/COMEDS Telemedicine Panel

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WHY COLLABORATE ?

• INTEROPERABILITY IS A KEY NATO DOCTRINE
• SHORTFALLS EXIST IN MEDICAL MANNING OR PROVISION
• DUPLICATION IS WASTEFUL

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THE REALITY

• MILITARY OPERATIONS ARE ALL MULTINATIONAL
• COMMUNICATION BETWEEN NATIONAL FORCES IS
  ESSENTIAL
• MEDICINE IS NO EXCEPTION

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MEDICAL LAY-DOWN BOSNIA
2
Tuzla
3
SIPOVO
SARAJEVO
3
2
ROLE 3 ROLE 2 MIMU
2


Mostar
Note the signifies a role facility, augmented
to cover additional peace time requirements
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KOSOVO MEDICAL FACILITIES
l
Lesak
ROLE 2 (MO)
Leposavic
ROLE 2 (FR)
l
ROLE 2 (UAE)
HEN
MITROVICA
l
ROLE 2 (SP)
z
o
s
l
l
Zubin Potok
Zvecan
MNB(N)

ROLE 3 (UK)
l
MNB(C)
t
Vucitrn
Rudrik
G Klina
ISTOK
l
S
i
t
n
i
ROLE 3 (RS)
c
Kacikol
PRISTINA
l
a
N
.
S
e
l
o
l
n
l
i
l
K
PEC
B
e
D
l
i
r
m
i
l
Obilic
KOSOVO POLJE
ROLE 3 (IT)
l

G
r
a
i
c
k
o
l

l
Klina
l
l
MNB(W)
l
Dacane
l
Rznic
GNJILANE
ROLE 2 (GR)
MNB(E)
ROLE 2 (ARG)
DAKOVICA
Prozaranje
MNB(S)
ROLE 3 (US)
l

UROSEVAC
Sasare
l
PRIZREN
l
Brod
l
FOX
l
ROLE 2 (GE)
LION
Musrjikov
l
D - Ljubinje
COMMZ (W) DURRES/ALB
FYROM
COMMZ (S) THESSALONIKI/GR
Dragas
ROLE 2 (GE)
ROLE 2 (FR)
ROLE 1 (IT)

Brod
l
ROLE 3 HNS
MED HNS
Restelica
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THE PROBLEMS

• TECHNICAL
• NON-TECHNICAL

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PROBLEMS TECHNICAL

• PHYSICAL COMMUNICATION LINKS
• TECHNICAL COMMUNICATION STANDARDS
• MEDICAL DATA SETS

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PROBLEMS NON TECHNICAL

• LANGUAGE
• LEGISLATION AND REGULATION
• BUSINESS PRACTICES

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SOLUTION A TRIAL

• E-MAIL/INTERNET BASED
• STANDARD, ANONYMISED DATA SET
• STORE FORWARD ONLY

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TRIAL OBJECTIVES

• IS IT TECHNICALLY POSSIBLE TO SEND TELEMEDICINE
  REFERRALS ACROSS NATIONAL BOUNDARIES?
• IS THE CLINICAL AND MANAGERIAL ADVICE THAT IS
  SENT CLINICALLY AND OPERATIONALLY ACCEPTABLE?
• NOT A TEST OF INDIVIDUAL CLINICIANS OR COUNTRIES

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OUTLINE

• INTERNET COMMUNICATION
• XML DATA FORMAT
• CENTRAL SERVER/ARCHIVE
• BROWSER
• DEDICATED CLIENT FOR REMOTE SITE
• PRE-GENERATED CLINICAL CASES

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SYSTEM DESIGN
STUDY MONITOR
Notification
Ortho Referral with attachments
Browse
Notification
Browse
E-mail reply
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STUDY DESIGN

• 200 PATIENT DATA PACKS
• RADIOLOGY, ORTHOPEDICS, INTERNAL MEDICINE,
  DERMATOLOGY, ENT
• 5-10 ROLE 1 (ORIGINATING) FACILITIES
• 5 SPECIALISTS (RECEIVING) IN EACH SPECIALTY

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REMOTE SOFTWARE

• PURPOSE BUILT OPEN SOURCE SOFTWARE
• GUIDES USERS THROUGH COMPOSITION OF REFERRAL
• MULTIPLE MEANS TO SEND REFERRAL

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SPECIALIST'S WEB VIEW
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PLAN

• TRIAL DELAYED BY CURRENT OPERATIONAL TEMPO AND
  COMMITMENTS
• ANTICIPATED TO TAKE 3 MONTHS TO COMPLETE, ONCE
  STARTED
• SOFTWARE AND PROTOCOLS ALREADY USED FOR UK
  NATIONAL SYSTEM

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SUMMARY

• INTEROPERABILITY IS A KEY NATO DOCTRINE
• MULTI-NATIONAL OPERATIONS ARE COMMON
• TECHNICAL AND NON TECHNICAL ISSUES MUST BE
  OVERCOME

More information on www.bktec.org
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