bad mole

What does it take to send an image of an ailment to a remote clinic for analysis, in real time? Can we look forward to having this available to us in our homes soon?

Here is an example of a sensibly high quality close up digital picture with 640x480 resolution, of a mole that could be malignant. This probably represents the best quality that could be sent today with high-quality CCD camera over an ethernet link to a remote site for evaluation. We explore some of the problems that could arise in interpreting the image, and form ideas about this aspect of telemedicine in the future.

arm wound

It is possible to get diagnostic information from a remote trauma, even if the video being used is low resolution, and the color is marginal. Here is an example. But, how much faster is it to send this quality of an image, than one like the top one? We explore the compromises.

After all thes years (now late 2005!) I find that we were in fact way ahead of our time. Read the following!

The Edge: Time-shaving technology
David Phelps, Star Tribune
December 26, 2005

There's a saying among paramedics and cardiologists that "time is muscle," meaning that the longer it takes a heart attack victim to get to a hospital's catheterization lab, the greater the possibility of significant heart damage.
Edina Fire Department paramedics and Fairview Southdale Hospital's Heart and Vascular Center are using new technology from Medtronic to slash the time it takes to get from the emergency-room front door to the operating table. Early results show the potential for significant time savings.
The new Medtronic Lifenet RS receiving station allows ER physicians and cardiologists to receive digitized EKG charts from paramedics while they still are en route to the hospital. Knowledge of the patient's condition allows the medical staff to take the appropriate steps to begin treatment as quickly as possible.
"If [paramedics] can do the EKG in the field and the emergency room says it's an acute heart attack, they then call us and we can get the ball rolling right away," said Dr. Stephen Battista, a cardiologist with the Minnesota Heart Clinic. "If you can shave 10 to 20 minutes off a heart attack, that can make a difference."
Fairview Southdale already does pretty good at "door-to-balloon time," when the treating physician can restore blood flow to the heart with the aid of a tiny balloon to open arteries. Fairview's average is 70 minutes, compared with a national recommended goal of 90 minutes.
In a recent instance of a heart attack since the Lifenet technology went on line, the door-to-balloon time was 41 minutes.
Fairview is the first hospital in Minnesota to use the Medtronic device, which costs $12,800 to $16,800. A smattering of hospitals in New Jersey, New York, Ohio, Washington and Connecticut operate the Lifenet, too.
Paramedics like the improved accuracy of the EKG readings. Typically, faxed readings lack the clarity of readings sent digitally and take several minutes to transmit. By sending the EKG digitally by cell phone, the message is almost instantaneous.
"Everyone with chest pains gets an EKG," said Edina paramedic Mike Hughes. "Whether to send it is our discretion, but if there is any question [about the seriousness of the pains], we'll send it and leave it up to [the doctors]."
"This technology will spread like wildfire," Battista said. "In a year or two, every ambulance [and hospital] in the Twin Cities will have this."

David Phelps • 612-673-7269

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