DRAFT

CONCEPT PROPOSAL

Distributed Medical Intelligence Training Center (DMITC)

Diana M. Henshaw, Ed.D. and David Balch, Principal Investigators

Center for Health Sciences Communication

East Carolina University

Introduction

The Telemedicine Center of East Carolina University's Brody School of Medicine has an active telemedicine program that employs an array of interactive video and audio technologies to deliver clinical care and education to the rural population of eastern North Carolina. ECU has integrated advanced telecommunication technologies into a homogeneous network, which remains one of the most integrated Telemedicine networks in the country, and perhaps around the world. The hybrid network, comprised of microwave, T1, ATM, ISDN, Microwave, and POTS technologies, allows for deployment of cost-effective technologies tuned to the specific needs of each remote site.

In 1999, ECU was awarded a three-year contract by the National Library of Medicine and the National Institutes of Health to examine biomedical applications of Next Generation Internet (NGI). http://www.nlm.nih.gov/research/ngiinit.html The project encompasses four different areas of NGI research and applications. Chief among the projects is an investigation into the use of Internet Protocol Video (IP Video) for the practice of clinical medicine. As part of this activity, ECU is developing wireless interactive communications systems that transmit field sequential 3-D video, and a micro-web server that facilitates real-time biosensor monitoring across secure sockets on the Internet.

In the aftermath of Hurricanes Floyd and Dennis, ECU utilized its extensive knowledge to deploy portable telemedicine systems in make-shift shelters which were isolated by floodwaters and hurricane damage. These links provided immediate access to medical professionals from surrounding clinics and hospitals. Most recently, ECU was invited to demonstrate it’s Distributed Medical Intelligence (DMI) model during a disaster simulation in a joint civil-military exercise (code name: Strong Angel) in a remote area in Puu Paa, located off the northwest corner of the Big Island of Hawaii. During the exercise, the DMI system provided a medical communications matrix consisting of an array of networked and “roaming” communication and monitoring devices, distributed knowledge resources, global connectivity, and clinical protocols.

Systematically tested for reliability and function, ECU's Telemedicine Practice Suite and Remote Bridge have become the model for refining advanced applications of emerging technologies to meet the requirements for a globally deployable, intelligently configurable medical communications system. Global medical expertise is made available through ECU's Bridge to enable rapid clinical response during disaster situations. This Distributed Medical Intelligence model enables civilian and military teams to utilize the most advanced medical technology to first responders to help save lives and minimize medical complications during natural and manmade disasters.

These advances in distributed medical care require highly trained medical, emergency, civil, and defense personnel. Twenty-first century disasters and threats require Americans be ready to respond both at home and abroad. DMI will achieve its full potential when well-trained first responders and well-trained physician consultants can provide on-demand care around the globe.

Training Objectives

In order to meet the training needs inherent in the deployment of DMI, East Carolina University proposes the establishment of a Distributed Medical Intelligence Training Center (DMITC). The objectives of the Center would be to:

• Train civilian and military personnel in the use of DMI equipment and protocols;
• Acquaint personnel with the logistical requirements of deploying DMI in various regions of the globe;
• Provide sustainable, high-speed access to resources through the East Carolina University Bridge;
• Develop curriculum and materials for specialized training such as responses to biological disasters, earthquake disasters, etc.;
• Provide practical models for United States-based international corporations supporting U.S. citizen groups abroad;
• Enhance the skills of civilian and military personnel in using advanced technologies to minimize the loss of life and serious injury to individuals as a result of larger scale disasters;
• Provide certification and continuing medical education to individuals as evidence of their training accomplishments and to maintain permanent certification records;
• Support the concept of integrative medicine for health care providers;
• Establish a Global DMI Community Network for sharing best practices.

Training Programs

Training activities will center initially on four types of disaster applications: biological, chemical, nuclear, and natural disaster management. The utilization of portable remote stations and other distributed medical intelligence tools will be the focus. Components of the training initiative will include:

• A core curriculum, accredited as appropriate by ACCME for Category I credit for physicians, physician assistants, and nurse practitioners;
• Simulations, Case Studies, and Hands-on Experiences;
• Development of cross-cultural communication skills;
• Building teamwork skills;
• Links to appropriate cutting edge research;
• Information sharing;
• Collaborative Deployment Groups for Exercises;
• A web site for materials, best practices, and other expert resources;
• Increase capacity to creatively use applications and professional DMI tools;
• A framework for on-going training and development;
• Access to ECU's Research and Prototype Laboratory

Time Line and Resources

It is anticipated that the design, implementation, and initial training will take place over a three-year period. While some resources are already in place at East Carolina University through its telemedicine and continuing education programs and through grants, additional support of $5,800,000 is projected as a requirement.