The Telemedicine Center
Brody School of Medicine  East Carolina University  Greenville, North Carolina

Thousands of Americans will travel each year on humanitarian missions to provide medical aid to locations throughout the world without access to healthcare. Delivering care to the victims of poverty, disaster, hunger, warfare, and epidemics presents inherent challenges. Medical resources are usually scare or non-existent at these points of need. Through the use of advanced telecommunications, medical knowledge and expertise can reach those in need to save lives and improve their health. Three major components need to be matured, building upon existing assets and experience to fully realize this goal: a Global Humanitarian Telemedicine Center, the ECU Bridge and an International Training Center. 

Global Humanitarian Telemedicine Center
In order to achieve the delivery of global medical resources, East Carolina University seeks support to develop a Center to oversee preparedness and operational aspects of telemedicine in humanitarian response and manage the ECU Bridge and International Training Program. The Center will provide leadership and management, liaison with organizations involved in disaster management, oversee preparedness, and build a network of trained health care professionals and managers in advance of a disaster. Working with international medical aid groups ECU will forge a clinical responder network of health care workers who have had overseas disaster experience and others who can respond to requests for telemedical consultations from field responders. 

ECU Bridge
During disasters and in humanitarian situations telecommunication links are often disrupted and aid workers must use available links. These links are often not capable of connecting directly to medical resources elsewhere, because of a mismatch in communication modes or a lack of information about where to link to. Under these circumstances the ECU Bridge can provide a vital connection between the point of need and the medical resource. Matches will be made between field requests and available medical resources, then a connection made between available disparate communication systems. Existing medical resources with telemedicine capability will be identified and tested for preparedness.

International Training
Advances in distributed medical care require highly trained personnel. The Center will achieve its full potential when well-trained field responders and physician consultants can provide on-demand care around the globe. ECU is developing an International Training Program with a focus on the use of technology and the organizational issues.  

Experience
The Telemedicine Center of East Carolina University's Brody School of Medicine has an active telemedicine program that over the past eight years has cared for over 6,400 patients. This has been achieved with an array of interactive video and audio technologies that deliver clinical care and education over high and low bandwidth links to the population of eastern North Carolina. Research efforts have accumulated one of the largest databases of information about telemedicine. ECU has shared its knowledge through the Advanced Telemedicine Training Program, training over 300 persons since 1996. http://www.telemed.med.ecu.edu/training/index.htm

In the aftermath of Hurricane Floyd, ECU deployed portable telemedicine systems in shelters, which were isolated by floodwaters. These interactive video links provided immediate access to medical professionals from surrounding clinics and hospitals. Recently, ECU participated in the refugee crisis simulation during the Strong Angel civil-military exercise in a remote area of Hawaii. 
•	Simulated patients and field responders were linked via the ECU Bridge to 14 telemedicine sites across the nation. 
•	Over five days an array of networked and roaming communication/monitoring devices, distributed knowledge resources, and global connectivity were evaluated. Clinical protocols and role of nurses at the ECU Bridge were also evaluated. http://www.telemed.med.ecu.edu/strong/whitepaper.htm
•	Knowledge gained has been incorporated into planning for the Global Humanitarian Telemedicine Center.

In 1999, ECU was awarded a three-year contract by the National Library of NIH to study biomedical applications of Next Generation Internet (NGI). http://www.nlm.nih.gov/research/ngiinit.html. Funding has also been received from the Office for the Advancement of Telehealth and the Health Care Financing Administration.

For more information, contact David C. Balch, Director, The Telemedicine Center, balchda@mail.ecu.edu or at 252.816.2466.