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  • Networking & Hospitals

    Dear Biomch-L readers,

    The following item was received today via the RESEARCH list; I should think
    that it is highly relevant in our field, too.

    Regards -- HJW.
    - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
    Date: Fri, 10 May 91 14:59:51 EDT
    Sender: Hospital Computer Network Discussion Group and Data Base

    From: "Donald F. Parsons MD"
    MARCH 1992
    To: Marty Hoag

    D. Parsons MD, Wadsworth Center, Room C273, New York State
    Department of Health,
    Empire State Plaza, Albany, NY 12201-0509. Tel: (518)474-7047;
    Fax: (518)474-8590. E-mail to moderator: BITNET dfp10@albnyvm1;
    Internet; UseNet;
    Compuserve 71777,212
    Date: May 10, 1991
    File: hspinvit.asp

    The New York Academy of Sciences Sponsored:

    Moderators and Editors: Donald Parsons MD and;
    Carl Fleischer Robert A. Greenes MD, PhD
    Dir., Consulting Services Assoc. Prof. Radiology
    FMS Telecommunications Dir., Decisions System Gp
    314 Walnut St. Brigham & Women's Hospital
    Wellesley, MA 02181 75 Francis St.
    617 235-2245; fax 617 235-9337 Boston, MA 02115
    617 732-6281; fax 617 732-6317
    NYAS Sub-Committee Chair:
    Morris Shamos PhD
    M.H. Shamos & Associates
    6 East 43rd St.
    New York, NY 10017
    212 573-6030w; 212 884-9030h; fax 212 263-713


    Dear Subscriber,

    The purpose of this letter is to invite you or a
    representative to participate in the upcoming New York Academy of
    Sciences sponsored meeting: "A CONFERENCE ON EXTENDED CLINICAL
    on Monday, March 23 through Wednesday, March 25, 1992 at the
    Marriott Hotel, Copley Square (across from the Prudential),
    Boston. I believe that this is the first national and
    international conference bringing together those interested in
    sharing consulting resources between large medical centers and
    rural hospitals and groups of physicians. As you know, the
    crisis in rural health care is worsening and telecommunications
    may well assist in restoring acute or emergency care to some
    rural areas.
    However, the Conference has a wider scope: it covers also
    the LANs, WANs and national networks involved in intra-hospital,
    inter-hospital, national and international consultation (or
    medical disaster management). Apart from the technical aspects;
    the personal, social, educational, economic and legal aspects of
    such communications will be considered. Emphasis will be placed
    on the medical informatics involved, and on training physicians,
    nurses, public health and social workers, and hospital
    administrators to give them a basic understanding of the new
    computer methods of assembling and distributing patient and
    hospital administration information.
    Having received full endorsement by the NYAS, we are in the
    process of putting together a preliminary program (enclosed).
    In some cases we have suggested a title and place for you in the
    program. If not, please examine the program and suggest your own
    place and topic. At this time all names of speakers and titles
    are preliminary only. Please give us your own title(s). We will
    be flexible about restructuring the arrangement of topics and the
    program itself. Your comments about the program and about
    additional speakers, will be most valuable. Let us know if some
    important areas have been omitted or underemphasized. At the
    same time we would like to keep the number of parallel sessions
    at a minimum. We hope that all chairpersons and co-chairs will
    also give a paper.
    A call for poster abstracts will be issued later. Please
    also let us have any suggestions about choice of commercial
    The papers of this conference will be published as a single-
    topic volume of the Annals of the New York Academy of Sciences.
    This serial publication is distributed throughout the world to
    virtually every major science library. It reaches a wide
    audience of basic, biomedical and clinical scientists. For the
    near future, this issue should become the major reference for
    clinical networking information. To achieve this status, rapid
    publication is necessary. The NYAS will publish our issue 6-9
    months after the conference. Authors are expected to submit
    papers 2 weeks before the conference, or at the very latest, at
    the time of the conference. A booklet of abstracts will be
    available to the attendees.
    At this stage, we are actively involved in fund raising. We
    hope to support those who indicate a need for travel and per diem
    expenses. Meanwhile, we hope you can commit yourself to
    participate regardless of financial assistance. The enclosed
    form is to indicate your needs.
    We sincerely hope that you will be able to participate. To
    confirm this, please complete the form and return immediately to
    Ms. Busacco by mail or fax as indicated on the form. Kindly send
    a copy to me (Donald Parsons) by mail, fax or e-mail, also.
    If you have further questions, please call me at (518) 474-
    7047 (it has an answering machine).


    Donald Parsons
    Professor, Albany School of Public Health
    Af.Professor of Biology, SUNY Albany
    Research Physician III, NY State Dept of Health


    In recent years there has been a serious and continuing
    decline in the number of operating rural health facilities and in
    the availability of acute care in rural hospitals. This
    situation has contributed significantly to rural economic decline
    and the rising cost of health care in USA. Increasingly,
    patients have the extra expense of travelling to distant large
    medical centers for treatment.
    A partial reparation of the situation can be achieved by
    computer networking between consultants at large medical centers
    and rural hospitals and physicians. Xrays or other medical
    images necessary for the consultation can be transmitted over
    ordinary phone lines in a few minutes, using new data compression
    algorithms and error-correcting modems. A diagnosis, or patient-
    stabilization information can be phoned, faxed or e-mailed back
    to the rural center in a short time. Chronic treatments that
    require repeated consultant control (such as chemotherapy) can be
    handled in the same way. The patient is able to stay at the home
    site for such treatment. Phone/fax consultant-access systems
    using dedicated switchboards, are already working well in several
    states (e.g., Alabama, Tennessee and Georgia). These states are
    attempting enhancement by addition of digital text and image
    transmission capability.
    The identification of preferred technical approaches to such
    computerized networking is a main objective of this Conference.
    We will review medical computer networks already operating, both
    in USA and elsewhere, and discuss new possibilities. This
    Conference is the first comprehensive discussion of this
    question. It is badly needed since communication between
    experimenting groups has been at a minimum, and the need for such
    systems has received little attention by granting agencies and
    legislators. Only recently, has a BITNET discussion group
    (HSPNET-L@albnydh2) on this subject become available.
    Apart from the technology and design of such hospital
    computer networks (including the place of local bulletin boards,
    landlines, satellite and packet-radio links), we will address
    many related issues: medical staff attitudes and training in use
    of computers, types of patient data packages, confidentiality of
    data, legal issues, etc. We will also address a variety of
    applications: high-definition TV, teleradiology, telepathology,
    fetal monitoring, accreditation/ education programs, access to
    literature searches in rural areas, improvement of disease
    notification, exchange of state and federal medical advisories,
    and disaster and trauma management.
    Hopefully, this Conference will serve to focus and catalyze
    the use of modern medical informatics principles for the
    improvement of the quality of health-care delivery.

    Scientific rationale for the conference.
    The economic and structural crisis in health delivery in USA
    today make a search for technical assistance an urgent matter.
    The possibility that computer assisted telecommunications and
    principles of medical informatics can provide a relatively
    inexpensive easement of the problem is important in these days of
    huge deficits.
    Recent major advances in several scientific fields have
    provided optimism that this approach will be rewarding. In image
    processing, data compression algorithms have switched attention
    from very expensive satellite communication to the use of
    ordinary land lines. Evolution of error-correcting modems have
    improved the outlook further for use of landlines.
    Very recently, there has been considerable legislative
    interest in developing a higher speed (T1,T3) national network
    (e.g. CREN) which might stimulate US industry. There is growing
    commercial interest towards making ISDN voice/data lines the
    national standard. If such developments occur, the improved
    hardware and expertise developed will help this kind of health-
    delivery task.
    Fortuitously, there have been many Defence grants recently
    awarded to medical-center radiology departments for the purpose
    of improving the digitization, storage and transmission of
    digitized medical images (PACS - picture archiving and
    communication systems). This funding has accelerated image
    processing and development of digitization and transmission
    methods. Many medical-center radiology departments now have
    personnel, equipment and expertise that make them a natural
    center for controlling the exchange of digitized patient data.
    Eventually it is hoped that the science of medical
    teleinformatics will develop to the point that national systems
    can be interlinked in a world-wide exchange of medical
    experience. This should be of particular benefit to developing
    countries and countries struck by large-scale disaster


    Speakers may choose 30 m. or 20 m. (which includes 5 m. for
    discussion). On-line computer sessions and videos will run
    during the 25 m. coffee breaks which will be held in the Poster
    Viewing Area, adjacent to the Commercial Exhibit Area. Press
    Conferences will be held at 5 pm on Day 2 and at noon on Day 3.
    All chairpersons will be expected to present papers. CME credit
    will be available.

    First Day:
    COMPUTER NETWORKS. Chair: D.F. Parsons, NYS Dept of Health,
    Albany, NY
    8.30-8.40. Welcome and Announcements: D.F. Parsons
    1. Opening Address: John S. Quarterman. "The Matrix:
    Computer Networks and Conferencing Systems Worldwide. What They
    Have to Offer for Medical Consulting."
    2. "The French Communicable Disease Network and Other
    European Networks," Philippe Garnerin DVM, PhD; Chief of Computer
    Operations, FCDN, Universite Paris, France (with live video
    3. "The DIV Netherlands Hospital and General Practice
    Network" P.G. Arnou, Stichting Dienst Informatie Verwerking,
    Hilvarenbeekseweg 60, 4460 BB Goes, Netherlands.
    4. "Medical Networks in Sweden," Eng-leong Foo, Director,
    UNEP/UNESCO/ICRO Microbiological Resources Center, Dept of
    Bacteriology, Karolinska Institute, S 104 01 Stockholm, Sweden.
    5. "Medical Networks in Canada," Lewis S. Carey MD,
    Department of Diagnostic Radiology and Nuclear Medicine,
    University Hospital, University of Western Ontario, Canada.

    PM 2.00-5.00. Session 2. TWO SIMULTANEOUS SESSIONS:

    Oeffinger, President Texas Hospital Education and Research
    Foundation, Co-Project Director of Texas Rural Hospital
    Electronic Exchange -TRHEX, Austin, TX
    1. "The State of Healthcare In Rural America." --------
    2. "Telecommunications Technology for Rural Healthcare."
    A.M. Bennet, National Center for Health Services Research,
    3. "Several Medical Networks in Texas (KARENET, MEDNET and
    Others)." John C. Oeffinger
    4. "Rural Networking In North Dakota." Marty Hoag, Manager
    System Services, Computer Center, North Dakota State University,
    PO Box 5164, Fargo ND 58105. (701)237-8639; fax (701)237-8541.

    B. MEDICAL INFORMATICS. Chair: Edward H. Shortliffe MD,
    PhD, Chief, Division of Internal Medicine, Stanford University
    Medical Center, Stanford, CA.
    1. "Teaching Informatics to Medical Personnel." E.H.
    2. "Improved Notification, Reporting and Exchange of State
    and Federal Advisories." -------
    3. "The WONDER System for On-line Epidemiological Data
    Analysis." CDC MAINlink, Sarah L. Lyle, PRI Inc, 18 Executive
    Park Drive, Atlanta, GA 30329.
    4. "Telecommunications in Medicine: The 3I Project." A.
    Hasman, Foundation 3I, Dept. Medical Informatics and Statistics,
    Univ. Limburg, PO Box 616, 6200 MD Maastricht, Netherlands.
    1.30 pm. Start of Poster Session. Start of Commercial Exhibits
    5. "Maintaining Confidentiality in Electronic Patient Data."
    6. "IEEE and Other Standards for Medical Data Interchange."
    T.E. Rutt, AT&T Bell Labs, Holmdel, NJ 07733.

    Evening: Free. Independently arranged Subgroup Meetings will be

    ++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++
    Second Day:

    Problems of Digital data transfer.
    3a. Teleradiology Chair: Steve Pizer PhD, Dept. of
    Computer Science, Univ. North Carolina, Chapel Hill, NC 27599-
    3175. (919)962-1785.
    i. "Teleradiology as an Important Consulting Tool." Steve
    ii. "Recent Image Data Compression Techniques." Joseph
    Caresio, University of Kansas, Medical Center, Kansas City,
    iii. "Teleradiology for the Emergency Room." Nolan J.
    Kagetsu MD, Dept of Radiology, St.Lukes/Roosevelt Hospital
    Center, Amsterdam Ave at 114th St, New York, NY 10025-1723.
    iv. "Ultra-high-speed Teleradiology with ISDN Technology."
    James L Lear MD, Dept Radiology, Box A034, University of
    Colorado, Health Sciences Center, 4200 E. Ninth Ave, Denver, CO
    v. "TAMRI - Rapid Reporting in Miami on Phone-line
    Transmitted Radiographs and Slides From Latin America."
    Mario A. Mendez, Director, Trans-American Medical Referrals,
    Inc., 5200 Blue Lagoon Drive, Suite 640, Miami, FL 33126.

    3b. Telepathology, Miscellaneous Telemedicine
    Applications. Chair: Ronald S. Weinstein MD,
    Chairman, Dept. Pathology, Rush-Presbyterian-St.Luke's Medical
    Center, 1653 W. Congress Parkway, Chicago, IL 60612.
    i. "Telepathology Consulting." R.S. Weinstein.
    ii."Fetal Heart Rate Monitoring in Rural Areas." Steven l.
    Clark MD, Utah Valley Regional Prenatal Center, 1034 North
    500 West, Provo, UT 84604.
    3c. Interhospital linkages. Chair: John P. Glaser
    PhD, Brigham and Women's Hospital, Boston.
    i. "The Longwood Medical Area Network" John P. Glaser PhD,
    Brigham and Women's Hospital, Boston.
    ii. "Data Communications Within a Health Authoritory," J.
    Moseley, Hammersmith Hospital, London.

    3d. Bulletin Boards and FidoNet. Chair: David Dodell
    DMD,10250 North 92nd Street, Suite 210,
    Scottsdale, AZ 85258-4599. (602)860-1121
    i. "FidoNet for Medical Consulting." David Dodell
    ii. "Medical Bulletin Boards Around the World" John
    Beasley, Family Medicine, Univ. Wisconsin Medical

    3e. Disaster and Trauma Center Networking. Chair:
    Dr. Andrew Bern, Head Disaster Medicine Section, American College
    of Emergency Physicians, 9846 NW 18th St., Coral Springs, FL
    33071. (305)755-7083.
    i. "Telecommunication Needs for Disaster Medicine in USA."
    Andrew Bern MD.
    ii. "Current Disaster Networking in USA." David Butler,
    Natural Hazards Research and Applications Information Center,
    Inst. Behavioral Science #6, Campus Box 482, Un. Colorado,
    Boulder, CO 80309-0482. (303)492-6818; fax (303)492-6924.

    3f. Special Compact Patient Data Packages. Chair:
    i. "SmartCards in Health Care." Nancy Mann, Health and
    Consumer Industries, Arthur D. Little, Acorn Park,
    Cambridge, MA 02140.
    ii. "Storage of Medical Data on Optical Discs." A. Hasman,
    Dept. of Medical Informatics and Statistics, University of
    Limburg, 6200 MD Maastricht, Netherlands.

    3g. Consulting via Satellite. High Definition TV
    Consulting. Chair: Charles Clements
    i. "Global Hospital Networking." Charles Clements,
    SatelLife, 225 Fifth Street, Cambridge, MA 02142.
    ii."Cost Containment in Satellite Medical Consulting."
    iii."The Satellite System at the University of
    iv. "The HDTV Consulting System in Texas." Cliff Eason,
    Vice President Southwestern Bell and the Texas Children


    Problems and Non-digital Consulting.

    4a. Problems for Medical Personnel in Using
    Computers, Confidentiality, Finance and Legal Problems.

    Chair: Benjamin Wright, Attorney, 3420 Granada, Suite
    400, Dallas, TX 75205. (214)526-5254.
    i. "Electronic Data Interchange and American Law." Ben
    ii. "Problems for Medical Personnel in Adapting to Use of
    iii."Third-party Reimbursement for Telecommunications
    Patient Care." A.M. Bennet.

    4b. Phone/Fax Consultant Services. Chair:
    i. "GaIN: Network of Physicians and Hospitals in Georgia"
    Jocelyn A. Rankin
    ii. "MIST - Medical Information by Telephone" Lynn Watson,
    MIST Coordinator, University of Alabama Medical School, UAB
    Station, Birmingham, AL 35294. (205)934-5957; fax (205)975-
    iii. "The Tennessee Consultation Center." Garlena
    Davenport, Director.
    iv. "West Virginia CONSULT Statewide Medical Information
    System." Linda Jacknowitz, Project Director, WV Univ.
    Health Sciences Center, Morgantown, WV 26506. (304)293-4996;
    fax (304)293-2901.


    4c. Packet Radio Medical Communication. Chair: Phil
    Karn, Bellcore Corp., (201)829-4299.
    i. "The Potential of Packet Radio for Medical Consulting."
    Phil Karn.
    ii. "Examples of International Medical Consulting by Packet
    Radio." Len Traubman DDS, 1448 Cedarwood Drive, San Mateo,
    CA 94403. (415)333-6812; fax (415)573-1217.


    Evening: Subscription Dinner (tables can be selected according
    to sub-interest), Cash Bar (both assisted by

    Guest speaker at dinner: Daniel R. Masys MD. FACP. Director
    Lister Hill National Center for Biomedical Communications,
    National Library of Medicine, NIH. "U.S. Federal Plans for
    Expansion of National Computer Networks and for Network Aid to
    Rural Medical Centers" Q. & A.
    ++++++++++++++++++++++++++++++++++++++++++++++++++ +++++++

    Third Day:

    AM. Session 5. PANEL DISCUSSION "What is the Best Approach to
    Restoring Acute-Care Consulting to Rural Hospitals and Physician
    Topics: Increasing discussion in trials of networks, increased
    and more goal-orientated federal funding for network
    Panelists: Chair: D. F. Parsons;
    PM. End of Poster Session and Commercial Exhibits. Departure.