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For immediate use

March 31, 2004 -- No. 177

Photo note:  To view image related to research, see end of release.

National grant funds ‘3-D telepresence technology’
research to aid medical professionals at remote sites

CHAPEL HILL -- A medical professional responding to an accident scene or dealing with a trauma at a remote clinic often must make split-second decisions within a rapidly changing situation to save lives.

Consultation with a health-care provider by phone, video or Internet offers crucial support, when possible. Researchers at the University of North Carolina at Chapel Hill are exploring if extending that distant consultation to a portable, three-dimensional telepresence technology could improve the quality of long-distance consultation and, as a result, increase the quality of medical diagnosis and treatment.

The National Library of Medicine recently awarded the department of computer science a three-year, $2.6-million contract to develop and test technology allowing 3-D video of the patient and surroundings, with opportunity for medical professionals on- and off-site to communicate in real time. The department is part of UNC’s College of Arts and Sciences.

UNC computer science researchers are developing a prototype for use in medical facilities. The research team plans to test its effectiveness by exploring its use, compared to the use of two-dimensional teleconferencing, during tracheostomies being performed at UNC Hospitals.

"Tracheostomies do not take long but are critical procedures in many emergencies and have a degree of difficulty," said Dr. Henry Fuchs, the study’s principal investigator and Federico Gil professor of computer science.

"Airway obstruction is the leading cause of preventable death in situations where patients die en route to the hospital," said Dr. Bruce Cairns, co-principal investigator on the study, research director in the N.C. Jaycee Burn Center and assistant professor of surgery in UNC’s School of Medicine.

"Testing this technology in an acute situation allows us to assess the hypotheses regarding the capture of these procedures and determine whether we can effectively bring the consultant to the bedside and the bedside to the consultant."

Fuchs said the idea behind the grant originated two years ago, when the team of investigators sent a proposal to the National Library of Medicine to study how high-speed mobile networks could improve health-care management. Two-dimensional teleconferencing, or telemedicine, is being done but does not allow full enough immersion into an emergency scenario, he said.

"What we wanted to explore was how to make that link significantly stronger in an emergency," Fuchs added.

"We hope that ultimately this 3-D technology will prove helpful not just in immediate treatment but in the ride in the ambulance to a medical facility, so that an EMT alone with a patient during that ride will not feel so alone."

Cairns said his experience as a doctor in the U.S. Navy, stationed in Guam, demonstrated the importance of telepresence technology. The closest land mass to Guam was five hours away by air, and his hospital, Naval Hospital Guam, had no neurosurgeon, yet served a civilian and Navy population of about 150,000. Therefore, he was occasionally called upon to operate on patients with life-threatening head injuries, despite having limited training and support in performing neurosurgical procedures.

The hospital, however, also was a participant in the first international Internet tumor board consultation, which allowed doctors in Guam to share detailed information and graphics about their cancer patients and discuss whether the individual should stay in Guam or seek treatment elsewhere.

"Our experience with the Internet tumor board gave us the sense that we were doing everything we could for our patients, while limiting transportation costs and separations from families," said Cairns. "The advantage of the experience for me was that, unlike being at an advanced academic medical center like UNC where people send patients for care, I was in a very remote location with limited support, or as we used to call it, at the tip of the spear.

"We were being asked to make decisions with limited resources but our instincts were that those patients should not suffer as a consequence of their being in a remote location."

The technical questions involved in extending telepresence are substantial, he said, but the need for such advances is intuitively obvious.

"If you could use technology to cross geographical barriers, you could extend opportunity to people who live in rural or remote areas. We believe people should be able to get the very best care they can get and not have their access to specialized acute care limited by where they live."

The other co-principal investigators on the National Library of Medicine project are Dr. Ketan Mayer-Patel, assistant professor, and Dr. Greg Welch, research associate professor, both of UNC’s department of computer science; and Dr. Diane Sonnenwald, professor, of Göteborg University and University College of Borås, Sweden. Additional collaborators include Dr. Anthony Meyer, professor and chair of UNC’s department of surgery; Dr. Eugene Freid, associate professor of anesthesiology and pediatrics; and Dr. Robert Vissers, assistant professor of emergency medicine.

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Note: To arrange an interview with Fuchs, Mayer-Patel, Sonnenwald or Welch, contact Myra Gwin-Summers at (919) 962-1851 or myra@cs.unc.edu. To arrange an interview with Cairns, Freid or Vissers, contact Kay Teague at (919) 966-3693 or kay_teague@med.unc.edu. To view or download illustrations related to the project, click on http://www.unc.edu/news/pics/research/complete_annotated.jpg 

News Services contact: Deb Saine, (919) 962-8415 or deborah_saine@unc.edu