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    Medical informatics is a broad field spanning electronic medical records, telemedicine, information retrieval, image processing and analysis, bioinformatics, and evaluation methodologies. Using Internet2 high-speed networking and distance learning modalities, students in the informatics programs within Oregon Health & Science University and the University of Pittsburgh have access to a broader range of faculty, areas of subject expertise, and other students with whom to collaborate.
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    This large, NLM-funded project focuses on providing a way for medical professionals to communicate detailed information about human embryo development in a visual form. This project comprises a network of medical collaboration workstations, using high-performance, off-the-shelf networked computer systems combined with advanced software for collaboration, and medical visualization. The workstations are installed at eight project locations and interconnected over high-performance networks operating at data rates over 100 megabits per second nationwide. As a result, doctors will be able to visualize and manipulate high-resolution image data collaboratively for diagnoses, clinical case management, and medical education.
    George Mason University is providing overall responsibility for the project as well as collaboration technology. Oregon Health Sciences University (OHSU) has a leading role in the Annotation and Modeling application and is responsible for aspects of embryology dealing with the heart and lungs. For example, using image sets from the Visible Embryo Project to create 3-D computer models, the OHSU Heart Research Center is helping to improve understanding of the complex processes of normal and abnormal heart development. Their Embryology Education Application makes visualization tools available for medical student use and creates animations of embryo organ system development. Internet2 networks allow sharing of the images in real-time with researchers in California and Washington, D.C.
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    Current one-dimensional mediums limit students’ ability to “see into” the dynamic systems of the body. To overcome these limitations, the Stanford University’s Medical Media and Information Technologies (SUMMIT) Project is developing interactive and simulation-based learning environments in physiology for undergraduates at Stanford;
    Internet2 advanced networking will enable future collaboration in curricula among member universities. The first module in renal physiology contains a knowledge base in kidney structure, function, and difficult renal concepts addressed in the traditional course material. Topics include auto regulation, urinalysis, and countercurrent (cc) multiplier. The module contains a laboratory and quiz section that allows students to integrate and apply their knowledge to real-life problems. Finally, a resource section contains a glossary, previous lecture material, and a link to an online office hours chat room. Future modules will include such topics as neuro, cardiovascular, respiratory, and gastrointestinal physiology.
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    SUMMIT’s Next Generation Internet (NGI) testbed network within the Stanford School of Medicine evaluates the effectiveness of the Anatomy and Surgery Workbench applications. The testbed network links selected classrooms, labs, clinical departments, and the medical library using a high-speed gigabit Ethernet backbone. The new 3-D Learning Space and connected classrooms allow students to learn anatomy and basic surgical skills through the use of 3-D workstations, haptic (touch sensitive) devices, stereoscopic displays, distributed rich media databases, and application program servers. Both applications support synchronous collaboration through a shared virtual workspace and will use haptic feedback to augment the visual sense. This technology permits the definition of new curricular elements including the repeated dissection of anatomical structures, visual segmentation of raw data sets, creation of 3-D organ models, and the practice of fundamental surgical maneuvers. The capabilities of Internet2 high-performance networks and use of a distributed client-server system allow teachers and users to share online, image-rich data, and professional experiences.
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    This project provides a centralized Internet-accessible source of information and tools for health science research and education to enable practitioners, administrators, educators, researchers, and students to improve the quality of health care services in rural and underserved areas. Through a "one-stop" searchable Internet portal, both novices and experts are able to quickly locate reliable sources of information on health and health-care issues. Their web-based research environment integrates rural health data with geographic information systems (GIS) technology to support studies of rural health and rural health care. Internet2 high-performance networks make it possible to quickly transmit large volumes of data for rapid display. In addition, the project supports continuing education for rural health care practitioners and in-residence opportunities for health science students through Internet resources and telecommunication.
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    The National Library of Medicine provides a testbed environment demonstrating the use of MPEG-2 videoconferencing and NTSC quality video over Internet2 networks and the Next Generation Internet (NGI) for use in telemedicine/consultation and distance learning programs. Quality of service requirements for healthcare applications on high-performance networks are being researched concerning the integrity of the information being transmitted and the value added by real-time interaction. The testbed environment allows point to point and multi-point videoconferencing (via multicast) between collaborating sites, and also allows transmission of a range of medical content from varied sources, including presentation stands, videomicroscopes, videotape, digital stethoscopes, and otoscopes. Demonstrations of the technology are ongoing and configuration of the testbed continues to evolve.
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    Successful surgical intervention depends on the surgeon's ability to conceptually visualize complex anatomical structures (such as the pelvic floor) three-dimensionally. Tele-immersive applications, combining teleconferencing, telepresence, and virtual reality, combined with the advanced network capabilities of Internet2 networks, allow both teacher and students to enjoy improved visualization of 3-D structures.
    Tele-immersion participants interact using two or more by networked ImmersaDeskTM systems and using special eyeglasses with sensors that track each viewer’s movements and cause the system to automatically orient the model in relation to the viewer. The teacher and students—even in geographically remote locations—are able to share and interact with a 3-D anatomical model, converse, see each other, and point in three dimensions using an electronic wand.
    ImmersaDesk is a trademark of The University of Illinois, Board of Trustees
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    The Virtual Aneurysm is a simulation and virtual reality visualization of brain blood flow. Using a software system that will be able to accurately model an aneurysm imaged using x-ray computed tomographic angiography (CTA), a doctor can visualize the aneurysm in a virtual reality environment, predict its future behavior, and gain insight into the type of treatment needed. Cutting planes and stream lines tools can to be used to examine the pressure, fluid velocity, and shear forces of the aneurysm. Researchers are working to improve the accuracy of blood flow simulations, and on the development of intelligent tools to enable doctors to more easily visualize critical flow patterns and to evaluate simulated surgical interventions. Internet2 high-performance networking provides the advanced capabilities (high-bandwidth and low delay) necessary to enable the remote visualization and navigation of multi-terabyte virtual aneurysm simulations stored on a high-performance server at UCLA.
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  • 20020628-AllStaff-Kratz.ppt

    1. 1. Health Science Applications Mary Kratz Project Manager, Health Science Initiatives All-Staff Retreat, June 2002
    2. 2. 01/28/15 2 Can you smell the $$$? •Trillion dollar “cottage” industry •NIH primary source of University research funding at $27 billion/year •1-5% of that $27 billion is IT research • $270,000,000 •NIH envisions IT research growing to 5- 10% within 2 years •10-20% within 5 years
    3. 3. 01/28/15 3 You Do the Math •Average University Medical School has $270,000,000 in research grants and contracts TODAY! •The average medical campus has •$15,000,000 in grants and contracts •~20 IT focused •130 Medical Schools are Internet2 members •130 x 20 = 2,600 grants and contracts
    4. 4. 01/28/15 4 Internet2 Health Sciences •Health Science Applications •Critical Success Factors (CSF) of Health Science Initiative •Organization of Health Science initiative
    5. 5. Applications! *NIH Funded
    6. 6. 01/28/15 6 Distributed Medical Informatics Education  Covers a broad range of fields including electronic medical records and information retrieval  Distance learning provides students with access to faculty, expertise, and other students Oregon Health & Science University and the University of Pittsburgh http://www.ohsu.edu/bicc-informatics/ http://www.cbmi.upmc.edu/
    7. 7. 01/28/15 7 Human Embryo Development  3-D visualizations of human embryo development  Doctors can manipulate data remotely  Animations of embryo system development for students George Mason University, Oregon Health & Science University, National Library of Medicine http://www.nac.gmu.edu/visembryo.htm http://www.ohsu.edu/chrc/
    8. 8. 01/28/15 8 Renal Physiology Modules  Overcomes the limits of one-dimensional mediums to represent dynamic systems of the body.  The modules allow students to integrate and apply their knowledge to real-life problems Stanford University Virtual Labs Project http://summit.stanford.edu/hhmi
    9. 9. 01/28/15 9 Anatomy and Surgery Workbench and Local NGI Testbed Network  Allows students to learn anatomy and practice surgery techniques using 3-D workstations  Network testbed evaluates the effectiveness of workbench applications Stanford University School of Medicine http://haiti.stanford.edu/~ngi/final/
    10. 10. 01/28/15 10 Surveyor  Web-based research environment integrates rural health data with GIS technology  Support for rural health care practitioners in underserved areas University of Wyoming, Wyoming Department of Health http://www.wims.uwyo.edu/
    11. 11. 01/28/15 11 NLM Testbed for Collaborative Videoconferencing  Provides an environment for videoconferencing in distance learning programs  Transmits a variety of medical information, including data from instruments National Library of Medicine http://tlc.nlm.nih.gov/distancelearningandcollaboration.html
    12. 12. 01/28/15 12 Virtual Pelvic Floor  Provides 3-D visualization of complex anatomical structures  Participants use ImmersaDesk™ systems to interact with 3-D anatomical model University of Illinois at Chicago http://www.sbhis.uic.edu/vrml/Research/PelvicFloor/PelvicFloor.htm
    13. 13. 01/28/15 13 Virtual Aneurysm  A simulation and virtual reality visualization of brain blood flow  Researchers examine critical flow pattern and evaluate simulated surgical interventions University of California at Los Angeles http://www.cs.ucla.edu/~dalee/radsci/
    14. 14. 1401/28/15
    15. 15. 01/28/15 15 Critical Success Factors •Federal Funding Opportunities •Outreach Activities • Internet2 Days • Professional Societies • Industry Meetings •Continue to develop process models for communities of engagement •Medical Middleware •Internet2 Commons
    16. 16. 01/28/15 16 Critical Success Factors: Federal Funding Opportunities •Federal Funding Opportunities • NLM BAA on “Application of Advanced Network Infrastructure in Health and Disaster Management” • RCMI/IDEA Programs • NIH NCRR SBIR • NLM funding for Privacy Testbed • Medical Informatics Fellowships • NLM survey project with End to End Performance •Corporate Funding Opportunities** • Johnson and Johnson (JNJ) • Pfizer
    17. 17. 01/28/15 17 Critical Success Factors: Outreach Activities •Advanced Technology “Roadshow” • Summer/Fall 2002 • NIH sponsored •Website Update • Summer 2002 • Henry Chou student intern •Radiological Society of North America • December 1-6, 2002 •DHHS Information Technology Modernization Committee • Fall 2002 •National Committee on Health Statistics • July 16, 2002 •SICOT (International Society of Surgery and Traumatology) • August 28-29, 2002 •Institute of Medicine (IOM) • September 18-20, 2002 •Formalize AAMC Collaboration
    18. 18. 01/28/15 18 Outreach Activity Milestones: aka why does Mary travel so much? •Human Resource Roundtable, July 2001 •AVMA Talbot Symposium, July 2001 •NIH Symposium on Component Based Management Systems, July 2001 •Testimony to NCVHS, August 2001 •Telemedicine Symposium, August 2001 •MedInfo 2001, September 2001 •ISO TC215, September 2001. •Internet2 Day Austin, Texas, October 2001 •Security and Privacy Guidelines, October 2001 •Upenn Internet2 Day, November 2001 •FDA Senior Science Board, November 2001 •RSNA, Advanced Technology Tutorial faculty, November 2001 •AMIA/AAMC, November 2001 •Pfizer Internet2 Day, January 2002 •Distributed Medical Intelligence, February 2002 •Internet2 Day at Thomas Jefferson University/MAGPI, March 2002 •Internet2 Day at University of Washington, March 2002 •RCMI Symposium at JSU, April 2002 •NCRR Advisory Council, May 2002
    19. 19. 01/28/15 19 Communities of Engagement: Clinical, Research, Education •Medical & Dental • Clinical Care (Pathology, Radiology, Orthopedic Surgery, Neurology, Dentistry…) • Telemedicine • Public Health Surveillance (Homeland Security, CDC) •Biotechnology • Genomics • Proteinomics • Micro Arrays • ***”omics” •Pharmacy • FDA • Pharmco drug research and development (Pfizer, Adventis, Eli Lilley) • Medical Devices/Remote Instrumentation •Agriculture • Veterinary Medical WG • USDA
    20. 20. 01/28/15 20 Medical Middleware •Leverage developments in “core” middleware •MeduPerson •Middleware Services • Person Identification • Terminology Mediation • Resource Access Decision (Shib) • Information Access Service • Order Entry • Health Information Locator • Gene Sequence Analysis (Decision Support) • Etc.
    21. 21. 01/28/15 21 Internet2 Commons in the Health Sciences •Virtual Tumor Board •Virtual Radiology Board •Veterinary Medical Grand Rounds •Continuing Medical Education; subscription model •Second Opinion Networks •Bio-terrorist nasty of the moment (anthrax, radiation poisoning, small pox…) •Distance Surgery; Haptics •Telemedicine
    22. 22. 01/28/15 22 Organization of Health Science Initiative •Advisory Committee in formation • Physician leadership input to Application Strategy Council • Strategic direction of HS initiative •Leadership Teams • Healthcare • Life Sciences • Operational/procedural responsibilities via Working Group Chairs •Working Groups • Health Sciences WG (Mary Kratz, Chair) • Medical Middleware WG (Jack Buchanan, MD/PhD, Chair) • Veterinary Medical WG (Gary Allen, DVM, Chair) • (Remote Instrumentation) • BioEthics in formation (John Yost, MD, Chair) •Collaborations • Visible Human Project Advanced Technology Demonstrations • RCMI Clinical Trials Research Network • Biomedical Informatics Research Network
    23. 23. 01/28/15 23
    24. 24. www.internet2.edu