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United States National Library of Medicine National Institutes of Health

Fact Sheet
Telemedicine Related Programs

Background

Telemedicine is the use of telecommunications technology for medical diagnosis and patient care, and is a medium for delivering medical services to sites that are at a distance from the provider. The concept encompasses everything from the use of standard telephone service to high-speed, wide-bandwidth transmission of digitized signals in conjunction with computers, fiber optics, satellites, and other sophisticated peripheral equipment and software.

The National Library of Medicine collects and indexes literature related to telemedicine through its MEDLINE® and HealthSTAR (Health Services/Technology Assessment Research) databases. HSRProj, Health Services Research Projects in Progress database, (http://www.nlm.nih.gov/pubs/factsheets/hsrproj.html) provides information on grants and contracts awarded by major public and private funding agencies in the area of health services research, including telemedicine. The NLM collaborates with a number of institutions in the development of leading edge technologies for telemedicine applications.

NLM National Telemedicine Initiative

In Fiscal Year 1997, NLM announced the award of 19 multi-year telemedicine projects which are intended to serve as models for:

In subsequent years, several additional awards were made under this program. Information on all of these telemedicine projects is available from the NLM National Telemedicine Initiative Home Page at http://www.nlm.nih.gov/research/telemedinit.html .

In FY 1994, under the HPCC Program, NLM awarded twelve research contracts (http://www.nlm.nih.gov/research/telemedhpcc.html) for "Biomedical Applications of High Performance Computing and Communications." Many of these have a telemedicine focus.

Four NLM grant programs -- Information Access, Information Systems, Internet Connection, and Integrated Advanced Information Management Systems -- focus heavily on the networked flow of health information, and grants awarded often have telemedicine goals. NLM's Extramural Program Division (http://www.nlm.nih.gov/ep/extramural.html) is responsible for these grant programs, and can be reached by eMail at fjohnson@nlm.nih.gov, by telephone at (301) 496-4221, or by FAX at (301) 402-0421.

National Academy of Sciences Studies Sponsored by NLM

In FY 1995, NLM, together with the Health Care Financing Administration and the Department of Veterans Affairs, sponsored a study by the Institute of Medicine of the National Academy of Sciences. The study, which was published in 1996, examined the appropriate criteria for evaluation of the impact of telemedicine on access, quality, and cost of care. A summary is available from the National Academy Press, along with ordering information for the full report: Telemedicine: A Guide to Assessing Telecommunications in Health Care. These criteria will be applied to evaluations of telemedicine projects supported by NLM and other Federal agencies.

In FY 1996, NLM requested, with support from the Warren Grant Magnuson Clinical Center of the National Institutes of Health and from the Massachusetts Health Data Consortium, that the Computer Science and Telecommunications Board (CSTB) initiate a study on maintaining privacy and security in health applications of the national information infrastructure. CSTB formed a committee to study "existing technical and non-technical mechanisms for protecting the privacy and maintaining the security of health care information systems, identify other mechanisms worthy of testing in a health care environment, and outline promising areas for further research." The report, For the Record: Protecting Electronic Health Information, was published in 1997 and a summary is available from the National Academy Press, along with ordering information for the full report. Findings from this study will also be applied to evaluations of telemedicine projects supported by NLM.

In October 1998, NLM announced the award of 24 contracts to medical institutions and companies to develop innovative medical projects that demonstrate the application and use of NGI capabilities. In conjunction with this program, NLM is funding a study with the Computer Science and Telecommunications Board for consideration of issues of quality of service, security, and other communications requirements related to health and biomedical applications of the NGI. A report on the current status of this study is available.

NLM Internal R & D Related to Telemedicine

Issues important in telemedicine are being addressed in several projects at the National Library of Medicine. In the Visible Human Project, a 3D computerized cadaver and a detailed atlas of the human body (both male and female) are being assembled digitally from thousands of xray, magnetic resonance, and photo images of cross sections of the body. Among the goals of the Visible Human Project (http://www.nlm.nih.gov/research/visible/visible_human.html) is the establishment of standards needed for linkages between image data and such text-based data as names, hierarchies, principles and theories, so that a print library and an image library could serve as a single unified resource for medical information. The long-term goal is to develop a system of knowledge structures that can transparently link visual knowledge forms to symbolic knowledge formats. Image data comprising thousands of 2D images have been acquired from both male and female cadavers. Image data include transverse CT, MRI, and high resolution cryosection color images. NLM makes the data available to interested researchers and developers.

The DocView project investigates end user access to the medical literature in the form of scanned pages of journals and other sources sent over the Internet from Ariel workstations (increasingly used by libraries) and document image databases. DocView is client software running under Microsoft Windows that has a communications module capable of TCP/IP linkage (for receiving Ariel transmissions), and also the capability of being used as a viewer for documents received by an Internet client such as NCSA Mosaic. In either case, the end user may display, manipulate, cut and paste, electronically bookmark the received pages, and print only the pages desired.

Telemedicine Current Bibliography in Medicine

A bibliography on telemedicine research, Telemedicine: Past, Present, Future, http://www.nlm.nih.gov/pubs/cbm/telembib.html, 1634 citations covering the period January 1966 through March 1995, is available as part of the series Current Bibliographies in Medicine.

For further information about the programs described here contact:

Office of Communications and Public Liaison
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
Fax: (301) 496-4450
publicinfo@nlm.nih.gov

Last updated: 11 December 1999
First published: 11 December 1999
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