The doctor is online – and on webcam

by Oleg Nikishenkov at 19/03/2012

The Moscow News

Since the 1990s, the Internet has continued to redefine communication, the media, education, retail, entertainment, and travel. Rapidly developing imaging technologies could come to revolutionize medical treatment, as well, making it possible for a doctor in Moscow to diagnose an illness for a patient in Vladivostok.

Epiphan Labs, a subsidiary of Ottawa-based Epiphan Systems, has taken up residence in the biomedical cluster at the Skolkovo Foundation to apply its parent company’s video-streaming technology to medical use.

“Our technology allows us to capture and transfer images from any type of medical equipment which has a monitor, such as a probe, and to send them using the Internet,” said Epiphan founder Mike Sandler, a Russian-born Canadian engineer.

Experiments in space

Austronaut Leroy Chiao gives cosmonaut Salizhan Sharipov an ultrasound

“The technology came from an experiment made on board the International Space Station,” U.S. astronaut Leroy Chiao said. Chiao and his crewmate, Russian cosmonaut Salizhan Sharipov, conducted what NASA called an “advanced diagnostic ultrasound in microgravity” on expedition 10 to the space station, which took place in 2004 and 2005. Epiphan Systems provided the equipment to capture, convert to digital format, compress, and send to Earth images from the ultrasound machine’s display, all in real time. The diagnoses made from the extraterrestrial ultrasounds were supervised on the ground by Scott Dulchavsky, head of surgery at Henry Ford Hospital in Detroit.

New telemedical technology has been tested not only in space, but on ships on the open ocean and in the Himalayas. Yevgeny Flerov, head of the Moscow-based Telemedicine Laboratory at the Russian Academy of Sciences, said that it is possible to send mega-highdefinition images, such as optically converted high-resolution X-rays, right to a computer monitor in a doctor’s office, just using the Internet.

“You open the image, log in to Skype, and you can discuss the capture with your patient or fellow doctor, who may be in another hemisphere,” he said.

Already ‘indispensable’

Laser technology in a Smolensk plant

The Brazilian state of Minas Gerais, the size of France and with a population of 20 million, has demonstrated this with the “Health at Home” project, which studied the cardiac health of residents of 675 villages and cities using telemedicine. Echocardiograms from around the state were sent to the university medical center in the capital, Belo Horizonte, on the Internet.

“The experiment cost no more than $200 per village,” the RAS’s Telemedicine Lab web site said, pointing out that the entire state had already been connected to the Internet, so the infrastructure to conduct the study had been in place before the project.

Flerov told The Moscow News that modern medicine is already unthinkable without telemedicine.

“It has become as indispensable as a PC in your office,” he said. “But the question is, what quality of images we are talking about.”

Connectivity a potential obstacle

Innovative surgery techniques in Kazan

Sandler believes that in a huge country like Russia, telemedicine will be useful in treating people living in remote regions.

“In Russia, many good doctors went to live in central cities like Moscow or St. Petersburg,” he said. “But it doesn’t mean that people in the regions get ill less, so they need online consultations from good specialists.”

While solving one problem, the technology raises some others. One of the reasons the Brazilian project was so inexpensive was the extant infrastructure needed to conduct it.

The lack of Internet service in far-flung Russian communities could impede development of telemedicine in the country, but if modernizing steps included in the government’s Health Development 2020 initiative—such as the computerization of local clinics and hospitals—take effect, it could be overcome.

Sandler is optimistic about the technology’s prospects in Russia. With Epiphan Labs, he hopes not only to sell equipment, but also to conduct research and development. Fully half of his staff are graduates of top Russian technical universities, he said.

Quick to learn

Further, the technology has proven easy to use.

“I am not a doctor, but literally, within a few hours of training I was able to learn how to use the ultrasound machine on board the ISS, and get the best-quality images,” said Chiao, the astronaut.

If similar training and universal Internet service were available throughout Russia, then elderly people in particular could avoid waiting in reception rooms to see a physician. Some obstacles still remain, but the benefits of the technology are within reach.

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