Teleradiology readies for war

If the U.S. launches war against Iraq, military physicians in the new theater will likely use a teleradiology system similar to one already in use in an Army field hospital in Afghanistan.

While the military won't say what systems they plan to use in Iraq, it is reasonable to assume the medical apparatus will resemble the telemedicine system in Afghanistan that, among other features, supports transmission of digital images via satellite link.

Last year, the field hospital in Bagran, Afghanistan, established a high-bandwidth satellite connection with Landstuhl Regional Medical Center in Germany, supporting telemedicine operations for radiology, dermatology, ophthalmology, and psychiatry.

The teleradiology component is capable of transmitting high-resolution imaging studies for consultations and second opinions.

Combat radiology support in Bagran is equipped for x-ray, ultrasound, and CT. The teleradiology system promises single-day report turnaround, meaning military hospitals now don't have to transfer every soldier whose injuries require a second opinion - saving time, transport, and hospital fees.

Backbone of the Afghanistan network is an in-house switching system called the brigade remote subscriber system (BRSS), an extension of the brigade subscriber node (BSN) system that provides mobile communication capability through the use of commercial switches and routers.

BRSS features a satellite link between Landstuhl and all notebook PCs distributed among the dozen tents that make up Bagran hospital.

Until recently, server and router equipment in Landstuhl and the remote locations transmitted at 768 Kbps, slow for teleradiology. Additional bandwidth has been purchased, however, boosting the hospital's ability to send digital medical images considerably faster.

Military field hospital telemedicine was first used in Somalia in February 1993, although physicians there had a mere 56 Kbps of bandwidth to work with - less than 14% of today's speed.

Military teleradiology actually got its start about two years earlier. CT was first used at mobile military hospitals in 1991 during Operation Desert Storm, when a teleradiology link via satellite to the U.S. mainland was also successfully deployed.