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Global TeleMedix uses ASP to extend multimedia clinical apps


Global TeleMedix uses ASP to extend multimedia clinical appsNew CEO solidifies Internet workflow strategyAdvances in Internet technologies continue to create new opportunities for large-scale clinical applications that might once have

Global TeleMedix uses ASP to extend multimedia clinical apps

New CEO solidifies Internet workflow strategy

Advances in Internet technologies continue to create new opportunities for large-scale clinical applications that might once have been called "telemedicine." This evolution has prompted numerous hardware and software vendors to shed their original skins and turn their store-and-forward and interactive consult technologies into Internet-based clinical care applications that are poised to become the most successful forms of e-health to date.

Some industry veterans contend that both "telemedicine" and "e-health" are already passé, however. In fact, Global Telemedix says its new Internet-based ASP product for clinicians is just a healthcare delivery solution, pure and simple.

"We believe there is no such thing anymore as telemedicine or even e-healthcare," said Bill Kazman, who founded GTI in 1995 and continues to serve as its president and chief technology officer. "It is all healthcare and care delivery. You have to provide the referring physicians with clinical results, and there are not good information solutions for this process today."

Westford, MA-based Global Telemedix began as a telemedicine software and systems developer, and its initial products were the PC-based TeleMedix system and TeleConsult software. First released in 1997, TeleConsult is a multispecialty workflow application with diagnostic imaging capabilities. TeleConsult enables physicians and consulting specialists to consult, collaborate, and share multimedia data and clinical information in real-time via the Internet. DICOM-compliant images can be uploaded from a variety of sources using the TeleConsult Image application.

"The whole concept of telemedicine has been difficult for the market to accept because it implies someone else doing something for you," said Ron Geraty, who recently joined GTI as CEO. "But what we provide is a workflow solution for the practitioner. We are really focused on the image-based specialists, the people who practice medicine by moving around to a lot of different locations, and this becomes their clinical tool."

With version 3.1 of TeleConsult, GTI is now making the software available via a subscription-based ASP model. Dell Computer is providing the Internet infrastructure and computing systems, while Exodus Communications (see related story, p. 4) is serving as the Web host. GTI still supports its installed base of around 100 TeleMedix systems, but its primary focus is on expanding its market penetration by making TeleConsult available to clinicians and referring physicians over the Internet.

"Rather than focusing just on the images, we will focus on moving clinical data that will assist any specialist in doing his or her job more effectively and achieving better clinical outcomes," Geraty said. "What we can now do is move huge clinical files like ECGs over the Web, and if we can do that, we can do anything."

GTI's ASP provides a rapidly scalable platform on the Web for asynchronous real-time consultation and collaboration among physicians and consulting specialists in disparate locations, using multimedia clinical imagines such as ultrasounds, CTs, MRs, and x-rays. A typical installation consists of GTI's capture upload workstation and software at the point of care to capture digital information directly from the modality equipment (such as an Acuson ultrasound machine), plus a server for the clinical device. The client application is embedded in the browser, so all that is needed is an Internet connection to the digital capture station to enable the data to be moved and shared.

"Our philosophy of data distribution is that in order to achieve high-speed performance, you need to have data locally available on your workstation," Kazman said. "So with that as a model, we distribute the data in advance, functioning as a workflow engine. If you think of all the things taking place in a transaction, we have a notion of where data need to be for a clinician, and we employ a push model."

The system also features a multitiered security architecture and extended data collaboration capabilities. Authorized users access the data by going to the GTI Web site and signing on with their specified user name and password. This then gives them access to their particular community.

"As long as there is an Internet connection, the data will flow to the hosted environment and it can then be accessed via the physician's laptop or workstation--anytime, anywhere," Kazman said.

The ASP model also enables GTI to take a specialty-by-specialty approach to the market, according to Geraty. The company unveiled a beta version of TeleConsult for cardiology at the American Society of Echocardiography meeting in June. This customized application is being beta tested at eight sites, including the University of Chicago Medical Center and the University of Michigan Health System. Other beta sites include Massachusetts General Hospital, which is working with GTI and Digital Broadband Communications to use digital subscriber lines (DSL), frame relay services, and TeleConsult to make medical records and high-resolution images, including pediatric echocardiograms, available to other hospitals and to physicians working at home.

"If you look across specialties, there are common aspects of care delivery and workflow, even how you interface with the various clinical modalities and digital cameras, ultrasound systems, microscopes, and so on," Kazman said. "What we are doing is putting all those common elements together, assembling the infrastructure to support that, and then taking that multipurpose technology infrastructure and deploying it in a multispecialty way."

GTI recently completed a $5 million second round of venture capital funding. The financing came from Egan-Managed Capital (a venture fund organized by the Egan family, founders of data storage giant EMC), Johnson & Johnson Development Corporation, Kestrel Venture Management, and the Massachusetts Technology Development Corporation.

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