THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Friday, July 5, 1996 TAG: 9607050131
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY DEBRA GORDON, STAFF WRITER
DATELINE: NORFOLK LENGTH: 123 lines
If he could have, Navy Cmdr. James R. De Voll would have brought an ophthalmologist, gynecologist, dermatologist and all manner of other ``-ologists'' with him during the carrier Enterprise's six-month Mediterranean cruise.
That way, when the ship is hundreds of miles out to sea and a sailor gets a piece of metal in his eye, ship's doctor De Voll would turn to the ophthalmologist and say: ``You fix it.''
On this deployment, however, De Voll can do something almost as good. He can show the eye doctor the sailor's eye.
Telemedicine - an array of video monitors, tiny cameras and computers scattered throughout the Enterprise' cramped medical clinic - will let De Voll communicate directly with any medical specialist he needs.
The system will let radiologists read X-rays; ophthalmologists ``sit in'' on exams; dermatologists examine skin rashes; and orthopedic surgeons consult on broken bones. It can all be done without sending a single sailor off the ship.
``It will let us push forward as much as possible our ability to take care of sailors as efficiently and with the highest quality of care possible,'' De Voll said.
And it will be done at a savings to the Navy. If earlier trials are any indication, the $500,000 investment the Navy made to outfit the Enterprise for telemedicine will reap savings of nearly $1 million during the next six months.
The Navy's surgeon general, Vice Adm. Harold M. Koenig, says he wants to bring quality health care ``to the deckplate'' - as close as possible to where sailors and Marines work.
Telemedicine is one way to do it.
``The object of telemedicine is to move information, not patients,'' said Lt. Kevin Darnell, the Navy's telemedicine project officer.
The idea is not new. Even a phone call to another doctor for advice can be considered a simple form of telemedicine.
But recent improvements in satellite communication mean data - pictures, video, charts - can be transmitted at high speed to and from ships at sea. This allows doctors in remote locations real-time communication with specialists in Naval medical centers at Bethesda and Portsmouth.
In the past two years, the Navy has used telemedicine in Zagreb, Croatia, to save an Egyptian soldier's foot damaged in a mine explosion; in Antarctica to diagnose kidney stones; and, for the past five months, in the Adriatic Sea on board the carrier George Washington.
``It's allowed us to give a quality of care no different than would have been provided at Portsmouth Naval Hospital,'' said Cmdr. Dean Bailey, the George Washington's senior medical officer.
Darnell, the Navy's telemedicine expert, estimates it's also saved the service about $960,000 by preventing about 24 of the 50 to 60 medical evacuations the George Washington usually has. Each ``med-evac'' costs about $40,000, he said.
In Antarctica, diagnosing the kidney stones meant the patient didn't have to leave the camp - which the Navy estimated would have cost $1 million.
Telemedicine won't solve every medical emergency, and the sailor who needs specialized, long-term treatment - for instance, for cancer or psychiatric problems - may still have to be sent to a mainland hospital.
The Enterprise got its high-speed communication linkup, dubbed Challenge Athena, which makes telemedicine possible, four months ago. Just days before the carrier shipped out last week, , engineers and computer specialists were frantically hooking up cables, loading software and bolting down terminals to bring state-of-the-art telemedicine to the Enterprise.
To De Voll, the most important aspect of telemedicine is that the 5,600 sailors aboard the Enterprise will get better care because specialists will be able to give advice on their problems.
For instance, if a sailor's chest X-ray looks suspicious, De Voll can send a digitized image directly to a radiologist at Portsmouth Naval Hospital. Or E-mail EKG tracings to a cardiologist. Or even tap into the Navy's enormous medical database and pull up the results of a sailor's tests from three years ago.
Using a bronchial scope with a tiny camera on the end, he can show an ear, nose and throat doctor the inside of a person's nose or throat.
He can examine slides under a microscope simultaneously with a pathologist at a Navy hospital. Previously, he would have had to send the slides off the ship. Then, he'd wait about a month for results.
In the George Washington battle group, video teleconferencing, or ``tele-consulting,'' helped when a sailor accidently caught her ring on a ladder and tore off her finger.
Ship's doctor Bailey said he and other medical staff thought the finger couldn't be saved, but they weren't sure. They called a hand surgeon in Portsmouth and, using a video camera and television monitors on the ship and in Portsmouth, ``showed'' him the wound and finger.
The surgeon agreed the finger couldn't be re-attached, but he was able to provide ``over-the-shoulder'' guidance during the ensuing surgery and advice on how best to care for the injury.
``In that case, we didn't do something we couldn't have done before,'' Bailey said. ``But it certainly gave us the knowledge that we were doing the right thing. And the patient was not deprived of the opinion of a specialist.''
In another case, a sailor had a shoulder injury none of the medical staff could diagnose. Using video teleconferencing, they hooked up with an orthopedic surgeon who watched them examine the patient, suggested additional tests and made a diagnosis.
The George Washington was also the first ship to deploy with an ultrasound machine - particularly useful in diagnosing gynecological problems in its female crew.
In the past, Bailey said, the ship couldn't have an ultrasound because they didn't have anyone to read the image. But using existing technology, an ultrasonographer at Portsmouth Naval was able to read the ultrasound images as Bailey conducted the test.
De Voll envisions even greater applications for the technology.
``Where this will really pay dividends is when we get this technology out to the smaller ships,'' he said.
There, a corpsman and general medical officer provide care for up to 400 sailors. With teleconferencing, he said, he could observe examinations and help with complicated procedures. This will reduce the transfers to the Enterprise, which, because of weather and high seas, are sometimes dangerous, De Voll said.
``That's when the pedal really hits the metal,'' he said. ``That will be just fantastic.'' ILLUSTRATION: Color photo by RICHARD L. DUNSTON photos\The
Virginian-Pilot
Lt. Tim Cunningham, onboard the Enterprise and on loan from the
Australian navy, observes a linkup, above, with Portsmouth Naval
Hospital. Cmdr. James De Voll, right, says technology lets him
communicate with any medical specialist.
KEYWORDS: U.S NAVY U.S.S. ENTERPRISE by CNB