Telemedicine system tailored for European rescue workers

A new ESA-funded satellite telemedicine system called I-DISCARE goes operational later this year. It is an integrated hardware and software system for telemedicine that uses satellite links instead of terrestrial communication infrastructure.

"Telemedicine is basically using Information and Communications Technology to enable the transfer of information – data, signals and images – instead of patients and medical personnel," explained Francesco Feliciani of ESA Telecom. "The result is effective and improved quality patient care."

I-DISCARE is due to be made commercially available on either a sale or lease basis by an ESA-led consortium – made up of French space medicine institute MEDES as well as Italian-based Elsacom and the Norwegian Centre for Telemedicine NST. I-DISCARE is derived from an earlier system called DELTASS, tested in simulated disasters in Toulouse and Ulm last autumn.

The original concept was a system solely for use in disaster areas where local communications are destroyed – such as earthquake-struck Bingol in south-east Turkey in early May, where telephone lines were cut by the 17-second quake – but its planned range of applications has been broadened since.

"After the DELTASS trials it became obvious that the overall system or parts of it would also be applicable to a wide range of contexts short of full-scale disaster," said Bernard Comet of MEDES.

I-DISCARE is based around a remote central dispatcher server linked via Globalstar satellites to multiple GPS-tracked terminals. Personal Digital Assistants and satellite phones are used by Search and Rescue (SAR) workers for initial patient identification and triage. Electronic patient forms are filled out as victims are found. These will be kept updated all through their subsequent treatment. The I-DISCARE dispatcher can also plot rescue teams' positions on an area map, enabling efficient 'top-down' management.

Portable Telemedicine Workstations (PTWs) utilised during initial medical treatment relay back a patient's vital signs such as electrocardiograms (ECGs) and blood pressure to the dispatching operator. Victims being evacuated in emergency vehicles can have their geographical locations and medical conditions remotely tracked by an Ambulance Terminal linked to onboard monitoring equipment. In addition, all I-DISCARE terminal users can keep in audio communication with the dispatcher and each other.

"For some users this complete system will not be necessary," said Comet. "Some might need only the SAR terminals, others only the PTWs or the Ambulance terminals."

System elements will be provided according to need. For instance, a mountain rescue organisation might require only the basic server plus PDA terminals, an ambulance company just the server along with Ambulance Terminals, or a general practitioner in an isolated part of Norway might want only a single PTW linked to a server at a cardiology call centre, for a second opinion on heart attack cases.

Elements of the system are already in routine use in French Guiana, where otherwise isolated clinics in the rainforest use PTWs to obtain specialist diagnoses in dermatology, cardiology and parasitology.

From this autumn, when deployment of I-DISCARE among European medical bodies is due to begin, the system will either be leased on a temporary basis or else purchased outright. Installation, upgrades and training will be included in the transaction. Leased I-DISCARE hardware will be guaranteed delivery anywhere in Europe within 48 hours.

ESA has initiated more than 20 different satellite telecommunication projects since 1996, and on the 23 and 24 May the Agency is hosting a symposium on satellite telemedicine in Frascati, Italy.