May 5 2004

NASA-funded telemedicine research brings medical care to people
living in Earth's remote regions, improves space medicine

What do villages in the Amazon jungles, the peaks of Mount Everest
and Mars have in common? All are remote places where doctors may not
be available to provide medical care for patients. Now, doctors can
reach patients via television and computers - a concept called
telemedicine. One day, space explorers may use telemedicine to
consult with doctors on Earth. Telemedicine research is being
conducted by Dr. Ronald Merrell, director of the Medical Informatics
Technology Applications Consortium - a NASA Research Partnership
Center managed by the Space Partnership Development program at the
Marshall Center.

Photo: Merrell (Virginia Commonwealth University)

What do villages in the Amazon jungles, the peaks of Mount Everest
and Mars have in common? All are remote places where doctors may not
be available to provide medical care for patients.

But now, thanks to high-tech electronics, doctors do not always have
to be with the patient to assist with medical care. Instead, doctors
can literally visit patients or consult with other doctors via
television and/or computers - a concept called "telemedicine." One
day, these "television calls" may become routine for the first humans
living on lunar and Martian outposts.

"Telemedicine changes the way we approach medical care, both
intellectually and logistically," explains Dr. Ronald C. Merrell,
director of the Medical Informatics Technology Applications
Consortium, a NASA Research Partnership Center at Virginia
Commonwealth University in Richmond, Va.

"And with the nation embarking on a new space exploration voyage,
back to the Moon and onto Mars, long-term medical care becomes even
more important for space travelers," adds Merrell. "The constraints
of providing medical treatment using telemedicine to patients at
remote places on Earth and to people in space are similar, so what we
learn on Earth can be applied to using telemedicine for human space

Merrell, a professor of surgery, recently returned from Sucua,
Ecuador, where his medical team and local physicians set up a mobile
unit for diagnosing and treating tropical diseases in Amazon villages
that are only reachable by small planes or canoes. They installed
computers, cameras and other equipment, along with medical and
surgical tools. Through this technology, Merrell and his team can
consult with their colleagues in South America.

The Medical Informatics and Technology Applications Consortium has
been a partner with Cinterandes Foundation in Cuenca, Ecuador, for
several years. The foundation has provided a mobile surgical facility
that transmits the vital signs of patients in Ecuador to doctors
3,000 miles away at Virginia Commonwealth University. In one case, an
anesthesiologist at the university, monitoring a surgery in Ecuador,
noticed a life-threatening irregularity in the patient's heart
rhythm. He warned the surgeons, who responded in time to prevent harm
to the patient.

"Testing technologies that provide medical care to space crews not
only benefits individuals who need medical care, but entire
countries," says Merrell. "Medical students and physicians from
across the globe have visited Virginia Commonwealth University,
learned about telemedicine and gone back to their countries to start
telemedicine programs."

For the past several years, the Medical Informatics and Technology
Applications Consortium has tested different telemedicine units
operating under a variety of conditions in many locations - including
Mount Everest, the Artic Circle, Russia, Brazil, Mongolia and Kenya.
Telemedicine is used not only to consult with colleagues, but also to
train medical students - requiring them to watch experts perform
surgeries and other procedures.

"Providing the best medical training to students and practicing
physicians is one of the most rewarding aspects of this research,"
Merrell says. "One of my teachers at Ensley High School in
Birmingham, Ala., was the first person who got me interested in
science, so I believe it is important to inspire the next generation.
What could be better than making it possible for students and doctors
- no matter where they are studying or practicing medicine - to learn
from the world's leading medical experts?"

Merrell, an Alabama native, obtained a bachelor's degree in chemistry
from the University of Alabama in Tuscaloosa and doctorate of
medicine from the University of Alabama in Birmingham. He completed
his residency and fellowship training at the Barnes Hospital at
Washington University in St. Louis. He has held prestigious positions
at Stanford University in Palo Alto, Calif., and Yale University
School of Medicine in New Haven, Conn. He began his relationship with
NASA in 1984 when he was a professor of surgery at the Texas Medical
Center in Houston near NASA's Johnson Space Center. He led programs
in clinical medicine, education and research, and his first
telemedicine project funded by NASA provided care as part of a relief
effort in Armenia.

Now, Merrell's team is testing how doctors might use telemedicine to
train space crews to perform surgery. This summer, doctors from
Virginia Commonwealth University will fly aboard NASA's KC-135
aircraft - a plane that flies roller coaster patterns and exposes
researchers to a few minutes of low-gravity in which they float about
like space crews. Merrell and his fellow researchers will practice
surgery techniques, so they can experience how space conditions
affect the way surgery is conducted.

"We know that performing surgery and other medical procedures in
space will be different from working on Earth," Merrell says. "The
more we can learn, the better we can help space crews complete long,
productive exploration missions to the Moon, to Mars and beyond."

For more information visit:

Medical Informatics Technology Applications Consortium

Office of Biological and Physical Research

Space Partnership Development Program