8.17.2005 – “Telemedicine,” says new Calit2 principal development engineer Phil Rios, “is the marriage of telecommunications with clinical medical practice so as to enable the presence of doctors and other medical personnel in places where they wouldn’t be able to go – cost-effectively or otherwise. The Calit2 StrokeDoc project is giving us the credibility and leverage we need to address other aspects of medical care and underserved populations.
StrokeDoc is a system that provides an emergency room or clinic with access to medical specialists in other locations by means of a personal laptop computer connected to the Internet via conditioned last-mile access loops and next-generation cellular data transport technologies. The prototype is becoming a commercial off-the-shelf product to be marketed by BF Technologies using the first cost-effective way of moving digital broadcast video over the Internet. It was developed in a collaboration between Ramesh Rao, Calit2 UCSD division director, and Pat Lyden and Brett Meyer, medical doctors at UCSD’s School of Medicine.
One of the issues pressing for more technology development in the medical arena is the potential closure of UCSD’s Hillcrest Hospital. If this happens, it's likely to be replaced by an outpatient facility, which will increase the potential role for telecommunications and information technology to link its providers with medical specialists located elsewhere to ensure responsive and cost-effective care.
There are also sociological issues related to whether people seek out health care, says Rios, on which technology can be brought to bear. If Hillcrest is closed, the patients in that area will need to go to other facilities. But fear of the unknown and possibly the need for special language services may cause patients to avoid care until it’s critically needed.
“For example, a Somali-speaking patient may not have access to a doctor who speaks his language,” says Rios. “Through telepresence, we can imagine supporting the participation of an interpreter in the meeting between the patient and the doctor. We’re looking at the most cost-effective ways to do this to benefit the people that need it the most.”
It should also be possible to create a rudimentary, telecom-enabled nursing function. Rios and colleagues think it’s possible to create a capability for patients with chronic conditions needing managed care, such as diabetes and stress-related problems, to use the phone system to transmit their vital signs from home to a medical facility in an ongoing way. When such indicators reached a sufficiently serious level, the doctor would be notified and respond accordingly.
In this context, Rios will be working with Ganz Chockalingam, known at Calit2 for development of the popular San Diego Wireless Traffic Report (http://traffic.calit2.net/index.jsp), which marries voice XML with telephony and back-end Web systems, to see how this system might be adapted for medical purposes.
Rios says Calit2 is trying to engage doctors in the area to identify community-oriented projects that use technology to serve real needs. He points to Les Lenert, associate director for medical informatics at the UCSD division of Calit2, as the driver of this initiative.
Rios comes with a wealth of directly relevant experience for his role at Calit2, including a BS degree in applied math and physics from UCSD. After graduation he worked as a software developer for Calma, a CADCAM company in Sorrento Valley (near UCSD), working on surface and solids modeling. “I fell in love with graphics during my six years there,” he says.
Then he joined a small team of physicists and engineers at Biomagnetic Technologies to develop a neuromagnetometer, a supercooled, superconducting quantum interference device (SQUID) to measure minute variations in physiologic signals (e.g., brain waves during epileptic seizures, anomalies in the beating of the heart). His two years there integrated research and scientific analysis with computer graphics.
Staying in the medical industry, he went to work for Radiation Oncology Computer systems where he was one of the lead engineers developing a radiation therapy pre-planning system. “I got hands-on experience in design, architecture, and, because the company only employed 25 people, even sales.”
In fact, he represented his company’s product at the annual meeting of the Radiological Society of North America. “We competed against the ‘big boys’ – Siemans, GE, Mitsubishi,” he says. “I saw a lot of glitz and glamour there, but because our system actually worked, it was one of the best-selling!”
Rios’ most recent position was as vice president of engineering at One Touch Systems. This job added the missing drop of telepresence to his resume, which prepared him to join Calit2. That company develops virtual learning systems through which an instructor can be “brought” to a remote classroom in a scalable manner. The system he worked on is satellite-based and is incorporating MPEG4 and digital broadcast video over IP to make it Internet-friendly.
“Calit2 offers me an interesting situation in which to apply my diverse background on projects that will have community impact,” says Rios. “I’m delighted to be here.”