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Next Generation Internet
Phase II Awards

Personal Internetworked Notary and Guardian.
The Personal Internetworked Notary and Guardian (PING) proposal aims to provide a patient-controlled personal medical records system. The PING record is available to the patient from any Internet-connected device. It is encrypted and accessible only to authorized parties for healthcare and/or research, or public health purposes. It will include integration of data from two birth hospitals, a tertiary care pediatric hospital, a pediatric practice network, public health authorities, and the patients and their families. The goals of the PING project include: 1) Providing access for highly mobile postpartum mothers at work, school and home to their infants' records. 2) Enabling patients and families to manage a fundamentally collaborative process of clinical documentation over the Internet. 3) To ensure that all PING transactions provide the highest available confidentiality of the patient's data, under their control.

Contact: Isaac S. Kohane, M.D., Ph.D.
Children's Hospital
Children's Hospital Informatics Program
300 Longwood Ave., Enders 150
Boston, MA 02115
Phone: 617-355-7821; Fax: 617-730-0456


Biomedical Tele-Immersion.
By combining teleconferencing, telepresence, and virtual reality, Tele-Immersion enables teachers and students to interact with three-dimensional models, point, gesture, converse, and see each other. Tele-Immersion combines CAVE and ImmersaDesk virtual reality systems with advanced network capabilities to make learning environments so compelling that people will use them even when they are in the same room. They plan to demonstrate and assess Tele-Immersive environments for surgical education.

Contact: Jonathan C. Silverstein, MD
University of Illinois at Chicago
School of Biomedical and Health Information Services
1919 W. Taylor
Chicago, IL 60612-7249
Phone 312-996-5112; Fax: 312-996-8342


Patient-Centric Tools for Regional Collaborative Cancer Care Using NGI
This project plans to investigate the application of collaborative tools in a distributed and differentiated medical enterprise, the Seattle area Cancer Care Alliance (CCA). The applications should: 1) enhance the CCA partner's existing clinical care programs into new highly collaborative patient-centered interdisciplinary efforts; 2) allow for a fully integrated team approach to cancer, i.e., state-of-the-art diagnosis, treatment and management of cancer patients through collaboration of distributed cancer care clinicians and researchers; 3) accelerate the dissemination and application of new knowledge related to the diagnosis and the treatment of cancer, both inside the enterprise and throughout the region. They propose to examine the application of collaborative technologies to the three areas of physician interaction with patient information in the diagnosis, management and treatment of cancer: consultations between referring physicians and CCA physician, including the patient; tumor board conferencing; and radiation oncology treatment planning.

Contact: Brent K. Stewart, Ph.D.
University of Washington
Department of Radiology
3935 University Way NE
Seattle, WA 98195
Phone: 206-616-1314; Fax: 206-543-3495


Connectivity, Security, and Performance of an NGI Testbed for Medical Imaging Applications.
The objective of this project is to implement an NGI testbed in Northern California's San Francisco Bay Area for medical imaging applications. The two regional sites are the University of California, San Francisco (UCSF), and Stanford University. This NGI testbed will be built on two existing high performance networks. The goal is to provide insight into NGI capabilities with respect to: performance in a regional environment; potential for extension to national level; and necessary improvements needed. The evaluation of the clinical applications include: impact of telemammography consultation service in a regional environment compared with a local level; and how real-time interactive teaching in breast imaging would improve the confidence level of general practice radiologists. The two characteristics of NGI that will be utilized include file size capability and near real-time transmission.

Contact: H.K. Huang, D.Sc.
University of California, San Francisco
Department of Radiology
530 Parnassus Avenue, Rm. CL-158
San Francisco, CA 94143-0628
Phone: 415-476-6044; Fax: 415-502-3217


Indianapolis Testbed Network for NGI Applications to Telemedicine.
Indiana University proposes to convert the Indianapolis Network for Patient Care (INPC) into a testbed of NGI technologies including IP security (IPsec), Quality of Service (QoS) in televideo applications at a nursing home, and IP roaming capabilities with portable wireless workstations in clinical settings. The project plans to conduct randomized trials to test the effects of nursing home televideo and nomadic computing in the clinical environment. They plan to perform a trial to determine the effects of patient-physician videoconferencing and batch video applications (linked to web-based electronic medical records) on health services utilization and physician/patient satisfaction at a 250-bed remote nursing home. The project will also perform a cross-over trial of hand-held personal computers, evaluating the effects on physician behavior by time-motion studies, physician satisfaction, and patient encounter data. These hand-held computers will be equipped with capabilities for computerized order-entry, access to patient data, task-list management, and e-mail.

Contact: Clement J. MacDonald, M.D.
Regenstrief Institute for Health Care
University of Indiana
101 West 10th Street, RG 6th Floor
Indiannapolis, IN 46202
Phone: 317-630-7070; Fax: 317-630-6962


Internet Protocol Video Telemedicine and Patient Cardiology Education.
The purpose of this project is to address the technical issues impacting the delivery of telemedicine and sophisticated medical education using IP video over the Next Generation Internet (NGI). IP video over NGI has the potential to provide a common telecommunication infrastructure for real-time high bandwidth medical applications that cannot be supported by the commodity Internet. NGI solutions for real-time telemedicine with high bandwidth video and audio requirements could eventually eliminate the need for expensive dedicated telemedicine networks and give broader access to these services. As part of the project extensive evaluation, including impact on patient care, will be done. Technical and clinical protocols will be developed for all applications.

Contact: Susan S. Gustke, M.D.
East Carolina University School of Medicine
Center for Health Science Communication
Brody Medical Science Building, 1S-10
600 Moye Blvd.
Greenville, NC 27854
Phone: 252-816-5219; Fax: 252-816-8596


A Multicenter Clinical Trial Using NGI Technology.
NGI technology will be applied to provide the infrastructure of a multicenter clinical trial of new therapies for adrenoleukodystrophy (ALD), a fatal neurologic genetic disorder. This project involves the formation of a worldwide imaging network of clinical institutions to evaluate ALD therapies. This network is required to provide a sufficient number of patients for evaluating ALD therapies. This can serve as a model for many other disorders. Three centers will collaborate on this project. The Imaging Science and Information Systems (ISIS) Center at Georgetown University Medical Center, the Kennedy Krieger Institute and the Department of Radiology at Johns Hopkins University. NGI technology will be used to speed the transmission and evaluation of high quality MRI images. Another important feature of this proposal is to gain insight into procedures that will ensure medical data privacy and security.

Contact: Hugo W. Moser, M.D.
Kennedy Krieger Research Institute, Inc.
707 North Broadway
Baltimore, MD 21205
Phone: 410-502-9405; Fax: 410-502-9839


PathMaster: A Web-Accessible Cell Image Database Indexed by Mathematical Descriptors and Supported by Parallel Computation.
The project will develop the PathMaster computer system as a testbed. PathMaster is designed to help the pathologist with the process of making a diagnosis in a cytologic specimen. Phase II focus will be on the analysis of lymphoma touch preparations and thyroid aspirates. To use PathMaster, the pathologist creates digitized images of a selected set of cells from a specimen and submits these to PathMaster over the Web. Each image is automatically subjected to a computational analysis to determine more than 2,000 mathematically derived descriptors. Each image will then be compared to a database using network-based parallel computation. The analysis will produce ranked sets of images from specimens whose diagnosis is known. Images will be returned to the user to help in making a diagnosis. A variety of NGI testbed evaluations will be performed.

Contact: Perry L. Miller, M.D., Ph.D.
Yale University School of Medicine
Center for Medical Informatics
333 Cedar Street, P. O. Box 208009
New Haven, CT 06520-8009
Phone: 203-785-6753; Fax: 203-785-6664


Remote, Real-time Simulation for Teaching Human Anatomy and Surgery.
Stanford University proposes to develop two teaching applications and a local NGI testbed network for evaluating their effectiveness. The first application will support instruction in human anatomy and the second the performance of surgical manipulations. Both applications will support synchronous collaboration through a shared virtual workspace and use haptic feedback to augment the visual sense. This technology will allow the definition of new curricular elements including the repeated dissection of anatomical structures, the visual segmentation of raw data sets, the creation of 3D organ models, and the practice of fundamental surgical skills. The investigators anticipate that a wide community of teachers and users will, through a distributed client-server system, share on-line, image-rich data and professional experiences.

Contact:Parvati Dev, Ph.D.
Stanford University
1215 Welch Road, MOD B
Stanford, CA 94035-540
Phone: 650-723-8087; Fax: 650-498-4082


Human Embryology Digital Library and Collaboratory Support Tools.
George Mason University proposes to develop and demonstrate technologies to enable collaboration between multiple, distributed researchers and to make progress toward advanced clinical and educational goals. The offeror plans to integrate existing data capture and analysis procedures at the National Museum of Health and Medicine (NMHM) into a high performance testbed network that will include a petabyte archive and analysis capability. The project will use an existing, government-funded gigabit network to connect the NMHM to key sites across the nation. The testbed requires a minimum data transport rate of 622 MB/sec in the key regional networks and quality of service.

Contact: J. Mark Pullen, Ph.D.
George Mason University
Computer Science MS 4A5
4400 University Drive
Fairfax, VA 22030
Phone: 703-993-1538; Fax: 703-993-1710


Medical Nomadic Computing Applications for Patient Transport.
The objective of this project is the real-time transmission of multimedia patient data from an incident scene and during transport to a receiving center enabling diagnostic and treatment opportunities prior to arrival. The offeror will use the diagnosis and treatment of challenging clinical models - including acute ischemic stroke and trauma scene response - to define a range of Quality of Service (QoS) requirements for multiple critical care applications, evaluate the effectiveness of the system, and derive principles of nomadic computing applicable in other time sensitive emergency care models in which treatment options are constrained by the delay between onset/injury and definitive diagnosis. TRW and the University of Maryland, Baltimore had previously developed a Mobile Telemedicine System (MTS) for remote, real-time diagnosis using narrow bandwidth wireless technologies, but suffered from QoS problems. Phase III will extend the trial in a larger regional setting.

Contact:David M. Gagliano
TRW, Inc.
One Federal Systems Park Drive
Fairfax, VA 22033
Phone: 703-345-7497; Fax:


Remote Treatment Planning System (RTPS).
This proposal addresses the development, implementation, and evaluation of an application to support remote treatment planning for radiation therapy. This application, Remote Treatment Planning System (RTPS), relies on network infrastructure technology for collaboration; on high bandwidth and quality of service (QoS) to support interactive review sessions; and on data privacy and security to protect patient privacy, confidentiality, and data integrity. Review sessions provide a collaborative environment for dosimetrists at the planning site, the oncologists at the care delivery site, and peer reviewers. It utilizes video teleconferencing and a shared view of the images to support treatment planning. The evaluation will measure outcomes at the care delivery site, process improvements at the treatment-planning site, and estimate cost impact on the remote treatment planning process. Phase III is proposed to deploy the application and test bed features to Peninsula Regional Medical Center in Salisbury, Maryland. Connectivity will be provided by the State Asynchronous Transfer Mode (ATM) backbone, NetWork.Maryland.

Contact: Joseph S. Lombardo
Johns Hopkins University Applied Physics Laboratory
11100 Johns Hopkins Drive
Laurel, MD 20723-6099
Phone: 240-228-6287; Fax: 240-228-5026


Next Generation Internet (NGI) Implementation to Serve Visible Human Datasets Phase II: Development of Test Beds.
The University of Michigan (UM) Visible Human (VH) Project team will develop a Next Generation Internet (NGI) production system to serve visible human datasets. These include a comprehensive set of interactive 2D and 3D VH browsers with arbitrary 2D cutting and 3D visualizations. An interactive Web navigation engine will be deployed to create and visualize anatomic fly-through, under haptic control of the user, and to deliver fly-through developed by expert anatomists and clinicians. Anatomical labels will enhance these visualization sequences, and enable real time links with appropriate resources on the Web using XML. The UM NGI VH system will complement and extend currently deployed passive Web information systems with active computational services. This will allow for delivery of several simultaneous high quality digital streams, creating structured medical knowledge using the VH datasets. An evaluation team will continually respecify and focus the testbed deployments, and measure performance and educational effectiveness.

Contact: Brian D. Athey, Ph.D.
University of Michigan School of Medicine
Ann Arbor, Michigan 48109-0616
Phone: 734-763-6150; Fax: 734-763-1166


Networked 3D Virtual Human Anatomy, Phase II.
The University of Colorado Health Sciences Center proposes to demonstrate and assess the use of web-based, 3D-explorable virtual humans to enhance traditional anatomic teaching. This will be accomplished with audio, graphic, and haptic interfaces. The application will be assessed in anatomy curricula developed for undergraduate to postgraduate levels of education. Modules teaching the anatomy, function and pathology of the knee will be used for this demonstration. The investigators will also demonstrate an extension of the virtual environment to include surgical simulation applied to arthroscopy.

Contact: Victor M. Spitzer, Ph.D.
University of Colorado Health Sciences Center
13001 East 17th Place, PO Box 6508, Mail Stop F-435
Aurora, CO 80045-0508
Phone: 303-724-0501; Fax: 303-724-0911


Mammography for the Next Generation Internet, Phase II.
The University of Pennsylvania proposes to develop a testbed to demonstrate the feasibility of a national breast imaging archive and network infrastructure to support digital mammography using Next Generation Internet (NGI) technologies. They plan to improve access and performance of breast cancer screening with an imaging archive that supports storage, retrieval and distribution of breast images for clinical and research purposes and ensures privacy and confidentiality with multilevel security embedded throughout the system. The proposed infrastructure would: 1) support traditional breast screening through the maintenance and distribution of a digital record of prior breast examinations and relevant medical history for primary interpretation and expert consultation; 2) provide the opportunity to maintain and apply computer-aided diagnosis (CAD) software at central, well-maintained computing resources to studies from all women; 3) provide unique tools for creating educational and training programs; and 4) create an unparalleled opportunity to study and understand many epidemiologic issues in breast cancer through searches of a national breast screening database. NGI technologies will be used to transfer large data files, execute real-time queries, and access information securely. The testbed will demonstrate that QoS (quality of service), medical data privacy and security, nomadic computing, network management research and development, and infrastructure technology for collaboration, are NGI technologies that are integral to widespread deployment and optimal utilization of digital mammography.

Contact: Mitchell Schnall, M.D.
University of Pennsylvania
Radiology Department
1 Silverstein
3400 Spruce Street
Philadelphia, PA 19104
Phone: 215-662-6470; Fax: 215-662-3013