Telemedicine Research at NLM (1994-2007)
This Web page and the pages to which it links describe NLM telemedicine research funding and related activities between 1994 and 2003. Those links include information about all NLM telemedicine research awards made during that time. These pages have been archived and are not kept current.
The definition of telemedicine evolved over the life of these activities. In the mid 1990s, telemedicine was defined as using a range of technologies including standard telephone service and high-speed, wide-bandwidth transmission of digitized signals in conjunction with computers, fiber optics, satellites, and other sophisticated peripheral equipment and software. By 2002, telemedicine had become the use of computers, the Internet, and other communication technologies to provide medical care information to patients at a distance. Through these years, NLM supported research and development of telecommunications technology and applications to enable providers to diagnose, provide information, and deliver health services when they are not available for on-site service delivery.
- Twelve High Performance Computing and Communications (HPCC) Health Care Awards (1994)
On May 10, 1994, NLM awarded 12 research contracts totaling $26 million designed to improve healthcare by utilizing the advanced computing and networking capabilities of the Internet. These were the first awards in health care made under the Federal High Performance Computing and Communications (HPCC) Program. Dr. Donald A.B. Lindberg, who was NLM Director from 1984 to 2015 and who from 1992 to 1995 served also as Director of the National Coordination Office for HPCC, noted in the announcement that “These awards are an important step in developing new computing and communications technologies to improve the quality of the Nation’s health care.” The awards were made in four categories: testbed networks to link hospitals, clinics, medical schools, and libraries to allow for sharing of medical data and images; virtual reality for medicine; collaborative technology for real-time treatment of patients; and information access. Press announcement and project summaries.
- National Telemedicine Initiative (1996-1997)
In October 1996 and September 1997, NLM announced the award of a total of 21 multi-year telemedicine research contracts (project summaries), with periods of performance lasting into 2002, to serve as models for:
- Evaluating the impact of telemedicine on cost, quality, and access to health care
- Assessing various approaches to ensuring the confidentiality of health data transmitted via electronic networks
- Testing emerging health data standards
The projects developed and evaluated the use of telemedicine in a wide variety of settings including rural, inner-city, and suburban areas.
Department of Health and Human Services Secretary Donna Shalala announced the October 1996 awards in an NIH News Alert, in which Vice President Al Gore is quoted.
As appropriate, the projects were to review and apply recommendations from two studies, for which NLM was the principal funder:
- Institute of Medicine, Committee on Evaluating Clinical Applications in Telemedicine. Telemedicine: A Guide to Assessing Telecommunications in Health Care. Field MJ, editor. Washington DC: National Academy Press; 1996. 288 pages. A study of telemedicine evaluation methodology.
- National Research Council, Computer Science and Telecommunications Board. For the Record: Protecting Electronic Health Information. Washington DC: National Academy Press; 1997. 288 pages. A study of patient privacy and data security issues, which contains policy recommendations for the Health Insurance Portability and Accountability Act (HIPAA).
- The Next Generation Internet (NGI) Initiative at NLM
3a. About the NGI Initiative
The Federal Next Generation Internet (NGI) Initiative was launched in October 1996 by President Bill Clinton and Vice President Al Gore and was part of the HPCC Program. The initiative had two planning documents, the NGI Concept Paper (July 1997) and the NGI Implementation Plan (February 1998). The NGI had three goals:
- Experimental research for advanced network technologies, which included network growth engineering, end-to-end quality of service, and security
- Next generation network fabric, which included high performance connectivity and next generation network technologies and ultrahigh performance connectivity
- Revolutionary applications
NLM participated in the third goal. As noted in the NGI Implementation Plan's Executive Summary, NLM brought extensive experience in medical research and great strength in health care applications.
3b. NGI at NLM Phases I and II (1998-2003)
In 1998, NLM announced what became a three-phase NGI research program to develop innovative medical projects that demonstrate the application and use of NGI capabilities:
- Quality of service
- Medical data privacy and security
- Nomadic computing
- Network management
- Infrastructure technology for scientific collaboration
In October 1998, NLM announced the award of 24 NGI Phase I contracts to medical institutions and companies. Press release and project summaries.
As part of its NGI program, NLM funded a study that produced:
- National Research Council, Computer Science and Telecommunications Board. Networking Health: Prescriptions for the Internet. Washington DC: National Academy Press; 2000. 388 pages. The report examined ways in which the Internet could be used to support applications in clinical care, consumer health, public health, health care finance and administration, professional education, and biomedical research.
In early FY 2000, NLM awarded 15 NGI Phase II contracts for projects to be implemented in local testbed settings. Project summaries.
NLM Director Lindberg testified at a March 1, 2001 hearing on the FY 2001 budget for the NGI and Large Scale Networking.
NGI Reverse Site Visits were held August 26-28, 2003. Presentations.
3c. NGI at NLM Phase III: Scalable Information Infrastructure (2003-2007)
The Scalable Information Infrastructure (SII) program was Phase III of the NGI research program. SII was responsive to the findings and recommendations in the February 1999 PITAC report “Information Technology Research: Investing in Our Future”.
In 2003, NLM awarded 11 NGI Phase III SII research project contracts demonstrating the application of scalable, network aware, wireless, geographic information system (GIS) and identification technologies to a networked health related environment. About SII and SII project summaries.
An SII Reverse Site Visit was held August 28-29, 2007.
- National Telemedicine Symposium (2001)
On March 13-14, 2001, the Office of High Performance Computing and Communications in the Lister Hill National Center for Biomedical Communications at NLM sponsored a National Telemedicine Symposium that highlighted telemedicine research that NLM funded from 1994 to 2000. The purpose of that research was to evaluate the use of communications technologies in the implementation and performance of telemedicine activities, and to examine the impact of telemedicine on medical care in terms of cost, quality, and access. Symposium proceedings, available final reports, and other supporting information.
- Additional Information
- NLM Current Bibliographies in Medicine: Telemedicine: Past, Present, Future, CBM 95-4. This retrospective bibliography contains 1,634 citations dated from January 1966 through March 1995.
- Institute of Medicine, Committee on Improving the Patient Record. The Computer-Based Patient Record: An Essential Technology for Health Care, Revised Edition. Dick RS, Steen EB, Detmer DE, editors. Washington DC: National Academy Press; 1997. 256 pages. Funded in part by NLM.
NLM is an institutional member of the American Telemedicine Association.