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Tumor Conferencing Tools for Regional Collaborative Cancer Care Using the Next Generation Internet

Tumor Conferencing Tools for Regional Collaborative Cancer Care Using the Next Generation Internet. Brent K. Stewart, PhD, DABMP Professor of Radiology, Bioengineering and Medical Education Director of Imaging Informatics and Diagnostic Physics University of Washington School of Medicine

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Tumor Conferencing Tools for Regional Collaborative Cancer Care Using the Next Generation Internet

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  1. Tumor Conferencing Tools for Regional Collaborative Cancer Care Using theNext Generation Internet Brent K. Stewart, PhD, DABMP Professor of Radiology, Bioengineering and Medical Education Director of Imaging Informatics and Diagnostic Physics University of Washington School of Medicine Department of Radiology, 357115 Seattle, WA 98195 bstewart@u.washington.edu

  2. What Have We Done? • Design, construction and evaluation of collaborative Internet tools providing effective, distributed tumor board conferencing among multiple sites of practice • Web accessible info. system that can upload (case preparation), store, and display (case presentation) clinical images, video, graphics, documents, URLs, and protocols • Web browser visuals and interactions trans. to all sites • The Web browser in parallel with IP videoconferencing • Both channels use high-bright/contrast LCD projectors • Special attention to sound quality required • Retrospective reference or clinical mgmt purposes

  3. Step 2 Step 1 Enter patient information in the database through the web and schedule them to the conference. Schedule a new conference. Step 3 Upload patient studies that are to be shown and sequence. Preparation Before a Conference

  4. Step 1 Step 2 Presentation During a Conference

  5. Information Objects Typically Presented at a Conference

  6. Why Have We Done It? • Seattle Cancer Care Alliance • University of Washington Medical Center • Childrens Hospital and Regional Medical Center • Fred Hutchinson Cancer Research Center • Southeast Lake Union (SELU) Outpatient Center • January 29, 2001: all outpatient adult oncology services move to SELU – inpatient/outpatient oncologists split • Tumor conferences important in oncology patient mgmt. • Requires a gathering of multidisciplinary experts • Relative advantages/disadvantages of treatment alternatives • Collegial atmosphere – a place for networking and learning • Hypothesis: more frequent expert participation

  7. CHRMC UWMC FHCRC SELU Gigapop CCA - Geographical Distribution

  8. How Have We Done It? • NLM Phase 2 award: Biomedical Applications of the NGI • Univ. of Washington participant in Internet2 and NGI • UW created the Pacific Northwest Gigapop • PNWGP connects the SCCA partners with 2.5 or 10 Gbps • Three investigational groups formed • Apache w/128-bit SSL encryption, Debian Linux, MySQL • Programming: server – PHP4; client - HTML/JavaScript • Digital connectivity to path. slide and radiology images • eSQL query connectivity with the UWAMC EMR • Three tiered security infrastructure (authentic./authoriz.)

  9. PNW Gigapop Seattle Cancer Care Alliance Network Seattle Cancer Care Alliance (SCCA/SELU) OC-48, 2.4 Gbps Fred Hutchinson Cancer Research Center OC-192, 10 Gbps Childrens Hospital and Regional Medical Center Internet University of Washington External Partner

  10. Three Teams • Contextual Inquiry/Contextual Design Team • Cultural anthropology (observations, interviews, coding) • Design requirements, simulation scenarios and usability testing • Evaluation • Technical Infrastructure Team • Collaborative tool development • Synthesis of existing on-line clinical information resources (e.g., MIND/MINDscape and PACS images) into developed tools • Medical data privacy and security, network QoS • Telepresence (Folie á Deux) Team • Our advanced R&D team (augmented reality, immersion, etc. ) • Technologies for human interfaces and collaboration

  11. Conference Attendance

  12. Biomedical Applications of the NGI - Phase 3 • Vision: extend infrastructure/tools from Phase 2 to demon. with SCCA affiliates throughout broader multi-state region • Treat the resultant ‘product’ of Phase 2 as a clinical trial in Phase 3 (IOM global telemedicine evaluation framework) • Use of multicast capabilities for conferencing “n” sites • Multi-resolution and multi-rate solutions • Tx info. from referring instit. for conference/patient mgmt • How effective at providing a collaborative environment?

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