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Telemedicine Fonds A GUIDE TO THE Telemedicine fonds COLL – 041 Arranged & Described by Jenny Seeman November 16, 2012 Updated December 6, 2013 Faculty of Medicine Founders’ Archive Health Sciences Library Title: Telemedicine Fonds Dates: 1974-2013 Extent: 7.8 metres; 474 photographs; 2781 slides; 74 vhs cassette tapes; 14 ¾” tapes, 789 digital files (1.57GB). Administrative history: The Telemedicine Centre at Memorial University, established in 1975 under the guidance of Dr. A. M. House, was officially opened in 1977. Telemedicine, later renamed the Tele-health and Educational Technology Resource Agency (TETRA), was created to provide continuing education courses for physicians, nurses and other health professionals throughout the province of Newfoundland and Labrador. On 25 January 2007, TETRA and the Office of Professional Development merged forming Professional Development & Conferencing Services (PDCS). Telemedicine, in the sense of medical care delivered from a distance, has existed since the invention of the telephone. The Faculty of Medicine at Memorial University was a pioneer in developing the concept of telemedicine by making use of emerging satellite technology in the early 1970s. From the very beginning, the idea was to use satellite communication for three main areas of medical care: Continuing Medical Education Programmes, Medical Consultative Services and Community Health Programmes. In 1972, the governmental Department of Communications (DOC), invited interested parties to participate in an experimental project involving the Hermes Communications Technology Satellite (CTS). A joint project between the DOC and the United States’ National and Aeronautics Space Administration (NASA), Hermes would provide prescheduled time slots to each of the approved projects in the US and Canada to carry out their experimental use of the satellite technology. By 1974, Memorial University was one of three experimenters chosen in the health care field, and the only participant east of Quebec. Four hospitals in Newfoundland and Labrador: Stephenville, St. Anthony, Labrador City and Goose Bay, were linked to The Health Sciences Centre of Memorial University via terminals capable of receiving audio and video signals. The broadcasting base at the University was able to transmit both audio and video, and the remote stations were able to return communication with an audio feed. In order to prepare for the use of the satellite, extensive simulation occurred using existing terrestrial technology. Working with the Educational Television Centre, a microwave broadcasting system linked the Health Sciences Centre to the General Hospital in St. John’s, a distance of about 4 miles. This link was used to test the programming for the continuing medical education courses to be provided. The experimental use of the satellite lasted 3 months, with 150 hours of use, and the results of the experiment are still unfolding today. By 1979 the Telemedicine Centre in St. John’s had created a teleconference system (TCS) with 4-wire technology to provide more consistent and better sound quality than a regular 2-wire telephone 2 conference call. The system began as a 9 site single dedicated circuit and grew to more than 215 sites province wide. There were contact sites at all provincial hospitals, several nursing stations as well as schools, universities and other health and education agencies. Aside from providing a means of distance education for health professionals, the TCS was used for university credit courses and business meetings. Telewriters were also used as part of the teleconferencing systems. These ‘whiteboards’ allowed hand drawn or computer images to be transferred in real time to all participants of the teleconference. EEGs and ECGs were also transmittable from remote locations. They were sent to the Health Sciences Centre and read by a specialist who was then able to give a direct report to the local physician. While Telemedicine was growing through the use of teleconference systems, the Faculty of Medicine and the Education Television Centre participated in another satellite trial known as Anik B. The aims of this trial were to expand the facilities of the Teleconference System using a hybrid terrestrial/satellite narrowband network, and evaluate the effect on offshore medical services by providing a direct link to an emergency department in a hospital. Audio, ECG equipment and slow scan television (SSTV) were installed on an oil rig and many successful transmissions were conducted during this trial. Telemedicine was originally established as a research and development unit within the Faculty of Medicine at Memorial University of Newfoundland. In 1988 the Atlantic Canada Opportunities Agency (ACOA) made a significant investment ($3.3 million) to the Telemedicine Centre, and the Division of Educational Technology (DET), School of Continuing Education. Under the funding the Telemedicine Centre and DET formulated the Telemedicine and Educational Technology Resources Agency (TETRA) enhancing the services offered by the two units. In particular, the Telemedicine Centre expanded its teleconferencing network with the addition of a new TETRA circuit, linking all the community colleges, the Marine and Cabot Institutes and Memorial University of Newfoundland. The funding allowed for the purchase of a dial access audio bridge, new hybrid teleconferencing audio kits for maximum flexibility, audiographics software and hardware packages, and construction of a new space in the Health Sciences Centre (10,000 square feet). At the time this represented the state of the art in conferencing technologies, and served as the basis for successful expansion of services by MUN throughout Newfoundland and Labrador. Over the years, TETRA also moved into satellite-based broadband service delivery, Internet Protocol (IP) technologies, and Province-wide video conferencing. In 2001, TETRA was confronted with a number of serious issues relating to the currency of its audio/video/data bridge technology. There were also increasing demands for a hybrid network, designed to link analogue audio and voice over IP, and video and data technologies from one technology to the other. A proposal was submitted to ACOA and subsequently approved to acquire and implement an integrated audio/video/data bridge and gateway facility consisting of the following: A 48 port audio bridge; A 24 port H.320/H.323 video bridge, data bridging facilities (200 users), associated telecommunications infrastructure, and Human Resources (IT support). TETRA’s project work allowed the organization to build valuable operating experience in a number of emerging communications and networking technologies, as well as assisting to refine its core technology 3 plans. What emerged was a strategic evolution of the organization from its analog technology base, with a primary focus on audio conferencing, to a fully digital IP-based facility with the capacity for audio/video/data bridging services for its client base. TETRA’s organizational structure consisted of the following management team: Chair, Director, Associate Director Operations, and Associate Director Programmes. The Chair had overall accountability to the University for TETRA, its operations, research and development activities, and interactions with the health and education systems of the Province. The Director was responsible for the overall management and leadership. The Associate Director Operations was responsible for the operations, maintenance and development of the network system and the Associate Director of Programmes was responsible for the management and evaluation of programmes and applications of TETRA’s audio/video/data conferencing networks, as well as local, national and international projects. Custodial history: The records came in several increments from various departments within Telemedicine/TETRA. The first accession came to the archive in February 2007 when Telemedicine/TETRA moved location. A further accrual came in June 2009 when the Office of the Dean transferred boxes from offsite storage. Further accruals have come from individuals holding offices within Telemedicine/TETRA over the life of the organization. Scope and Content: Series in this fonds cover the daily operations of Telemedicine/TETRA. Sous-fonds follow the organizational structure of Telemedicine/TETRA. Telemedicine had a Chair and a director overseeing operations, as did TETRA, with TETRA also having Associate Directors managing Operations and Programmes. The series and sub series in these sous-fonds reflect the work managed by those offices. There are also sous-fonds containing audio-visual materials created and/or used by Telemedicine/TETRA, photographs, and research papers and original reports, many of which were compiled during the research for a bibliography of Telemedicine (1981). The various projects may have files in the different sous-fonds, such as when the Associate Director (Operations) would have technical files and the Director may have planning files. For this reason, a brief description of projects undertaken by Telemedicine/TETRA is included here at the fonds level description. Projects, programmes and proposals undertaken by Telemedicine/TETRA Acadia University: The university installed a Teleconference system in 1987 with the help of the Telemedicine team at Memorial. There were 13 sites on a dedicated 4-wire audio network. Addiction Research Foundation (ARF): ARF was a client of Telemedicine. The files in this series largely deal with the Eastern Addictions Network,
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