Pacific Medical Technology Symposium (1998)
Aug. 17, 1998 to Aug. 20, 1998
Victoria Garshnek , Tripler Army Medical Center and AMEDD Center and School
L. Harrison Hassell , Tripler Army Medical Center and AMEDD Center and School
Project AKAMAI is a Federally funded program designed to augment health care delivery to DoD and beneficiaries in the Pacific Basin using telecommunications technology. The AKAMAI Evaluation Initiative is a systematic evaluation of the potential contribution of telemedicine technologies and processes in a health care delivery system. In this prospective study, patients are randomly allocated to usual care (UC) or telemedicine (TC) for routine dermatology or orthopedic consultations between a primary care outpatient clinic and a tertiary care center. To assess the impact of this change in health care, measures of structure, process and clinical outcome are performed over a 90 day period from the date of consultation. Data analysis will include descriptive and analytical statistics, and construction of medical models based on individual patient trajectories. The automation infrastructure for the study employs a thin client-server design and integrates existing hospital legacy systems and image servers on a secure network. Health care providers access the AKAMAI server using web browser software and use predefined clinical protocols that define required Hx, PE, labs, and images for problem oriented consultation. The overall study investigates four areas of interest (Clinical Outcomes, Patient/Provider Satisfaction, Organizational Impact, and Cost/Effectiveness). The objective is to provide healthcare policy-makers with scientific and technical information and provide a tested methodology for future evaluation of deployed DoD telemedicine systems in the Pacific. The evaluation project background, status, and anticipated applications will be discussed.
V. Garshnek and L. H. Hassell, "Overview and Status of the AKAMAI Telemedicine Evaluation Initiative," Pacific Medical Technology Symposium(PACMEDTEK), Honolulu, Hawaii, 1998, pp. 252.