Medical outreach to Armenia by telemedicine linkage.

Telemedicine, an electronic mode of transmitting medical information interactively between remote sites, was launched as an educational support for a 3-year-old medical partnership between Boston University School of Medicine and Emergency Hospital, of Yerevan, Armenia. Emergency Hospital is the first site in Armenia to have an audiographic teleconference capability linking it to a major medical center. Emergency Hospital and Boston University School of Medicine share the remote connection in order to allow educational conferences, peer consultations, and distance learning to take place, thus enhancing the partnership's aims to improve the emergency and trauma care system of Yerevan. To date, eight teleconferences have been transmitted linking 100 physicians, nurses and hospital administrators. The teleconference program provides, in effect, a formal continuing medical education program for Emergency Hospital. It is a key tool of low-cost technology transfer with the potential of broadening resources over the wide territory of the 15 republics of the former Soviet Union. The telemedicine system is comprised of Optel Communications' Remote Viewing System computer hardware and software plus two dedicated AT&T telephone lines. The system has been in use at Boston University School of Medicine for live voice and still image transmission between international sites since 1987. This level of technology suited environmental conditions in Armenia, marked by frequent power outages and unreliability of local telephone connections. A protocol for presentations was established governing length of time, number of visuals per session, visual format, compatibility with interpretive services, congruence with project mission, and adaptability to local conditions that was shown to provide clear and concise delivery of the information necessary. This paper reports the process of development, installation, and initial use of the technology in one nation of the post-Soviet world.