Solutions to the world's problems again are on my mind especially in the area of affortable medical care for everyone.
I came across this article at changemakers a previous competition. Horray for Changemakers making a difference. Read it and tell me what you think.

Define the innovation: Remote expert guidance of portable ultrasound examinations has significantly improved medical care capabilities in the Space Program by allowing the diagnosis of over 300 common medical conditions by non-physicians on the International Space Station. This model was recently exported for use in professional and amateur sporting injuries in the Winter Olympic Games in Turino where the technique was used over 250 times for injured athletes. We currently have 3 portable ultrasound units in the Olympic training facilities which are used to help diagnose a variety of injures in athletes across the country. We have recently provided these capabilities to the professional sporting teams of Hockey (Detroit Red Wings), Football (Detroit Lions), and Baseball (Detroit Tigers) where the technique is used during practice and game situations in professional athletes by their trainers. We have been asked to help export these techniques to Northern Ontario, via satellite support, to help extend care to underserved populations in these remote areas. These techniques are readily scalable to almost unlimited areas via internet, cell, or satellite coverage in during routine or disaster care.
Context for Disruption: The primary focus of this innovation is the expansion of health care capabilities, developed by NASA, for use on Earth to increase diagnostic capabilities in under-served populations. The innovation involves rapid training and remote expert guidance of non-expert users in dispersed centers to perform targeted ultrasound examinations using in-expensive, portable ultrasound devices which are coupled to centers of excellence through the internet, cell, or telephone networks. The target populations of this innovation are remote, rural, or underserved populations where immediate and accurate diagnostic information concerning numerous health conditions including obstetrics, child care, musculoskeletal disease, trauma, kidney, liver, gallbladder disease, and cardiovascular health could be assessed. Currently, there is a long waiting period for a patient to obtain a radiologic test such as a CT, MRI, or ultrasound scan which are extremely expensive and site limited. The portable ultrasound devices are 1/6th the cost of previous devices, and can be placed in non-hospital, community settings, staffed by remote physicians for a fraction of the cost of a similar examination under standard conditions. Recent NASA investigations have demonstrated that ultrasound can provide similar diagnostic images to these expensive interventions and that the ultrasound examinations can be performed by non-physicians with high accuracy: this proposal will modify these techniques used successfully on the International Space Station and Winter Olympic Games to expanded health care on the Earth.
Delivery Model: This medical care innovation reaches its target population by selecting community sites which are convenient access points (schools, community centers, existing health clinics) can be quickly adapted. The access locations are readily available as the requirements are modest (comfortable, private location for scanning protocols, connectivity to a designated remote expert site via internet, cell network, or phone line). Target populations can be demographically screened (well obstetrics checks, vascular check ups in elderly, abdominal scans for pain, musculoskeletal examinations for pain or injury) or the technique can be on an as needed.Currently, we support remote medical care on the International Space Station, 3 United States Olympic Committee Training Facilities in the US, the professional sporting teams in Detroit, and are in process of developing programs for Northern Ontario and the Summer Olympic Games in China. The utilization of these services is dependent of the activity of the participants in these locations and varies from almost continuous use for the National Football League during practices, to sporadic for the baseball team.The distribution of remote expert guidance is not limited by the system and can be a dispersed skill set and asset. We currently serve as the primary center of excellence for this activity, however, we have trained additional support sites in Dallas, Texas, Houston, Texas, and Pensacola Florida with the technique. Additional sites could be added without significant monitary or time cost.
Key Operational Partnerships: NASA: Remote expert guidance was originally developed by NASA scientists to expand medical care capabilities on the Shuttle and International Space Station. Training programs and algorithms for the non-traditional uses of ultrasound were supported by 2 research grants and the technology was developed for terrestrial use. This original partnership was crucial to the success of the program and continual cooperation is ensured by a 5 year extension of this research effort with collaboration with the Russian Space Agency. This partnership is not central to this proposal, however, it provides additional resources for expansion.GE: General Electric has state of the art portable ultrasound devices which have been provided to the Olympic effort which have aided the initial trials used in this proposal. Continued corporate support with innovation of technology, and advantageous pricing is crucial to this proposal.Mediphan: This company is an essential partner in the terrestrial expansion of this technique through proprietary video compression and streaming to remote locations. Continued cooperation is ensured through a shared business vision of expansion of remote medical technology.
Financial Model: The financial model for this innovation is variable based on the intended patient population. Provision of care to underserved populations can be inexpensively provided by using existing funds to purchase the ultrasound units and connectivity options. Partnering with local/regional centers of excellence will allow the parent center to provide expert services as an intact mechanism for patients where pathology is found or as a community outreach mechanism. Funding mechanisms through community health initiatives will also allow outfitting of these diagnostic centers in designated regions.Currently, we are developing a funding model to extend these techniques to established medical facilities where these additional capabilities are required (e.g. Advanced musculoskeletal ultrasound for the Andrews Orthopedic Institute in Pensacola Fl). Earned income on this venture will be used to expand this technique (appx 15% of operating costs) to develop additional training modules for expanded ultrasound indications
What is your annual operating budget? 400K
What are your current sources of revenue? (please list any sources that are foundation grants) General Electric: 100K
NASA, National Space Biomedical Research Institute 200K
Henry Ford Hospital 100K
Effectiveness: This innovation has exponentially increased medical care capabilities for the space program and International Space Station; Astronaut Mike Fincke "this is the biggest scientific achievement we have had in the space program during my time" Over 250 Olympic athletes were treated during the Winter Olympic Games with these techniques. Numerous professional athletes were benefitted during practice and competition as well. The National Football League is in the process of adopting this innovation for care of football players across the league.
Which element of the program proved itself most effective? The most effective component of this program is enpowering non-expert users to acquire high quality diagnostic images to transmit to a remote expert for interpretation and care planning. We have utilized high school educated operators, with less than 2 hours of training, to obtain images that classically required a skilled operator or physician to complete.
Number of clients in the last year? The current clients supported by this innovation include:NASA: International Space Station and Shuttle, Johnson Space CenterRussian Space Agency: International Space Station, Gagarin Cosmonaut Training Facility, Institute for Biomedical ProblemsGE: Training centers in Wisconsin, and Field Agents crosscountryWayne State University School of Medicine: Medical School Ultrasound Training ProgramUnited States Olympic Committee: Chula Vista CA, Colorado Springs CO, Lake Placid NY, Winter Olympic Games, Turino ItalyDetroit Lions: NFL Professional teamDetroit Tigers: AL Professional Baseball teamDetroit Red Wings: NHL Professional hockeyCanadian Space Agency: Northern Ontario Health Project
What is the potential demand? There is a potential worldwide demand for this innovation in numerous areas:Underserved or rural: Obstetrics, musculoskeletal, cardiovascular, injury, abdominalDisaster and triage: Trauma, injury, musculoskeletalSports: MusculoskeletalMilitary: Trauma and injury
Scaling up Strategy: The scaling up strategy is divided into educational, technologic, and economic.Educational: The education of non-expert providers for trauma, abdominal, cardiovascular, and musculoskeletal uses of remote ultrasound are mature programs. Additional educational components for obstetrical care, and disaster management will need to be developed in the first year.Technologic: Current use of this innovation is based on broadband internet connectivity. Alpha testing of video compression/transmission algorithms for cellular network configurations is ongoing and will be expanded to encompass routine telephone lines within the first 2 years.Economic: Partnering with local, regional, and national funding authorities for community health and disaster managment will be explored throughout the first three years to provide funding for staffing, tech development, and equipment purchase/upkeep.
Stage of the initiative: Scaling up
Expansion plan: This innovation was only recently described in the literature as well as at scientific conferences to a limited audience. We anticipate that numerous additonal parties (military, homeland security, World Health Organization etc) will be interested in acquiring and expanding these capabilities. Furthermore, we have recently demonstrated this technique to regional hospitals which may use this techique to expand their care (and patient) base.
Origin of the Initiative: Providing medical care for astronauts in deep space and patients in many areas of the world is more similar than you might think. There isnt a doctor on the Space Station, we have no X-ray or cat scan, and health problems occur despite precautions. We do have an ultrasound machine, so we developed a way to use it for things which would require a doctor and X ray capabilities on Earth. We've been very surprised (and pleased) that non-physicans can learn to use ultrasound very rapidly following a specialized training program, coupled with remote guidance by an expert using satellite or internet communication. Ultrasound proved to be better than X ray in many uses. We've migrated this technique to the Olympics; a few months ago a speed skater went off the track and injured his shoulder. An athletic trainer called me; i opened my laptop in Starbucks, and diagnosed his injury in 5 minutes.
What are your two main challenges to finance the growth of your initiative: Purchasing the ultrasound equipment for initial deployment in disseminated centers (10 centers at 100K per center)Incentivizing remote experts to provide guidance and interpretation of the resulting examinations (cost is dependent on the useage, estimated at 50K per site)
How did you hear about this contest and what is your main incentive to participate? We have partnered with engineers at Ford Motor Company, vehicle design to fast track video transmission technology. An electrical engineer knew of this contest.
Do you have an annual financial statement? Henry Ford Health System and Hospital have a financial statement which tracks profit and loss (profit from operations in 2006 was 110$ Million dollars)
Do you currently have an annual financial statement that tracks profit/loss? Year 1 Equipment, staffing, educational development, outreach 500KYear 5 Continued expansion, equipment, staffing 250K
Contact Information:
Scott DulchavskyChairman of SurgeryHenry Ford Hospital(non profit hospital)sdulcha1@hfhs.orgDept of Surgery, CFP-12799 W Grand BoulevardDetroit, MI 48202United StatesTel: 313 916 9903Fax: 313 916 9445Website: www.henryfordimagineering.com
Submitted by: sdulcha1