Winter 1995 (3.4)
View to the Future
by Betty Blair
Editor's note: We sadly note the passing of Dr. Hooshang Kangarloo of cancer on May 15, 2012. In lieu of flowers, his family and friends request donations to the Taslimi-Kangarloo Endowment, managed by the UCLA Foundation. UCLA Health Sciences Development, Attn: Valerie Amador, DGSOMUCLAHS @mednet.ucla.edu. Posted: May 24, 2012.
The Medical Hospital at UCLA (University of California at Los Angeles) is one of the largest hospitals in the United States. Allegedly, it has more than 25 miles of corridors. Back in 1985-86, Dr. Hooshang Kangarloo, a pediatric radiologist and his colleagues were searching for ways to move X-ray images electronically over telephone wires between doctors and researchers. "We were probably in on the pioneering stage of developing an infrastructure for electronic medicine simply because we wanted to communicate within the hospital from one building to the next, one floor to the next. We wanted to be more efficient by moving information electronically instead of physically. Everything we developed was built in-house."
According to Kangarloo, who is an Azerbaijani from Iran whose ancestors come from the little village of Kangarloo in the Azerbaijan Republic, Radiology is probably one of the most difficult aspects to handle electronically because of the vast amount of information contained in each single image. One chest X-ray is equivalent to 500-600 page book. It takes, at least, 4 megabytes of computer space.
But what started out as a time-saver is turning into a big money saver. If these technologies are used correctly, they could drastically cut health care costs while radically improving care quality. A large chunk of health care costs goes into diagnosing the patient. "It's impossible to know everything you need to know in medicine," says Kangarloo. "Teleradiology provides the chance to get the diagnosis right the first time." In other words, it breaks that vicious, expensive cycle of "trial and error" when the doctor doesn't know what's wrong. With telemedicine, the doctor has the option of consulting someone who has had more experience in a given specialty who can look at the same X-rays, ultrasounds, CT scans, etc., and offer his opinion.
Currently, UCLA has pilot projects with Melbourne, Florida, and Chile, South America, They estimate they'll save Melbourne about $20 million in local radiology fees alone over the next five years.
Could such an arrangement work in Azerbaijan? "Absolutely," insists Kangarloo. One of the most exciting aspects of this technology is that it transcends geographical borders. "There's no reason why the rest of the world shouldn't have access to the same quality that is available in the West. People are the same everywhere. If you left me alone, I'd remove all these borders."
Equipment is the easy part, and the least expensive aspect in setting up such a project. More importantly, according to Kangarloo, is a commitment to health care by some entity in Azerbaijan-whether it be government, a local hospital, the medical university or oil company. The hardware system design is not very difficult. It requires a viewing station on the receiving end, telephone lines, interface computer and similar equipment on the other end. If there is access to satellite transmission, that's better yet.
Kangarloo insists that the larger question is the health system itself. How is Azerbaijan going to provide some kind of health service to its people? How will it be organized and paid for? Telemedicine could certainly contribute to lowering costs while increasing quality. But such a project needs to be based on the needs and existing infrastructure already in place.
Telemedicine offers opportunities broader than simply patient care. One of the areas that excites Kangarloo is the potential for research and education. "The backbone of any country is its education," says Kangarloo who has been honored with UCLA's "Gold Medal for Teaching". "A tremendous amount can be done in education via telemedicine and teleradiology. There's never enough good teachers anywhere in the world. This technology can have a profound effect in exciting our students. You don't have to sit beside someone to teach them something."
"Telemedicine is the future. There's no doubt about it. We're on the cutting edge of something phenomenal."
For more information about Teleradiology, contact Dr. Hooshang Kangarloo, UCLA School of Medicine, Dept Radiological Sciences, Los Angeles, CA 90024. Tel: (310) 825-5433; Fax: (310) 794-7797; e-mail: <firstname.lastname@example.org>.
From Azerbaijan International (3.4) Winter 1995.
© Azerbaijan International 1995. All rights reserved.