title: Telemedicine and international disaster response:  medical consultation to Armenia and Russia via a Telemedicine Spacebridge.
abstract: The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa.
  
  
  METHODS
  During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences.  A total of 209 patients were discussed, requiring expertise in 20 specialty areas.
  
  
  RESULTS
  Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent.
  
  
  CONCLUSIONS
  These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.
authors.affiliation: Department of Surgery, University of Utah, Salt Lake City, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Houtchens
authors.forename: T P
authors.initials: TP
authors.lastname: Clemmer
authors.forename: H C
authors.initials: HC
authors.lastname: Holloway
authors.forename: A A
authors.initials: AA
authors.lastname: Kiselev
authors.forename: J S
authors.initials: JS
authors.lastname: Logan
authors.forename: R C
authors.initials: RC
authors.lastname: Merrell
authors.forename: A E
authors.initials: AE
authors.lastname: Nicogossian
authors.forename: H A
authors.initials: HA
authors.lastname: Nikogossian
authors.forename: R B
authors.initials: RB
authors.lastname: Rayman
authors.forename: A E
authors.initials: AE
authors.lastname: Sarkisian
authors.forename: J H
authors.initials: JH
authors.lastname: Siegel
mesh_terms: D000337:Aerospace Medicine; D001136:Armenia; D004189:Disaster Planning / Q000379:methods; D004190:Disasters; D004632:Emergency Medical Services / Q000379:methods; D006801:Humans; D007391:International Cooperation; D012017:Referral and Consultation; D012066:Relief Work; D012426:Russia; D017215:Satellite Communications; D017216:Telemedicine; D014481:United States; D018557:United States National Aeronautics and Space Administration; D014947:Wounds and Injuries / Q000628:therapy