Don't be surprised if -- in the near future -- a check-up by your doctor requires neither leaving your home or the physical presence of a doctor. A recent news release from Yale University illustrates how the integration of telecommunications, information systems and medical databases is expanding the capabilities of telemedicine, which is defined as the provision of health care and education over a distance. Yale University reported on an expedition organized by the Yale-NASA Commercial Space Center, known as the Medical Informatics and Technology Applications Consortium (MedITAC), in which telemedicine was used to deliver advanced medical care to one of the most hostile regions on earth. According to the news release, a group of 15 physicians, climbers and scientists traveled to Katmandu, Nepal. An air plane ride and a subsequent 10-day hike later brought the team to the Base Camp of Mt. Everest. The team then lived and worked at Everest Base Camp, 17,500 feet above sea level, for about three weeks. A commercially available telemedicine unit as displayed by MedITAC at NASA Johnson Space Center. "The mountain served as an extreme testing ground for telemedicine," said Richard Satava, M.D., professor of surgery and gastroenterology at Yale School of Medicine and an investigator in the National Aeronautics and Space Administration project on Mt. Everest. "The lessons learned further clarify the ability to provide better health care in remote and extreme environments, which for some may even be their home environment during or after a medical illness." Telemedicine connections brought high-resolution images, real-time interactive video, and audio communication to the Yale campus in New Haven from the remote Everest location. The team provided medical care for the Everest Base Camp community, conducted validation experiments for several types of advanced medical technologies, and performed real-time monitoring of selected climbers while assessing the basic science of altitude physiology. MedITAC has a strong relationship with NASA Johnson Space Center to explore requirements that will integrate telemedicine into the infrastructure for the delivery of medical care in space flight as well as other applications throughout the world. According to Yale's news release, the same technology that was used to monitor the vital signs of climbers ascending Mt. Everest could be used by physicians to monitor patients in their own homes. Such systems could also be integrated with a disaster response team to support medical consultations between a disaster area and experts located within the region or at another site. The expedition also served to test a vital signs monitor (VSM), which is a lightweight wearable system that is made up of sensors, a global positioning system (GPS) and a telecommunications system. The VSM monitors heart rate, temperature, respiratory rate, electrodiagram motion detection (accelerometers) and pulse oximetry. The VSM was typically strapped across the chest or wrist or swallowed in pill form, the news release stated. The telecommunications system was usually a radio-frequency transmission system repackaged into a miniaturized wearable configuration. "This is the first time that there has actually been documentation of long distance monitoring of vital signs in real time," Satava said. "One of the more exciting developments from these efforts is that data transfer from remote locations is plausible." Satava said the system is commercially viable because of its low-bandwidth requirement and the use of commercial off-the-shelf products. The communication conduit is already in place in the form of ISDN lines and the Internet. The software needed is readily available and affordable. Satava said the most expensive element is the hardware. Each VSM unit costs about $15,000. But the cost could be reduced significantly by eliminating the GPS, making the monitoring system an option for home-based care, Satava said. "If these devices could work on the mountain, their applications are limitless in the homes of patients suffering from chronic conditions such as diabetes, heart disease and emphysema," Satava said. This story has been adapted from a news release issued by Yale University for journalists and other members of the public. For more information visit: http://www.sciencedaily.com/releases/2000/12/001219075108.htm