Feds explore health net

National Library of Medicine officials plan to ask information technology companies next week to submit ideas on how to build advanced networks that would enable physicians to access a patient's medical history, a capability that would allow health care professionals to treat victims of a disaster or other emergencies.

NLM plans to spend $40 million in the next three years to develop the networks, which would provide better communication and health information flow among health professionals. NLM plans to issue a request for proposals March 25.

Although the proposal is not specifically a homeland security initiative, officials say scalable networks could be used to deliver medical care in the wake of a terrorist attack, natural disaster or crisis when traditional communications are knocked out.

Michael Ackerman, NLM's assistant director of high performance computing and communications and project manager for the program, said he is looking for ideas to help develop the next generation of scalable networks — technologies that still may be in a scientist's head or on a drawing board.

The networks could link hospitals and health professionals with patients, provide health education or information in an emergency and use advanced identification such as biometrics or smart cards to identify patients.

"We're looking for big ideas, little ideas," he said. "If you can gin up some kind of great idea for health care, we're interested."

For example, he said, a medical disaster relief team reaches a town devastated by a hurricane and identifies a victim by a medical smart card the patient is carrying. A doctor uses the card to gain access via a satellite network to the patient's electronic medical history. If communication via the satellite is down, the doctor could obtain essential health information from the smart card.

Ackerman also said physicians could use scalable networks to learn that a receiving computer is not sophisticated enough to read a CAT scan, that a small handheld computer cannot reach a Web site, or that a computer technician has a monochrome screen when a color screen is needed to properly read test results.

David Sobel, general counsel for the Electronic Privacy Information Council, warned that systems have to be designed with public participation "because there are design decisions that can have serious privacy implications."

Ross Brechner, Maryland's state epidemiologist, said that it's more important to move slowly to find new ways to communicate than to rush toward a broad sweep of projects.

"Get a couple of ideas you know are universal. 'A' has to communicate with 'B.' Then solve those smaller issues and build up the pieces," said Brechner, whose office is working on dealing with future bioterrorism threats.

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Networking health

The National Library of Medicine is looking for revolutionary technology ideas to improve the flow of medical and patient information among doctors, hospitals and clinics. Here are the projects officials want industry to provide:

* Networks linking patients, hospitals, clinics, medical libraries and universities, and public health officers.

* Wireless applications.

* Geographic information systems.

* Advanced technology to help public health or homeland defense initiatives.

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