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TELEMEDICINE DEPLOYMENT TO OPERATION IRAQI FREEDOM - CURRENT STATUS AND LESSONS LEARNED R. K. Poropatich Telemedicine and Advanced Technology Research Center, US Army Medical Research Medical Command, Fort Detrick, Maryland U.S.A. [email protected] Telemedicine support for forward deployed Army Combat Support Hospitals in Iraq was initiated in 2004. Clinical reach-back consultation for medical specialties included radiology, pathology, dermatology, ophthalmology, infectious disease, pediatrics, nephrology, burn/trauma and dentistry. Tele-consultations was accomplished using satellite connectivity over the non-secure military Internet network using both e-mail with JPEG image attachments and DICOM server file transfers. As of December 2005, over 1100 non-radiology consults were completed. Radiology image transfers exceeded 10,000 and include intra- and interfacility file transfers (to the referring medical facility in Germany). Measures of clinical effectiveness included the number of avoided aeromedical evacuations, decreased lost duty time, and intra-theater medical management of complex cases which improved access to subspecialty care. Deployment problems encountered included frequent interruption of electrical power, initial bandwidth constraints, and network reconfiguration delaying initial implementation of teleradiology. A follow-on deployment to sites in Kuwait and Afghanistan for tele-radiolgy was completed in January 2005. Key words: TATRC, Telemedicine, Operational Medicine, Lessons Learned, U.S. Military Operations