There is not sufficient access to medical care or medical expertise in many parts of the world. An innovative telemedicine system has been developed to provide expert medical guidance to field caregivers [who have less medical expertise but can reach the patient population in need]. Real-time ultrasound video images have been securely transmitted from the Dominican Republic to Hackensack University Medical Center, Hackensack NJ (HackensackUMC), while the expert physician at HackensackUMC maintained direct voice communication with the field caregiver. Utilizing a portable ultrasound machine (Sonosite) integrated with portable broadcasting device (LiveU), extended Focused Assessment Sonography in Trauma (e-FAST) examinations were performed on healthy volunteers and transmitted via the local cellular network. Additionally, two e-FAST examinations were conducted from a remote location without cellular coverage and transmitted via broad ground area network (BGAN) satellites. The demonstration took the technology "out of the lab" and into a real life, austere environment. The conditions of the Dominican Republic ultrasound mission provided experience on how to manage and utilize this innovative technology in areas where reliable communications and medical coverage are not readily available. The resilient transmission capabilities coupled with the security features deem this portable Telesonography (TS) equipment highly useful in the telemedicine forefront by offering healthcare in underdeveloped areas as well as potentially enhancing throughput in disaster situations.
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