Telemedicine demo in Manila from Columbia University on March 29th

<<January 7, 2000>>

Shin Takuma, M.D. <st245@columbia.edu>

Clarito Dimayuga, MD <dimen426@worldnet.att.net>

Frank S. Govern, M.B.A., Ph.D. <fg36q@nih.gov>

Kenneth M. Kempner <kempner@helix.nih.gov>

Maj. Christian Macedonia, MD <cmacedonia@aol.com>

Edward Dodds <dodds@home.com>

Arturo M. Pesigan, M.D. <artpesigan@yahoo.com>

Herman D. Tolentino, MD <hermant@I-manila.com.ph>

Rafael Bozeman Rodriguez, Ph.D. <rbrsat@pworld.net.ph>

Ms. Penelope Price <pprice@adbi.org>

Frederick M. Burkle, Jr., M.D. <skip@website.tamc.amedd.army.mil>

Victoria Garshnek, Ph.D. <74072.3104@compuserve.com>

Ms. Robin Hayden <haydenr@website.tamc.amedd.army.mil>

Mr. Myron Nordquist <myron_nordquist@burns.senate.gov>

Ben I. Haraguchi <haragucb@aren+fox.com>

(1) Many thanks for your msgs;

ATTACHMENT I from Shin,

ATTACHMENT II from Frank,

ATTACHMENT III from Ken,

ATTACHMENT IV from Penelope,

ATTACHMENT V from Ed,

ATTACHMENT VI from Skip.

Dear Chris, Frank and Ken:
==========================

(2) It was certainly very fruitful discussions we had at your office
yesterday. I was very impressed with your wonderful workstation. I
visited your web sites and browsed through some of pages -- very
informative. We would be very happy if our project can be of some help
to yours, too.

Dear Shin, Frank and Ken:
=========================

(3) I would like to suggest that Shin's group make one hour demo and Frank
and Ken's group another hour demo.

(4) Should Frank and Ken accept this proposition, Ken's presentation may
start first and Shin's second (starting around 8:30 am of NY time).

Dear Clarito:
=============

Pls prepare your demo with Art, Herman and Ralph in Manila.

ATTACHMENT IV is a msg I received from Ms. Penelope Price. I would
greatly appreciate it if you can kindly visit the web mentioned in her
msg and contact the organizations listed there by phone to find out
which can support your demonstration.

Dear Ken:
=========

(5) Although Manila people may not have enough broadband lines for your
wonderful workstation, you may present your system via ordinary
ISDN/PictureTel while we access your web site.

This is what we did for Yale University Hospital people last
August in Tampere, Finland.

You may emphasize that if there will be a broadband Internet (or
ATM) lines via satellite (or terrestrical optical fibers) in the
near future, your system can greatly benefit Filipino's medical
conditions.

(6) I hope some people from WHO/Manila office will watch your demo -- I know
its Secretary General so that I may ask him to send his people to the
workshop in Manila.

Dear Frank:
===========

(7) Sorry to say that I could not open your attachment with MacLinkPlus on
my Mac/G3.

Dear Chris, Frank and Ken:
==========================

(8) ATTACHMENT V is the article I mentioned to you yesterday -- about
Tripler's activities around the Pacific.

Dear Skip and Victoria:
=======================

(9) Pls inform me if you would like to participate in this telemedicine demo
from your Tripler.

Dear Myron:
===========

(10) I would greatly appreciate your arrangement of our visiting your friend,
Mr. Negroponte, Senior Vice President for International Affairs at
McGraw Hill in NYC (a brother of world renowned scholar at MIT and a
former Ambassador to Philippines). I will be back from Vienna on
1/19th, but I will also attend Joe Pelton's conference at INTELSAT
Headquarters on February 5th. Therefore, our visit to Mr. Negroponte
could be in the early part of the February 7th week. (BTW, David
Johnson is considering to have me in Tennessee in the week of 2/14th or 2/21st.)

Best, Tak
****************************************
ATTACHMENT I

Date: Fri, 7 Jan 2000 18:41:56 -0500 (EST)
From: "Shin Takuma" <st245@columbia.edu>
To: utsumi@columbia.edu
Subject: Re: Min-workshop in Manila on March 29-31, 2000

Dear Tak,

According to your schedule, we would like to start preparation for
Telemedicine presentation in Manila.
Please consider following offers:

(1) Time difference: if you want to make telemedicine communication between
Manila and NY. I need to ask visual audio studio of Columbia University
first. I guess 9 am NY time starting will be possible. But before 9 am, I
need to make hard negociations in advance.(please remind we had better test
network on the day before the presentation.)
(2) Network: even if Manila staffs don't have broadband line, so far, we
suppose to use our high-speed line.
(3) Contents: we may produce update telemedicine might be greater than I did
in tampere. Not only 3D echo, we will able to give most usefull information
about telemedicine.
(4) Equipment: we will check it (HP or not) from next week.

Since Dr. Dimayuga came from Mania and is capable to organize both medicine
and internet, how about let him produce a kind of special telemedicine
session (ex; panel talk, comparisons of medical source web, technical consultation......)

Best regards,
Shin Takuma, MD
Columbia University
Department of Medicine
TEL: 212-305-9875 or 0594
FAX: 212-305-9049
****************************************
ATTACHMENT II

From: "Frank Govern" <fg36q@nih.gov>
To: "Takeshi Utsumi" <utsumi@columbia.edu>
Subject: Our Meeting Yesterday
Date: Fri, 7 Jan 2000 08:26:14 -0500

I was very pleased to meet with you and to hear of the similarities between
our telemedicine goals and objectives. I look forward to working with you
in the future for the betterment of cancer research and care around the world.

Frank S. Govern, M.B.A., Ph.D.; Special Advisor for Institutional
Outreach to the Dir.,Div. of Clinical Sciences;
Deputy Dir., Radiation Oncology Sciences Program
National Cancer Institute
Building 10. Room B3B69
9000 Rockville Pike
Bethesda, MD 20892

Voice-301-496-5457
Fax-301-480-5439
Beeper - 301-496-4567 then 5460 then return number
Portable Phone: 301-257-6964
****************************************
ATTACHMENT III

Date: Fri, 7 Jan 2000 13:04:45 -0500
To: utsumi@columbia.edu
From: "Kenneth M. Kempner" <kempner@helix.nih.gov>
Subject: Your Visit to the NIH
Cc: fg36q@nih.gov, cmacedonia@aol.com

Dear Dr. Utsumi,

My colleagues and I were very pleased to meet with you yesterday afternoon,
and we enjoyed the active discussion about our common interests. Hopefully
we will be able to work together on an international telemedicine
collaboration in the near future.

Please have a pleasant journey to your meeting in Geneva next week, and we
would like to be in contact with you when you return to the United States.
We would also like you to describe our TELESYNERGY System to your
colleagues, if it is appropriate for the topic being discussed.

The TELESYNERGY System is described on the following web site:
http://www-dcs.nci.nih.gov/branches/rosp/index.html

The National Cancer Institute's new "Partnership in Science Program",
provides institutional outreach to distant hospitals that wish to
participate in NIH Clinical Trials. The TELESYNERGY System is the official
medical consultation platform which links institutions that participate in
this program. The "Partnership in Science Program" is described on the
following web site:
http://www-dcs.nci.nih.gov/branches/rosp/partnersci.html

The NCI All Ireland Cancer Conference was held October 3-6, 1999. The
TELESYNERGY System was transported to this conference and demonstrated via
a dial-up ISDN PRI circuit to the NIH Clinical Center in Bethesda. See the
following Web site for detailed information about this conference:
http://www.allirelandcancer.com/

For further technical information about the initial version of our
TELESYNERGY Medical Consultation WorkStation (MCWS), see the following web
site: http://imcs.cit.nih.gov/publications/spie97/

Thank you for your interest in our medical consultation activities here in
Bethesda, and we are looking forward to meeting with you again soon.

Best Wishes,

Ken

_________________________________________________________

Sent by Kenneth M. Kempner
Chief, Image Management and
Communication Section
Computational Bioscience and
Engineering Laboratory
Center for Information Technology
National Institutes of Health
Building 12A, Room 2019
12 South Drive MSC 5624
Bethesda, MD 20892-5624 USA
E-mail: kempner@helix.nih.gov
Tel: (301) 496-9344
Fax: (301) 402-2867
****************************************
ATTACHMENT IV

From: Price Penelope <pprice@adbi.org>
To: "'utsumi@columbia.edu'" <utsumi@columbia.edu>
Cc: Morrison Terrence <tmorrison@adbi.org>
Subject: sponsorships for the Finland conference
Date: Fri, 11 Jun 1999 19:16:04 +0900

Dear Dr. Utsumi:

it was a pleasure to meet you recently in Tokyo.

As I suggested, perhaps you will be able to have sponsors
through the many Filipino chambers of commerce and Filipino
organizations based abroad.

This is a web site that lists Filipino-American professional
organizations in the States - perhaps this will be a source of
sponsorship? http://www.phil-net.com/nprof.htm .From this site there may
be useful links to other potential sponsors.

Kind regards

penelope price
****************************************
ATTACHMENT V

From: "Ed Dodds" <dodds@home.com>
To: <utsumi@columbia.edu>
Subject: TELEHEALTH ACROSS THE PACIFIC
Date: Wed, 5 Jan 2000 08:23:55 -0600

http://www.healthcare-informatics.com/issues/2000/01_00/international.htm

Tak:

Saw this article. Note the calendar at the bottom. Is anyone allowed to send
to the gu-l@www.friends-partners.org listserv if they have a "tip"?

Ed Dodds
========================================

Excerpt from
<http://www.healthcare-informatics.com/issues/2000/01_00/international.htm>

Healthcare Informatics Online International

January 2000 - Healthcare Informatics

--------------------------------------------------

TELEHEALTH ACROSS THE PACIFIC

by G. Berton Latamore

After four years of beating impossible odds the
Tripler Army Hospital in Hawaii is delivering
advanced medical support through more than 30
separate telemedicine projects known as Akamai.
These projects deliver everything from tumor
diagnoses to medical care for isolated medical
corpsmen needing appendectomies.

The venture began in 1995 when Congress challenged
the Pacific Regional Program Office (PRPO),
headquartered at Tripler Army Hospital in Hawaii,
to develop a telemedicine system to support the
entire Pacific basin. This area encompasses 52
percent of the earth's surface, many isolated
islands, and Navy and Coast Guard ships at sea.

Tripler is the only federal tertiary medical
facility in the Pacific Region and provides
advanced medical support for 750,000 federally
eligible individuals--including members of the
three military services plus the Coast Guard, U.S.
veterans and groups from the former Pacific Trust
territories. The PRPO runs more than 20 separate
telemedicine projects, including Akamai, and it
has learned how to design a successful
system--despite the challenges.

Choppy waters
The Pacific region is the ultimate test for
telemedicine. Besides the large area it covers,
five of the seven largest armies on earth are
located here. While the beneficiary population in
the Pacific region is predominantly U.S. citizens,
they are scattered over a number of nations
including the Federated States of Micronesia, the
Republic of Palau, the Commonwealth of the
Northern Marianas Islands, the Marshall Islands,
Korea, Japan and the U.S. flag territories of the
Marshall Islands and Guam.

The medical communities involved in the Akamai
telemedicine project range from the large military
hospitals in South Korea and Japan to some of the
most isolated communities on earth, such as Diego
Garcia Island in the Indian Ocean and U.S. Navy,
Army and Coast Guard vessels at sea. To compound
the difficulties of developing telemedicine
systems in this area, the Pacific region also
experiences 60 percent of the earth's natural
disasters, including tsunamis, hurricanes,
typhoons, volcanic eruptions and earthquakes.

The only communications links to most of this area
are satellite systems that carry large amounts of
other traffic, leaving limited bandwidth for
telemedicine. Air transportation is minimal--even
the larger of the Pacific islands see just three
commercial flights a week--making equipment
delivery a challenge and patient evacuation often
impossible.

Further, some of these locations do not have a
medical doctor. A ship or small military site may
only have a medical corpsman, or a small island
may only have a nurse. Also, the time zone
problems can be tremendous in a region that
crosses the international dateline. Some of the
sites in the Micronesian Republic, for instance,
have about 10 hours per week of business time that
overlap with Hawaii.

Traffic trouble
"When we first thought about telemedicine we
looked at videoconferencing," says F. Craig Floro,
program director for Akamai. He picked Kwajalein
Atoll in the South Pacific as the first remote
site because it contained a missile and space
tracking site and had a dedicated communications
satellite, providing a lot of bandwidth. It also
had teleconferencing equipment.

The doctors at Tripler were initially
uncomfortable diagnosing patients 1,000 miles
away, but that first project provided a good
experience. The doctors did hundreds of
consultations with clinicians in more than 30
different specialties. "It was amazing to see how
these doctors, who were apprehensive at first,
relaxed as the patients were presented," Floro
says.

But after two years, traffic began to drop off.
Clinicians had trouble making appointments across
the time zones, which allowed about 18 hours of
overlapping work time per week. On both sides, the
consultation required that physicians interrupt
their rounds to go to the videoconferencing
studio. Often the referrals were not emergency
cases, so the clinicians put them off. Also, the
videoconferencing equipment did not always deliver
a sufficient image quality. As a result, the
specialist at Tripler was uncomfortable making a
diagnosis.

Another reason for the drop off, however, was that
the system succeeded in teaching the doctors at
Kwajalein to make their own preliminary diagnoses.
In dermatology cases, for example, physicians
learned to recognize which lesions required a
biopsy, so instead of scheduling a videoconference
they simply ordered the tests and faxed the
results to Tripler.

The videoconferencing system was more successful
in cases where real-time consultation was
required. For instance, a cardiologist could talk
a technician through the process of administering
an echo cardiogram, get the reading from it
immediately and render a diagnosis.

E-mail in a bottle
Ultimately, videoconferencing was not practical
for most of the sites the PRPO needed to reach.
The equipment was too expensive and the bandwidth
and technical personnel were not available to
support it. Instead Akamai turned to the Defense
Switching Network and the Internet. Of the 30
separate telemedicine projects it now runs, more
than half use Internet e-mail to ship data and
medical images to Tripler and receive back
diagnoses, says Robert Whitton, PRPO clinical
project manager.

Bandwidth limitations forced the choice of
multimedia e-mail, but it soon proved superior in
other ways. E-mail eliminated time zone problems
and interruptions, allowing clinicians at both
ends to work during their normal hours. Also, it
was easy for clinicians to use and it delivered a
great deal of information, including high-quality
medical images, directly to the clinician's
desktop. Instead of operating at peak hours,
e-mail took advantage of the time zones and
dateline to allow transmissions when people in
either Hawaii or Asia were asleep and bandwidth
demand across the Pacific was lower.

Clinicians in the Pacific were early users of the
Internet and so were familiar with the technology.
Because of their isolation, they use it for
everything from purchasing personal items to
continuing education. "The choice of e-mail was
not something our technical people came up with,"
says Floro. "It was something the clinicians
started. We got involved when one of our doctors
received an e-mail with an attachment in MIME
format he could not open and came to us for help."
The e-mail was from a doctor in Micronesia who
used a digital camera to take a picture of a huge
melanoma on a child's cheek.

"We are replicating the phone call," says Floro.
"Physicians do phone calls to consultants from
their desks. Our 'phone calls' can carry clinical
images and data and can reach several people, but
they are all done from the desktop when it is
convenient for the clinicians at both ends."

But Akamai's physicians sometimes literally used
telephones. One of the early projects involved
connecting providers on the islands of the
Federated States of Micronesia using Picasso, an
AT&T telephone that could capture and transmit
digital images. After several months, the calls to
Tripler dropped off. "When we investigated, we
discovered that the medical officers were tapping
expertise they found among themselves," said Tony
Gelish, program director of the Pacific Medical
Network (PACMEDNET), a part of the PRPO. "For
instance, they discovered that one of their
members had expertise in dermatology, so instead
of contacting us, they referred their dermatology
cases to him. They were doing grand rounds through
the islands over the system."

Today Picasso has been replaced by the Internet,
but the island medics still pool their expertise
to do electronic grand rounds and only contact
Tripler when they have a case that is outside
their collective expertise.

Bandwidth on the run
Shipboard medical support in the Pacific depends
heavily on how much bandwidth the ship's captain
is willing to release for telemedicine. Akamai's
experience is that when a problem arises, captains
are more than willing to provide the bandwidth.
They know the system will help their corpsmen
provide better treatment to a crewman in an
emergency, and they also have a financial
incentive.

"I recently talked with a medical officer on a
nuclear carrier that had just returned from a
six-month deployment in the Western Pacific," says
Gelish. "He estimated that telemedicine helped
them avoid 20 to 30 air medical evacuations during
that tour."

Those evacuations are very expensive because they
are unscheduled air launches. The carrier has to
turn into the wind to launch the plane, which
means the entire fleet has to turn into the wind.
Just the fuel expense for turning a fleet 10
degrees is measured in the thousands of dollars.
At least a carrier can launch a medical
evacuation, however. Other ships and small islands
cannot.

Army transport ships routinely carry army units
between Hawaii and Korea, at which time they are
outside the range of medical helicopters for 20
days. If someone develops a medical problem that
the corpsman on board cannot handle, all they can
do is stabilize the patient and head for the
nearest medical facility as quickly as possible.
With telemedicine, a surgeon could talk a corpsman
through an appendectomy in an emergency and
possibly save a life.

Sharing the wealth
Information transfer to civilian medical
facilities interested in telemedicine has been
part of the Akamai plan from its inception. This
year the Akamai team hopes to start an aggressive
information transfer program to distribute the
knowledge they have developed. One of the first
clients is likely to be a civilian hospital in
Hawaii interested in developing a telemedicine
program to provide support for cruise ships.

However, the PRPO makes constant efforts to
provide the benefits of its experience in
telemedicine to a wider audience. Team members
present their stories at major conferences such as
HIMSS. They also are willing to provide private
presentations to institutions if they happen to be
in the area on business.

For further information, visit the PRPO Web site
at http://www.prpo.tamc.amedd.army.mil.

G. Berton Latamore is a healthcare technology
writer based in Alexandria, Va.

-------------------------

Pointers from the Pacific

HERE ARE SOME RULES FOR CREATING A successful
telemedicine project, based on the experience of
the Pacific Regional Program Office (PRPO):

1. Before starting a project, do a needs
assessment to determine whether a technological
answer is appropriate. PRPO turned down one
project request when initial analysis showed that
the problem presented would be best solved by
hiring a filing clerk.

2. Do not be seduced by the latest and greatest,
or the fanciest and most expensive. Always look
first at the simplest, least expensive solutions.
Only look at expensive answers such as
teleconferencing when simpler solutions such as
e-mail are clearly not sufficient.

3. The mantra for a successful project is
"research, prototype, demonstrate, validate."

4. Develop clinical champions. Clinicians
inexperienced in telemedicine will be apprehensive
about participating, since none of the accrediting
bodies deal with telemedicine and it is not taught
in the medical schools. Clinical champions can
break down those barriers and help their
colleagues become comfortable with the process.

5. Make the system convenient for clinicians at
both ends. Systems that interrupt the routines of
busy clinicians discourage them from using
telemedicine.

6. Finally, understand from the start that you may
not be able to address all medical problems.
Emergency medicine, in particular, is
unpredictable and demands instant response from a
team of specialists. It is not appropriate for
telemedicine.

--G.L.

--------------------------------------------------

INTERNATIONAL CALENDAR OF EVENTS

February 3-4, RACGP 10th Computer Conference,
Sydney Convention Centre, Darling Harbour,
Australia. Royal Australian College of General
Practitioners (RACGP):
http://www.racgp.org.au/conference/10cc/index.htm.

February 17-18, The Fifth International Making
Medical Informatics Work Conference, Manchester,
UK. The British Medical Informatics Society: 0161
247 1490, mmiw@meridian74.freeserve.co.uk.

March 20-22, HC2000: Conference & Exhibition,
Harrogate, England. The British Computer Society
Health Informatics Committee: +44 0 1886 833868,
judy@amiconf.demon.co.uk.

March 22-24, World Conference on Telemedicine,
Toulouse, France. European Telemedicine Institute:
europa@europa-organisation.com.

April 28-May 3, 7th International Symposium and
Working Conference on Nursing Informatics, Aotea
Centre, Auckland, New Zealand. Nursing Informatics
New Zealand (NINZ):
http://www.2000plus.co.nz/Nursing.htm.

June 21-24, Security of the Distributed Electronic
Patient Record, Victoria, Canada. International
Medical Informatics Association Working Group 4
(IMIA WG4): +31 (0) 7136 21984,
http://hinf.uvic.ca/imia_wg4.

June 24-27, INFOcus 2000, Vancouver Trade and
Convention Centre. Canada's Health Informatics
Association (COACH): (403) 489-4553,
coach@v-wave.com, http://www.coachorg.com.

August 23-27, ITCH 2000: An International
Conference Addressing Information Technology In
Community Health, University of Victoria, British
Columbia, Canada. School of Health Information
Science: (250) 721-8576, his@hsd.uvic.ca.

September 1-3, Telehealth Kuala Lumpur 2000, Kuala
Lumpur, Malaysia. Malaysian Health Informatics
Association (MHIA): 603 6167788,
jmohan@pc.jaring.my.

September 13-16, 3rd Nordic Congress on
Telemedicine, Copenhagen, Denmark. Nordic Council
of Ministers: +45 35 45 22 25, dahms@rh.dk.

September 21-23, EuroPACS 2000, Graz, Austria.
Institute of Medical Informatics (IMI): ++43 316
385 3590,
http://www.kfunigraz.ac.at/imiwww/europacs.

September 28-29, APAMI-MIC 2000: Hong Kong China
IT and Health in the 21st Century, Hong Kong
Convention Centre. Asia Pacific Association for
Medical Informatics (APAMI):
apami.mic2000@ha.org.hk.

--------------------------------------------------

NEWS BRIEFS

Singapore and Argentina Investigate Telemedicine
A live telemedicine event between Singapore's
National University Hospital and Argentina's
Santojanni University Hospital, Buenos Aires, took
place in November. This marked the first
telemedicine project between the two countries
since Singapore's Prime Minister Goh Chok Tong
visited Argentina earlier last year. As a result
of his visit, Goh is encouraging all of
Singapore's hospitals to establish telemedicine
links with their Argentinean counterparts.

The event that took place in November focused on a
minimally invasive surgery and was witnessed by
Singapore's Parliamentary Secretary (Prime
Minister's Office and Health) Chan Soo Sen.

Strategic Alliance for Round-the-Clock Service
Healthcare e-business company, The TriZetto Group,
Newport Beach, Calif., last fall formed a
strategic alliance with RHE Associates, Aukland,
New Zealand. This partnership, which involves
companies on opposite sides of the world, will
provide TriZetto's HealthWeb customers with
24-hour customer service. HealthWeb is a
healthcare business portal. RHE, a provider of
systems integration and other healthcare IT
services in New Zealand and Australia, will also
help TriZetto add customized features to its
portal, as requested by customers.

Partnering North of the Border
Two videoconferencing companies will narrow the
market in the United States and in Canada when
they join forces. V-SPAN, King of Prussia, Pa., in
October announced its intent to acquire Vector
Videoconferencing, Toronto. This acquisition,
creating a company called V-SPAN Canada LTD, will
broaden V-SPAN's geographic coverage, making it
the largest privately-held videoconferencing
network management company in both the United
States and Canada. V-SPAN also specializes in
broadband gateway services.

-------------------------
****************************************
ATTACHMENT VI

From: skip@website.tamc.amedd.army.mil
Subject: Re: UN's peace keeping distance learning program
To: Tak Utsumi <utsumi@www.friends-partners.org>
Date: Sun, 14 Nov 1999 05:19:01 GMT

Dear Tak:
Thank you for the e-mail message. Very interesting. Where would you
like to go with this and what do you see the role of the Center of
Excellence? Looking forward to hearing from you.
Regards,
Skip Burkle
****************************************
List of Distribution

Shin Takuma, M.D.
Cardiology Division
Columbia Presbyterian Medical Center
Department of Medicine
College of Physicians & Surgeons
Columbia University
630 West 168th street
New York, NY 10032-10391
USA
Tel: +1-212-305-9875
Fax: +1-212-305-9049
st245@columbia.edu

Clarito Dimayuga, MD
dimen426@worldnet.att.net

Frank S. Govern, M.B.A., Ph.D.
Special Advisor for Institutional Outreach to the Director
Deputy Director, Radiation Oncology Science Program
Division of Clinical Sciences (DCS)
National Cancer Institute
Building 10, Room B3-B69
9000 Rockville Pike
Bethesda, MD 20892-1002
301-496-5457
Fax: 301-480-5439
Beeper - 301-496-4567 then 5460 then return number
Portable Phone: 301-257-6964
fg36q@nih.gov

Kenneth M. Kempner
Chief, Image Management and Communication Section
Computational Bioscience and Engineering Laboratory
Division of Computer Research and Technology
Center for Information Technology
National Cancer Institute
National Institutes of Health
Building 12A, Room 2019
12 South Drive MSC 5624
Bethesda, MD 20892-5624 USA
301-496-9344
Fax: (301) 402-2867
kempner@helix.nih.gov
http://www.nih.gov/welcome/maps.html

Maj. Christian Macedonia, MD
Guest Researcher, NIH-CIT
Major, US Army Medical Corps
Staff Maternal-Fetal Medicine Specialist
Prenatal Assessment Center
National Naval Medical Center
and the Uniformed Services University of the Health Sciences (USUHS)
8901 Wisconsin Avenue
Bethesda, MD 20889-5600
301-319-5050
pager 888-470-4287
Fax: 301-319-5047
cmacedonia@aol.com
cmacedonia@mxa.usuhs.mil
www.usuhs.mil
http://cbel.cit.nih.gov/~macedonc/

Edward Dodds
Association for the Development of Religious Information Systems (ADRIS)
PO Box 210735
Nashville TN 37221-0735
615-429-8744
Fax: 508-632-0370
dodds@home.com
http://members.home.com/dodds
www.ttalk.com

Arturo M. Pesigan, M.D.
Assistant to the Chancellor for Administraiton
University of the Philippines/Manila
625 Pedro Gil Street
Ermita, Manila 1000
Philippines
Tel: 632-526-5966
524-7102
Fax: 632-523-7745
Pager: 150-354071
artpesigan@yahoo.com
http://www.upou.edu.ph

Herman D. Tolentino, MD
Associate Professor
UP College of Medicine
Anesthesiology / Medical Informatics
Email: hermant@I-manila.com.ph
Web: http://www.veranda.com.ph/hermant

Rafael Bozeman Rodriguez, Ph.D.
#7 Visayas Avenue, VASRA
1128 Quezon City, Philippines
+632-524-7118
Cedllphone: 0918-880-2799
Pager: 1481-792171
Powerpage: 633-3333
rbrsat@pworld.net.ph
ralphrod@nsclub.net
paeling@mailcity.com

Ms. Penelope Price
Training & Learning Methods Specialist
Asia Development Bank Institute (ADB Institute)
Kasumigaseki Building 8F
3-2-5 Kasumigaseki
Chiyoda-ku, Tokyo 100-6008
JAPAN
+81-3-3593-5500 (General)
+81-3-3593-5506 (direct)
Fax: +81-3-3593-5571
pprice@adbi.org
http://www.adbi.org

Frederick M. Burkle, Jr., M.D., M.P.H., FAAP, FACEP
Director
Center of Excellence in Disaster Management & Humanitarian Assistance
A WHO Collaborating Center
1 Jarrett White Road (MCPA-DM)
Tripler Army Medical Center (AMC), HI 96859-5000
808-433-7035 (main #)
Fax: 808-433-1757
skip@website.tamc.amedd.army.mil
http://coe.tamc.amedd.army.mil
Or,
Professor of Pediatrics, Surgery & Public Health
Chair, Division of Emergency Medicine
John A. Burns School of Medicine
University of Hawaii

Victoria Garshnek, Ph.D.
Project Manager, AKAMAI Telemedicine Evaluation
Clinical Research Manager
Information Systems Support, Inc.
Pacific Regional Program Office
1 Jarrett White Road
Tripler Army Medical Center (AMC), HI 96859-5000
808-433-3600
Fax: 808-433-1920
Pager: 808-549-7835
74072.3104@compuserve.com
garshnek@mhpcc.edu
http://prpo.tamc.amedd.army.mil

Ms. Robin Hayden
Public Affair Officer
Center of Excellence in Disaster Management & Humanitarian Assistance
1 Jarrett White Road (MCPA-DM)
Tripler Army Medical Center (AMC), HI 96859-5000
808-433-1433
Fax: 808-433-1757
haydenr@website.tamc.amedd.army.mil
http://coe.tamc.amedd.army.mil

Mr. Myron Nordquist
Legislative Counsel
U.S. Senator Conrad Burns' Office
187 Dirksen Senate Building
Washington, D.C. 20510-2603
202-224-6808
Fax: 202-224-8594
Cell: 301-646-8153
myron_nordquist@burns.senate.gov
http://www.senate.gov/~burns/
804-924-7573 -- at the U. of VA.
Fax: 804-982-2622 -- at the U. of VA.

Ben I. Haraguchi
President
Foundation for the Support of the United Nations (FSUN)
809 United Nations Plaza, Suite 1200
New York, NY 10017
USA
Tel: +1-212-986 8114
Fax: +1-212-986 8131
bharaguchi@fsun.org
haragucb@aren+fox.com
http://www.fsun.org
**********************************************************************
* Takeshi Utsumi, Ph.D., P.E., Chairman, GLOSAS/USA *
* (GLObal Systems Analysis and Simulation Association in the U.S.A.) *
* Laureate of Lord Perry Award for Excellence in Distance Education *
* Founder of CAADE *
* (Consortium for Affordable and Accessible Distance Education) *
* President Emeritus and V.P. for Technology and Coordination of *
* Global University System (GUS) *
* 43-23 Colden Street, Flushing, NY 11355-3998, U.S.A. *
* Tel: 718-939-0928; Fax: 718-939-0656 (day time only--prefer email) *
* Email: utsumi@columbia.edu; Tax Exempt ID: 11-2999676 *
* http://www.friends-partners.org/GLOSAS/ *
**********************************************************************

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