<<May 12, 2000>>

Edward Dodds <dodds@home.com>

Rafael Bozeman Rodriguez <rbrsat@pworld.net.ph>

Prof. Jose Brenes Andre <jbrenes@cariari.ucr.ac.cr>

Roger Lee Boston <rboston@tenet.edu>

Dear Ed:

(1)  Many thanks for your msg (ATTACHMENT I).

     This is a very valuable info (ATTACHMENT II).  It does legitimize the
     direction of our telemedicine demonstrations at our workshops in Manaus and Manila, etc.

Dear Ralph:

(2)  Many thanks for your msg (ATTACHMENT III) in reply to my previous
     inquiry of the dates of Manila mini-workshop from October 29 (Sunday) to
     October 31 (Tuesday).

     You may print ATTACHMENT II and show to Dr. Arsenio Cantos - president
     of St. Luke's College of Medicine.

(3)  Pls also mention to him of the progress in Costa Rica as equipping all
     hospitals with telemed consulting capability with videoconferencing unit
     and high speed data telecom network (ATTACHMENT IV).

(4)  Man has to live with bread, too, so that it is quite all right to try to
     make money.  However, it is unfortunate that many people do not realize
     that the New Economy (such as the burgeoning one in the US) stems from the
     use of Internet, i.e., information and knowledge are the driving force
     of the new economy.  This means that, in order to make money, the first
     thing to do is to get the information and knowledge -- not the other way
     around. And since technology is advancing so rapidly, such acquiring of new
     information and knowledge (or, LEARNING) is the more urgent necessity --
     hence the need for distance learning!!

Dear Jose:

(5)  Congratulations for your advancement.

(6)  Hope you can view our Manaus session with a help from Roger Boston

(7)  Pls have a very fruitful and pleasant trip to Israel and Egypt.

Dear Electronic Colleagues:

(8)  Should you wish to view our Manaus telemed demo, videoconferencing and
     sessions, pls follow Roger's instruction and help.

Dear Roger:

(9)  Compared with your success NetMeeting demo with 56 Kbps dial-up modem
     during our Manaus GLH in October of 1998, you can have 256 Kbps line
     during your session on May 31st, according to Alex.  Therefore, I think
     you can do more than before.

(10) However, Alex told me that the conference room in June 1 and 2 has only
     33.8 Kbps dial-up modem.

     This speed may work out for audio, but not video or for downloading
     large files of photo in web, etc.

     Subsequently, I would suggest that you bring back-up copies of your web
     pages in CD-ROM.

     If you have done any NetMeeting via broadband Internet (as we did
     between Tampere and Montana last August), pls bring its video tape or
     CD-ROM, and show to audience as what they would be able to see when they
     will have broadband Internet.  This is very important item to encourage
     attendees to work toward the establishment of such broadband wireless
     and satellite Internet which is one of main thrust of our Global
     University System project.

Best, Tak
                          ATTACHMENT I

From: "Ed Dodds" <dodds@home.com>
To: <ken@kenradio.com>
Cc: "Tak Utsumi \(E-mail\)" <utsumi@columbia.edu>
Subject: The telemedicine movement took a giant leap forward yesterday
Date: Wed, 10 May 2000 07:47:48 -0500

Ed Dodds
ICQ 49457096
                         ATTACHMENT II

                          Excerpt from

Doctors go online with 2d opinions

Pact will expand overseas program

By Liz Kowalczyk, Globe Staff, 5/10/2000

[T]he telemedicine movement took a giant leap forward yesterday when a
Cambridge company and several Boston hospitals agreed to provide second
opinions for one of the world's largest insurers by reviewing patient records
on the Internet.

WorldCare Inc. of Cambridge signed the contract with American Life Insurance
Co., which will allow American Life's customers, for a fee, to seek electronic
second opinions from specialists at Massachusetts General Hospital, Brigham
and Women's Hospital, Dana-Farber Cancer Institute, and three other US hospitals.

It's illegal in this country for doctors to provide medical advice to out-of-state
patients over the Internet. But the telemedicine director for the Boston
hospitals said his doctors will not communicate directly with the patients,
all of whom live overseas. Instead, they will consult with their regular doctors.

''It's a question of doing it in a way that promotes the highest quality of
care and ethics,'' said Dr. Joseph Kvedar, director of telemedicine for
Partners HealthCare, the parent company of Massachusetts General and Brigham
and Women's.

''Some companies promote doctor-to-patient chats online,'' he said. ''To me,
that's offensive. What we're talking about is doctor-to-doctor.''

Critics of online care argue that it's inappropriate for doctors to advise and
conduct ongoing relationships with patients they've never met. And they say
that's particularly true when the doctor is not licensed in the patient's home
state, and therefore not subject to state standards and oversight.

Kvedar said that doctors charge WorldCare a fee, which he would not disclose,
for the consultations. But, he said, the program ''is not a revenue center for
us.'' WorldCare, founded in 1992, has helped arrange second opinions to more
than 10,000 patients and physicians.

The Partners hospitals have provided about 600 second opinions a year to
patients in 30 countries for WorldCare and other online organizations for
several years. The agreement with American Life is expected to significantly
expand the program and increase the number of countries where it's available.

It also will make the practice less expensive for the insured, who now pay
about $1,000 for a second opinion from a US hospital. American Life will
charge patients $5 per year for second-opinion coverage.

Of the 600 second opinions that Partners provides annually to overseas
patients, about 60 patients end up coming to one of the Boston hospitals for
treatment - which may be the real financial benefit.

''Our goal is to raise the standard of care around the world,'' Kvedar said.
But, he added, ''it does get our name out.''

American Life Insurance will provide the second opinions to patients in 16
countries in Latin American, the Middle East, and Eastern Europe. Using secure
digital technology and a private telecommunications network, WorldCare will
transmit medical records to the hospitals. Also participating are the
Cleveland Clinic Foundation, Duke University Health System, and Johns Hopkins

WorldCare's telemedicine coverage includes analysis of the patient's MRI, X-ray,
ultrasound, CT scan, and other radiology studies; analysis of pathology
slides; treatment plans recommended by a top subspecialist in the field; and a
conference call, if needed, between the attending doctor and US specialist.

This story ran on page D1 of the Boston Globe on 5/10/2000.
Copyright 2000 Globe Newspaper Company.
                         ATTACHMENT III

From: Ralph Rodriguez <ralphrod@nsclub.net>
To: "'utsumi@columbia.edu'" <utsumi@columbia.edu>
Subject: RE: Dates of workshop
Date: Fri, 12 May 2000 11:32:19 +0800

Dear Tak -
Sorry for this delay in answering you. I just got back from a national
annual conference of the Philippines Society for Microbiology this morning
(all night trip on a bus - took 10 hours). It was a very busy meeting and I
was actively participating. Anyway, about the dates for the mini-workshop
for telemedicine - I printed out a copy of your last lettter to me stating
the date of the meeting to Dr. Arsenio Cantos - president of St.  Luke's
College of Medicine and will have to see him if the date sounds all right
and if we can have  the active participation of the medical school. If he
approves of it I will immediately email you. Is that okay with you?

I will try to help as much as I can because I believe in what you are
doing. Others are in it for the money only and that is unfortunate. I will
personally go and speak with Dr. Cantos Monday, May 15, and will email you
as soon as I get a reply from him. May 14, Sunday, our second baatch of
medical students will be graduating and we will be there. Keep up with your
great work and may the Lord continue to bless you in the good you are doing.

With best wishes always,

                         ATTACHMENT IV

Date: Thu, 11 May 2000 16:16:02 -0600 (CST)
From: Jose Brenes <jbrenes@cariari.ucr.ac.cr>
To: rboston <rboston@tenet.edu>
cc: alex_mau@argo.com.br, utsumi@columbia.edu, daj@utk.edu,
        Jose Brenes <jbrenes@cariari.ucr.ac.cr>
Subject: Re:

On Thu, 11 May 2000, rboston wrote:

Dear Roger

Thanks a lot for your help

Let me brief you about what the status is down here

The governement program is halfway throygh, and now quite a few of Class A
and Class B hospitals have the equipment neecessary to do remote diagnostics.

ASt the end of this year it is expected that ALL hospitals in the country
will have such a capability. My understanding is that they all use VTEL,
and transmit at 128, or else at 384.

On account of the above I wanted to have the responsible for such a
program take a look at the VTEL signal of the telemed.

As for money we do not have much, but enough to pay the 1,5 hour hook via
Embratel, at 128. Problem is time frame now.

With respect to your offer wanted to tell you this

a= we have a 512 Kbps channel used for all the university
b= we have separate anthenas for down and uplinking.
c= at the time of the conference it is possible that some of my colleagues
may be downloading some megas, because they support several mirrors

In spite of that I am very willing to learn new stuff, and prepare my PC
for that purpose 400 MHtz, 132 M RAM, 6 GB of Hard disk, and all multimedia stuff.

Thus please advice as to how to proceed, and which soft I have to download
in order to receive signal.

I am now able to receive AO VIVO from embratel, with good continuity and resolution.

I will be leaving to Isarel May 13 and come back May 29, hence I will
barely have May 30 to be set. But what the heck. Let us try it.

Thanks again for your offer.


> Jose,
> If the problem has to do with your ability or cost  to RECEIVE the proceedings,
> I would find it trivial to TELECAST at any speed you can receive straight to our
> Houston Video Servers -- and you could stream it from there in RealVIDEO. If it
> is your VOICE that is needed in manaus, we do have options with the Firetalk and
> HearMe tools.
> Don't know what your internet capacity is there, but you might find that an
> attractive, ZERO cost option?  I am bringing that capability with me when I travel
> there and would like to see you be included.
> Let me know either way,
> I am sitting here not far from this screen, grading my way through final
> examination projects.
> Roger
> By the way did you see any of the images from China this most recent trip?
> I have them tucked away at http://www.teched.org, click "International
> Initiatives" -- may do something siliar for the event in Manaus.
                          ATTACHMENT V

Date: Thu, 11 May 2000 20:48:05 -0500
From: Roger Boston <rboston@tenet.edu>
To: Jose Brenes <jbrenes@cariari.ucr.ac.cr>
CC: alex_mau@argo.com.br, utsumi@columbia.edu, daj@utk.edu
Subject: Re:

Make sure you have good, recent copies of the following:

(1)  Real Player, Latest version, able to receive nice realaudio and realvideo
      ==> When you are ready I will transmit some live video for you to
              receive, see how it looks.

       ==> A small download now, and superb for two way talking PLUS
               remote control of the "group's" web browsers -- I was in room
               today with several speakers in Tiawan, sounding as if we were in the
               same physical room.

       ==> You have used before, does not actually need a download, just
               get your new machine familiar with it, same as we used last day
               of "Peace and Conflict" Webcast Series

All three can be obtained from our website:  http://www.teched.org, and then click
"Telecommunications" link, download from there.

Next week, early, we can verify that you can participate, and whebn I arrive in Brazil I
will work to piece together the other end.

                      List of Distribution

Edward Dodds
Association for the Development of Religious Information Systems (ADRIS)
PO Box 210735
Nashville TN 37221-0735
Fax: 508-632-0370

Rafael Bozeman Rodriguez, Ph.D.
Former President of Trinity College of Quezon City
#7 Visayas Avenue, VASRA
1128 Quezon City, Philippines
Cedllphone: 0918-880-2799
Pager: 1481-792171
Powerpage: 633-3333

Prof. Jose Brenes Andre
President of Consta Rica Fulbright Association
Escuela de Fisica
Universidad de Costa Rica
San Pedro
Tel: +506-207-5019
Fax: +506-225-5511

Roger Lee Boston
Rockwell Chair/Instructor
Distance Education/Technology Center
Houston Community College System
4310 Dunlavy Street
P.O.Box 7849
Houston, Texas 77006
Tel: +1-713-718 5224
Fax: +1-713-718 5301
boston_r@hccs.cc.tx.us (secondary)

* 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.               *
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