The northeastern corner of Ontario — a vast area extending from just northeast of Wawa to Hudson Bay — has 51 hospitals and one permanent radiologist.

That’s why Northern Radiology (NORrad) was created seven years ago to allow nine of those hospitals to share digital diagnostic images such as X-rays and ultrasounds. Before NORrad, emergency-room physicians in remote communities with only limited diagnostic capabilities often had to ship patients out to larger centres.

Now 17 hospitals are tied in to NORrad, allowing a radiologist in Timmins and visiting specialists — known as locums — to read medical images remotely, which has greatly reduced the number of patients being transferred, says Guy Guindon, manager of NORrad’s medical imaging and cardiopulmonary department.

Especially in remote communities, that’s one big reason Canadian hospitals need to share medical images — something many still can’t do.

Picture archiving and communications systems (PACS) replace film with digital images, which must happen before hospitals can share them electronically.

The shift to PACS is nearly complete, says Mark Nenadovic, group director of programs for Canada Health Infoway, the federally funded non-profit organization promoting electronic health records across the country. But most are still limited to a single hospital or multi-site health-care organization.

Projects like NORrad have started breaking down those barriers across Canada.
Easier access to images

Another reason to share images is that patients don’t always visit the same hospital. If a Sydney, N.S., resident goes to Halifax to see a specialist, that specialist can look at any medical images taken of that patient in Sydney, says Sandra Cascadden, chief information and health transformation officer for the Nova Scotia Department of Health.

Images taken anywhere in the province are available because Nova Scotia is one of three provinces — the other two are neighbouring Prince Edward Island and Newfoundland — that have fully adopted diagnostic image sharing.

Alberta is well along with a similar system. More than 90 per cent of that province’s diagnostic images are digital, and all hospitals can share images within their health districts, according to Dan Sheplawy, executive director of Alberta Health and Wellness’s information systems delivery branch.

By the end of 2010, image-sharing will be possible between Alberta’s health districts.

British Columbia has image sharing in its Fraser and Interior health authorities and is working to extend it through the province.

The other provinces and territories are in various stages of implementation, Nenadovic says. Ontario and Quebec, the largest provinces with the most hospitals, each have some regional image-sharing projects but will not have provincewide sharing for at least a year.

Digital networks help to bridge staffing gaps at Canadian hospitals

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A wheelchair-mounted robotic arm controlled by thought alone has been created by scientists at the University of South Florida.

The device could give people with amytrophic lateral sclerosis (ALS) or full body paralysis the ability to perform simple day to day functions that would otherwise be impossible.

“We aren’t reading people’s thoughts,” said Redwan Alqasemi, a scientist at the University of South Florida who, along with Rajiv Dubey and Emanuel Donchin of USF, helped develop the software and hardware. “This is the first time a person with severe disabilities like ALS can perform daily activities for themselves.”

Over time, patients with ALS slowly lose control over their muscle movement, losing the ability to move their arms, legs and eventually all muscles except those around the eye. Patients with ALS have fully functional brains, but have no way to express their thoughts.

EEG scans offer one way for patients with ALS to communicate with the outside world. By fitting patients with a head cap equipped with electrodes and filled with an electrically conductive gel, scientists can monitor particular kinds of electrical impulses coursing through the brain.

In this case, the scientists monitor a particular brain wave called P300, so-called because it lasts about one-third of a second. Reading P300 waves is basically like reading a person’s thoughts, but only in the most coarse kind of way.

For the wheelchair-mounted robotic arm, the person in the wheelchair looks at directional arrows flashing across a small screen. When the arrow points in the direction that they want to go, their brain lights up on the EEG, and the wheelchair or robotic arm moves accordingly.

This doesn’t happen at the speed of thought, however. Turning the wheelchair or moving the robotic arm takes about seven seconds as the arrows cycle across the screen. The wheel chair or arm continues in that direction until it receives a new command.

The wheelchair or arm could move faster, but it might not move as accurately, said Alaqsemi. The next step for the USF scientists is to refine the model’s hardware and software, to increase speed and reliability while cutting down on weight.

“Every pound you take off the robotic arm is another pound of payload that can be lifted,” said Alqasemi.

Right now the robotic arm can lift about four pounds, about the weight of a gallon of milk. In the next version Alqasemi hopes to double the payload.

Lifting a door handle or moving a gallon of milk may seem like simple tasks, but according to Jonathan Wolpaw, who builds brain computer interfaces at the Wadsworth Center in New York, using thought-controlled devices is harder than simply just thinking.

“Our normal muscle movements require practiced skill and control,” said Walpaw. “Controlling brain activity is also a skill that requires practice.”

Reading P300 brain waves is a good system, argues Walpaw, because it doesn’t take a lot of practice to train the brain. With only one WMRA built so far and no current plans to commercialize the design, not many people will get the chance for their brain to learn the new skill. But when commercial models appear in several years, even slow brain computer interfaces could make the impossible, possible.

“It would allow patients with severe disabilities the ability to control their own environment and have some form of independent mobility,” said William Heetderks, Director of the National Institute of Biomedical Imaging and Bioengineering. “It would be very valuable to these individuals.”

Wheelchair arm controlled by thought alone

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Researchers have discovered human antibodies that neutralise not only H5N1 bird flu, but other strains of influenza as well. They now hope to develop them into life-saving treatments.

The antibodies — immune system proteins that attach to invaders such as viruses —also might be used to protect frontline workers and others at high risk in case a pandemic of flu broke out, the researchers said.

Several types

In tests on mice, the viruses neutralised several types of influenza A viruses, including the H5N1 avian influenza virus, the researchers reported in Sunday’s issue of the journal Nature Structural & Molecular Biology.

“We were surprised and actually delighted to find that these antibodies neutralised a majority of other influenza viruses, including the regular seasonal (H1N1 strain of) flu,” Robert Liddington of the Burnham Institute for Medical Research in La Jolla, California, told reporters in a telephone briefing.

Influenza is especially difficult to fight because it cloaks itself in lollipop-shaped proteins called hemagglutinin and neuraminidase, which mutate regularly.

Bird flu war could soon be won

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