Doctor, it hurts where I'm clicking. Telemedicine holds great promise as an innovative way to deliver medical services to remote locations using information technologies such as videoconferencing and image storage. More and more American hospitals are investing in telemedicine to open new patient markets, cut costs, and deliver expert services to a wider range of locations. But according to Huseyin Tanriverdi, a GSM information systems doctoral student, and Assistant Professor of Management Information Systems Suzanne Iacono, both at SMG's Systems Research Center, hospitals have a long way to go before they can realize the potential of telemedicine.

In a survey of 25 Boston-area hospitals and in case studies of 17 telemedicine applications in three world-renowned academic medical centers in Boston, Tanriverdi and Iacono found that only a few telemedicine applications -- teleradiology, internal medicine, and fetal telemedicine -- are used frequently to deliver care at a distance. The reason? The team found that hospitals are having trouble integrating telemedicine into their daily routines.

"For telemedicine to become regularly used at hospitals, its champions need to develop technically feasible, medically valid, economically sustainable, and institutionally supported applications," says Iacono. "Otherwise, we found that physicians won't often use telemedicine. Telemedicine's champions will have to go through intensive learning processes to meet these criteria." This learning can't be acquired outside of the hospital, they say. The solution lies in an investment of considerable educational effort in telemedicine within their own medical care settings.

Drug may decrease complications following heart surgery. Researchers at the Boston University Medical Center have developed a new method to inhibit a bodily response known as complement activation during open heart surgery, thus reducing the risk of postoperative complications that can prolong hospital stays, increase medical expenses, and impair recovery from surgery.

Complement activation -- an inflammatory response triggered by blood circulating through the heart-lung machine -- can lead to complications such as weight gain, decreased pulmonary and cardiac function, and irregularities in heartbeat. According to Dr. Harold Lazar, associate professor of cardiothoracic surgery at the School of Medicine, infusing a drug called soluble complement receptor type I (sCR1) effectively inhibits complement activation. The study appears in the April issue of the Annals of Thoracic Surgery.

"If you injure your knee, in a few minutes it becomes swollen and tender, an inflammatory response caused by complement activation," says Lazar. "When patients are placed on the heart-lung machine -- even if they are having minimally invasive surgery -- the increased inflammatory response due to complement activation results in this swelling and inflammation throughout the body. Our study shows that sCR1 can block complement activation and decrease its detrimental effects on heart function. Ultimately this will lead to fewer postoperative complications, shorter hospital stays, and a faster recovery from surgery."

Lazar is hopeful that these positive experimental results will lead to FDA approval to use sCR1 -- developed by T-Cell Sciences in Needham, Mass. -- in clinical trials in patients undergoing open heart surgery. "We may now have a novel approach to eliminating, or at least containing, the problem of complement activation during open heart surgery and the harmful effects of the inflammatory response that accompanies it," he notes.