This allows surgeons to refine decision-making skills before ever operating on a real patient.

The augmented-reality system designed by Bajura et. al (1992), described above, could also be used for preplanning complex abdominal procedures, such as complex tumor resections. Liver masses, pancreatic pseudocysts, and edematous gallbladders could be viewed in three dimensions, making it easier to estimate size and interrelations with other abdominal organs and to plan and perform invasive procedures.

Telemedicine

Telemedicine is the technology that would allow physicians to interact directly from locations thousands of miles apart. They would be in the same virtual "room" when discussing a case or when performing a procedure and could refer, simultaneously, to paramedical data, reducing the likelihood that a miscommunication would occur, that information would be missed, or that results would be misdirected or lost.

The Medical College of Georgia in Augusta has developed and introduced the first stages of a statewide telemedicine system. The system uses interactive voice, video telecommunication, and biomedical telemetry to link rural health care facilities and primary care physicians with large medical centers. As a result, primary care physicians and their patients can consult with specialists without leaving their communities. In these consultations, the participants would see each other and share common diagnostic data and images. The idea also extends to providing remote assistance to surgeons in rural hospitals during surgery. According to Sanders and Tedesco (1993), the system will eventually have five hubs, each serving several clinics and rural facilities. Currently, a test is being conducted with one hub—the Medical College of Georgia—serving five sites. The ultimate goal is to deliver the quality health care available at major medical centers to all underserved areas in the state. Early results suggest that the proposed system, when fully developed, will not only make high-quality care more accessible but will also reduce costs. Telemedicine networks are also under development in Iowa, West Virginia, and Colorado.

Telesurgery

Developments are also under way in telesurgery. One example is the Green Telepresence system, created at SRI International (Palo Alto, Calif.) by Phillip Green. The system based on technology used by the National Aeronautics and Space Administration (NASA) for remote manipulation consists of a separate operative worksite and surgical workstation (Rosen



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