1) Brief introduction about you, your back ground and how you came to the Alaska Federal Health Care Access Network

I have attached my c.v. to this document in case you want a more complete background. Essentially, I began working in Biomedical Engineering in graduate school because of my intense interest in using my engineering skills in a medical setting. Between graduate school, my post-doctorate work, and my research associate positions, I worked in this field for almost 13 years. The latter part of that involved working in MCG (magnetocardiography), which is a fascinating field whereby cardiac activity is measured and interpreted by measuring the magnetic field generated by the heart.

My wife and I moved to American Samoa for 2 years, at which time I started a business devoted to a wide range of computer network and telecommunications issues, including the development of databases, network installations, training, etc. During this time, we began to recognize first-hand that telemedicine could have a significant effect in these distant locations. American Samoa is 2,500 miles south of Hawaii, and receives 2 planes per week from Hawaii. Telemedicine would help to bridge the gap both in terms of distance but also in terms of time between connecting flights when patient health is at risk.

We then moved to Alaska, where I pursued a position in a telemedicine project funded by the National Library of Medicine (NLM). I was hired as the Chief Information Officer for that project, and my duties included designing the hardware and software systems for that project, reviewing and evaluating all hardware and software options, installation and support of equipment, etc.

The AFHCAN project was founded on much of the success of the NLM project, and I moved into the same position (CIO) within the AFHCAN project after the NLM project was finished. I am now the Associate Director and also Director of Technology for the AFHCAN project, and work with the technology group in the project to develop the broad range of technologies specific to AFHCAN.

2) What is the Alaska Federal Health Care Access Network?

AFHCAN is a project of the Alaska Federal Health Care Partnership (AFHCP), a voluntary network of Alaska Federal health care providers consisting of the Indian Health Service, the Department of Defense, Department of Veteran's Affairs, and the U.S. Coast Guard. AFHCP was founded in 1996 to create efficiencies among Federal agencies providing health care in Alaska. The Alaska Native Tribal Health Consortium (ANTHC) currently manages AFHCAN.

3) How long as it been in existence, what is it goals and objectives?

The original proposal submitted to the U.S. Congress in 1998 to establish the AFHCAN Project proposed to extend and improve access to health care service and health information for Alaska's 200,000 federal beneficiaries through the adoption of a state wide telehealth system. The proposal focused on providing telehealth solutions at all IHS hospitals, health centers, and community health aide clinics, and U.S. Coast Guard, Department of Veteran Affairs, Department of Defense, and Department of Public Health Nursing facilities in the state. These solutions were based on the use of store and forward imaging, interactive video conferencing, and telehealth kiosks as mechanisms to improve health care and health care education. More recently, the scope of the project has broadened to include the development of a state wide telehealth network, and support for the Phase III teleradiology plan.

The mission of the Alaska Federal Health Care Access Network is "to improve access to health care for federal beneficiaries in Alaska through sustainable telehealth systems".

The vision is "235 federal and state health care sites in Alaska linked in a telehealth network." We will:
Create "needs based" solutions
Build flexible and scaleable systems
Build on existing capabilities
Utilize open architecture
Utilize "Off the Shelf," proven technology where possible
Ensure sustainability
Evaluate our solutions
Coordinate our efforts with all telehealth projects in Alaska

The project began receiving funds in FY99 (October 1st, 1998), and just began the second year (FY00).

4) How is it going so far and what role is Telehealth play in it?

This project is surprisingly complicated, partly because of the technologies and communication hurdles that have to be overcome, but because of the many varied partners involved in this project. The 235 project sites encompass 37 distinct member organizations: 1 site is the VA Medical Center, 4 sites are U.S. Coast Guard clinics, 9 sites are run by the U.S. Army and U.S. Air Force, 26 sites are Public Health Nursing Sites, and the remaining 195 sites are managed by 32 native health corporations. Designing a system that meets the needs of each site and each organization is a complex task.

The success of such a project requires active state wide discussion and decision making to formulate telehealth solutions that fulfil existing health needs, are flexible and scalable, and are sustainable. State wide advisory committees composed of staff from the 37 member organizations are used for this purpose, representing specialists in the following fields: Clinical, Training, Informatics, Technology and Business. The committees are very active, meeting regularly every month. Through these committees, we have evaluated and selected equipment for the project, designed a state wide communications network, and are currently working on assessment and evaluations plans, clinical forms and protocols, kiosk development, software design, and a host of other key issues.

We plan to begin deploying telehealth solutions to the first of the 235 sites in July 2000. We have an ambitious project time line, which is currently on schedule, that allows for 12 months to deploy appropriate technology and training to all 235 sites in Alaska. This first deployment will offer a specific list of choices that each member organization may opt to install: acquisition telemedicine stations with video otoscopes, digital cameras, EKG equipment and electronic forms; review stations for reviewing consults; a patient health education kiosk; and video teleconferencing equipment. The latter is being offered where the connectivity exists - the other equipment is designed to work over the worst POTS connection in Alaska.

5) What are you doing in Alaska with Telehealth so far and how has evolved?

The AFHCAN project plan has evolved in the last 12 months, and is significantly different from the original plan. A key decision was recognizing that many organizations had not participated in telemedicine, and need to be offered simpler telehealth solutions to begin a learning curve. Moreover, we have extensive experience with design of specific telehealth solutions for ear disease through the NLM project (I can send you a copy of several reports I generated regarding the NLM project), which is a key health issue in Alaska.

Consequently, the project plan now promotes a multiphase deployment, with the first deployment offering very specific choices based on know health priorities in Alaska (ear disease, dermatology, and cardiac care). A second deployment will follow this, offering technologies specifically tailored to regional health needs (e.g. EEG or retinal scans for diabetes screening).

The entire AFHCAN project may be viewed as a natural evolution of the earlier project funded by the NLM (NLM Contract # N01-LM-6-3540) to the University of Alaska Anchorage (UAA - Fred Pearce was the Principal Investigator). That project deployed equipment and training to 4 regional hospitals and 26 village clinics staffed by community health aides (CHAs). A CHA has a minimum requirement for reading and writing at the 6th grade level, and received up to 4 months of class training. The telehealth systems developed for that project is currently being used actively. One region, consisting of the regional hospital and 11 village clinics, conducts no less than 100 cases per month and has more than 1000 cases in the last 9 months. We are using the lessons learned from that project to design a significantly more simple, yet more robust, and technically more capable systems for the AFHCAN project.

6) To me Alaska seems like a perfect place for Telehealth, because of distance, remoteness and weather. What has been the reaction so far and what are some of the problems and success's?

Recognizing that the AFHCAN project has not deployed equipment to sites, I can speak more from experience in regards to the NLM project. That equipment has received universal support from the health aides, and state wide is used for over 200 cases every month. My favorite reaction is a health aide that, when asked what she thought about the equipment, said "It makes my guts flop". Many health aides wonder what they did before. Typically, health aides report many cases over the phone line to regional physicians who may be located 100 or more miles away at the regional hospital. This process, called "radio medical traffic" (RMT) for historical reasons, is the only link most health aides have with physicians. The ability to add an image to that conversation with simple "store and forward" technology cannot be overstated.

A major success being documented by the evaluation team on the NLM project (at UAA) is a significant decrease in the use of antibiotics following the introduction of telemedicine equipment. the CDC is reporting an added advantage in that a reduction in antibiotic usage also ties with a significant reduction in the antibiotic-resistant strains of bacteria.

We have a lot of anecdotal evidence from specific cases in the NLM project, indicating major improvements in the quality of health care delivery. A young girl that was reported as having "bruising" was later diagnosed using the telemedicine images as having "hemorrhaging", flown immediately to the regional hospital, received 6 units of blood and would certainly have died without the rapid response generated by the telemedicine system. Patients with severe wounds during harsh winter conditions were treated successfully by health aides who used the telemedicine system to receive guidance on closing the wounds. The wounds would otherwise have remained open for possibly several days until weather improved for airplane travel.

Major problems with the installation of telemedicine systems in Alaska continue to be related to problems with the telecommunications systems. Many of the sites have only poor telephone connectivity, attaining less than 2400 baud with intermittent connections. Some sites are now receiving T1 connectivity, but that is very expensive (about $12,000 per month to each site). Almost all sites employ satellite connections, because land lines simply do not exist to the vast majority of Alaska locations outside Anchorage, Fairbanks and Juneau. Satellite connectivity introduces delays and bandwidth constraints that have to be considered when designing systems. Consequently, we are designing a system that will work over the best and worst of connections. Image and video compression technologies are key to this project, but we also recognize that some capability simply cannot be made available at locations with 2400 baud connectivity.

We are also designing a state wide network for telehealth that will allow all member organizations to connect in a "seamless" and "secure" manner to all other health organizations. The core of this network is a series of scaleable routers co-located at the major carriers in Anchorage, to which the member organizations obtain either leased-lines or dial-up connectivity. This network has the potential to not only move health data but also video and voice, and offers many significant technological advances to the member organizations. Currently, the state wide Informatics committee has adopted a design specifications and we plan to build the network in the next quarter.

7) If you could look to the future in Alaska. what do you see as the legacy and the future of the Network and Telehealth in Alaska?

The legacy will be a sustainable, state wide network that improves the quality and access to health care for all Alaskans. The system currently being designed will allow any health care provider to participate, and allow health care organizations to control and manage the flow of their health information to best meet the needs of the customers (patients).

8) What have you learned and what would you tell readers about the Network and Telehealth?

I never feel free to tell anyone about telehealth, because a lot of our experience is unique to Alaska. That being said, a major goal that we strive to attain is to design a system that is not "telemedical" but is rather "medical". We expect that about 75% of our equipment funds will be spent on the medical equipment (video otoscopes, EKG hardware, etc) compared to 25% spent on computers, modems, keyboards, etc. Therefore, we are investing heavily in medical equipment that, by itself, provides a significantly better platform for diagnosis and treatment.

We believe any system we implement must allow the care provider to leverage these medical tools to maximum allowable usage. For example, a system that requires providers to logon then enter significant patient information before they can even begin to view ear images... is less likely to be used than a system that allows the provider to immediately view ear images. Our systems are being designed to allow the user to immediately grab relevant medical data within 2 mouse clicks of the initial screen with no keyboard input. Furthermore, we are deploying touchscreens to minimize the need for mouse or keyboard usage whatsoever. All in all, we are designing systems that are virtually "manual free", with a near-zero learning curve and hugely intuitive interface.

A significant advantage to a "medical" rather than "telemedical" approach is the constant use of the equipment. A major problem with systems that are only used for "telemedical" purposes is the rarity with which the equipment is used. Consequently, the user forgets the minor adjustments critical to diagnostic quality data (e.g. forgetting to focus, allow the light source to warm up, cleaning the lens or tip of the apparatus, etc.). Frequent use of any equipment is the best way to assure good quality data.

Obviously there is a wealth of lessons learned in the past deployment to 30 different sites. Don't deploy in an Alaska winter (we had trainers that could not leave the clinics due to polar bears being in town). Continually redesign the interface to make it simpler simpler simpler. Develop appropriate training materials. Always involve the end users in all aspects of the project, and actively seek input from all levels of care providers. Design a system that users want to use on every patient - not just the telemedicine cases. A simple system that works and is easy to use is worlds better than a complex system that is hard to understand. We have to remember that often 90% of the relevant clinical data is in the first good image, and the remaining 10% can be gleamed from the attached forms and the often redundant images. Systems should be designed to best grab that 90% of the data.

See, after saying I would not tell anyone about our lessons learned, I had to ramble for paragraphs.

9) Thanks for your time and you where can be reached for further information?

Stewart Ferguson, Ph.D.
Associate Project Director
Director of Technology
Alaska Federal Health Care Access Network

Alaska Federal Health Care Access Network
4201 Tudor Centre Dr., Suite 310
Anchorage, AK 99508
phone: (907) 729-2262
fax: (907) 729-2269
email: SFerguson@ANHB.org

Thanks,
Bob Pyke Jr.,RN,CPNP
Assistant Editor & Roving Reporter TelehealthNet News

A. STEWART FERGUSON
4327 Birch Run Dr., Anchorage, AK 99507
phone: 907-349-3423 email: FREEZE@ALASKA.NET

SUMMARY
Two and half years in the design, deployment, and support of telehealth systems in Alaska. Over twenty years of progressive computer and research experience in academic, industrial, biomedical and business environments. Owner/partner of two consulting firms specializing in custom software development, database design, and integrated network installation.

EDUCATION
1991 Ph.D. in Biomedical Engineering
Case Western Reserve University, Cleveland, OH
Doctoral Thesis: "Theoretical Calculations of Magnetic Fields Generated by Neural Currents"

1985 M.S. in Biomedical Engineering
Case Western Reserve University, Cleveland, OH
Masters Thesis: "Muscle Plasticity: Changes Due to Different Frequencies and Total Activity of Electrical Stimulation"

1981 B.S. in Electrical Engineering, summa cum laude
Bradley University, Peoria, IL

1981 B.S. in Mathematics, summa cum laude
Bradley University, Peoria, IL

EXPERIENCE
1999-present Chief Technology Officer, Alaska Federal Health Care Access Network (AFHCAN) Project, Alaska Native Health Board, Anchorage, Alaska. Direct all technical aspects related to the AFHCAN Project, whose mission and vision is to implement sustainable telehealth solutions at 235 sites in Alaska. Supervise a staff of 4 technical personnel responsible for all technical research and design, including the design of a state wide telehealth network, design of state wide "store and forward" and "live video conferencing" systems, selection of medical-grade and computer hardware, development of a "virtual operating environment", and design of a telehealth kiosk. Currently serving as Acting Project Director.

1997-1999 Chief Technology Officer, Alaska Telemedicine Testbed Project, Alaska Native Health Board, Anchorage, Alaska. Designed and installed a telemedicine system serving 26 remote Alaska village health clinics and 4 regional hospitals. Reviewed and selected medical equipment (video otoscopes, digital cameras), developed and customized software, installed and maintained hardware and software.

1991-1998 Owner, Founder, Large Pond Networks, Pago Pago, American Samoa. A consulting firm located in American Samoa specializing in developing MIS (Management Information Systems) and providing network installation and training. Clients include Port Administration, Customs and Excise Division, High Court, District Court, Department of Education, Department of Human Resources, Special Education, Environmental Protection Agency, and local airlines.

1995-1997 Co-founder, Partner, Abort, Retry, Fail, Inc., Cleveland, OH. Corporation specializing in networking and custom software development for DOS and MAC based computers.

1990-1996 Post-Doctoral Fellow and Research Associate, Physics Department, Dalhousie University, Halifax, Nova Scotia, Canada. Collaborated with Dr. Gerhard Stroink in Biomagnetic Imaging of Cardiac Activity. Developed new theoretical approaches to applying the Boundary Element Method (BEM) to solving the "inverse" problem in Biomagnetism. Developed algorithms and software to improve the stability, accuracy, computational speed and clinical viability of inverse solutions.

1984-1991 System Manager, Applied Neural Control Laboratory, Case Western Reserve University, Cleveland, OH. Maintained software and hardware for a mixed network of 25 DOS and MAC based computers. Involved in decision making for purchasing software and hardware.

1984-1991 Computer Programmer and Consultant, Cleveland, OH. Custom programming for private, academic and industrial clients.

Membership
American Telemedicine Association
Honors and Awards
Elected as "One of Cleveland's 89 Most Interesting People", Cleveland Magazine, 1989
NIH Fellowship to attend workshop on supercomputer applications in biomedical research at the Pittsburgh Supercomputer Center, 1988.
Co-Winner, Advanced Category, Research Day Presentation Contest, 1988
Recipient of first "Outstanding Resident Director Award", Case Western Reserve University, 1986
NIH Training Grant for graduate studies in Biomedical Engineering, 1981-1985.
Winner, Intermediate Category, Research Day Presentation Contest, 1984
Tau Beta Phi honor society, 1981
Eta Kappa Nu honor society, 1981
National Scholarship winner, Instrument Society of America, 1976

PUBLICATIONS - Abstracts, presentations
Ferguson, A.S., R. Rawls and F.W. Pearce. "Successful Solutions to Information Flow and User Interface Issues Affecting Telemedicine in Alaska". Abstract and presentation presented at 4th Annual Conference of the American Telemedicine Association, Salt Lake City, Utah, 1999.

R. Rawls, D. Statz, A.S. Ferguson, F.W. Pearce and H. Hammond. "The Impact of Store and Forward Telemedicine Systems on the Treatment of Ear Disease in Rural Alaska". Abstract and presentation presented at 4th Annual Conference of the American Telemedicine Association, Salt Lake City, Utah, 1999.

Ferguson, A.S., F.W. Pearce, R. Rawls, M. Terry and K. Boucha-Roberts. "Narrow Bandwidth Solutions for Telemedicine and Telehealth in Alaska". Abstract and presentation presented at 3rd Annual Conference of the American Telemedicine Association, Orlando, Florida, 1998.

Ferguson, A.S., D. Vardy, R. Hren and G. Stroink. "A Regularized Minimum Norm Method for Calculating Distributions of Source Currents on Epicardial Surfaces". Abstract and poster presented at 9th International Conference on Biomagnetism, Vienna, Austria, 1993.

Hren, R., D. Vardy, R. Miller, A.S. Ferguson and G. Stroink. "Approximation of Torso Geometries by Surface Harmonic Expansion". Abstract and poster presented at 9th International Conference on Biomagnetism, Vienna, Austria, 1993.

Stroink, G., A.S. Ferguson, R. Lamothe, D. Vardy, M. Gardner, B. Miller. "Imaging Cardiac Function Using Magnetic Field and Body Surface Potential Maps". Abstract and presentation presented at Cardiovascular Science and Technology Conference, Association for the Advancement of Medical Instrumentation, Washington DC, 1993.

Zhang, X., A.S. Ferguson and G. Stroink. "A Node-Based Boundary Element Method to Calculate the Continuous Variation of Cardiac Potentials Over a Closed Surface". Poster only (no abstract) for 14th Annual IEEE-EMBS Conference, Paris, France, 1992.

Ferguson, A.S. and D. Durand. "A New Approach to Modelling Current Sources: Theory and Applications". Abstract and poster at 8th International Conference on Biomagnetism, Munster, Germany, 1991.

Nagarajan, S.S., D. Durand, A.S. Ferguson and E.N. Warman. "Magnetic Stimulation of Finite Neuronal Structures". Paper and presentation for 13th Annual IEEE-EMBS Conference, Orlando, 1991.

Hill, M.R.S., O.J. Prohaska and A.S. Ferguson. "Evaluation of a Chamber-Type Microelectrode for Intracortical Stimulation". Poster for 4th Annual Applied Neural Control Research Day, Cleveland, 1989.

Dalbasti, T., D. Durand and A.S. Ferguson. "Induced Electric Fields by Magnetic Stimulation". Poster for 4th Annual Applied Neural Control Research Day, Cleveland, 1989.

Ferguson, A.S. and D. Durand. "Magnetic Fields of Current Monopoles". Abstract and poster at 7th International Conference on Biomagnetism, New York City, 1989.

PUBLICATIONS - Abstracts, presentations (continued) Hill, M.R.S., A.S. Ferguson, and O.J. Prohaska. "Chambered versus Unchambered Thin-Film Microelectrodes". Poster and presentation for BME Research Day, Dept. Biomed. Eng., Case Western Reserve University, Cleveland, 1989.

D. Durand, and A.S. Ferguson. "Induced Electric Fields by Magnetic Stimulation in Conducting Media". Abstract for 3rd Vienna International Workshop on Functional Electrostimulation, Vienna, Austria, 1989.

Hill, M.R.S., A.S. Ferguson, and O.J. Prohaska. "Stimulation Efficacy of Chamber-Type, Thin-Film Microelectrodes". Paper and presentation for 11th Annual IEEE-EMBS Conference, Seattle, 1989.

D. Durand, A.S. Ferguson, and T. Dalbasti. "Induced Electric Fields by Magnetic Stimulation in Non-Homogeneous Conducting Media". Abstract for 11th Annual IEEE-EMBS Conference, Seattle, 1989.

Ferguson, A.S. and D. Durand. "Design of a Room Temperature Magnetic Field Sensor". First place poster in the Advanced group at BME Research Day, Dept. Biomed. Eng., Case Western Reserve University, Cleveland, 1988.

Ferguson, A.S. and D. Durand. "Finite Difference Modelling of Neuronal Potentials and Current Densities". Poster for 3rd Annual Applied Neural Control Research Day, Cleveland, 1988.

Sweeney, J.D., J.T. Mortimer, D.R. Bodner, and A.S. Ferguson. "Collision Block of Motor Activity in Peripheral Nerve". Abstract at World Congress on Medical Physics and Biomedical Engineering, San Antonio, Texas, 1988.

Mortimer, J.T., J.D. Sweeney, D.R. Bodner and A.S. Ferguson. "An Implantable Cuff Electrode for Collision Block of Pudendal Nerve Motor Activity". Invited paper and presentation for 10th Annual IEEE-EMBS Conference, New Orleans, 1988.

Durand, D., A.S. Ferguson, and J.D. Sweeney. "Finite Differences Modelling of Neuronal Activity". Presentation at ACEMB 1987 Conference, Niagara Falls, 1987.

Ferguson, A.S., and D. Durand. "Finite Difference Modelling of Neuronal Potentials and Current Densities". Soc. Neurosci. Abstr., Vol. 12, p. 851, 1986.

Ferguson, A.S. "Muscle Plasticity: Changes Due to Different Frequencies and Total Activity of Electrical Stimulation". M.S. Thesis, January 1985; Case Western Reserve University.

Ferguson, A.S., H.E. Stone and J.T. Mortimer. "Muscle Plasticity Induced by Electrical Stimulation: A Comparison of Stimulation Paradigms and Hours/Day of Stimulation". First place poster in the Intermediate group at BME Research Day, Dept. Biomed. Eng., Case Western Reserve University, Cleveland, 1984.

Stone, H.E., A.S. Ferguson, J.T. Mortimer, and E. Tisdale. "Effects of Manual and Voluntary Ranging on Muscle Stimulated Under Restricted Length Conditions". Soc. Neurosci. Abstr., Vol. 10, p. 908, 1984.

PUBLICATIONS - Abstracts, presentations (continued) Ferguson, A.S., H.E. Stone, J.T. Mortimer, M. Burke, and E. Tisdale. "Muscle Plasticity Induced by Electrical Stimulation: A Comparison of Stimulation Paradigms and Hours/Day of Stimulation". Soc. Neurosci. Abstr., Vol. 10, p. 907, 1984.

Stone, H.E., A.S. Ferguson, J.T. Mortimer, and U. Roessmann. "Effects of Different Stimulation Paradigms on Physiological and Histochemical Properties of Stimulated Muscle". Soc. Neurosci. Abstr., Vol. 9, p. 1038, 1983.

PRESENTATIONS - Invited Talks Ferguson, A.S. "Localization of Epicardial Sources Using Magnetic and Potential Maps". Invited speaker for 9th International Conference on Biomagnetism, Vienna, Austria, 1993.

Ferguson, A.S., D. Durand, and T. Dalbasti. "Optimization of Coil Design for Neuronal Excitation by Magnetic Stimulation". Invited paper and presentation for 11th Annual IEEE-EMBS Conference, Seattle, 1989.

Ferguson, A.S., J.D. Sweeney, D. Durand, and J.T. Mortimer. "Finite Difference Modelling of Nerve Cuff Electric Fields". Invited paper and presentation for 9th Annual IEEE-EMBS Conference, Boston, 1987.

PUBLICATIONS - Peer Review Articles Ferguson, A.S. and G. Stroink. "Factors Affecting the Accuracy of the Boundary Element Method in the Forward Problem. Part I: Calculating Surface Potentials". IEEE Trans. Biomed. Eng, 1997.

Ferguson, A.S. and G. Stroink. "Localization of Epicardial Sources Using Magnetic and Potential Maps". Advances in Biomagnetism 93, L. Deecke (ed.) et al., pp. 641-646, 1995.

Ferguson, A.S., D. Vardy, R. Hren, and G. Stroink. "A Regularized Minimum Norm Method for Calculating Distributions of Source Currents on Epicardial Surfaces". Advances in Biomagnetism 93, L. Deecke (ed.) et al., pp. 676-679, 1995.

Hren, R., D. Vardy, R. Miller, A.S. Ferguson, and G. Stroink. "Approximation of Torso Geometries by Surface Harmonic Expansion". Advances in Biomagnetism 93, L. Deecke (ed.) et al., pp. 668-670, 1995.

Ferguson, A.S. and G. Stroink. "The Potential Generated by Current Sources Located in an Insulated Rectangular Volume Conductor". J. Appl. Phys., 76, 1994.

Ferguson, A.S., X. Zhang, and G. Stroink. "A Complete Linear Discretization for Calculating the Magnetic Field Using the Boundary Element Method", IEEE Trans. Biomed. Eng, 41(5):455-460, 1994.

Ferguson, A.S. and D. Durand. "A Theory of the Magnetic Field from Current Monopoles". J. Appl. Phys., 71(6) 1992.

Durand, D. , A.S. Ferguson, and T. Dalbasti, "Effect of Surface Boundary on Neuronal Magnetic Stimulation", IEEE Trans. Biomed. Eng., 39(1):58-64, 1992.

PUBLICATIONS - Peer Review Articles (continued) Ferguson, A.S. and D. Durand. "Magnetic Fields of Current Monopoles in Special Volume Conductors", IEEE Trans. Mag., 27(2):758-767, 1991.

D. Durand, and A.S. Ferguson. "Induced Electric Fields by Magnetic Stimulation in Conducting Media", Artificial Organs, 14:475, 1990.

Ferguson, A.S. and D. Durand. "Magnetic Fields of Current Monopoles", in Advances in Biomagnetism, S.J. Williamson (ed.) et al., Plenum Press, New York, 1989.

Ferguson, A.S., H.E. Stone, U. Roessmann, M. Burke, E. Tisdale, and J.T. Mortimer. "Muscle Plasticity: Comparison of the Effects of a 30 Hz Burst Paradigm with 10 Hz Continuous Stimulation", J. Appl. Physiol., 66(3):1143-1151, 1989.