Bluetooth-enabled teleradiology: applications and complications.

Science.gov (United States)

Hura, Angela M

2002-01-01

Wireless personal area networks and local area networks are becoming increasingly more prevalent in the teleradiology and telemedicine industry. Although there has been much debate about the role that Bluetooth will play in the future of wireless technology, both promoters and doubters acknowledge that Bluetooth will have an impact on networking, even if only as a "niche" product. This article provides an overview of the Bluetooth standard and highlights current and future areas of inclusion for use in a teleradiology environment. The possibilities for Bluetooth in a teleradiology environment without wires are nearly boundless and an overview of current and proposed Bluetooth-enabled radiology equipment and vendors is provided. A comparison of Bluetooth and other wireless technologies is provided, including areas of similarity and potential conflict. Bluetooth and other wireless technologies can not only peacefully coexist but also complement each other and provide enhanced teleradiology services.

Borderless teleradiology with CHILI.

Science.gov (United States)

Engelmann, U; Schroeter, A; Schwab, M; Eisenmann, U; Vetter, M; Lorenz, K; Quiles, J; Wolf, I; Evers, H; Meinzer, H P

1999-01-01

Teleradiology is one of the most evolved areas of telemedicine, but one of the basic problems which remains unsolved concerns system compatibility. The DICOM (Digital Imaging and Communications in Medicine) standard is a prerequisite, but it is not sufficient in all aspects. Examples of other currently open issues are security and cooperative work in synchronous teleconferences. Users without a DICOM radiological workstation would benefit from the ability to join a teleradiology network without any special tools. Drawbacks of many teleradiology systems are that they are monolithic in their software design and cannot be adapted to the actual user's environment. Existing radiological systems currently cannot be extended with additional software components. Consequently, every new application usually needs a new workstation with a different look and feel, which must be connected and integrated into the existing infrastructure. This paper introduces the second generation teleradiology system CHILI. The system has been designed to match both the teleradiology requirements of the American College of Radiology (ACR), and the functionality and usability needs of the users. The experiences of software developers and teleradiology users who participated in the first years of the clinical use of CHILI's predecessor MEDICUS have been integrated into a new design. The system has been designed as a component-based architecture. The most powerful communication protocol for data exchange and teleconferencing is the CHILI protocol, which includes a strong data security concept. The system offers, in addition to its own secure protocol, several different communication Methods: DICOM, classic e-mail, Remote Copy functions (RCP), File Transfer Protocol (FTP), the internet protocols HTTP (HyperText Transfer Protocol) and HTTPS (HyperText Transfer Protocol Secure),and CD-ROMs for off-line communication. These transfer METHODS allow the user to send images to nearly anyone with a

Swiss teleradiology survey: present situation and future trends

International Nuclear Information System (INIS)

Lienemann, Bernhard; Hodler, Juerg; Pfirrmann, Christian W.A.; Luetolf, Marcus

2005-01-01

The purpose of this study was to obtain a survey about the present situation including the usage pattern, technical characteristics and the anticipated future of teleradiology in Switzerland. An internet-based questionnaire was made available to all members of the Swiss Society of Radiology. Questions concerning current teleradiology usage, the type of transmitted modalities, the technology employed, security, billing issues and the anticipated future of teleradiology were addressed. One hundred and two (22.67%) of 450 radiologists responded to the survey. Of the total, 41.2% (42) were teleradiology users, 35.3% (36) planned to use teleradiology in the near future and 24.5% (25) did not use or plan to use teleradiology. The mean number of examinations transmitted per month was 198 (range 1-2,000) and the mean distance was 33 km (range 1,250 km). An emergency service was considered the most important purpose (mean score 6.90; minimum 1, maximum 10) for the use of teleradiology, followed by image distribution (mean 6.74) and expert consultation (mean 6.61). The most commonly transmitted modality was computed tomography (mean 8.80), followed by conventional X-rays (8.40) and magnetic resonance imaging (8.32). The most commonly transmitted format was Digital Imaging and Communications in Medicine (DICOM) (66.7%), followed by bitmap/Joint Photographic Experts Group (jpg) (38.1%), using the DICOM send/receive protocol (52.4%), followed by the hypertext transfer protocol (26.2%) and e-mail (21.4%). For security a secure connection (54.8%) followed by encryption (14.3%) and anonymization (9.5%) was used. For the future, image distribution was rated the most important aspect of teleradiology (7.88), followed by emergency (7.22) and expert consultation (6.53). Development of legal regulations is considered most important (8.17), followed by data security guidelines (8.15). Most radiologists believe that insurance companies should pay for the costs of teleradiology (37

Legal aspects of cross-border teleradiology

International Nuclear Information System (INIS)

Pattynama, Peter M.T.

2010-01-01

The growth of cross-border teleradiology has created legal challenges that are insufficiently addressed by nation health laws. New legislation is currently under development at the European level. This article will look at the details of the existing and proposed legislation and the still unsettled issues and will discuss the implications for international teleradiology.

Teleradiology - a blessing or a curse

International Nuclear Information System (INIS)

Bodemeyer, J.; Mariss, G.; Gursky, S.

2002-01-01

Several hospitals in northern Hessen, not having their own radiology departments, want to run CT-scanners with the goal of improving medical quality. They requested co-operation from the Radiological Institute in the Hardtwaldklinik 1 in Bad Zwesten. Therefore a teleradiological network was developed, which enables the exchange of radiological-images and -reports between 19 hospitals today. An elementary requirement for this co-operation is an efficient and functional computer infrastructure and verified co-operation contracts. The conception, structure and development of the program, as well as associated difficulties are presented and discussed from different perspectives in the light of the controversy among experts. The results, experiences and benefits gained in four years, in which the teleradiological network of northern Hessen has been in place, demonstrate the importance and possibilities of teleradiology as an element of telemedicine. Teleradiology/telediagnostics improves the quality of patient care in smaller hospitals located in less-populated areas and present possibilities to optimize and integrate health care structures, taking economic considerations into account. (orig.) [de

Current status and history of teleradiology in India.

Science.gov (United States)

Jankharia, B

2001-05-01

Teleradiology is yet to take off in India. This is unfortunate since this technology is ideal for a country like India, where expertise in remote areas for advanced investigations such as CT and MR, is lacking. We were the first center in India to use teleradiology on a regular basis. Our initial methodology in 1996 was using video-capture cards and Windows 95 dial-up protocols. Now we use DICOM transfers and remote-access software. Even today, 4 years later, we are the only center in India using teleradiology on a regular basis.

Teleradiology in Southeast Iran: Evaluating the Views of Senior Executives and Radiologists.

Science.gov (United States)

Sadoughi, Farahnaz; Erfannia, Leila; Sancholi, Mahboobe; Salmani, Fatemeh; Sarsarshahi, Aida

Teleradiology is considered as one of the important forms of telemedicine. Positive views of the users and providers of these services play an important role in its successful implementations. The aim of this study was to investigate the views of radiologists used in the radiology departments of teaching hospitals in the Zahedan University of Medical Sciences through teleradiology, as well as evaluate the executive possibility of teleradiology in these hospitals by the views of chief executive officer and comparison between these two views. The current cross-sectional research was performed in 2014 at Zahedan teaching hospitals. The views of 13 chief executive officers on the possibility of the execution of teleradiology and 26 radiologists on the teleradiology process were evaluated by means of two valid and reliable questionnaires. The results of the research revealed that most of the radiologists had knowledge of and positive opinions about teleradiology. Conversely, the view by chief executive officers was that implementation of these processes was not possible in the studied hospitals. Dealing with some issues including data security, controlling or restricting access to clinical information of patients during the process of teleradiology, the possibility of legal protection for the participating radiologists, constitution of executive teams in the organization along with the financial supports, and, subsequently, invitation of the supports from the chief executive officers as the main sponsors of teleradiology implementation in the teaching hospitals are all guidelines for improvement of the successful implementation of teleradiology.

Teleradiology in Europe

International Nuclear Information System (INIS)

Caramella, Davide; Reponen, Jarmo; Fabbrini, Fabrizio; Bartolozzi, Carlo

2000-01-01

The new concept of teleradiology is centered on the consideration that it involves management of medical information rather than the simple transmission of diagnostic images from one location to another. Teleradiology must therefore be able to contribute to the seamless integration of the digital environment in which medical data are managed throughout and beyond the hospital, generating value added services for the patients as well as prospective economical benefits for the institution. In this perspective the evolution of telecommunication with the spectacular success of mobile telephony and Internet will play and increasingly important role, by allowing further development in the exchange of multimedia medical information on a regional as well as international level. However, new responsibilities are being given to the radiologists, who must take all necessary technical and organizational actions in order to avoid that the digital management of data may endanger the confidentiality and the integrity of patients' data

The impact of globalisation on teleradiology practice.

Science.gov (United States)

Shieh, Yao Y; Tsai, Fong Y; Shieh, Mengkai

2008-01-01

Some advocates of globalisation argue that a free market with little regulation is the best approach for achieving cost-effective healthcare. Healthcare, however, is different from other business activities in that it is typically less profit-driven; instead, it often involves the goal of providing equitable care to the underprivileged. Traditionally, the government has subsidised the expenses of delivering affordable healthcare to underserved communities. Because of the many recent advances in telecommunications technology, telemedicine has gained increasing attention. Teleradiology, in particular, is by far the maturest of all telemedicine disciplines and, thus, it may serve as a pivotal indicator of whether telemedicine on a global scale is feasible or not. In this paper, a prediction of the future landscape of globalised teleradiology operations is attempted based on the extrapolation of the historical trends in teleradiology practice as well as the growing pressure on federal and local governments to reduce their regulatory power under the General Agreement on Trade in Services (GATS).

The clinical usefulness of teleradiology of neonates: Expanded services without expanded staff

International Nuclear Information System (INIS)

Slovis, T.L.; Guzzardo-Dobson, P.R.

1991-01-01

Teleradiology was utilized to link an offsite, high-risk nursery to the Department of Pediatric Radiology of Children's Hospital of Michigan. Interpretations via teleradiology were made in 4200 examinations and taken as the final reading. During the initial 3 months of the study, 40% of the teleradiographic images were double-read to evaluate the accuracy of the technique. There was a 98% agreement between the interpretations made using teleradiology and those made using hard copy. Our results indicate that teleradiology linkage for interpreting neonatal examinations serves as a valuable tool for expansion of subspecialty expertise, allows more expedient recognition of abnormalities in the neonate, and facilitates faster transport to the appropriate tertiary care center. (orig./GDG)

Teleradiology support for maternal and newborn health in II level perinatal centers

International Nuclear Information System (INIS)

Stratulat, P.; Gamurari, Inesa; Caraus, Tatiana; Curteanu, Ala

2013-01-01

Telemedicine can be defined as the use of electronic signals to transfer medical information from one system to another. The emergence and development of teleradiology occurred due to the needs of optimal allocation of resources. The effectiveness of medical care is being increasing simply by the fact that an expert radiologist or other specialist can view patient images from his working place without losing his precious time for traveling. Teleradiology solution offers a range of advantages: reducing the presence of specialists on call, rapid obtaining of second opinions, medical centers interconnection etc.In our study we will focus on the teleradiology activity. A prospective study of consulted cases was conducted via teleradiology; there were applied two basic methods of transmitting information. In 01.01.2012 to 31.12.2012 there were totally examined 393 children and consulted 430 radiological images, of them - through Skype - 102 children and 199 images via iPath platform. Successful implementation of teleradiology within telemedicine has improved the quality of diagnosis in cases treated in the pilot centers. (authors)

From shared data to sharing workflow: Merging PACS and teleradiology

International Nuclear Information System (INIS)

Benjamin, Menashe; Aradi, Yinon; Shreiber, Reuven

2010-01-01

Due to a host of technological, interface, operational and workflow limitations, teleradiology and PACS/RIS were historically developed as separate systems serving different purposes. PACS/RIS handled local radiology storage and workflow management while teleradiology addressed remote access to images. Today advanced PACS/RIS support complete site radiology workflow for attending physicians, whether on-site or remote. In parallel, teleradiology has emerged into a service of providing remote, off-hours, coverage for emergency radiology and to a lesser extent subspecialty reading to subscribing sites and radiology groups. When attending radiologists use teleradiology for remote access to a site, they may share all relevant patient data and participate in the site's workflow like their on-site peers. The operation gets cumbersome and time consuming when these radiologists serve multi-sites, each requiring a different remote access, or when the sites do not employ the same PACS/RIS/Reporting Systems and do not share the same ownership. The least efficient operation is of teleradiology companies engaged in reading for multiple facilities. As these services typically employ non-local radiologists, they are allowed to share some of the available patient data necessary to provide an emergency report but, by enlarge, they do not share the workflow of the sites they serve. Radiology stakeholders usually prefer to have their own radiologists perform all radiology tasks including interpretation of off-hour examinations. It is possible with current technology to create a system that combines the benefits of local radiology services to multiple sites with the advantages offered by adding subspecialty and off-hours emergency services through teleradiology. Such a system increases efficiency for the radiology groups by enabling all users, regardless of location, to work 'local' and fully participate in the workflow of every site. We refer to such a system as SuperPACS.

Assessment of pulmonary emphysema on CT teleradiology

International Nuclear Information System (INIS)

Satoh, Katashi; Kato, Koji; Mitani, Masahiro

2003-01-01

The present study assessed the current wave of using CT for the diagnosis of pulmonary emphysema using teleradiology. Thirty patients were examined. CT images were transmitted by Digital Imaging and Communications in Medicine (DICOM) to an image viewer and displayed in 4-image and 1-image arrays for reading. Pulmonary emphysema was found in 7 of the 30 patients. On both displays, the same diagnosis was obtained in 5 cases. In the remaining 2 cases, the low attenuation areas (LAAs) of mild centrilobular emphysema could be recognized only on the 1-image display. The diagnosis of pulmonary emphysema can be made by CT examination using teleradiology even in cases with mild lesions. (author)

Teleradiology requirements and aims in Germany and Europe: status at the beginning of 2000

International Nuclear Information System (INIS)

Walz, M.; Brill, C.; Bolte, R.; Reimann, C.; Weisser, G.; Lehmann, K.J.; Georgi, M.; Cramer, U.; Wein, B.; Haimerl, M.; Loose, R.

2000-01-01

Specific radiological requirements have to be considered for realization of telemedicine. In this article the goals and requirements for an extensive implementation of teleradiology are defined from the radiological user's point of view. Necessary medical, legal and professional prerequisites for teleradiology are presented. Superior requirements, such as data security and privacy or standardization of communication, must be realized. Application specific requirements, e. g. quality and extent of teleradiological functions as well as technological alternatives, are discussed. Each project must be carefully planned in relation to one's own needs, extent of functions and system selection. Topics like legal acceptance of electronic documentation, reimbursement of teleradiology and liability must be clarified in the future. (orig.)

Teleradiology requirements and aims in Germany and Europe: status at the beginning of 2000

Energy Technology Data Exchange (ETDEWEB)

Walz, M.; Brill, C.; Bolte, R.; Reimann, C.; Weisser, G.; Lehmann, K.J.; Georgi, M. [Department of Clinical Radiology, Klinikum Mannheim, University of Heidelberg (Germany); Cramer, U. [Management of the Profession Organization of German Radiologists, Munich (Germany); Wein, B. [Clinic for Diagnostic Radiology, Technical University of Aachen (Germany); Haimerl, M. [Institute for Algorithms and Cognitive Systems, University of Karlsruhe (Germany); Loose, R. [Department of Interventional and Diagnostic Radiology, Klinikum Nuernberg Nord, D-90340 Nuremburg (Germany)

2000-09-01

Specific radiological requirements have to be considered for realization of telemedicine. In this article the goals and requirements for an extensive implementation of teleradiology are defined from the radiological user's point of view. Necessary medical, legal and professional prerequisites for teleradiology are presented. Superior requirements, such as data security and privacy or standardization of communication, must be realized. Application specific requirements, e. g. quality and extent of teleradiological functions as well as technological alternatives, are discussed. Each project must be carefully planned in relation to one's own needs, extent of functions and system selection. Topics like legal acceptance of electronic documentation, reimbursement of teleradiology and liability must be clarified in the future. (orig.)

Diagnoses accuracy in the detection of abnormalities in the thorax x-ray: Teleradiology vs. conventional radiology

International Nuclear Information System (INIS)

Moron, Fanny Emilia; Melendez, Patricia; Martinez, Carlos Eli

1998-01-01

Background: introduction of teleradiology in Colombia is very recent and its operative characteristics and reliability are unknown. Objective: to evaluate intra and interobserver concordance in the interpretation of digitized chest x-ray films and to compare diagnostic Accuracy of teleradiology and film screen interpretation. Design: cross-sectional study for evaluation or concordance and operative characteristics of a diagnostic test. Patients and methods: convenience sample of 40 chest films. Independent lecture of digitized images for each radiologist to evaluate interobserver concordance: second lecture of digitized images for evaluation of intraobserver concordance. Generation of a gold standard diagnosis with a consensus interpretation of film screens, comparison of operative characteristics of teleradiology and conventional interpretation, using as a reference the gold standard (consensus lectures) and comparison of diagnostic precision using receiver operating characteristics curves (ROC curves). Results: agreements and concordance were significant higher than expected in both evaluations (inter and intraobserver). Sensitivity of teleradiology was similar to sensitivity of film screen interpretation and areas under ROC curves were not statistically different. Conclusions: concordance in the interpretation of chest radiological studies are significant in a teleradiology system and diagnostic utility of teleradiology is the same as conventional film screen interpretation. Accuracy and reliability of teleradiology are optimal

Satellite teleradiology test bed for digital mammography

Science.gov (United States)

Barnett, Bruce G.; Dudding, Kathryn E.; Abdel-Malek, Aiman A.; Mitchell, Robert J.

1996-05-01

Teleradiology offers significant improvement in efficiency and patient compliance over current practices in traditional film/screen-based diagnosis. The increasing number of women who need to be screened for breast cancer, including those in remote rural regions, make the advantages of teleradiology especially attractive for digital mammography. At the same time, the size and resolution of digital mammograms are among the most challenging to support in a cost effective teleradiology system. This paper will describe a teleradiology architecture developed for use with digital mammography by GE Corporate Research and Development in collaboration with Massachusetts General Hospital under National Cancer Institute (NCI/NIH) grant number R01 CA60246-01. The testbed architecture is based on the Digital Imaging and Communications in Medicine (DICOM) standard, created by the American College of Radiology and National Electrical Manufacturers Association. The testbed uses several Sun workstations running SunOS, which emulate a rural examination facility connected to a central diagnostic facility, and uses a TCP-based DICOM application to transfer images over a satellite link. Network performance depends on the product of the bandwidth times the round- trip time. A satellite link has a round trip of 513 milliseconds, making the bandwidth-delay a significant problem. This type of high bandwidth, high delay network is called a Long Fat Network, or LFN. The goal of this project was to quantify the performance of the satellite link, and evaluate the effectiveness of TCP over an LFN. Four workstations have Sun's HSI/S (High Speed Interface) option. Two are connected by a cable, and two are connected through a satellite link. Both interfaces have the same T1 bandwidth (1.544 Megabits per second). The only difference was the round trip time. Even with large window buffers, the time to transfer a file over the satellite link was significantly longer, due to the bandwidth-delay. To

Teleradiology: the Indian perspective

International Nuclear Information System (INIS)

Burute, Nishigandha; Jankharia, Bhavin

2010-01-01

The demand for diagnostic and image interpretation services in radiology is growing rapidly all over the world. This has highlighted two issues: the lack of adequate staff for providing interpretative coverage and the lack of specialty expertise. To some extent, these problems can be overcome by utilizing robust communication and image transfer systems to draw on the expertise of distantly located radiologists. This process whereby images are transferred to distant locations for the purpose of interpretation and diagnosis is termed teleradiology

Commoditization of the international teleradiology market.

Science.gov (United States)

McLean, Thomas

2007-04-01

Telemedicine improves access to medical care. However, telemedicine will also increase market volatility because of its ability to stimulate price competition and the insidious way it shifts liability for providing medical services. To cope with increased volatility, other economic sectors have evolved commodities markets by making greater use of standardized forward/future contracts. In the past, the need for medical services to be produced and consumed locally and a lack of an objective definition for medical quality, prohibited the use of forward contracts for health-care services. However, telemedicine, and the increasing use of statistical definitions of medical quality now make standardized forward contracts for health-care services conceivable. Commoditization of teleradiology would offer several advantages including increasing market transparency, a mechanism for ensuring medical quality, and a means for bringing capital into the health-care sector. To reap the benefits of a commodities market in teleradiology, the key will be for market stakeholders to overcome their fear of the unknown in order to organize a central exchange.

Cost-benefit study of different application scenarios in teleradiology

International Nuclear Information System (INIS)

Heckermann, D.; Wetekam, V.; Hundt, W.; Reiser, M.

1997-01-01

With the increasing number of users and technical improvements, there are several application scenarios of teleradiology. To perform a cost-benefit analysis, an approach is presented, which focuses on both monetary and qualitative aspects. Process-related, qualitative and quantitative evaluations are described. The prestudy compares the radiological workflow before and after the introduction of a teleradiology system. A scoring model is part of the qualitative evaluation. The quantitative study focuses on costs and savings. Amortisation and a net present value of savings versus costs can be derived using dynamic investment methods. Savings can be achieved after a short time under ideal conditions, but there is no guarantee for a reimbursement for all systems. (orig.) [de

[Advantages and cost-benefit analysis of various teleradiology scenarios].

Science.gov (United States)

Heckermann, D; Wetekam, V; Hundt, W; Reiser, M

1997-04-01

With the increasing number of users and technical improvements, there are several application scenarios of teleradiology. To perform a cost-benefit analysis, an approach is presented, which focuses on both monetary and qualitative aspects. Process-related, qualitative and quantitative evaluations are described. The prestudy compares the radiological workflow before and after the introduction of a teleradiology system. A scoring model is part of the qualitative evaluation. The quantitative study focuses on costs and savings. Amortisation and a net present value of savings versus costs can be derived using dynamic investment methods. Savings can be achieved after a short time under ideal conditions, but there is no guarantee for a reimbursement for all systems.

Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

Science.gov (United States)

Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

2013-08-01

Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

Security aspects in teleradiology workflow

Science.gov (United States)

Soegner, Peter I.; Helweg, Gernot; Holzer, Heimo; zur Nedden, Dieter

2000-05-01

The medicolegal necessity of privacy, security and confidentiality was the aim of the attempt to develop a secure teleradiology workflow between the telepartners -- radiologist and the referring physician. To avoid the lack of dataprotection and datasecurity we introduced biometric fingerprint scanners in combination with smart cards to identify the teleradiology partners and communicated over an encrypted TCP/IP satellite link between Innsbruck and Reutte. We used an asymmetric kryptography method to guarantee authentification, integrity of the data-packages and confidentiality of the medical data. It was necessary to use a biometric feature to avoid a case of mistaken identity of persons, who wanted access to the system. Only an invariable electronical identification allowed a legal liability to the final report and only a secure dataconnection allowed the exchange of sensible medical data between different partners of Health Care Networks. In our study we selected the user friendly combination of a smart card and a biometric fingerprint technique, called SkymedTM Double Guard Secure Keyboard (Agfa-Gevaert) to confirm identities and log into the imaging workstations and the electronic patient record. We examined the interoperability of the used software with the existing platforms. Only the WIN-XX operating systems could be protected at the time of our study.

Design of a high-speed high-resolution teleradiology system

Science.gov (United States)

Stewart, Brent K.; Dwyer, Samuel J., III; Huang, H. K.; Kangarloo, Hooshang

1992-07-01

A teleradiology system acquires radiographic images from one location and transmits them to one or more distant sites where they are displayed and/or converted to hardcopy film recordings. The long term goal of this research is to demonstrate that teleradiology systems can provide diagnostically equivalent results when compared to conventional radiographic film interpretation. If this hypothesis is proven, the following radiology tasks will be improved: (1) providing for primary interpretation of radiological images for patients in under served areas as well as other medical facilities; (2) integration of radiological services for multi- hospital/clinic health care provides consortiums (HMOs); (3) improving emergency service and intensive care unit coverage; (4) offering consulting-at-a-distance with sub-speciality radiologists; and (5) providing radiologists in the community or in rural areas immediate access to large academic centers for help in the interpretation of difficult and problematic cases. We are designing a high-speed, high-resolution teleradiology system between our level I medical center and several outlying medical centers within the metropolitan area. CT, MR and screen-film examinations will be digitized to 2 K or 4 K at the remote sites, transmitted to the central referral facility and sent to a laser film printer, reproducing the original film. The film can then be used for primary diagnosis, overreading/consultative purposes or for emergency room preparation. Inherently digital modality data (e.g. MR and CT) can be sent without digitization of the multi-format film is desired. A teleradiology system using a Wide Area Network (WAN) is to be connected to the following sites: (1) Olive View Medical Center; (2) Harbor General Medical Center; (3) UCLA Department of Radiological Sciences; and (4) two radiologist''s private residences. The wide area network (WAN) consists of a local carrier (GTE California Incorporated) and an inter-exchange carrier

Teleradiology - practical aspects and lessons learnt

International Nuclear Information System (INIS)

Buxton, Peter J.

1999-01-01

Teleradiology is the most widely practised form of tele medicine and the necessary equipment is readily available. The limiting technical factor is often the communication links between the two sites. A balance must be struck between the degree of image compression and the transmission time. Non technical issues such as organisation of staff and medico-legal aspects must also be considered. Many problems can be avoided by written protocols and agreements

Legal aspects of teleradiology

International Nuclear Information System (INIS)

Ulsenheimer, K.; Heinemann, N.

1997-01-01

It is hoped that the implementation of teleradiology will improve the quality and economic effectiveness of health care in the future. The German federal government has submitted a bill for a legal statute, thereby creating the necessary framework to guarantee the essential 'document security'. The responsibility of those involved with orderly data transmission as well as the limited responsibility for physicians' findings are both government by general liability. General principles apply also with regard to professional discretion. Authorized utilization of external networks depends upon the quality of data security. Networks with unlimited public access may not be used without explicit concent from those concerned. (orig.) [de

Evaluation of transmitted images by teleradiology system

International Nuclear Information System (INIS)

Hoshikawa, Yoshikazu

1993-01-01

Teleradiology system is a combination of digital data networks and computer systems, which is the electric transmission of radiographs and/or radiologic images from local to center radiological system. The author evaluated reproducibility of transmitted images using Photophone (Image Data Corporation) as teleradiology system. Proven cases of abdominal free air (38 plain films, 15 CT), pneumothorax (24 plain films, 20 CT) and small bowel obstruction (30 plain films, 8 CT) were transmitted. Findings could be identified on non-magnified plain films in 75.6%, 83.3% and 96.7% respectively and on magnified CT in 100%, 100% and 100%. Transmitted images of 57 cases of abdominal trauma were read for positive findings and diagnosis by three radiologists. Average positive ratio was 47.3% on plain films and 70.9% on CT. Diagnosis was correct in 66.7% on CT. Specificity and sensitivity were 81.9% and 61.6% respectively on plain film and 88.6% and 93.9% on CT. The accuracy of transmitted images appears to be unsatisfactory on this study. It is suggested that the system is useful for consultation of already identified findings on the original images. (author)

Evaluation of transmitted images by teleradiology system

Energy Technology Data Exchange (ETDEWEB)

Hoshikawa, Yoshikazu (St. Marianna Univ., Kawasaki (Japan). School of Medicine)

1993-12-01

Teleradiology system is a combination of digital data networks and computer systems, which is the electric transmission of radiographs and/or radiologic images from local to center radiological system. The author evaluated reproducibility of transmitted images using Photophone (Image Data Corporation) as teleradiology system. Proven cases of abdominal free air (38 plain films, 15 CT), pneumothorax (24 plain films, 20 CT) and small bowel obstruction (30 plain films, 8 CT) were transmitted. Findings could be identified on non-magnified plain films in 75.6%, 83.3% and 96.7% respectively and on magnified CT in 100%, 100% and 100%. Transmitted images of 57 cases of abdominal trauma were read for positive findings and diagnosis by three radiologists. Average positive ratio was 47.3% on plain films and 70.9% on CT. Diagnosis was correct in 66.7% on CT. Specificity and sensitivity were 81.9% and 61.6% respectively on plain film and 88.6% and 93.9% on CT. The accuracy of transmitted images appears to be unsatisfactory on this study. It is suggested that the system is useful for consultation of already identified findings on the original images. (author).

The value teleradiology represents for Europe: A study of lessons learned in the U.S

International Nuclear Information System (INIS)

Pechet, Tiron C.M.; Girard, Greg; Walsh, Brent

2010-01-01

Pathology and demography have combined to fuel exponential demand for advanced medical imaging. To support this demand, radiology must move beyond traditional department or modality-based picture archiving and communication systems (PACS) to solutions that ensure access regardless of location. This article delineates underlying reasons for the growth in demand for access to medical imaging in both Europe and the United States. It explains why teleradiology/PACS is critical to support this growth in Europe. It discusses the benefits of and barriers to its widespread implementation as discovered in Canada and the U.S. and how these lessons learned relate to Europe. The article establishes the technological imperatives for teleradiology/PACS and presents three real-world case studies of successful data sharing and shared workflow models via single imaging implementations. CML HealthCare: Geographically spanning Canada and the United States with 129 sites performing nearly 5 million plus annual exams. Shields MRI: 29 facilities, including 3 Radiation Oncology centers, across an area 4 times the size of Switzerland. MRA/Novant: 40 radiologists working in a complete subspecialty reporting environment. Finally, it provides a high-level list of selection criteria for teleradiology/PACS and examines how industry trends affecting the U.S. are important baseline considerations to the success of teleradiology/PACS in Europe.

Clinical usefulness of teleradiology in general dental practice

Energy Technology Data Exchange (ETDEWEB)

Choi, Jin Woo [Dept. of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan (Korea, Republic of)

2013-06-15

This study was performed to investigate the clinical usefulness of teleradiology in general dental practice. Two hundred and seventy five cases were submitted for inquiry to the case presentation board of the website of The Korean Academy of Oral and Maxillofacial Radiology for a 5 year periods. The diagnosis results of those cases were analyzed according to the disease classification, the correlation with the patient's chief complaint, the necessity of additional examinations or treatments, the image modalities, and the number of dentists inquiring. Differential diagnoses of normal anatomic structures were the most frequently submitted cases, covering 15.6% of all cases. Among 275 cases, 164 cases required no additional treatments or examinations. Panoramic radiographs were the most frequently submitted images, accounting for 248 inquiries. The 275 cases were submitted by 96 dentists. Fifty-two dentists wrote one inquiry, and 44 inquired 2 or more times. The average inquiry number of the latter group was 5.0 cases. A teleradiology system in general dental practice could be helpful in the differential diagnosis of common lesions and reduce unnecessary costs.

Design necessities for future teleradiology systems. Conclusions from the Medicus-2 field test

International Nuclear Information System (INIS)

Bahner, M.L.; Engelmann, U.; Meinzer, H.P.; Kaick, G. van

1997-01-01

During the Medicus field test we gained experience using the teleradiology system for almost daily teleconferences between a radiology department and clinics for internal medicine, urology, and gynecology. The existing system has a high degree of functionality. The full 12-bit data format is available using the DICOM protocol. A data security concept is implemented, ensuring data integrity, privacy and authentication of communication partners. This concept covers the areas of organization, technique, user training, and software implementation. A future system should be a general purpose radiology workstation covering viewing functionality, image manipulation, and digital archive access. Dedicated teleradiology features have to be a part. Specialized evaluation software, e.g. for dynamic MRI, should be integratable in a modular way. For data exchange with other systems and for the synchronization of teleconference sessions, the protocols should be independent of the network standard used (ISDN, Ethernet, ATM) and based on the DICOM protocol. Extensions of the existing standard are therefore necessary. Besides future technical developments, reimbursement for teleradiology must be accomplished. (orig.) [de

Virtual surgery in a (tele-)radiology framework.

Science.gov (United States)

Glombitza, G; Evers, H; Hassfeld, S; Engelmann, U; Meinzer, H P

1999-09-01

This paper presents telemedicine as an extension of a teleradiology framework through tools for virtual surgery. To classify the described methods and applications, the research field of virtual reality (VR) is broadly reviewed. Differences with respect to technical equipment, methodological requirements and areas of application are pointed out. Desktop VR, augmented reality, and virtual reality are differentiated and discussed in some typical contexts of diagnostic support, surgical planning, therapeutic procedures, simulation and training. Visualization techniques are compared as a prerequisite for virtual reality and assigned to distinct levels of immersion. The advantage of a hybrid visualization kernel is emphasized with respect to the desktop VR applications that are subsequently shown. Moreover, software design aspects are considered by outlining functional openness in the architecture of the host system. Here, a teleradiology workstation was extended by dedicated tools for surgical planning through a plug-in mechanism. Examples of recent areas of application are introduced such as liver tumor resection planning, diagnostic support in heart surgery, and craniofacial surgery planning. In the future, surgical planning systems will become more important. They will benefit from improvements in image acquisition and communication, new image processing approaches, and techniques for data presentation. This will facilitate preoperative planning and intraoperative applications.

Is image selection a useful strategy to decrease the transmission time in teleradiology? A study using 100 emergency cranial CTs

International Nuclear Information System (INIS)

Ludwig, K.; Bick, U.; Oelerich, M.; Schuierer, G.; Puskas, Z.; Nicolas, K.; Koch, A.; Lenzen, H.

1998-01-01

This study examines the suitability of working with a selection of images in a teleradiology consulting system in neurological or neurosurgical emergency situations. The teleradiology system was based on IBM-compatible personal computers, video digitization for data acquisition, and data transmission by Integrated System Digital Network. Forty normal and 60 abnormal emergency cranial computed tomograms were shown to a radiologist on call who presented all cases he regarded as pathologic to a neuroradiologic expert by teleradiology. To reduce transmission time, only a selection of images from the CT study was presented (up to four images per case). For each case the on-call radiologist's diagnosis (D on-call ), the expert's diagnosis on the teleradiology screen (D monitor ), and the expert's diagnosis on the original film (D original ) was documented, together with an estimation of the agreement between those diagnoses. There was clinically relevant disagreement between the on-call radiologist's diagnosis and the neuroradiologist's diagnosis based on the image selection on the teleradiology monitor in 23 % of cases. A clinically important discrepancy between the neuroradiologist's diagnosis based on the image selection and his diagnosis using the original films was found in 30 % of cases. This was due to the presence of clinically relevant information on images not transferred by the on-call radiologist. Image quality of the transferred images was sufficient in all cases. Drastic selection of images from a complete CT study leads to a high rate of incorrect diagnoses and is not appropriate to reduce transmission time in teleradiology. (orig.)

Teleradiology with DICOM e-mail: recommendations of rate at GIT

International Nuclear Information System (INIS)

Mildenberger, P.; Kaemmerer, M.; Klos, G.; Schuetze, B.; Engelmann, U.; Ruggiero, S.; Runa, A.; Weisser, G.; Schroeter, A.; Walz, M.

2005-01-01

E-mail is ideal for ad-hoc connections in teleradiology. The DICOM standard offers the possibility to append DICOM data types as a MIME attachment to any e-mail, thus ensuring the transmission of the original DICOM data. Nevertheless, there are additional requirements (e.g. protection of data privacy) which must be obeyed. Because of the lack of given standards which would grant interoperability as well as manufacturer independence, teleradiology has not been established in Germany until today. Therefore, the IT-Team (Arbeitsgemeinschaft fuer Informationstechnologie, rate at GIT) of the Radiological Society of Germany (Deutsche Roentgengesellschaft, DRG) set up an initiative to standardise telemedicine by using e-mail. Its members agreed that an e-mail-based variant would be the most practicable way to a communication solution - as easy to implement as to use. In their opinion, e-mail represents the smallest common denominator for a safe data interchange that would fulfill the legal advantages for telemedicine in Germany. (orig.)

Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

Directory of Open Access Journals (Sweden)

Matthew Larrison

2016-01-01

Full Text Available Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options for their patients. In addition to the installation and operation of advanced imaging equipment, the need for professional expert interpretation of these studies remains a challenge for mission hospitals. Historically these hospitals have used either voluntary services on site or paid for interpretations from local radiologists; however, with the introduction of high speed internet, teleradiology has become a possibility. This article describes the teleradiology experience of two mission hospitals in rural Africa.

Teleradiology: threat or opportunity?

International Nuclear Information System (INIS)

Jarvis, L.; Stanberry, B.

2005-01-01

The rapid advances in information technology and communication bandwidth have spawned an equally rapid development of clinical teleradiology. Current computer technology and communication capability allow easy transfer of diagnostic images, of any complexity, to any location in the world. This provides the opportunity to acquire swift primary and secondary diagnostic opinions from the remotest of locations, often at economically attractive rates, with the potential for easing the burden on hard-pressed departments of radiology. However, this comes at the potential cost of distancing the clinical radiologist from the patient, with consequent impact upon direct clinical care. As this technology advances across the world, it is vital that UK radiologists are familiar with the clinical implications, the medicolegal framework within which the field operates and the associated governance issues. This paper reviews current practice and discusses the associated risks

Geographic Distribution of Radiologists and Utilization of Teleradiology in Japan: A Longitudinal Analysis Based on National Census Data.

Science.gov (United States)

Matsumoto, Masatoshi; Koike, Soichi; Kashima, Saori; Awai, Kazuo

2015-01-01

Japan has the most CT and MRI scanners per unit population in the world, and as these technologies spread, their geographic distribution is becoming equalized. In contrast, the number of radiologists per unit population in Japan is the lowest among OECD countries and their geographic distribution is unknown. Likewise, little is known about the use of teleradiology, which can compensate for the uneven distribution of radiologists. Based on the Survey of Physicians, Dentists and Pharmacists and the Static Survey of Medical Institutions by the Ministry of Health, Labour and Welfare, a dataset of radiologists and CT and MRI utilizations in each of Japan's 1811 municipalities was created. The inter-municipality equity of the number of radiologists was evaluated using Gini coefficient. Logistic regression analysis, based on Static Survey data, was performed to evaluate the association between hospital location and teleradiology use. Between 2006 and 2012 the number of radiologists increased by 21.7%, but the Gini coefficient remained unchanged. The number of radiologists per 1,000 CT (MRI) utilizations decreased by 17.9% (1.0%); the number was highest in metropolis and lowest in town/village and the disparity has widened from 1.9 to 2.2 (1.6 to 2.0) times. The number of hospitals and clinics using teleradiology has increased (by 69.6% and 18.1%, respectively). Hospitals located in towns/villages (odds ratio 1.61; 95% confidence interval 1.26-2.07) were more likely to use teleradiology than those in metropolises. Contrary to the CT and MRI distributions, radiologist distribution has not been evened out by the increase in their number; in other words, the distribution of radiologists was not affected by market-derived spatial competition force. As a consequence, the gap of the radiologist shortage between urban and rural areas is increasing. Teleradiology, which is one way to ameliorate this gap, should be encouraged.

Teleradiology for a family practice center

International Nuclear Information System (INIS)

Franken, E.A.; Driscoll, C.E.; Berbaum, K.S.; Smith, W.L.; Sato, Y.; Kao, S.C.; Steinkraus, L.

1988-01-01

This study evaluated the role of teleradiology (TR) in providing radiology consultation to a family practice center. All radiographs obtained in the center over a 5-month period were read twice independently: once by TR and once with the original radiograph. Accuracy was comparable for TR and plain films, with an average error rate of 7%. Effect of the radiologist's consultation on the family practitioner was substantial, causing changes in the confidence of diagnosis in over half of cases, and in treatment or prognosis in others. The immediate TR report tended to have a greater impact than the late consultation. The authors conclude that TR offers an acceptable mechanism for radiologic consultation

Interdisciplinary expert consultation via a teleradiology platform. Influence on therapeutic decision-making and patient referral rates to an academic tertiary care center

International Nuclear Information System (INIS)

Helck, Andreas; Matzko, M.; Trumm, C.G.; Grosse, C.; Reiser, M.; Ertl-Wagner, B.; Piltz, S.

2009-01-01

In addition to teleradiological reporting as a nighthawking or a regular service, teleradiological communication can be used for interdisciplinary expert consultation. We intended to evaluate an interdisciplinary consultation system based on a teleradiology platform with regard to its impact on therapeutic decision-making, directed patient referrals to an academic tertiary care center and the economic benefit for the hospital providing the service. Therefore, consultations from five secondary care centers and consecutive admissions to an academic tertiary care center were prospectively evaluated over a time period of six months. A total of 69 interdisciplinary expert consultations were performed. In 54% of the cases the patients were consecutively referred to the university hospital for further treatment. In all acutely life-threatening emergencies (n=9), fast and focused treatment by referral to the academic tertiary care center was achieved (average time to treat 130 min). The admissions to the academic tertiary care center led to improved utilization of its facilities with additional revenue of more than 1 000 000 Euro p.a. An interdisciplinary expert consultation via a teleradiology platform enables fast and efficient expert care with improved and accelerated patient management and improved utilization of the service providing hospital. (orig.)

Quality assessment of out sourced after-hours computed tomography teleradiology reports in a Central London University Hospital

International Nuclear Information System (INIS)

Hohmann, Joachim; Villiers, Petrie de; Urigo, Carlo; Sarpi, Dino; Newerla, Caroline; Brookes, Jocelyn

2012-01-01

The study was designed to assess the quality of out sourced after-hours computed tomography teleradiology service reports. We evaluated 1028 patients over a time period of five month in 2009/2010 (437 female, 591 male, mean age: 51 years, range: 0–97 years) who were referred either by the A and E or other in house departments from 7 pm to 8 am for different reasons. Reporting was done by a teleradiology service provider located in the UK and Australia. Reports were assessed during the routinely performed morning meeting by a panel of in house radiologists. Assessment was done by a five point agreement scale (5 = “No disagreement”, 1 = “…unequivocal potential for serious morbidity or threat to life”). In 811 (79%) patients no disagreement was found, 164 (16%) were rated as category 4, 40 (4%) as category 3 (“…likelihood of harm is low”). In 13 (1.3%) patients a decision of category 2 was made (“…strong likelihood of moderate morbidity but not threat to life”). No category 1 decision was made. As this was just a discrepancy decision, a follow up of the category 2 patients was done over a period of a maximum of 6 months. In 8 (0.8%) patients the in house reports were correct, in 2 (0.2%) patients the teleradiology service provider was right and in 3 (0.3%) patients the final diagnoses remained unclear. In conclusion there was a small rate (0.8%) of proven serious misinterpretations by the teleradiology service provider, but these were less than in comparable studies with preliminary in house staff reports (1.6–24.6%).

The future progress of teleradiology-An empirical study in Sweden

International Nuclear Information System (INIS)

Lundberg, N.; Wintell, M.; Lindskoeld, L.

2010-01-01

This paper describes a novel teleradiology solution, its services and graphical user interfaces (GUIs), and the strategic decisions taken in the development of the services. The novel services are embedded in a radiology information infrastructure in Vaestra Goetalandsregionen (VGR), Sweden. The application is fully integrated with all different RIS and PACS systems in the region and interconnected through the radiology information infrastructure. In practice, the solution offers new ways of collaborating through information sharing within a region. Knowledge can be used collectively to improve the radiology workflow and its outcomes for clinicians and patients. The new shared approach marks the beginning of a change from local to enterprise workflow. The challenges are to develop useful and secure services for different groups related to the radiological information infrastructure. It involves continuous negotiation with people concerning how they should collaborate within the region. The need for teleradiology as a service provided 'by somebody' has disappeared in VGR; today it is a shared service embedded in the innovative radiology information infrastructure. This infrastructure is just a starting point for a novel and limitless telemedicine service including limitless healthcare actors and activities. The method applied for this study was action research. The study was carried out in collaboration between practitioners and researchers.

The future progress of teleradiology-An empirical study in Sweden

Energy Technology Data Exchange (ETDEWEB)

Lundberg, N. [Center for Surgical Sciences, Karolinska Institutet, Stockholm (Sweden); SLL, Stockholm (Sweden)], E-mail: nina.lundberg@ki.se; Wintell, M. [HSA, Vaestra Goetalandsregionen, Gothenburg (Sweden); Lindskoeld, L. [Center for Surgical Sciences, Karolinska Institutet, Stockholm (Sweden); HSA, Vaestra Goetalandsregionen, Gothenburg (Sweden)

2010-01-15

This paper describes a novel teleradiology solution, its services and graphical user interfaces (GUIs), and the strategic decisions taken in the development of the services. The novel services are embedded in a radiology information infrastructure in Vaestra Goetalandsregionen (VGR), Sweden. The application is fully integrated with all different RIS and PACS systems in the region and interconnected through the radiology information infrastructure. In practice, the solution offers new ways of collaborating through information sharing within a region. Knowledge can be used collectively to improve the radiology workflow and its outcomes for clinicians and patients. The new shared approach marks the beginning of a change from local to enterprise workflow. The challenges are to develop useful and secure services for different groups related to the radiological information infrastructure. It involves continuous negotiation with people concerning how they should collaborate within the region. The need for teleradiology as a service provided 'by somebody' has disappeared in VGR; today it is a shared service embedded in the innovative radiology information infrastructure. This infrastructure is just a starting point for a novel and limitless telemedicine service including limitless healthcare actors and activities. The method applied for this study was action research. The study was carried out in collaboration between practitioners and researchers.

Computer-aided diagnosis workstation and teleradiology network system for chest diagnosis using the web medical image conference system with a new information security solution

Science.gov (United States)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kaneko, Masahiro; Kakinuma, Ryutaro; Moriyama, Noriyuki

2010-03-01

Diagnostic MDCT imaging requires a considerable number of images to be read. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. Because of such a background, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis. We also have developed the teleradiology network system by using web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. Our teleradiology network system can perform Web medical image conference in the medical institutions of a remote place using the web medical image conference system. We completed the basic proof experiment of the web medical image conference system with information security solution. We can share the screen of web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with the workstation that builds in some diagnostic assistance methods. Biometric face authentication used on site of teleradiology makes "Encryption of file" and "Success in login" effective. Our Privacy and information security technology of information security solution ensures compliance with Japanese regulations. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new teleradiology network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis

Teleradiology system analysis using a discrete event-driven block-oriented network simulator

Science.gov (United States)

Stewart, Brent K.; Dwyer, Samuel J., III

1992-07-01

Performance evaluation and trade-off analysis are the central issues in the design of communication networks. Simulation plays an important role in computer-aided design and analysis of communication networks and related systems, allowing testing of numerous architectural configurations and fault scenarios. We are using the Block Oriented Network Simulator (BONeS, Comdisco, Foster City, CA) software package to perform discrete, event- driven Monte Carlo simulations in capacity planning, tradeoff analysis and evaluation of alternate architectures for a high-speed, high-resolution teleradiology project. A queuing network model of the teleradiology system has been devise, simulations executed and results analyzed. The wide area network link uses a switched, dial-up N X 56 kbps inverting multiplexer where the number of digital voice-grade lines (N) can vary from one (DS-0) through 24 (DS-1). The proposed goal of such a system is 200 films (2048 X 2048 X 12-bit) transferred between a remote and local site in an eight hour period with a mean delay time less than five minutes. It is found that: (1) the DS-1 service limit is around 100 films per eight hour period with a mean delay time of 412 +/- 39 seconds, short of the goal stipulated above; (2) compressed video teleconferencing can be run simultaneously with image data transfer over the DS-1 wide area network link without impacting the performance of the described teleradiology system; (3) there is little sense in upgrading to a higher bandwidth WAN link like DS-2 or DS-3 for the current system; and (4) the goal of transmitting 200 films in an eight hour period with a mean delay time less than five minutes can be achieved simply if the laser printer interface is updated from the current DR-11W interface to a much faster SCSI interface.

Keynote Address: ACR-NEMA standards and their implications for teleradiology

Science.gov (United States)

Horii, Steven C.

1990-06-01

The ACR-NEMA Standard was developed initially as an interface standard for the interconnection of two pieces of imaging equipment Essentially the Standard defmes a point-to-point hardware connection with the necessary protocol and data structure so that two differing devices which meet the specification will be able to communicate with each other. The Standard does not defme a particular PACS architecture nor does it specify a database structure. In part these are the reasons why implementers have had difficulty in using the Standard in a full PACS. Recent activity of the Working Groups formed by the Committee overseeing work on the ACR-NEMA Standard has changed some of the " flavor" of the Standard. It was realized that connection of PACS with hospital and radiology information systems (HIS and RIS) is necessary if a PACS is ever to be succesful. The idea of interconnecting heterogeneous computer systems has pushed Standards development beyond the scope of the original work. Teleradiology which inherenfly involves wide-area networking may be a direct beneficiary of the new directions taken by the Standards Working Groups. This paper will give a brief history of the ACR-NEMA effort describe the " parent" Standard and its " offspring" and describe the activity of the current Working Groups with particular emphasis on the potential impacts on teleradiology.

Teleradiology - a blessing or a curse; Teleradiologie - Segen oder Fluch? Vier Jahre Routine im Teleradiologischen Datennetz Nordhessen

Energy Technology Data Exchange (ETDEWEB)

Bodemeyer, J.; Mariss, G. [Radiologisches Inst. in der Hardtwaldklinik I - Praxis Dres. med. Mariss/Aref, Bad Zwesten (Germany); Gursky, S. [Medos AG, Langenselbold GSt., Eilenburg (Germany)

2002-02-01

Several hospitals in northern Hessen, not having their own radiology departments, want to run CT-scanners with the goal of improving medical quality. They requested co-operation from the Radiological Institute in the Hardtwaldklinik 1 in Bad Zwesten. Therefore a teleradiological network was developed, which enables the exchange of radiological-images and -reports between 19 hospitals today. An elementary requirement for this co-operation is an efficient and functional computer infrastructure and verified co-operation contracts. The conception, structure and development of the program, as well as associated difficulties are presented and discussed from different perspectives in the light of the controversy among experts. The results, experiences and benefits gained in four years, in which the teleradiological network of northern Hessen has been in place, demonstrate the importance and possibilities of teleradiology as an element of telemedicine. Teleradiology/telediagnostics improves the quality of patient care in smaller hospitals located in less-populated areas and present possibilities to optimize and integrate health care structures, taking economic considerations into account. (orig.) [German] Mehrere Krankenhaeuser der Grund- und Regelversorgung in Nordhessen, die nicht ueber eine eigene radiologische Fachabteilung verfuegen, wollen eigene Computertomographen mit dem Ziel der medizinischen Qualitaetsverbesserung betreiben und traten 1997 mit dem Wunsch nach Kooperation an das Radiologische Institut der Hardtwaldklinik I, Bad Zwesten - Praxis Dres. med. Mariss/Aref, heran. Es entwickelte sich daraus ein Datennetz, mit dem heute 19 Krankenhaeuser radiologische Bild- und Befunddaten via ISDN austauschen koennen. Elementare Voraussetzung hierfuer sind eine effiziente und funktionale EDV-Infrastruktur und juristisch abgesicherte Kooperationsvertraege. Konzeption, Aufbau und Entwicklung der teleradiologischen Kooperationen sowie verbundene Probleme werden

Evaluation of teleradiology for interpretation of intravenous urograms

International Nuclear Information System (INIS)

Halpern, E.J.; Newhouse, J.H.; Amis, E.S.; Lubetsky, H.W.; Jaffe, R.M.; Esser, P.D.; Alderson, P.O.

1990-01-01

This paper reports on diagnostic yield of urography evaluated following digitization and transmission of the images from a satellite hospital via a commercial teleradiology/picture archiving and communications system (T/PACS) (AT and T-Philips CommView). Following digitization of 100 urograms to 2,048 x 1,684-pixel resolution with a laser scanner (Dupont FD2000), the radiographs were transmitted approximately 3 miles over a dedicated T-1 line to a receiving digital archive. Each digital image was first displayed at half resolution on a 1,024-line monitor and subsequently evaluated at full resolution with a zoom feature. Three radiologists, who had interpreted the original films over 2 years earlier, independently reviewed the digitized images

Concept and applicability of the KAMEDIN teleradiology system in view of a cost-benefit analysis

International Nuclear Information System (INIS)

Lehmann, K.J.; Walz, M.; Bolte, R.; Georgi, M.; Schinkmann, M.; Busch, C.

1997-01-01

Introduction: Different concepts and applications of teleradiology systems have been realised. However, their cost-effectiveness is still questionable. Therefore, a cost-benefit analysis of three different scenarios of the new teleradiology system Kamedin (Kooperatives Arbeiten und rechnergestuetzte Medizinische Diagnostik auf innovativen Netzen der Deutschen Telekom) was performed. Methods: CT examinations were transmitted from an Advantage Windows (GE) workstation to a Kamedin workstation using DICOM 3 protocol. Afterwards a teleconference was established with a Kamedin workstation in the intensive care unit within the hospital via FDDI/Ethernet, with an external workstation in a radiology department 6 km away via ISDN and with a Kamedin PC located with radiologist on duty 22 km away via ISDN. On average, 36 CT slices per patient were transferred. A break-even analysis was performed with respect to costs of hardware, software, support, use of ISDN and staff, as well benefits like the decrease in transportation or film documentation costs. Results: Owing to the different reductions in transportation costs, two applications (intensive care unit and external PC) showed a break-even of 1817 and 528 teleconferences/year, respectively. Further optimisation of cost-effectiveness is possible on condition that existing hardware can be used and an automatic data transfer without staff control is available. When all optimisation factors were combined, the break-even decreased to a minimum of 167 and 77 teleconferences/year, respectively. Conclusion: Teleconferences with high image quality can be set up between workstations and PCs using the Kamedin system. Depending on the possible decrease in transportation costs, teleconferencing is cost-effective under certain conditions. Teleradiology has additional advantages, such as the acceleration and optimisation of patient management. (orig.) [de

Performance evaluation of an interactive teleradiology system for real-time teleconsultation in different network environments

International Nuclear Information System (INIS)

Lian Ping; Gong Jun; Zhuang Jun; Sun Jianyong; Yang Yuanyuan; Zhang Jianguo; Meng Lili

2004-01-01

Objective: Measure the performance of self-developed Interoperable teleradiology system at various communication conditions. Methods: Through three different network media ( satellite network, Asymmetrical Digital Subscriber Loop (ADSL), and Shanghai health system's private broadband WAN), Digital images in radiology were transmitted and experiments on teleradiology consultation were applied. Results such as transmission time were recorded, effects of real-time consultation were evaluated subjectively, and experimental data were analyzed. Results: In satellite network, time spent on the transmission of images is long and effects of consultation is normal; in broadband network, time spent is short and no delay is observed in interoperation. Conclusion: teleconsultation can be hold on image sets composed of small matrix size images and compressed large matrix size images in satellite narrowband network, optimum transmission bandwidth is 192 kbps; original large matrix size images such as CR can be transmitted through broadband network and be used in teleconsultation. Real-time interoperation of the system doesn't require very high bandwidth. It can be implemented at various communication conditions

Teleradiology network system using the web medical image conference system with a new information security solution

Science.gov (United States)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kusumoto, Masahiro; Kaneko, Masahiro; Kakinuma, Ryutaru; Moriyama, Noriyuki

2012-02-01

We have developed the teleradiology network system with a new information security solution that provided with web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. We are studying the secret sharing scheme and the tokenization as a method safely to store or to transmit the confidential medical information used with the teleradiology network system. The confidential medical information is exposed to the risk of the damage and intercept. Secret sharing scheme is a method of dividing the confidential medical information into two or more tallies. Individual medical information cannot be decoded by using one tally at all. Our method has the function of automatic backup. With automatic backup technology, if there is a failure in a single tally, there is redundant data already copied to other tally. Confidential information is preserved at an individual Data Center connected through internet because individual medical information cannot be decoded by using one tally at all. Therefore, even if one of the Data Centers is struck and information is damaged due to the large area disaster like the great earthquake of Japan, the confidential medical information can be decoded by using the tallies preserved at the data center to which it escapes damage. Moreover, by using tokenization, the history information of dividing the confidential medical information into two or more tallies is prevented from lying scattered by replacing the history information with another character string (Make it to powerlessness). As a result, information is available only to those who have rightful access it and the sender of a message and the message itself are verified at the receiving point. We propose a new information transmission method and a new information storage method with a new information security solution.

Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer

International Nuclear Information System (INIS)

Lefere, Philippe; Silva, Celso; Gryspeerdt, Stefaan; Rodrigues, António; Vasconcelos, Rita; Teixeira, Ricardo; Gouveia, Francisco Henriques de

2013-01-01

Purpose: To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer. Materials and methods: A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm. Results: 510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6–99.9% 95% CI), 90.97% (87.8–93.4% 95% CI), 56.52% (45.8–66.7% 95% CI), 99.75% (98.4–99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7–100% 95% CI), 87.07% (83.6–89.9% 95% CI), 34.78% (25.3–45.5% 95% CI) and 100% (98.8–100% 95% CI), respectively. Conclusion: In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer

Teleradiology based CT colonography to screen a population group of a remote island; at average risk for colorectal cancer

Energy Technology Data Exchange (ETDEWEB)

Lefere, Philippe, E-mail: radiologie@skynet.be [VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede (Belgium); Silva, Celso, E-mail: caras@uma.pt [Human Anatomy of Medical Course, University of Madeira, Praça do Município, 9000-082 Funchal (Portugal); Gryspeerdt, Stefaan, E-mail: stefaan@sgryspeerdt.be [VCTC, Virtual Colonoscopy Teaching Centre, Akkerstraat 32c, B-8830 Hooglede (Belgium); Rodrigues, António, E-mail: nucleo@nid.pt [Nucleo Imagem Diagnostica, Rua 5 De Outubro, 9000-216 Funchal (Portugal); Vasconcelos, Rita, E-mail: rita@uma.pt [Department of Engineering and Mathematics, University of Madeira, Praça do Município, 9000-082 Funchal (Portugal); Teixeira, Ricardo, E-mail: j.teixeira1947@gmail.com [Department of Gastroenterology, Central Hospital of Funchal, Avenida Luís de Camões, 9004513 Funchal (Portugal); Gouveia, Francisco Henriques de, E-mail: fhgouveia@netmadeira.com [LANA, Pathology Centre, Rua João Gago, 10, 9000-071 Funchal (Portugal)

2013-06-15

Purpose: To prospectively assess the performance of teleradiology-based CT colonography to screen a population group of an island, at average risk for colorectal cancer. Materials and methods: A cohort of 514 patients living in Madeira, Portugal, was enrolled in the study. Institutional review board approval was obtained and all patients signed an informed consent. All patients underwent both CT colonography and optical colonoscopy. CT colonography was interpreted by an experienced radiologist at a remote centre using tele-radiology. Per-patient sensitivity, specificity, positive (PPV) and negative (NPV) predictive values with 95% confidence intervals (95%CI) were calculated for colorectal adenomas and advanced neoplasia ≥6 mm. Results: 510 patients were included in the study. CT colonography obtained a per-patient sensitivity, specificity, PPV and, NPV for adenomas ≥6 mm of 98.11% (88.6–99.9% 95% CI), 90.97% (87.8–93.4% 95% CI), 56.52% (45.8–66.7% 95% CI), 99.75% (98.4–99.9% 95% CI). For advanced neoplasia ≥6 mm per-patient sensitivity, specificity, PPV and, NPV were 100% (86.7–100% 95% CI), 87.07% (83.6–89.9% 95% CI), 34.78% (25.3–45.5% 95% CI) and 100% (98.8–100% 95% CI), respectively. Conclusion: In this prospective trial, teleradiology-based CT colonography was accurate to screen a patient cohort of a remote island, at average risk for colorectal cancer.

Evaluation of a "no-cost" Internet technology-based system for teleradiology and co-operative work.

Science.gov (United States)

Bergh, B; Schlaefke, A; Pietsch, M; García, I; Vogl, T J

2003-02-01

The aim of this study was to assess the suitability of a no-cost system based on standard Internet technology components for teleradiology. The system was composed of free software (communication, DICOM viewer, compression) and standard off-the-shelf hardware components. For different image (CR, CT, MR) and network types (LAN and ISDN) the File Transfer, Audio and Video Conference, and Co-operative Work properties were examined and compared with the literature referring to standard complete packages and dedicated teleradiology systems. The main advantages of the no-cost system are: price; ease of use; independence from specific hardware; and potential connection to any possible partner. The performance of the File Transfer and the Audio and Video Conference was comparable to the other system groups with slight disadvantages in the usability. For Co-operative Work the employed "application sharing" technology does not meet the clinical requirements, which applies identically to the standard complete packages. Here the specialized systems prove superior, although they are proprietary. With minimal restraints the evaluated no-cost solution can be used for File Transfer and Conference scenarios. The usage for Co-operative Work with ISDN is not recommended, unless for the purpose of gaining experience or when dealing with small amounts of cases or images.

Evaluation of a ''no-cost'' Internet technology-based system for teleradiology and Co-operative Work

International Nuclear Information System (INIS)

Bergh, B.; Schlaefke, A.; Pietsch, M.; Garcia, I.; Vogl, T.J.

2003-01-01

The aim of this study was to assess the suitability of a no-cost system based on standard Internet technology components for teleradiology. The system was composed of free software (communication, DICOM viewer, compression) and standard off-the-shelf hardware components. For different image (CR, CT, MR) and network types (LAN and ISDN) the File Transfer, Audio and Video Conference, and Co-operative Work properties were examined and compared with the literature referring to standard complete packages and dedicated teleradiology systems. The main advantages of the no-cost system are: price; ease of use; independence from specific hardware; and potential connection to any possible partner. The performance of the File Transfer and the Audio and Video Conference was comparable to the other system groups with slight disadvantages in the usability. For Co-operative Work the employed ''application sharing'' technology does not meet the clinical requirements, which applies identically to the standard complete packages. Here the specialized systems prove superior, although they are proprietary. With minimal restraints the evaluated no-cost solution can be used for File Transfer and Conference scenarios. The usage for Co-operative Work with ISDN is not recommended, unless for the purpose of gaining experience or when dealing with small amounts of cases or images. (orig.)

Image Reference Database in Teleradiology: Migrating to WWW

Science.gov (United States)

Pasqui, Valdo

The paper presents a multimedia Image Reference Data Base (IRDB) used in Teleradiology. The application was developed at the University of Florence in the framework of the European Community TELEMED Project. TELEMED overall goals and IRDB requirements are outlined and the resulting architecture is described. IRDB is a multisite database containing radiological images, selected because their scientific interest, and their related information. The architecture consists of a set of IRDB Installations which are accessed from Viewing Stations (VS) located at different medical sites. The interaction between VS and IRDB Installations follows the client-server paradigm and uses an OSI level-7 protocol, named Telemed Communication Language. After reviewing Florence prototype implementation and experimentation, IRDB migration to World Wide Web (WWW) is discussed. A possible scenery to implement IRDB on the basis of WWW model is depicted in order to exploit WWW servers and browsers capabilities. Finally, the advantages of this conversion are outlined.

Teleradiology and PACS - strategy of the Innsbruck University Hospital

International Nuclear Information System (INIS)

Vogl, R.

2005-01-01

Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [de

Intrahospital teleradiology from the emergency room

Science.gov (United States)

Fuhrman, Carl R.; Slasky, B. S.; Gur, David; Lattner, Stefanie; Herron, John M.; Plunkett, Michael B.; Towers, Jeffrey D.; Thaete, F. Leland

1993-09-01

Off-hour operations of the modern emergency room presents a challenge to conventional image management systems. To assess the utility of intrahospital teleradiology systems from the emergency room (ER), we installed a high-resolution film digitizer which was interfaced to a central archive and to a workstation at the main reading room. The system was designed to allow for digitization of images as soon as the films were processed. Digitized images were autorouted to both destinations, and digitized images could be laser printed (if desired). Almost real time interpretations of nonselected cases were performed at both locations (conventional film in the ER and a workstation in the main reading room), and an analysis of disagreements was performed. Our results demonstrate that in spite of a `significant' difference in reporting, `clinically significant differences' were found in less than 5% of cases. Folder management issues, preprocessing, image orientation, and setting reasonable lookup tables for display were identified as the main limitations to the systems' routine use in a busy environment. The main limitation of the conventional film was the identification of subtle abnormalities in the bright regions of the film. Once identified on either system (conventional film or soft display), all abnormalities were visible and detectable on both display modalities.

Teleradiology with DICOM e-mail: recommendations of rate at GIT; Teleradiologie mit DICOM E-mail: Empfehlungen der rate at GIT

Energy Technology Data Exchange (ETDEWEB)

Mildenberger, P.; Kaemmerer, M.; Klos, G.; Schuetze, B. [Klinik und Poliklinik fuer Radiologie, Johannes Gutenberg-Univ. Mainz (Germany); Engelmann, U. [Deutsches Krebsforschungszentrum, Abt. Medizinische und Biologische Informatik, Heidelberg (Germany); Ruggiero, S.; Runa, A.; Weisser, G. [Inst. fuer Klinische Radiologie, Universitaetsklinikum Mannheim (Germany); Schroeter, A. [CHILI GmbH, Heidelberg (Germany); Walz, M. [TUeV Industrie Service GmbH, TUeV-SUeD-Gruppe, Aerztliche Stelle fuer Qualitaetssicherung in der Radiologie, Eschborn (Germany)

2005-05-01

E-mail is ideal for ad-hoc connections in teleradiology. The DICOM standard offers the possibility to append DICOM data types as a MIME attachment to any e-mail, thus ensuring the transmission of the original DICOM data. Nevertheless, there are additional requirements (e.g. protection of data privacy) which must be obeyed. Because of the lack of given standards which would grant interoperability as well as manufacturer independence, teleradiology has not been established in Germany until today. Therefore, the IT-Team (Arbeitsgemeinschaft fuer Informationstechnologie, rate at GIT) of the Radiological Society of Germany (Deutsche Roentgengesellschaft, DRG) set up an initiative to standardise telemedicine by using e-mail. Its members agreed that an e-mail-based variant would be the most practicable way to a communication solution - as easy to implement as to use. In their opinion, e-mail represents the smallest common denominator for a safe data interchange that would fulfill the legal advantages for telemedicine in Germany. (orig.)

A novel approach to optimize workflow in grid-based teleradiology applications.

Science.gov (United States)

Yılmaz, Ayhan Ozan; Baykal, Nazife

2016-01-01

This study proposes an infrastructure with a reporting workflow optimization algorithm (RWOA) in order to interconnect facilities, reporting units and radiologists on a single access interface, to increase the efficiency of the reporting process by decreasing the medical report turnaround time and to increase the quality of medical reports by determining the optimum match between the inspection and radiologist in terms of subspecialty, workload and response time. Workflow centric network architecture with an enhanced caching, querying and retrieving mechanism is implemented by seamlessly integrating Grid Agent and Grid Manager to conventional digital radiology systems. The inspection and radiologist attributes are modelled using a hierarchical ontology structure. Attribute preferences rated by radiologists and technical experts are formed into reciprocal matrixes and weights for entities are calculated utilizing Analytic Hierarchy Process (AHP). The assignment alternatives are processed by relation-based semantic matching (RBSM) and Integer Linear Programming (ILP). The results are evaluated based on both real case applications and simulated process data in terms of subspecialty, response time and workload success rates. Results obtained using simulated data are compared with the outcomes obtained by applying Round Robin, Shortest Queue and Random distribution policies. The proposed algorithm is also applied to a real case teleradiology application process data where medical reporting workflow was performed based on manual assignments by the chief radiologist for 6225 inspections. RBSM gives the highest subspecialty success rate and integrating ILP with RBSM ratings as RWOA provides a better response time and workload distribution success rate. RWOA based image delivery also prevents bandwidth, storage or hardware related stuck and latencies. When compared with a real case teleradiology application where inspection assignments were performed manually, the proposed

MDA-image: an environment of networked desktop computers for teleradiology/pathology.

Science.gov (United States)

Moffitt, M E; Richli, W R; Carrasco, C H; Wallace, S; Zimmerman, S O; Ayala, A G; Benjamin, R S; Chee, S; Wood, P; Daniels, P

1991-04-01

MDA-Image, a project of The University of Texas M. D. Anderson Cancer Center, is an environment of networked desktop computers for teleradiology/pathology. Radiographic film is digitized with a film scanner and histopathologic slides are digitized using a red, green, and blue (RGB) video camera connected to a microscope. Digitized images are stored on a data server connected to the institution's computer communication network (Ethernet) and can be displayed from authorized desktop computers connected to Ethernet. Images are digitized for cases presented at the Bone Tumor Management Conference, a multidisciplinary conference in which treatment options are discussed among clinicians, surgeons, radiologists, pathologists, radiotherapists, and medical oncologists. These radiographic and histologic images are shown on a large screen computer monitor during the conference. They are available for later review for follow-up or representation.

Teleradiology network system and computer-aided diagnosis workstation using the web medical image conference system with a new information security solution

Science.gov (United States)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kaneko, Masahiro; Kakinuma, Ryutaru; Moriyama, Noriyuki

2011-03-01

We have developed the teleradiology network system with a new information security solution that provided with web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. We are studying the secret sharing scheme as a method safely to store or to transmit the confidential medical information used with the teleradiology network system. The confidential medical information is exposed to the risk of the damage and intercept. Secret sharing scheme is a method of dividing the confidential medical information into two or more tallies. Individual medical information cannot be decoded by using one tally at all. Our method has the function of RAID. With RAID technology, if there is a failure in a single tally, there is redundant data already copied to other tally. Confidential information is preserved at an individual Data Center connected through internet because individual medical information cannot be decoded by using one tally at all. Therefore, even if one of the Data Centers is struck and information is damaged, the confidential medical information can be decoded by using the tallies preserved at the data center to which it escapes damage. We can safely share the screen of workstation to which the medical image of Data Center is displayed from two or more web conference terminals at the same time. Moreover, Real time biometric face authentication system is connected with Data Center. Real time biometric face authentication system analyzes the feature of the face image of which it takes a picture in 20 seconds with the camera and defends the safety of the medical information. We propose a new information transmission method and a new information storage method with a new information security solution.

A smartphone client-server teleradiology system for primary diagnosis of acute stroke.

Science.gov (United States)

Mitchell, J Ross; Sharma, Pranshu; Modi, Jayesh; Simpson, Mark; Thomas, Monroe; Hill, Michael D; Goyal, Mayank

2011-05-06

Recent advances in the treatment of acute ischemic stroke have made rapid acquisition, visualization, and interpretation of images a key factor for positive patient outcomes. We have developed a new teleradiology system based on a client-server architecture that enables rapid access to interactive advanced 2-D and 3-D visualization on a current generation smartphone device (Apple iPhone or iPod Touch, or an Android phone) without requiring patient image data to be stored on the device. Instead, a server loads and renders the patient images, then transmits a rendered frame to the remote device. Our objective was to determine if a new smartphone client-server teleradiology system is capable of providing accuracies and interpretation times sufficient for diagnosis of acute stroke. This was a retrospective study. We obtained 120 recent consecutive noncontrast computed tomography (NCCT) brain scans and 70 computed tomography angiogram (CTA) head scans from the Calgary Stroke Program database. Scans were read by two neuroradiologists, one on a medical diagnostic workstation and an iPod or iPhone (hereafter referred to as an iOS device) and the other only on an iOS device. NCCT brain scans were evaluated for early signs of infarction, which includes early parenchymal ischemic changes and dense vessel sign, and to exclude acute intraparenchymal hemorrhage and stroke mimics. CTA brain scans were evaluated for any intracranial vessel occlusion. The interpretations made on an iOS device were compared with those made at a workstation. The total interpretation times were recorded for both platforms. Interrater agreement was assessed. True positives, true negatives, false positives, and false negatives were obtained, and sensitivity, specificity, and accuracy of detecting the abnormalities on the iOS device were computed. The sensitivity, specificity, and accuracy of detecting intraparenchymal hemorrhage were 100% using the iOS device with a perfect interrater agreement (kappa=1

Evaluation of a ''no-cost'' Internet technology-based system for teleradiology and Co-operative Work

Energy Technology Data Exchange (ETDEWEB)

Bergh, B.; Schlaefke, A.; Pietsch, M.; Garcia, I. [Department of Information and Communication Technology, Klinikum der Johann Wolfgang Goethe Universitaet, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Vogl, T.J. [Institute of Diagnostic and Interventional Radiology, Klinikum der Johann Wolfgang Goethe Universitaet, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany)

2003-02-01

The aim of this study was to assess the suitability of a no-cost system based on standard Internet technology components for teleradiology. The system was composed of free software (communication, DICOM viewer, compression) and standard off-the-shelf hardware components. For different image (CR, CT, MR) and network types (LAN and ISDN) the File Transfer, Audio and Video Conference, and Co-operative Work properties were examined and compared with the literature referring to standard complete packages and dedicated teleradiology systems. The main advantages of the no-cost system are: price; ease of use; independence from specific hardware; and potential connection to any possible partner. The performance of the File Transfer and the Audio and Video Conference was comparable to the other system groups with slight disadvantages in the usability. For Co-operative Work the employed ''application sharing'' technology does not meet the clinical requirements, which applies identically to the standard complete packages. Here the specialized systems prove superior, although they are proprietary. With minimal restraints the evaluated no-cost solution can be used for File Transfer and Conference scenarios. The usage for Co-operative Work with ISDN is not recommended, unless for the purpose of gaining experience or when dealing with small amounts of cases or images. (orig.)

Fracture diagnostics, unnecessary travel and treatment: a comparative study before and after the introduction of teleradiology in a remote general practice.

Science.gov (United States)

Jacobs, Jac J W M; Jacobs, Jan P A M; van Sonderen, Eric; van der Molen, Thys; Sanderman, Robbert

2015-05-06

Teleradiology entails attainment of x-rays in one location, transfer over some distance and assessment at another location for diagnosis or consultation. This study documents fracture diagnostics, unnecessary trips to the hospital, treatment and number of x-rays for the years 2006 and 2009, before and after the introduction of teleradiology in a general practice on the island of Ameland in the north of the Netherlands. In a retrospective, descriptive, observational before and after study of the introduction of x-ray facilities in an island-based general practice, we compared the number of accurately diagnosed fractures, unnecessary trips, treatments and number of x-rays taken in 2006 when only a hospital x-ray facility was available 5 hours away with those in 2009 after an x-ray facility became available at a local general practice. All patients visiting a general practice on the island of Ameland in 2006 and 2009 with trauma and clinical suspicion of a fracture, dislocation or sprain were included in the study. The initial clinical diagnoses, including those based on the outcomes of x-rays, were compared for the two years and also whether the patients were treated at home or in hospital. A total of 316 and 490 patients with trauma visited a general practice in 2006 and 2009, respectively. Of these patients, 66 and 116 were found to have fractures or dislocations in the two years, respectively. In 2006, 83 x-rays were ordered; in 2009, this was 284. In 2006, 9 fractures were missed; in 2009, this was only 2. In 2006, 15 patients with fractures or dislocations were treated at the general practice; in 2009, this had increased to 77. Since the introduction of teleradiology the number of missed fractures in patients visiting the general practice with trauma and the number of the unnecessary trips to a hospital are reduced. In addition more patients with fractures and dislocations can be treated in the general practice as opposed to the hospital.

Application of the advanced communications technology satellite for teleradiology and telemedicine

Science.gov (United States)

Stewart, Brent K.; Carter, Stephen J.; Rowberg, Alan H.

1995-05-01

The authors have an in-kind grant from NASA to investigate the application of the Advanced Communications Technology Satellite (ACTS) to teleradiology and telemedicine using the JPL developed ACTS Mobile Terminal (AMT) uplink. This experiment involves the transmission of medical imagery (CT, MR, CR, US and digitized radiographs including mammograms), between the ACTS/AMT and the University of Washington. This is accomplished by locating the AMT experiment van in various locations throughout Washington state, Idaho, Montana, Oregon and Hawaii. The medical images are transmitted from the ACTS to the downlink at the NASA Lewis Research Center (LeRC) in Cleveland, Ohio, consisting of AMT equipment and the high burst rate-link evaluation terminal (HBR-LET). These images are then routed from LeRC to the University of Washington School of Medicine (UWSoM) through the Internet and public switched Integrated Serviced Digital Network (ISDN). Once images arrive in the UW Radiology Department, they are reviewed using both video monitor softcopy and laser-printed hardcopy. Compressed video teleconferencing and transmission of real-time ultrasound video between the AMT van and the UWSoM are also tested. Image quality comparisons are made using both subjective diagnostic criteria and quantitative engineering analysis. Evaluation is performed during various weather conditions (including rain to assess rain fade compensation algorithms). Compression techniques also are tested to evaluate their effects on image quality, allowing further evaluation of portable teleradiology/telemedicine at lower data rates and providing useful information for additional applications (e.g., smaller remote units, shipboard, emergency disaster, etc.). The medical images received at the UWSoM over the ACTS are directly evaluated against the original digital images. The project demonstrates that a portable satellite-land connection can provide subspecialty consultation and education for rural and remote

Teleradiology in a neonatal intensive care unit: Comparison between the interpretation of transmitted digital images and film radiographs

International Nuclear Information System (INIS)

McFee, W.H.; Bramson, R.T.; Cates, J.D.; Curran, J.S.

1987-01-01

Using a Raytel teleradiology system, a prospective comparison was made between the interpretations of 700 transmitted digital images and the film radiographs from which these digital images were made. The original films consisted of all of the radiographs obtained from the infants in a 40-bed level III neonatal intensive care unit over a 6-week period. Interpretations were done by two radiologists, initially from transmitted images and subsequently from the original films. Comparison of the interpretations demonstrates a remarkably high degree of correlation, with less than 0.5% clinically significant discrepancies reported

An assessment of the iPad 2 as a CT teleradiology tool using brain CT with subtle intracranial hemorrhage under conventional illumination.

Science.gov (United States)

Park, Joon Bum; Choi, Hyuk Joong; Lee, Jeong Hun; Kang, Bo Seung

2013-08-01

We examined the potential of the iPad 2 as a teleradiologic tool for evaluating brain computed tomography (CT) with subtle hemorrhage in the conventional lighting conditions which are common situations in the remote CT reading. The comparison of the clinician's performance was undertaken through detecting hemorrhage by the iPad 2 and the clinical liquid crystal display (LCD) monitor. We selected 100 brain CT exams performed for head trauma or headache. Fifty had subtle radiological signs of intracranial hemorrhage (ICH), while the other 50 showed no significant abnormality. Five emergency medicine physicians reviewed these brain CT scans using the iPad 2 and the LCD monitor, scoring the probability of ICH on each exam on a five-point scale. Result showed high sensitivities and specificities in both devices. We generated receiver operating characteristic curves and calculated the average area under the curve of the iPad 2 and the LCD (0.935 and 0.900). Using the iPad 2 and reliable internet connectivity, clinicians can provide remote evaluation of brain CT with subtle hemorrhage under suboptimal viewing condition. Considering the distinct advantages of the iPad 2, the popular out-of-hospital use of mobile CT teleradiology would be anticipated soon.

Teleradiology in neurosurgery, based on the experience of the Department of Neurosurgery, Polish Academy of Sciences

International Nuclear Information System (INIS)

Glowacki, M.; Czernicki, Z.; Jurkiewicz, J.; Walasek, N.; Czernicki, Z.; Jurkiewicz, J.

2005-01-01

The aim of the study was to analyze experience with the teleconsulting system applied at the Department of Neurosurgery, Polish Academy of Sciences (PAN) and to establish the best medical and economic conditions for teleradiological networks. The presented system is based on frame-grabbing technology and is operated by MultiView TM 2.0D (eMeD, Tech.) software. Computed tomography (CT) examinations performed in the hospitals in Ciechanow or Ostroleka are transmitted to the teleconsulting center in the Department of Neurosurgery, PAN. Regular telephone lines with a transmission speed of 56 kbps are utilized. One whole CT examination is transmitted in 5 to 7 minutes. All clinical information is reported during telephone conversation optimized by a specific questionnaire which helps improve arrangements for neurosurgical intervention and to document consultations. The usefulness of mobile phones and e mail in teleradiology was also evaluated.The period from December 1996 to April 2002 was studied. During this time, 931 transmission were performed. The most common were control examinations (26%), followed by neurotrauma (19%), spontaneous intracerebral hemorrhage (18%), neurooncology (13%), subarachnoidal hemorrhage (7%), hydrocephalus (5%), cerebral ischemia (3%), and those without any intracranial pathologies (4%). Disturbances were observed in 4% of transmissions. Seventy percent of the consulted patients were treated conservatively in remote hospitals. Thirty percent of the cases were admitted to our department, of whom 86% were operated. Mobile phones were found to be a useful tool in urgent neurosurgical consultations. Sending compressed CT images via e mail provided sufficient quality,but requires a particular technical background. The system allows for: 1) proper qualification for neurosurgical treatment, 2) fast and easy access to consultations with specialists, 3) patient follow-up (repeated consultations),4) avoidance of unnecessary transportation, and 5

Establishment and preliminary application of the interactive tele-radiologic conference system based on virtual private network

International Nuclear Information System (INIS)

Wang Xuejian; Hu Jian; Wang Kang; Yu Hui; Luo Min; Lei Wenyong

2005-01-01

Objective: To investigate the establishment and characteristics of the interactive tele-radiological system (IATRS). Methods: Local area network (LAN) of local hospitals with firewall and ADSL Modem was connected into internet, then connected into the Virtual Private Network (VPN) server of the affiliated hospital of Guiyang Medical College (GMCAH) through anti-firewall of GMCAH. The VPN tunnel was acquired and LAN of local hospitals was connected into the PACS server of GMCAH, resulting in sharing of radiological data by both the GMCAH and local hospitals. Results: Radiological data from local hospitals could be transmitted by the PACS server of GMCAH safety and rapidly. The IATRS could provide high-quality images with high-speed, and with ease to perform. Conclusion: IATRS is useful and reliable for transmitting radiological data between remote places. (authors)

Securing a web-based teleradiology platform according to German law and "best practices".

Science.gov (United States)

Spitzer, Michael; Ullrich, Tobias; Ueckert, Frank

2009-01-01

The Medical Data and Picture Exchange platform (MDPE), as a teleradiology system, facilitates the exchange of digital medical imaging data among authorized users. It features extensive support of the DICOM standard including networking functions. Since MDPE is designed as a web service, security and confidentiality of data and communication pose an outstanding challenge. To comply with demands of German laws and authorities, a generic data security concept considered as "best practice" in German health telematics was adapted to the specific demands of MDPE. The concept features strict logical and physical separation of diagnostic and identity data and thus an all-encompassing pseudonymization throughout the system. Hence, data may only be merged at authorized clients. MDPE's solution of merging data from separate sources within a web browser avoids technically questionable techniques such as deliberate cross-site scripting. Instead, data is merged dynamically by JavaScriptlets running in the user's browser. These scriptlets are provided by one server, while content and method calls are generated by another server. Additionally, MDPE uses encrypted temporary IDs for communication and merging of data.

Telemedicina: a multimedia broadband teleradiology and radiosurgery project

Science.gov (United States)

de Blas-Garcia, Pedro; Lopez-Viver, Rodolfo; Martinez, Demetrio; Ruiz, Ignacio; Barriuso, Daniel; Janez-Escalada, Luis; Gomez, Jose L.; Luyando, Luis

1996-05-01

Telemedicina is a Spanish project that covers teleradiology and radiosurgery areas. This project is under the frame of the Spanish Broadband National Plan (PLANBA). The final technical tests are being ended over Ethernet and ATM and it is planned to get their first clinical results on February-96. Two pilots will be installed: one in Madrid linking two sites through a ATM network (provided by Telefonica, Spanish PTT) and a second one in Asturias (north of Spain) using ISDN primary access (2 Mbps). The system handles still images, voice and video records, scanned documents, text and slides allowing doctors to interchange this data using cooperative tools. The system is based on a multimedia Unix platform with voice, video and videoconference devices and boards. The platform will be used in several ways: as desktop videoconferencing, primary diagnosis and review. Communications are based on ATM (over AAL5) at 155 Mbps and ISDN (primary access). The protocol used in both networks is TCP/IP. The application is written in C++ (object oriented design and programming) and C. GUI is built under X-Windows and Motif. The codification of video is MJPEG done through dedicated hardware. The system is integrated in a small PACS (previously installed); the images are captured from the modalities such as CT using the DICOM standard and it is connected with the Radiological Information System. The application allows collaborative work: telepointer, shared windows, editors and actions. Main news of the Telemedicina project will be the incorporation of broadband networks (ATM at 155 Mbps) and the integration of collaborative work. This two aspects allow the doctors to improve their work speeding up the transmission and retrieval of medical records. Also this platform can be used to achieve several goals: such as primary diagnosis, videoconference, review.

A Cloud Architecture for Teleradiology-as-a-Service.

Science.gov (United States)

Melício Monteiro, Eriksson J; Costa, Carlos; Oliveira, José L

2016-05-17

Telemedicine has been promoted by healthcare professionals as an efficient way to obtain remote assistance from specialised centres, to get a second opinion about complex diagnosis or even to share knowledge among practitioners. The current economic restrictions in many countries are increasing the demand for these solutions even more, in order to optimize processes and reduce costs. However, despite some technological solutions already in place, their adoption has been hindered by the lack of usability, especially in the set-up process. In this article we propose a telemedicine platform that relies on a cloud computing infrastructure and social media principles to simplify the creation of dynamic user-based groups, opening up opportunities for the establishment of teleradiology trust domains. The collaborative platform is provided as a Software-as-a-Service solution, supporting real time and asynchronous collaboration between users. To evaluate the solution, we have deployed the platform in a private cloud infrastructure. The system is made up of three main components - the collaborative framework, the Medical Management Information System (MMIS) and the HTML5 (Hyper Text Markup Language) Web client application - connected by a message-oriented middleware. The solution allows physicians to create easily dynamic network groups for synchronous or asynchronous cooperation. The network created improves dataflow between colleagues and also knowledge sharing and cooperation through social media tools. The platform was implemented and it has already been used in two distinct scenarios: teaching of radiology and tele-reporting. Collaborative systems can simplify the establishment of telemedicine expert groups with tools that enable physicians to improve their clinical practice. Streamlining the usage of this kind of systems through the adoption of Web technologies that are common in social media will increase the quality of current solutions, facilitating the sharing of

Radiation protection of patients and quality controls in teleradiology

Energy Technology Data Exchange (ETDEWEB)

Vermiglio, G.; Testagrossa, B.; Sansotta, C.; Tripepi, M.G. [Messina Univ., Dept. of Protezionistica Ambientale, Sanitaria, Sociale ed Industriale (Italy)

2006-07-01

Nowadays, it is well-known that tele-radiology represents the new frontier of radiodiagnostic imaging. In this case, the continuous broadening of transmission bands and the more sophisticated procedures of information packaging constitute a no negligible inducement. Moreover, standards used to convert analogical signals into the digital ones, necessary to transfer via ether radiological images and information, involve a more limited loss of information. Nevertheless, unlike the common images, in case of the X-ray diagnostic images it must take into account that the EURATOM Council Directives give the health physicist all the procedures to be followed for checking the status of X-ray equipments. In particular, the EURATOM Council Directives provide minimum criteria of acceptance for parameters that characterised the correct working of the radiological equipments and the guide lines for standardised execution of X-ray images, in order to obtain high quality information. In addiction, for maintaining such level it is necessary to adopt adequate programs of Quality Assurance. Naturally, the high quality of radiological images must be conserved after the transmission of information. So, in order to evaluate the amount of losses that can be introduced after transferring the X-ray images from source to user, the authors have carried out specific procedures in order to evaluate the quality level of the images after transmission and to compare them with the correspondent ones acquired at the equipment console. To this aim, the AAs have identified all the parameters able to verify the quality level of the images and measured the values obtained for the directly acquired images and the transferred ones. They have also considered different kinds of transmission protocols to define suitable procedures of remote quality controls. (authors)

Radiation protection of patients and quality controls in teleradiology

International Nuclear Information System (INIS)

Vermiglio, G.; Testagrossa, B.; Sansotta, C.; Tripepi, M.G.

2006-01-01

Nowadays, it is well-known that tele-radiology represents the new frontier of radiodiagnostic imaging. In this case, the continuous broadening of transmission bands and the more sophisticated procedures of information packaging constitute a no negligible inducement. Moreover, standards used to convert analogical signals into the digital ones, necessary to transfer via ether radiological images and information, involve a more limited loss of information. Nevertheless, unlike the common images, in case of the X-ray diagnostic images it must take into account that the EURATOM Council Directives give the health physicist all the procedures to be followed for checking the status of X-ray equipments. In particular, the EURATOM Council Directives provide minimum criteria of acceptance for parameters that characterised the correct working of the radiological equipments and the guide lines for standardised execution of X-ray images, in order to obtain high quality information. In addiction, for maintaining such level it is necessary to adopt adequate programs of Quality Assurance. Naturally, the high quality of radiological images must be conserved after the transmission of information. So, in order to evaluate the amount of losses that can be introduced after transferring the X-ray images from source to user, the authors have carried out specific procedures in order to evaluate the quality level of the images after transmission and to compare them with the correspondent ones acquired at the equipment console. To this aim, the AAs have identified all the parameters able to verify the quality level of the images and measured the values obtained for the directly acquired images and the transferred ones. They have also considered different kinds of transmission protocols to define suitable procedures of remote quality controls. (authors)

A broadband multimedia collaborative system for advanced teleradiology and medical imaging diagnosis.

Science.gov (United States)

Gómez, E J; del Pozo, F; Ortiz, E J; Malpica, N; Rahms, H

1998-09-01

This paper presents a new telemedicine system currently in routine clinical usage, developed within the European Union (EU) ACTS BONAPARTE project (1). The telemedicine system is developed on an asynchronous transfer mode (ATM) multimedia hardware/software platform comprising the following set of telemedicine services: synchronous cooperative work, high-quality video conference, multimedia mail, medical image digitizing, processing, storing and printing, and local and remote transparent database access. The medical information handled by the platform conforms to the Digital Imaging and Communications in Medicine (DICOM) 3.0 medical imaging standard. The telemedicine system has been installed for clinical routines in three Spanish hospitals since November 1997 and has been used in an average of one/two clinical sessions per week. At each clinical session, a usability and clinical evaluation of the system was carried out. Evaluation is carried out through direct observation of interactions and questionnaire-based subjective data. The usability evaluation methodology and the results of the system usability study are also presented in this article. The experience gained from the design, development, and evaluation of the telemedicine system is providing an indepth knowledge of the benefits and difficulties involved in the installation and clinical usage of this type of high-usability and advanced multimedia telemedicine system in the field of teleradiology and collaborative medical imaging diagnosis.

Implementación de un sistema para interpretación de imágenes médicas (teleradiología), en los hospitales públicos del país

OpenAIRE

Espol; Flores Duarte, Mariuxi Elizabeth

2017-01-01

El objetivo fundamental de este documento, es dar a conocer como la intervención de la tecnología y sus continuos avances están modificando las diferentes actividades de nuestras vidas, en diferentes ámbitos incluso el sanitario. Los cuidados sanitarios informatizados o telemedicina, han posibilitado poner en práctica procedimientos que años atrás, no se hubiesen sido considerados como factibles o viables. Siendo la teleradiología, probablemente el de mayor auge o aplicación en la última d...

A statewide teleradiology system reduces radiation exposure and charges in transferred trauma patients.

Science.gov (United States)

Watson, Justin J J; Moren, Alexis; Diggs, Brian; Houser, Ben; Eastes, Lynn; Brand, Dawn; Bilyeu, Pamela; Schreiber, Martin; Kiraly, Laszlo

2016-05-01

Trauma transfer patients routinely undergo repeat imaging because of inefficiencies within the radiology system. In 2009, the virtual private network (VPN) telemedicine system was adopted throughout Oregon allowing virtual image transfer between hospitals. The startup cost was a nominal $3,000 per hospital. A retrospective review from 2007 to 2012 included 400 randomly selected adult trauma transfer patients based on a power analysis (200 pre/200 post). The primary outcome evaluated was reduction in repeat computed tomography (CT) scans. Secondary outcomes included cost savings, emergency department (ED) length of stay (LOS), and spared radiation. All data were analyzed using Mann-Whitney U and chi-square tests. P less than .05 indicated significance. Spared radiation was calculated as a weighted average per body region, and savings was calculated using charges obtained from Oregon Health and Science University radiology current procedural terminology codes. Four-hundred patients were included. Injury Severity Score, age, ED and overall LOS, mortality, trauma type, and gender were not statistically different between groups. The percentage of patients with repeat CT scans decreased after VPN implementation: CT abdomen (13.2% vs 2.8%, P < .01) and cervical spine (34.4% vs 18.2%, P < .01). Post-VPN, the total charges saved in 2012 for trauma transfer patients was $333,500, whereas the average radiation dose spared per person was 1.8 mSV. Length of stay in the ED for patients with Injury Severity Score less than 15 transferring to the ICU was decreased (P < .05). Implementation of a statewide teleradiology network resulted in fewer total repeat CT scans, significant savings, decrease in radiation exposure, and decreased LOS in the ED for patients with less complex injuries. The potential for health care savings by widespread adoption of a VPN is significant. Copyright © 2016 Elsevier Inc. All rights reserved.

A joint FED watermarking system using spatial fusion for verifying the security issues of teleradiology.

Science.gov (United States)

Viswanathan, P; Krishna, P Venkata

2014-05-01

Teleradiology allows transmission of medical images for clinical data interpretation to provide improved e-health care access, delivery, and standards. The remote transmission raises various ethical and legal issues like image retention, fraud, privacy, malpractice liability, etc. A joint FED watermarking system means a joint fingerprint/encryption/dual watermarking system is proposed for addressing these issues. The system combines a region based substitution dual watermarking algorithm using spatial fusion, stream cipher algorithm using symmetric key, and fingerprint verification algorithm using invariants. This paper aims to give access to the outcomes of medical images with confidentiality, availability, integrity, and its origin. The watermarking, encryption, and fingerprint enrollment are conducted jointly in protection stage such that the extraction, decryption, and verification can be applied independently. The dual watermarking system, introducing two different embedding schemes, one used for patient data and other for fingerprint features, reduces the difficulty in maintenance of multiple documents like authentication data, personnel and diagnosis data, and medical images. The spatial fusion algorithm, which determines the region of embedding using threshold from the image to embed the encrypted patient data, follows the exact rules of fusion resulting in better quality than other fusion techniques. The four step stream cipher algorithm using symmetric key for encrypting the patient data with fingerprint verification system using algebraic invariants improves the robustness of the medical information. The experiment result of proposed scheme is evaluated for security and quality analysis in DICOM medical images resulted well in terms of attacks, quality index, and imperceptibility.

Multimedia Messaging Service teleradiology in the provision of emergency neurosurgery services.

Science.gov (United States)

Ng, Wai Hoe; Wang, Ernest; Ng, Ivan

2007-04-01

Neurosurgical emergencies constitute a significant proportion of workload of a tertiary neurosurgical service. Prompt diagnosis and emergent institution of definitive treatment are critical to reduce neurological mortality and morbidity. Diagnosis is highly dependent on accurate interpretation of scans by experienced clinicians. This expertise may not be readily available especially after office hours because many neurosurgical units are manned by middle-level neurosurgical staff with varying levels of experience in scan interpretation. Multimedia Messaging Service mobile phone technology offers a simple, cheap, quick, and effective solution to the problem of scan interpretation. An MMS takes only a few minutes to send and receive and allows senior doctors to view important images and make important clinical decisions to enhance patient management in an emergency situation. A mobile phone (with VGA camera and MMS capabilities) was provided to the neurosurgery registrar on call. The on-call mobile phone is passed on to the corresponding registrar on-call the next day. All consultants had personal mobile phones that are MMS-enabled. Relevant representative CT/MRI images can be taken directly from the mobile phone from the PACS off the computer screen. When only hard copies are available, the images can be taken off the light box. After a 12-month trial period, a questionnaire was given to all staff involved in the project to ascertain the usefulness of the MMS teleradiology service. The survey on the use of the MMS service in a tertiary neurosurgical service demonstrated that the technology significantly improved the level of confidence of the senior-level staff in emergent clinical decision making. Significantly, the MMS images were of sufficient quality and resolution to obviate the need to view the actual scans. The impact of MMS is less pronounced in the middle-level staff, but there was a trend that most of the junior staff found the service more useful. The MMS

The Canadian Association of Radiologists national standards for technology

International Nuclear Information System (INIS)

Hynes, D.M.

1997-01-01

Unlike any other technological development before it, teleradiology is revolutionizing the diagnostic medical imaging field by enabling broad access to radiological images. Images can today be transmitted between departments or between hospitals. Doctors in remote areas can share images with specialists in larger centres for consultation. Physicians can access hospital records from their office or home computer. Teleradiology also offers valuable educational opportunities. Like other technologies, however, the implementation and continuing development of teleradiology requires careful consideration of issues related to image quality, patient care, security of patient records, and other important matters. The following standard was prepared by the CAR Expert Advisory Panel on Teleradiology Standards in collaboration with the Ontario Association of Radiologists Teleradiology Committee to provide a model for teleradiology applications. The standard is based upon U.S. standards prepared by the American College of Radiology. (author). 21 refs

Evaluation of the feasibility of security technologies in teleradiology as biometric fingerprint scanners for data exchange over a satellite WAN

Science.gov (United States)

Soegner, Peter I.; Helweg, Gernot; Holzer, Heimo; zur Nedden, Dieter

2000-05-01

We evaluated the feasibility of fingerprint-scanners in combination with smart cards for personal identification and transmission of encrypted TCP/IP-data-packages via satellite between the university-hospital of Innsbruck and the rural hospital of Reutte. The aim of our study was the proof of the userfriendliness of the SkymedTM technology for security purpose in teleradiology. We examined the time of the personal identification process, the time for the necessary training and the personal satisfaction. The images were sent from the local PACS in Reutte via a Data-Encryption-and-Transmission- Box via satellite from Reutte to Innsbruck. We used an asymmetric bandwidth of 512 kbit/s from Reutte to Innsbruck and 128 kbit/s in the opposite direction. Window NT 4.0- operating PCs were used for the electronical patient record, the medical inquiry of the referring physician and the final report of the radiologist. The images were reported on an UNIX-PACS viewing station. After identification through fingerprint-scanners in combination with the smart card the radiologist was able to open the electronic patient record (EPR) from Reutte and sign with his digital signature his confirmed final report before it was send back to Reutte. The used security technology enables encrypted communication over a WAN, which fulfill data-protection.

Teleradiology and PACS - strategy of the Innsbruck University Hospital; Teleradiologie und PACS - das Konzept des Universitaetsklinikums Innsbruck

Energy Technology Data Exchange (ETDEWEB)

Vogl, R. [HITT - Health Information Technologies Tirol, Innsbruck (Austria)

2005-08-01

Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [German] Die Systeme zum digitalen Bilddatenmanagement haben grosse Bedeutung und weite Verbreitung an der Universitaetsklinik Innsbruck und sind zentraler Bestandteil der IT-Strategie der Krankenhausbetreibergesellschaft TILAK (Tiroler Landeskrankenanstalten). Ziel dabei ist es insbesondere, saemtliche Bilddaten in die elektronische Krankengeschichte zu integrieren und von jedem der ca. 2500 klinischen Arbeitsplaetze aus online zugreifbar zu machen sowie den elektronischen Datenaustausch mit anderen Gesundheitsdiensteanbietern zu gewaehrleisten. Seit 1995 bestehen Teleradiologieverbindungen der Universitaetsklinik fuer Radiologie; diese wurden laufend ausgebaut und die Einbindung in das zentrale PACS hergestellt. Zur Kommunikation von Bild- und Befunddaten aus den Krankenhaeusern der TILAK an andere Gesundheitseinrichtungen wurde kuerzlich ein eHealth WebPortal geschaffen, ueber das saemtliche radiologischen Bilddaten durch zeitbefristete Freigaben fuer registrierte Benutzer zugaenglich gemacht werden koennen. (orig.)

[Telecommunications, health and radiology: potential synergies for the new millennium].

Science.gov (United States)

Lagalla, R

2001-01-01

Healthcare telematics, or telemedicine, is a new methodology that applies the potentialities of telecommunications technologies to the needs of medicine, thereby greatly contributing to improving the management of clinical data and medical information for the benefit of the individual patient and the community at large. The fields of application of Telemedicine are becoming increasingly vast, and this gives rise to technical problems (interconnections) as well as professional, ethical, medico-legal and legal problems. The dissemination of Telemedicine will require changes to be made to the organisation and delivery of the medical/administrative services connected to the management of patient data, the remote provision of care, and the impact of Telemedicine itself (e.g. need to standardise the nomenclature for telemedicine services). In addition, it will also call for a careful analysis of costs and benefits for both healthcare providers and patients. One of the most interesting experiences in terms of impact is Teleradiology. This is neither a new discipline nor a (sub)specialty: the practice of Teleradiology must comply with the rules regulating any radiological medical act, the primary aim of which is to contribute to establishing - rapidly and accurately - a diagnosis that will affect treatment strategies. It may be anticipated that in some situations Teleradiology will significantly change the working practices of Radiology Specialists and Radiology Technicians. Because it is better to anticipate problems rather than wait for them to arise, our Scientific Society, which is always sensitive to emerging issues, intends to propose the following recommendations/guidelines for the use of Teleradiology in the common interest of the community and healthcare workers. The invitation to take part in the initiative proposed by the Italian Society of Medical Radiology (SIRM), the Italian Association of Nuclear Medicine (AIMN) and the Italian Association of Neuroradiology

Legal directives in the X-ray regulation for the field of X-ray diagnostics

International Nuclear Information System (INIS)

Huhn, Walter

2012-01-01

The operation of each X-ray device is subject to the requirements of the X-ray regulations (RoeV); for different operational modes or applications like curative diagnostics, X-ray serial examinations, X-ray radiotherapy and teleradiology different directives exist and have to be respected. The report discusses the issues licensing and notification procedures, radiation protection representative, requirements for the commissioning (teleradiology, serial X.ray examinations), technical qualification and radiation protection knowledge of physicians, technical qualification of the assistant personnel.

Legal directives in the X-ray regulation for the field of X-ray diagnostics; Rechtsvorschriften der Roentgenverordnung fuer den Bereich der Roentgendiagnostik

Energy Technology Data Exchange (ETDEWEB)

Huhn, Walter [Ministerium fuer Arbeit, Integration und Soziales des Landes Nordrhein-Westfalen, Duesseldorf (Germany)

2012-11-01

The operation of each X-ray device is subject to the requirements of the X-ray regulations (RoeV); for different operational modes or applications like curative diagnostics, X-ray serial examinations, X-ray radiotherapy and teleradiology different directives exist and have to be respected. The report discusses the issues licensing and notification procedures, radiation protection representative, requirements for the commissioning (teleradiology, serial X.ray examinations), technical qualification and radiation protection knowledge of physicians, technical qualification of the assistant personnel.

Consultation of orthopaedics cases using multimedia messaging services.

Science.gov (United States)

Eranki, Vivek; Munt, Justin; Lim, Ming J; Atkinson, Robert

2010-04-23

Frequently, radiological data is transferred verbally between the Emergency Department (ED) and orthopaedic registrar. Given the different language skills and medical experience of health staff, there is often a limit to the adequacy of the verbal description that could lead to suboptimal patient care. This study proposes that concurrent review of MMS teleradiology with traditional verbal reporting results in a significant therapeutic benefit. Case notes of 40 patients who presented to ED were reviewed. Images were captured and sent to an Orthopaedic registrar along with a brief clinical synopsis. Information was collected on the diagnosis of the MMS radiograph, need for urgent admission and management plan outlined to ED. Correct diagnosis was made in 27 of 40 cases. Using the latest technology available, MMS teleradiology had 79% sensitivity, 83% specificity and an accuracy of 80%. 50% of paediatric fractures and 60% of undisplaced fractures were diagnosed successfully. MMS teleradiology is not suitable by itself as a remote diagnostic tool. However, when combined with existing clinical practice, it is effective in screening patients, enhances confidence in decision making and communication between doctors.

On-call service of neurosurgeons in Germany: organization, use of communication services, and personal acceptance of modern technologies.

Science.gov (United States)

Brenke, Christopher; Lassel, Elke A; Terris, Darcey; Kurt, Aysel; Schmieder, Kirsten; Schoenberg, Stefan O; Weisser, Gerald

2014-05-01

A significant proportion of acute care neurosurgical patients present to hospital outside regular working hours. The objective of our study was to evaluate the structure of neurosurgical on-call services in Germany, the use of modern communication devices and teleradiology services, and the personal acceptance of modern technologies by neurosurgeons. A nationwide survey of all 141 neurosurgical departments in Germany was performed. The questionnaire consisted of two parts: one for neurosurgical departments and one for individual neurosurgeons. The questionnaire, available online and mailed in paper form, included 21 questions about on-call service structure; the availability and use of communication devices, teleradiology services, and other information services; and neurosurgeons' personal acceptance of modern technologies. The questionnaire return rate from departments was 63.1% (89/141), whereas 187 individual neurosurgeons responded. For 57.3% of departments, teleradiology services were available and were frequently used by 62.2% of neurosurgeons. A further 23.6% of departments described using smartphone screenshots of computed tomography (CT) images transmitted by multimedia messaging service (MMS), and 8.6% of images were described as sent by unencrypted email. Although 47.0% of neurosurgeons reported owning a smartphone, only 1.1% used their phone for on-call image communication. Teleradiology services were observed to be widely used by on-call neurosurgeons in Germany. Nevertheless, a significant number of departments appear to use outdated techniques or techniques that leave patient data unprotected. On-call neurosurgeons in Germany report a willingness to adopt more modern approaches, utilizing readily available smartphones or tablet technology. Georg Thieme Verlag KG Stuttgart · New York.

The role of university hospitals as centers of excellence for shared health-care-delivery of in- and outpatients

International Nuclear Information System (INIS)

Adelhard, K.; Matzko, M.; Bruening, R.; Holzknecht, N.; Stark, V.; Reiser, M.

2002-01-01

Problem. Health care delivery in Germany has to face severe challenges that will lead to a closer integration of services for in- and out-patients. University hospitals play an important role due to their activities in research, education and health care delivery. They are requested to promote and evaluate new means and ways for health care delivery. Methods. The Institute of Clinical Radiology at the University Hospital of the Ludwig-Maximilians-University started teleradiological services for hospitals and general practices in January 1999 in the framework of the ''Imaging services - teleradiological center of excellence''. Legal, technical and organizational prerequisites were analyzed. Results. Networks between university hospitals and general practices are not likely to solve all future problems. They will, however, increase the availability of the knowledge of experts even in rural areas and contribute to a quality ensured health care at the patients home. Future developments may lead to international co-operations and such services may be available to patients abroad. Conclusion. Legal, technical and organizational obstacles have to be overcome to create a framework for high quality telemedical applications. University hospitals will play an important role in promoting and evaluating teleradiological services. (orig.) [de

Certificação digital de exames em telerradiologia: um alerta necessário Digital certification in teleradiology: a necessary warning

Directory of Open Access Journals (Sweden)

Luiz Felipe Nobre

2007-12-01

Full Text Available A crescente popularização das atividades de telemedicina em todo o mundo tem exigido de médicos e demais profissionais da saúde novas abordagens em sua prática profissional. No que se refere à telerradiologia, observamos forte tendência à transformação de documentos clínicos - como resultados de exames, que até hoje existiam na forma de filmes impressos e laudos em papel - em documentos eletrônicos, disponibilizados em redes internas de clínicas e hospitais, ou pela internet. Esta tendência torna necessária a divulgação e o esclarecimento de conceitos como a certificação digital, a criptografia de dados na internet, a confiabilidade de sites, o documento eletrônico confiável e a assinatura digital. Os princípios básicos desses conceitos, embora por vezes complexos para os profissionais da saúde, podem ser compreendidos de forma efetiva sem que o leitor tenha de mergulhar de cabeça em labirintos como a matemática da criptografia de chaves assimétricas ou os protocolos de comunicação digital de dados. Neste artigo abordaremos de forma direta e com exemplos práticos os aspectos de segurança e confiabilidade de documentos clínicos eletrônicos baseados na internet, com o objetivo de que os usuários médicos possam interagir de forma informada, segura e bem fundamentada com serviços de telerradiologia.The increasing worldwide popularization of telemedicine activities has demanded a new approach to the professional practice by physicians and other health professionals. As far as teleradiology is concerned, a remarkable trend has been observed toward the transformation of clinical documents - like radiological studies results, that so far existed as printed films and paper-based reports - into electronic documents available in internal networks of medical clinics and hospitals or through the internet. As a result of this trend, it is necessary to divulge and explain concepts such as digital certification, internet

A low cost tele-imaging platform for developing countries

Directory of Open Access Journals (Sweden)

Kokou eADAMBOUNOU

2014-09-01

Full Text Available Purpose: To design a low cost tele-imaging method allowing real time tele-ultrasound expertise, delayed tele-ultrasound diagnosis and tele-radiology between remote peripherals hospitals and clinics (patient centres and university hospital centres (expert centre.Materials and Methods: A system of communication via internet (IP camera and remote access software enabling transfer of ultrasound videos and images between two centres, allows a real time tele-radiology expertise in the presence of a junior sonographer or radiologist at the patient centre. In the absence of a sonographer or radiologist at the patient centre, a 3D reconstruction program allows a delayed tele-ultrasound diagnosis with images acquired by a lay operator (e.g. midwife, nurse, technician. The system was tested both with high and low bandwidth. The system can further accommodate non-ultrasound tele-radiology (conventional radiography, mammography and computer tomography for example. The system was tested on 50 patients between CHR Tsevie in Togo (40km from Lomé-Togo and 4500km from Tours-France and CHU Campus at Lomé and CHU Trousseau in Tours.Results: A real time tele-expertise was successfully performed with a delay of approximately 1.5 seconds with an internet bandwidth of around 1Mbps (IP Camera and 512kbps (remote access software. A delayed tele-ultrasound diagnosis was also performed with satisfactory results. The transmission of radiological images from the patient centre to the expert centre was of adequate quality. Delayed tele-ultrasound and tele-radiology was possible even in the presence of a low bandwidth internet connection. Conclusion: This tele-imaging method, requiring nothing by readily available and inexpensive technology and equipment, offers a major opportunity for telemedicine in developing countries.

Images crossing borders: image and workflow sharing on multiple levels.

Science.gov (United States)

Ross, Peeter; Pohjonen, Hanna

2011-04-01

Digitalisation of medical data makes it possible to share images and workflows between related parties. In addition to linear data flow where healthcare professionals or patients are the information carriers, a new type of matrix of many-to-many connections is emerging. Implementation of shared workflow brings challenges of interoperability and legal clarity. Sharing images or workflows can be implemented on different levels with different challenges: inside the organisation, between organisations, across country borders, or between healthcare institutions and citizens. Interoperability issues vary according to the level of sharing and are either technical or semantic, including language. Legal uncertainty increases when crossing national borders. Teleradiology is regulated by multiple European Union (EU) directives and legal documents, which makes interpretation of the legal system complex. To achieve wider use of eHealth and teleradiology several strategic documents were published recently by the EU. Despite EU activities, responsibility for organising, providing and funding healthcare systems remains with the Member States. Therefore, the implementation of new solutions requires strong co-operation between radiologists, societies of radiology, healthcare administrators, politicians and relevant EU authorities. The aim of this article is to describe different dimensions of image and workflow sharing and to analyse legal acts concerning teleradiology in the EU.

Teleradiology in KwaZulu- Natal

African Journals Online (AJOL)

rural doctors and hospitals have in accessing specialist advice in South Africa. Telemedicine programmes between remote rural hospitals and central hospitals have been successfully implemented in Canada, the USA, Saudi Arabia and Australia.' In all these countries telemedicine has allowed the specialist to come to the ...

PACS: implementation in the U.S. Department of Defense

Science.gov (United States)

Chacko, Anna K.; Wider, Ronald; Romlein, John R.; Cawthon, Michael A.; Richardson, Ronald R., Jr.; Lollar, H. William; Cook, Jay F.; Timboe, Harold L.; Johnson, Thomas G.; Fellows, Douglas W.

2000-05-01

The Department of Defense has been a leader in Radiology re- engineering for the past decade. Efforts have included the development of two landmark PACS specifications (MDIS and DIN- PACS), respective vendor selection and implementation programs. A Tri-Service (Army, Navy and Air Force) Radiology re-engineering program was initiated which identified transitioning to digital imaging, PACS and teleradiology as key enabling technologies in a changing business scenario. Subsequently, the systematic adjustment of procurement process for radiological imaging equipment included a focus on specifying PACS-capable-digital imaging modalities and mini- PACS as stepping stones to make the hospitals and health clinics PACS-ready. The success of the PACS and teleradiology program in the DOD is evidenced by the near filmless operation of most Army and Air Force Medical Centers, several community hospitals and several operational teleradiology constellations. Additionally, the MDIS PACSystem has become the commercial PACS product for General Electric Medical Systems. The DOD continues to forge ahead in the PACS arena by implementing advanced configurations and operational concepts such as the VRE (Virtual Radiology Environment), the negotiation of Regional Archiving and Regional PACS Maintenance Programs. Newer regulations (HIPAA, the FDA approval of digital mammography) have been promulgated impacting the culture and conduct of our business. Incorporating their requirements at the very outset will enable us to streamline the delivery of radiology. The DOD community has embraced the information age at multiple levels. The Healthcare portion of this community with these initiatives is integrating itself into DOD's future. The future holds great possibilities, promises and challenges for the DOD PACS programs.

The clinical application of mobile technology to disaster medicine.

Science.gov (United States)

Case, Timothy; Morrison, Cecily; Vuylsteke, Alain

2012-10-01

Mobile health care technology (mHealth) has the potential to improve communication and clinical information management in disasters. This study reviews the literature on health care and computing published in the past five years to determine the types and efficacy of mobile applications available to disaster medicine, along with lessons learned. Five types of applications are identified: (1) disaster scene management; (2) remote monitoring of casualties; (3) medical image transmission (teleradiology); (4) decision support applications; and (5) field hospital information technology (IT) systems. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Deployments of teleradiology and field hospital IT systems to disaster zones suggest that mHealth can improve resource allocation and patient care. The key problems include suitability of equipment for use in disaster zones and providing sufficient training to ensure staff familiarity with complex equipment. Future research should focus on providing unbiased observations of the use of mHealth in disaster medicine.

Digital medical imaging

International Nuclear Information System (INIS)

Goeringer, F.; Mun, S.K.; Kerlin, B.D.

1989-01-01

In formulating an implementation strategy for digital medical imaging, three interrelated thrusts have emerged for the defense medical establishment. These thrusts: totally filmless medical imaging on the battlefield, teleradiology, and DIN/PACS for peacetime military health care are discussed. They have implications in their fully developed form as resource savers and quality improvers for the unique aspects of military health care

Remote CT reading using an ultramobile PC and web-based remote viewing over a wireless network.

Science.gov (United States)

Choi, Hyuk Joong; Lee, Jeong Hun; Kang, Bo Seung

2012-01-01

We developed a new type of mobile teleradiology system using an ultramobile PC (UMPC) for web-based remote viewing over a wireless network. We assessed the diagnostic performance of this system for abdominal CT interpretation. Performance was compared with an emergency department clinical monitor using a DICOM viewer. A total of 100 abdominal CT examinations were presented to four observers. There were 56 examinations showing appendicitis and 44 which were normal. The observers viewed the images using a UMPC display and an LCD monitor and rated each examination on a five-point scale. Receiver operating characteristics (ROC) analysis was used to test for differences. The sensitivity and specificities of all observers were similarly high. The average area under the ROC curve for readings performed on the UMPC and the LCD monitor was 0.959 and 0.976, respectively. There were no significant differences between the two display systems for interpreting abdominal CTs. The web-based mobile teleradiology system appears to be feasible for reading abdominal CTs for diagnosing appendicitis and may be valuable in emergency teleconsultation. Copyright © 2012 by the Royal Society of Medicine Press Ltd

Watermark Compression in Medical Image Watermarking Using Lempel-Ziv-Welch (LZW) Lossless Compression Technique.

Science.gov (United States)

Badshah, Gran; Liew, Siau-Chuin; Zain, Jasni Mohd; Ali, Mushtaq

2016-04-01

In teleradiology, image contents may be altered due to noisy communication channels and hacker manipulation. Medical image data is very sensitive and can not tolerate any illegal change. Illegally changed image-based analysis could result in wrong medical decision. Digital watermarking technique can be used to authenticate images and detect as well as recover illegal changes made to teleradiology images. Watermarking of medical images with heavy payload watermarks causes image perceptual degradation. The image perceptual degradation directly affects medical diagnosis. To maintain the image perceptual and diagnostic qualities standard during watermarking, the watermark should be lossless compressed. This paper focuses on watermarking of ultrasound medical images with Lempel-Ziv-Welch (LZW) lossless-compressed watermarks. The watermark lossless compression reduces watermark payload without data loss. In this research work, watermark is the combination of defined region of interest (ROI) and image watermarking secret key. The performance of the LZW compression technique was compared with other conventional compression methods based on compression ratio. LZW was found better and used for watermark lossless compression in ultrasound medical images watermarking. Tabulated results show the watermark bits reduction, image watermarking with effective tamper detection and lossless recovery.

Progress of computer-aided detection/diagnosis (CAD in dentistryCAD in dentistry

Directory of Open Access Journals (Sweden)

Akitoshi Katsumata

2014-08-01

CAD is also useful in the detection and evaluation of dental and maxillofacial lesions. Identifying alveolar bone resorption due to periodontitis and radiolucent jaw lesions (such as radicular and dentigerous cysts are important goals for CAD. CAD can be applied not only to panoramic radiography but also to dental cone-beam computed tomography (CBCT images. Linking of CAD and teleradiology will be an important issue.

Efficient reconfigurable architectures for 3D medical image compression

OpenAIRE

Afandi, Ahmad

2010-01-01

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Recently, the more widespread use of three-dimensional (3-D) imaging modalities, such as magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), and ultrasound (US) have generated a massive amount of volumetric data. These have provided an impetus to the development of other applications, in particular telemedicine and teleradiology. In thes...

Overview of PACS

Science.gov (United States)

Vanden Brink, John A.

1995-08-01

Development of the DICOM standard and incremental developments in workstation, network, compression, archiving, and digital x-ray technology have produced cost effective image communication possibilities for selected medical applications. The emerging markets include modality PACS, mini PACS, and teleradiology. Military and VA programs lead the way in the move to adopt PACS technology. Commercial markets for PACS components and PAC systems are at LR400 million growing to LR500 million in 1996.

DICOM-compliant PACS with CD-based image archival

Science.gov (United States)

Cox, Robert D.; Henri, Christopher J.; Rubin, Richard K.; Bret, Patrice M.

1998-07-01

This paper describes the design and implementation of a low- cost PACS conforming to the DICOM 3.0 standard. The goal was to provide an efficient image archival and management solution on a heterogeneous hospital network as a basis for filmless radiology. The system follows a distributed, client/server model and was implemented at a fraction of the cost of a commercial PACS. It provides reliable archiving on recordable CD and allows access to digital images throughout the hospital and on the Internet. Dedicated servers have been designed for short-term storage, CD-based archival, data retrieval and remote data access or teleradiology. The short-term storage devices provide DICOM storage and query/retrieve services to scanners and workstations and approximately twelve weeks of 'on-line' image data. The CD-based archival and data retrieval processes are fully automated with the exception of CD loading and unloading. The system employs lossless compression on both short- and long-term storage devices. All servers communicate via the DICOM protocol in conjunction with both local and 'master' SQL-patient databases. Records are transferred from the local to the master database independently, ensuring that storage devices will still function if the master database server cannot be reached. The system features rules-based work-flow management and WWW servers to provide multi-platform remote data access. The WWW server system is distributed on the storage, retrieval and teleradiology servers allowing viewing of locally stored image data directly in a WWW browser without the need for data transfer to a central WWW server. An independent system monitors disk usage, processes, network and CPU load on each server and reports errors to the image management team via email. The PACS was implemented using a combination of off-the-shelf hardware, freely available software and applications developed in-house. The system has enabled filmless operation in CT, MR and ultrasound within

Digital imaging in diagnostic radiology

International Nuclear Information System (INIS)

Newell, J.D. Jr.; Kelsey, C.A.

1990-01-01

This monograph on digital imaging provides a basic overview of this field at the present time. This paper covers clinical application, including subtraction angiography; chest radiology; genitourinary, gastrointestinal, and breast radiology; and teleradiology. The chest section also includes an explanation of multiple beam equalization radiography. The remaining chapters discuss some of the technical aspects of digital radiology. It includes the basic technology of digital radiography, image compression, and reconstruction information on the economics of digital radiography

Teleradiology (TELEACE) system: results of a field trial

International Nuclear Information System (INIS)

Lee, Jong Min; Kim, Gi Bum; Seong, Yeung Soon; Suh, Kyung Jin; Kang, Duk Sik

1993-01-01

We report the results of field operation of TELEACE system between Kyung-Pook National University Hospital and Ul-Jin Goon Health Care Medical Center from December, 1990 to September, 1991, which had been operated as a kind of Integrated Services Digital Network projects by KOREA TELECOMMUNICATION Inc. Ul-Jin Goon Health Care Medical Center transmitted 414 plain radiographs to our hospital in speed of 9600BPS. Each image was composed of 1024X1024 pixelsX8 bits/pixel. In our hospital, the image flies were displayed on high resolution monitor (1280X1024 pixels). Text files of image interpretations were transmitted to the health care medical center. The two radiologists who had interpreted the transmitted images, went to the health care medical center and read radiographic films with blind test method. We obtained the following results: false negative rate of 6.3%, false positive rate of 2.4%, mean sensitivity of 81.4%, mean specificity of 96.3%, and mean accuracy of 91.3%. In predictive value of 0.05, there was no significant difference between results of these two types of radiographs. In conclusion, TELEACE system was valuable to the clinicians isolated from services of radiologists

A Brazilian educational experiment: teleradiology on web TV.

Science.gov (United States)

Silva, Angélica Baptista; de Amorim, Annibal Coelho

2009-01-01

Since 2004, educational videoconferences have been held in Brazil for paediatric radiologists in training. The RUTE network has been used, a high-speed national research and education network. Twelve videoconferences were recorded by the Health Channel and transformed into TV programmes, both for conventional broadcast and for access via the Internet. Between October 2007 and December 2009 the Health Channel website registered 2378 hits. Our experience suggests that for successful recording of multipoint videoconferences, four areas are important: (1) a pre-planned script is required, for both physicians and film-makers; (2) particular care is necessary when editing the audiovisual material; (3) the audio and video equipment requires careful adjustment to preserve clinical discussions and the quality of radiology images; (4) to produce a product suitable for both TV sets and computer devices, the master tape needs to be encoded in low resolution digital video formats for Internet media (wmv and rm format for streaming, and compressed zip files for downloading) and MPEG format for DVDs.

How safe is teleradiological telediagnosis for CT imaging?

International Nuclear Information System (INIS)

Ricke, J.; Wolf, M.; Hosten, N.; Zielinski, C.; Liebig, T.; Lopez-Haenninen, E.; Lemke, A.J.; Siekmann, R.; Stroszczynski, C.; Schauer, W.; Amthauer, H.; Kleinholz, L.; Felix, R.

1997-01-01

Purpose: To define the value of teleradiographic studies, a comparison was carried out between digitised copies of CT examinations of the skull with the original images. Differences in image quality obtained from a digital scanner and a camera were quantified. Material and method: 56 CT examinations of the skull, 28 of which had discrete abnormalities, were chosen for ROC analysis. The original films were digitised with a Vidar VXR-12 scanner and Panasonic WV-160 and WV-PB 500 cameras. The images were evaluated by five radiologists after image transfer with Video Conference software to a personal computer. Results: For the analysis of the films the area under the ROC curve was 0.91±0.04, for the digital scanner it was 0.85±0.04, for camera WV-BP 500 0.89±0.06 and for camera WE-160 0.87±0.09. Comprison with the film findings showed a minimal p-value of 0.17 which indicated that there was no significant reduction in diagnostic value following digitisation. Conclusion: The probable reason for the slight deterioration using the digital scanner was the reduction to 75 dpi compared with 134 dpi on the CT films. The cameras produce image noise comparable to CT with low window settings and reduced local resolution. We expect similar results for CT with soft tissue windows or for MRT of the skull. Conventional radiographs containing high local resolution, wide grey scale and low image noise would presumably make higher demands on methods of digitisation. (orig.) [de

Challenges in sending large radiology images over military communications channels

Science.gov (United States)

Cleary, Kevin R.; Levine, Betty A.; Norton, Gary S.; Mundur, Padmavathi V.

1997-05-01

In cooperation with the US Army, Georgetown University Medical Center (GUMC) deployed a teleradiology network to sites in Bosnia-Herzegovina, Hungary, and Germany in early 1996. This deployment was part of Operation Primetime III, a military project to provide state-of-the-art medical care to the 20,000 US troops stationed in Bosnia-Herzegovina.In a three-month time frame from January to April 1996, the Imaging Sciences and Information Systems (ISIS) Center at GUMC worked with the Army to design, develop, and deploy a teleradiology network for the digital storage and transmission of radiology images. This paper will discuss some of the problems associated with sending large files over communications networks with significant delays such as those introduced by satellite transmissions.Radiology images of up to 10 megabytes are acquired, stored, and transmitted over the wide area network (WAN). The WAN included leased lines from Germany to Hungary and a satellite link form Germany to Bosnia-Herzegovina. The communications links provided at least a T-1 bandwidth. The satellite link introduces a round-trip delay of approximately 500 milliseconds. This type of high bandwidth, high delay network is called a long fat network. The images are transferred across this network using the Transmission Control Protocol (TCP/IP). By modifying the TCP/IP software to increase the window size, the throughput of the satellite link can be greatly improved.

Computer assisted radiology

International Nuclear Information System (INIS)

Lemke, H.U.; Jaffe, C.C.

1991-01-01

The present proceedings contain all papers and posters presented at the CAR 91 meeting. The topics were as follows: Digital image generation including CT, MR, DSA, US, SPECT, PET and DR (41 papers, 31 posters), application systems (22 papers, 14 posters), image management and communication (27 papers, 8 posters), medical workstations (31 papers, 12 posters). The sessions were dealing with social aspects (5 papers, 2 posters), pediatric radialogy (5 papers), and teleradiology (5 papers, 4 posters). (MG) With 389 figs

Computerized radiology instruction

International Nuclear Information System (INIS)

Goldberg, M.E.; Drake, D.G.; Day, D.L.

1987-01-01

The storage and display capabilities of a teleradiology system are used in an educational setting to allow the student (radiologist, resident, or medical student) to interactively respond to questions regarding a series of displayed images (radiographs, CT and US scans, and so forth). The computer prompts the respondent for the correct response, and both correct and incorrect responses are made known to the user. The immediate feedback to the user is a key to the student's acceptance of this form of teaching

Mobile CT. Technical aspects of prehospital stroke imaging before intravenous thrombolysis

International Nuclear Information System (INIS)

Gierhake, Daniel; Villringer, K.; Fiebach, J.B.; Weber, J.E.; Audebert, H.J.; Charite - Universitaetsmedizin Berlin; Ebinger, M.; Charite - Universitaetsmedizin Berlin

2013-01-01

To reduce the time from symptom onset to treatment with tissue plasminogen activator (tPA) in ischemic stroke, an ambulance was equipped with a CT scanner. We analyzed process and image quality of CT scanning during the pilot study regarding image quality and safety issues. The pilot study of a stroke emergency mobile unit (STEMO) ran over a period of 12 weeks on 5 weekdays from 7a. m. to 6:30 p. m. A teleradiological service for the justifying indication and reporting was established. The radiographer was responsible for the performance of the CT scan on the ambulance. 64 cranial CT scans and 1 intracranial CT angiography were performed. We compared times from ambulance alarm to treatment decision (time of last brain scan) with a cohort of 50 consecutive tPA treatments before implementation of STEMO. 62 (95 %) of the 65 scans performed had sufficient quality for reading. Technical quality was not optimal in 45 cases (69 %) mainly caused by suboptimal positioning of patient or eye lense protection. Motion artefacts were observed in 8 exams (12 %). No safety issues occurred for team or patients. 23 patients were treated with thrombolysis. Time from alarm to last CT scan was 18 minutes shorter than in the tPA cohort before STEMO implementation. A teleradiological support for primary stroke imaging by CT on-site is feasible, quality-wise of diagnostic value and has not raised safety issues. (orig.)

What is found positive in healthcare information and communication technology implementation?-the results of a nationwide survey in Finland.

Science.gov (United States)

Winblad, Ilkka; Hämäläinen, Päivi; Reponen, Jarmo

2011-03-01

Considerable expectations have been placed on information and communication technology (ICT) in improving the processes and quality of healthcare. Our purpose was to find out which element is found positive in healthcare ICT implementation. An online questionnaire on e-Health implementation submitted to all Finnish public health service providers and a sample from the private sector included an open question about which the electronic working methods, systems, or applications have most positively influenced the fluency or quality of service processes. The electronic health record was mentioned as an item that has positive influence by 52% of the respondents from the hospital districts, 27% of those from the primary healthcare centers, and 38% of those from the private providers. Digital radiology systems (including teleradiology) were mentioned by 52% of the hospital districts and 27% of the primary healthcare centers. The figures for digital laboratory systems (including telelaboratory) were 5% and 11%, respectively. The figures for teleradiology itself were 5% for the hospital districts and 15% for the primary healthcare centers; the figures for telelaboratory systems were 5% and 9%, respectively. The specialized healthcare seem to experience intraorganizational electronic services integrated to the electronic health record, such as digital radiology and laboratory services as exerting a positive influence, whereas the primary healthcare find such influence from different functions such as interorganizational data exchange and telemedicine services. These might indicate where the efforts should be focused when implementing ICT in healthcare.

Interactive tele-radiological segmentation systems for treatment and diagnosis.

Science.gov (United States)

Zimeras, S; Gortzis, L G

2012-01-01

Telehealth is the exchange of health information and the provision of health care services through electronic information and communications technology, where participants are separated by geographic, time, social and cultural barriers. The shift of telemedicine from desktop platforms to wireless and mobile technologies is likely to have a significant impact on healthcare in the future. It is therefore crucial to develop a general information exchange e-medical system to enables its users to perform online and offline medical consultations through diagnosis. During the medical diagnosis, image analysis techniques combined with doctor's opinions could be useful for final medical decisions. Quantitative analysis of digital images requires detection and segmentation of the borders of the object of interest. In medical images, segmentation has traditionally been done by human experts. Even with the aid of image processing software (computer-assisted segmentation tools), manual segmentation of 2D and 3D CT images is tedious, time-consuming, and thus impractical, especially in cases where a large number of objects must be specified. Substantial computational and storage requirements become especially acute when object orientation and scale have to be considered. Therefore automated or semi-automated segmentation techniques are essential if these software applications are ever to gain widespread clinical use. The main purpose of this work is to analyze segmentation techniques for the definition of anatomical structures under telemedical systems.

Interactive Tele-Radiological Segmentation Systems for Treatment and Diagnosis

Directory of Open Access Journals (Sweden)

S. Zimeras

2012-01-01

Full Text Available Telehealth is the exchange of health information and the provision of health care services through electronic information and communications technology, where participants are separated by geographic, time, social and cultural barriers. The shift of telemedicine from desktop platforms to wireless and mobile technologies is likely to have a significant impact on healthcare in the future. It is therefore crucial to develop a general information exchange e-medical system to enables its users to perform online and offline medical consultations through diagnosis. During the medical diagnosis, image analysis techniques combined with doctor’s opinions could be useful for final medical decisions. Quantitative analysis of digital images requires detection and segmentation of the borders of the object of interest. In medical images, segmentation has traditionally been done by human experts. Even with the aid of image processing software (computer-assisted segmentation tools, manual segmentation of 2D and 3D CT images is tedious, time-consuming, and thus impractical, especially in cases where a large number of objects must be specified. Substantial computational and storage requirements become especially acute when object orientation and scale have to be considered. Therefore automated or semi-automated segmentation techniques are essential if these software applications are ever to gain widespread clinical use. The main purpose of this work is to analyze segmentation techniques for the definition of anatomical structures under telemedical systems.

Teleradiology in clinical practices and teaching of pediatric radiology

International Nuclear Information System (INIS)

O'Connor, J.F.

1987-01-01

A software program developed by OPTEL has been evaluated for use in consultation and interactive teaching in pediatric radiology in a university system with three interconnected hospitals. The system uses IBM PC hardware. Screen capture allows users to run graphics and text in foreground and permits conventional television images to be grabbed and stored. Images are retrieved using a graphics tablet and pen. Annotation of the graphics tablet permits arrows and other indicators to be superimposed on radiographs. Color and black-and-white images can be transmitted from any hospital site with television imaging capability and a PC. Applications in clinical practice and teaching programs via interactive telephone communication are described

95. German Roentgen congress and 7. joint congress of the DRG and OeRG. Program with abstracts

International Nuclear Information System (INIS)

Diederich, Stefan; Lammer, Johannes

2014-01-01

The volume contains the program and the abstracts of the 95th German Roentgen congress and the 7th joint congress of the DRG and OeRG. The radiological focal points of the congress were thorax radiology (pneumology: lung fibrosis, emphysema); oncological radiology: skeletal carcinoma, lung carcinoma, kidneys, lung metastases, primary liver carcinoma, liver metastases. Further topics included radiology in hospitals and medical centers, tele-radiology, ambulant health care, legal issues, financial accounting and management issues. Several courses an specific radiological issues and radiological techniques were offered, including radiation protection and legal aspects.

95. German Roentgen congress and 7. joint congress of the DRG and OeRG. Program with abstracts; 95. Deutscher Roentgenkongress und 7. Gemeinsamer Kongress von DRG und OeRG. Vollstaendiges Programm mit Abstracts

Energy Technology Data Exchange (ETDEWEB)

Diederich, Stefan; Lammer, Johannes (eds.)

2014-05-15

The volume contains the program and the abstracts of the 95th German Roentgen congress and the 7th joint congress of the DRG and OeRG. The radiological focal points of the congress were thorax radiology (pneumology: lung fibrosis, emphysema); oncological radiology: skeletal carcinoma, lung carcinoma, kidneys, lung metastases, primary liver carcinoma, liver metastases. Further topics included radiology in hospitals and medical centers, tele-radiology, ambulant health care, legal issues, financial accounting and management issues. Several courses an specific radiological issues and radiological techniques were offered, including radiation protection and legal aspects.

Radiology and the mobile device: Radiology in motion

Directory of Open Access Journals (Sweden)

Sridhar G Panughpath

2012-01-01

Full Text Available The use of mobile devices is revolutionizing the way we communicate, interact, are entertained, and organize our lives. With healthcare in general and radiology in particular becoming increasingly digital, the use of such devices in radiologic practice is inevitable. This article reviews the current status of the use of mobile devices in the clinical practice of radiology, namely in emergency teleradiology. Technical parameters such as luminance and resolution are discussed. The article also discusses the benefits of such mobility vis-à-vis the current limitations of the technologies available.

Radiology and the mobile device: Radiology in motion

International Nuclear Information System (INIS)

Panughpath, Sridhar G; Kalyanpur, Arjun

2012-01-01

The use of mobile devices is revolutionizing the way we communicate, interact, are entertained, and organize our lives. With healthcare in general and radiology in particular becoming increasingly digital, the use of such devices in radiologic practice is inevitable. This article reviews the current status of the use of mobile devices in the clinical practice of radiology, namely in emergency teleradiology. Technical parameters such as luminance and resolution are discussed. The article also discusses the benefits of such mobility vis-à-vis the current limitations of the technologies available

A Review of Telemedicine Services in Finland

DEFF Research Database (Denmark)

Khatri, Vikramajeet; Peterson, Carrie Beth; Kyriazakos, Sofoklis

2011-01-01

Telemedicine is gaining popularity due to the provision of ubiquitous health care services that is a fundamental need for every socialized society. In this paper, telemedicine services in Finland are discussed, as well as how they came into existence, how they are funded, evaluated, and what...... are their impacts on health care systems and society. Telemedicine services like teleradiology, telelaboratory, telepsychiatry and remote consultations, are being offered in all hospital districts. Primary health care centers in Finland are lacking telemedicine services, and are planning to have them. Electronic...

Presidential address: distinction or extinction.

Science.gov (United States)

Pressman, Barry D

2008-10-01

Despite its continuing scientific successes in imaging, radiology as a specialty is faced with a very difficult and competitive environment. Nonradiologists are more and more interested in vertically integrating imaging into their practices, while teleradiology and picture archiving and communication systems are resulting in the greater isolation of radiologists. Commoditization is a realistic and devastating threat to the survival and professionalism of the specialty. To remain viable as a specialty, radiologists must elevate their practice by subspecializing, becoming more involved with clinical care, and actively interacting with patients and referring clinicians. Distinction will prevent extinction.

The use of web internet technologies to distribute medical images

International Nuclear Information System (INIS)

Deller, A.L.; Cheal, D.; Field, J.

1999-01-01

Full text: In the past, internet browsers were considered ineffective for image distribution. Today we have the technology to use internet standards for picture archive and communication systems (PACS) and teleradiology effectively. Advanced wavelet compression and state-of-the-art JAVA software allows us to distribute images on normal computer hardware. The use of vendor and database neutral software and industry-standard hardware has many advantages. This standards base approach avoids the costly rapid obsolescence of proprietary PACS and is cheaper to purchase and maintain. Images can be distributed around a hospital site, as well as outside the campus, quickly and inexpensively. It also allows integration between the Hospital Information System (HIS) and the Radiology Information System (RIS). Being able to utilize standard internet technologies and computer hardware for PACS is a cost-effective alternative. A system based on this technology can be used for image distribution, archiving, teleradiology and RIS integration. This can be done without expensive specialized imaging workstations and telecommunication systems. Web distribution of images allows you to send images to multiple places concurrently. A study can be within your Medical Imaging Department, as well as in the ward and on the desktop of referring clinicians - with a report. As long as there is a computer with an internet access account, high-quality images can be at your disposal 24 h a day. The importance of medical images for patient management makes them a valuable component of the patient's medical record. Therefore, an efficient system for displaying and distributing images can improve patient management and make your workplace more effective

Radiographic film digitizing devices

International Nuclear Information System (INIS)

McFee, W.H.

1988-01-01

Until recently, all film digitizing devices for use with teleradiology or picture archiving and communication systems used a video camera to capture an image of the radiograph for subsequent digitization. The development of film digitizers that use a laser beam to scan the film represents a significant advancement in digital technology, resulting in improved image quality compared with video scanners. This paper discusses differences in resolution, efficiency, reliability, and the cost between these two types of devices. The results of a modified receiver operating characteristic comparison study of a video scanner and a laser scanner manufactured by the same company are also discussed

Telemedicine in the German Armed Forces - the initial results of a pilot project

International Nuclear Information System (INIS)

Wickenhoefer, R.; Froessler, H.; Schell, T.

1997-01-01

The growing number of teleradiology examinations demonstrate the increasing acceptance of this procedure. Furthermore, the faster reporting service by qualified specialists is apparently not only used by the Medical Clinic in Bonn but, more and more, also by other medical facilities in the area via referrals. The purposeful use and expansion of telemedicine can, in the long-term, lead to significant quality improvements, cost savings and the more efficient utilization of resources. However, note that these benefits cannot be obtained free of charge; investments are required in hardware/software and in personnel for expertise centers. (orig./AJ)

Protecting clinical data in PACS, teleradiology systems, and research environments

Science.gov (United States)

Meissner, Marion C.; Collmann, Jeff R.; Tohme, Walid G.; Mun, Seong K.

1997-05-01

As clinical data is more widely stored in electronic patient record management systems and transmitted over the Internet and telephone lines, it becomes more accessible and therefore more useful, but also more vulnerable. Computer systems such as PACS, telemedicine applications, and medical research networks must protect against accidental or deliberate modification, disclosure, and violation of patient confidentiality in order to be viable. Conventional wisdom in the medical field and among lawmakers legislating the use of electronic medical records suggests that, although it may improve access to information, an electronic medical record cannot be as secure as a traditional paper record. This is not the case. Information security is a well-developed field in the computer and communications industry. If medical information systems, such as PACS, telemedicine applications, and research networks, properly apply information security techniques, they can ensure the accuracy and confidentiality of their patient information and even improve the security of their data over a traditional paper record. This paper will elaborate on some of these techniques and discuss how they can be applied to medical information systems. The following systems will be used as examples for the analysis: a research laboratory at Georgetown University Medical Center, the Deployable Radiology system installed to support the US Army's peace- keeping operation in Bosnia, a kidney dialysis telemedicine system in Washington, D.C., and various experiences with implementing and integrating PACS.

Teleradiology in KwaZuluNatal | Corr | South African Medical Journal

African Journals Online (AJOL)

... whether any errors in interpretation of the radiographs had been made and whether the reports had changed patient management. Results. The service changed patient management in 10% of cases. Undetected pathology was recognised by the radiologist in 20 patients - pulmonary tuberculosis in 10, spinal tuberculosis ...

Teleradiology mobile internet system with a new information security solution

Science.gov (United States)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kusumoto, Masahiko; Kaneko, Masahiro; Moriyama, Noriyuki

2014-03-01

We have developed an external storage system by using secret sharing scheme and tokenization for regional medical cooperation, PHR service and information preservation. The use of mobile devices such as smart phones and tablets will be accelerated for a PHR service, and the confidential medical information is exposed to the risk of damage and intercept. We verified the transfer rate of the sending and receiving of data to and from the external storage system that connected it with PACS by the Internet this time. External storage systems are the data centers that exist in Okinawa, in Osaka, in Sapporo and in Tokyo by using secret sharing scheme. PACS continuously transmitted 382 CT images to the external data centers. Total capacity of the CT images is about 200MB. The total time that had been required to transmit was about 250 seconds. Because the preservation method to use secret sharing scheme is applied, security is strong. But, it also takes the information transfer time of this system too much. Therefore, DICOM data is masked to the header information part because it is made to anonymity in our method. The DICOM data made anonymous is preserved in the data base in the hospital. Header information including individual information is divided into two or more tallies by secret sharing scheme, and preserved at two or more external data centers. The token to relate the DICOM data anonymity made to header information preserved outside is strictly preserved in the token server. The capacity of header information that contains patient's individual information is only about 2% of the entire DICOM data. This total time that had been required to transmit was about 5 seconds. Other, common solutions that can protect computer communication networks from attacks are classified as cryptographic techniques or authentication techniques. Individual number IC card is connected with electronic certification authority of web medical image conference system. Individual number IC card is given only to the person to whom the authority to operate web medical image conference system was given.

Digital imaging and communications in medicine (DICOM). A practical introduction and survival guide

International Nuclear Information System (INIS)

Pianykh, O.S.

2008-01-01

This is the first Digital Imaging and Communications in Medicine (DICOM) book to introduce this complex imaging standard from a very practical point of view. It is aimed at a broad audience of radiologists, clinical administrators, information technologists, and digital medicine practitioners. It provides a gradual, down-to-earth introduction to DICOM and is accompanied by an analysis of the most common pitfalls and problems associated with its implementation. Whether you are running a teleradiology project or writing DICOM software, this book is for you; it will prepare you for any DICOM project or problem solving and will help you to take full advantage of this powerful tool. (orig.)

[Digital imaging system are rapidly introduced in Swedish departments of radiography. This calls for new strategic planning].

Science.gov (United States)

Laurin, S; Norberg, K A

2000-10-11

Diagnostic radiology in Sweden is changing rapidly to digital (filmless) technique. The advantages are more rapid delivery of radiologic service, better working conditions and less negative effects on the environment. Teleradiology is also facilitated. The Swedish Board of Health and Welfare has investigated the speed with which this change is taking place. In 1998, 26 of the 118 departments of diagnostic radiology had already turned digital; it is estimated that in the near future at least five departments will become fully digital each year. For planning purposes, less emphasis should be put on the supply of radiographic film, and more on telecommunications, computer hardware and digital storage.

Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

OpenAIRE

Matthew Larrison; Stanley G. Cheng; Stephen McManus

2016-01-01

Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options ...

Ordering of diagnostic information in encoded medical images. Accuracy progression

Science.gov (United States)

Przelaskowski, A.; Jóźwiak, R.; Krzyżewski, T.; Wróblewska, A.

2008-03-01

A concept of diagnostic accuracy progression for embedded coding of medical images was presented. Implementation of JPEG2000 encoder with a modified PCRD optimization algorithm was realized and initially verified as a tool for accurate medical image streaming. Mean square error as a distortion measure was replaced by other numerical measures to revise quality progression according to diagnostic importance of successively encoded image information. A faster increment of image diagnostic importance during reconstruction of initial packets of code stream was reached. Modified Jasper code was initially tested on a set of mammograms containing clusters of microcalcifications and malignant masses, and other radiograms. Teleradiologic applications were considered as the first area of interests.

Systematic approach to acquisition and transmission of digital images

International Nuclear Information System (INIS)

Lear, J.L.; Pratt, J.P.; Roberts, D.R.; Feyerabend, A.; Nemchak, J.; Johnson, S.

1990-01-01

While the feasibility of teleradiology has been demonstrated locally and over long distances, general use remains limited for reasons including the expense of the equipment, difficulty in use of the equipment, and slow rates of data transmission. This paper examines remote image transmission in a systematic fashion directed at the above problems. A Macintosh II-based nuclear medicine computer system was developed and interfaced directly to gamma cameras within our department. A network was then established linking multiple computers within the hospital with the use of Apple Talk to nearby hospitals that use Ethernet and to remove locations up to 1,000 miles away with use of a VPN 56 telephone service

Shared Medical Imaging Repositories.

Science.gov (United States)

Lebre, Rui; Bastião, Luís; Costa, Carlos

2018-01-01

This article describes the implementation of a solution for the integration of ownership concept and access control over medical imaging resources, making possible the centralization of multiple instances of repositories. The proposed architecture allows the association of permissions to repository resources and delegation of rights to third entities. It includes a programmatic interface for management of proposed services, made available through web services, with the ability to create, read, update and remove all components resulting from the architecture. The resulting work is a role-based access control mechanism that was integrated with Dicoogle Open-Source Project. The solution has several application scenarios like, for instance, collaborative platforms for research and tele-radiology services deployed at Cloud.

The future of PACS in healthcare enterprises

International Nuclear Information System (INIS)

Faggioni, Lorenzo; Neri, Emanuele; Castellana, Carlo; Caramella, Davide; Bartolozzi, Carlo

2011-01-01

Picture Archiving and Communication System (PACS), which was originally designed as a tool for facilitating radiologists in interpreting images more efficiently, is evolving into a hospital-integrated system storing diagnostic imaging information that often reaches far beyond Radiology. The continuous evolution of PACS technology has led to a gradual broadening of its applications, ranging from teleradiology to CAD (Computer-Assisted Diagnosis) and multidimensional imaging, and is moving into the direction of providing access to image data outside the Radiology department, so to reach all the branches of the healthcare enterprise. New perspectives have been created thanks to new technologies (such as holographic media and GRID computing) that are likely due to expand PACS-based applications even further, improving patient care and enhancing overall productivity.

Can PACS make a radiology department more competitive?

International Nuclear Information System (INIS)

Strickland, Nicola H.

1999-01-01

One of the motives for putting in a picture archiving and communication system (PACS) is to improve efficiency and hence enhance the competitive strength of the radiology department. Many would argue that it is now negligent to consider installing an old fashioned conventional radiology department rather than a PACS. In considering the issue it is important to be clear about the nature of the competition facing radiologists. This varies depending on the country and upon whether the institution is public or private. PACS can potentially help to overcome this competition in two ways: by providing real-time radiology, and by enabling teleradiology. Success in these areas requires state-of-the-art implementations of PACS, particularly clinically relevant PACS software, and adequate staffing levels

Worldwide Implementation of Digital Imaging in Radiology. A Resource Guide. In Cooperation with the World Health Organization

International Nuclear Information System (INIS)

2015-01-01

This publication provides a basic introduction to digital technology and digital networks as well as an overview of the issues to consider when implementing such technology in diagnostic radiology. In an area that is under rapid development, it provides a careful analysis of the principles and advice on implementation and sustainability of digital imaging and teleradiology. The transition from film to digitally based medical imaging is complex and requires knowledge and planning to be successful. This comprehensive resource guide contains information on the needs and implications of a transition to digital imaging with case studies for different facilities requiring different levels of communication connectivity. It is aimed at hospital administrators and managers, radiologists and radiographers/technologists, medical physicists and clinical engineers as well as information technology staff

Application of an internet web-site of medical images in tele-radiology

International Nuclear Information System (INIS)

Wang Weizhong; Wang Hua; Xie Jingxia; Wang Songzhang; Li Xiangdong; Qian Min; Cao Huixia

2000-01-01

Objective: To build and Internet web-site of medical images for tele-education and tele-consultation. Methods: Collecting medical images of cases that fulfilled diagnostic standards for teaching and were pathologically proved. The images were digitized using digital camera and scanner. Frontpage 98, Homesite 2.5 and text editors were used for programming. Results: The web site encompasses many useful cases and was update every week. With smart and friendly interface, easy used navigation, the site runs reliably in TCP/IP environment. The site's URL is http://imager.163.net. At present, the site has received about 100 visits per week. Conclusion: The well-designed and programmed internet web site of medical images would be easily acceptable and is going to play an important role in tele-education and tele-consultation

Professional Acceptance Of Electronic Images In Radiologic Practice

Science.gov (United States)

Gitlin, Joseph N.; Curtis, David J.; Kerlin, Barbara D.; Olmsted, William W.

1983-05-01

During the past four years, a large number of radiographic images have been interpreted in both film and video modes in an effort to determine the utility of digital/analogue systems in general practice. With the cooperation of the Department of Defense, the MITRE Corporation, and several university-based radiology departments, the Public Health Service has participated in laboratory experiments and a teleradiology field trial to meet this objective. During the field trial, 30 radiologists participated in the interpretation of more than 4,000 diagnostic x-ray examinations that were performed at distant clinics, digitized, and transmitted to a medical center for interpretation on video monitors. As part of the evaluation, all of the participating radiologists and the attending physicians at the clinics were queried regarding the teleradiology system, particularly with respect to the diagnostic quality of the electronic images. The original films for each of the 4,000 examinations were read independently, and the findings and impressions from each mode were compared to identify discrepancies. In addition, a sample of 530 cases was reviewed and interpreted by a consensus panel to measure the accuracy of findings and impressions of both film and video readings. The sample has been retained in an automated archive for future study at the National Center of Devices and Radiological Health facilities in Rockville, Maryland. The studies include a comparison of diagnostic findings and impressions from 1024 x 1024 matrices with those obtained from the 512 x 512 format used in the field trial. The archive also provides a database for determining the effect of data compression techniques on diagnostic interpretations and establishing the utility of image processing algorithms. The paper will include an analysis of the final results of the field trial and preliminary findings from the ongoing studies using the archive of cases at the National Center for Devices and Radiological

A cost-effectiveness analysis of shipboard telemedicine.

Science.gov (United States)

Stoloff, P H; Garcia, F E; Thomason, J E; Shia, D S

1998-01-01

The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships. Besides improving the quality of care, benefits would arise from avoiding medical evacuations (MEDEVACs) and returning patients to work more quickly. Because telemedicine has not yet been fully implemented by the Navy, we relied on projections of anticipated savings and costs, rather than actual expenditures, to determine cost-effectiveness. To determine the demand for telemedicine and the cost-effectiveness of various technologies (telephone and fax, e-mail and Internet, video teleconferencing (VTC), teleradiology, and diagnostic instruments), as well as their bandwidth requirements. A panel of Navy medical experts with telemedicine experience reviewed a representative sample of patient visits collected over a 1-year period and estimated the man-day savings and quality-of-care enhancements that might have occurred had telemedicine technologies been available. The savings from potentially avoiding MEDEVACs was estimated from a survey of ships' medical staff. These sample estimates were then projected to the medical workload of the entire fleet. Off-the-shelf telemedicine equipment prices were combined with installation, maintenance, training, and communication costs to obtain the lifecycle costs of the technology. If telemedicine were available to the fleet, ship medical staffs would initiate nearly 19, 000 consults in a year-7% of all patient visits. Telemedicine would enhance quality of care in two-thirds of these consults. Seventeen percent of the MEDEVACs would be preventable with telemedicine (representing 155,000 travel miles), with a savings of $4400 per MEDEVAC. If the ship's communication capabilities were available, e-mail and Internet and telephone and fax would be cost-effective on all ships (including small ships and submarines). Video teleconferencing would be cost-effective on large ships (aircraft carriers and amphibious) only. Teleradiology would be cost

Real-Time Tele-Mentored Low Cost "Point-of-Care US" in the Hands of Paediatricians in the Emergency Department: Diagnostic Accuracy Compared to Expert Radiologists.

Directory of Open Access Journals (Sweden)

Floriana Zennaro

Full Text Available The use of point-of-care ultrasonography (POC US in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED when performed by paediatricians under the remote guidance of radiologists (TELE POC.Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC; by the same radiologist (UNBLIND RAD; by an independent blinded radiologist (BLIND RAD. Tele-radiology was implemented using low cost "commercial off-the-shelf" (COTS equipment and open-source software. Data were prospectively collected on predefined templates.Fifty-two children were enrolled, for a total of 170 ultrasound findings. Sensitivity, specificity, positive and negative predictive values of TELE POC were: 93.8, 99.7, 96.8, 99.4 when compared to UNBLIND RAD and 88.2, 99.7, 96.8, 98.7 when compared to BLIND RAD. The inter-observers agreement between the paediatricians and either the unblind or blind radiologist was excellent (k = 0.93. The mean duration of TELE POC was 6.3 minutes (95% CI 4.1 to 8.5. Technical difficulties occurred in two (3.8% cases. Quality of the transmission was rated as fair, good, very good and excellent in 7.7%, 15.4%, 42.3% and 34.6% of cases respectively, while in no case was it rated as poor.POC US performed by paediatricians in ED guided via tele-radiology by an expert radiologist (TELE POC produced reliable and timely diagnoses. Findings of this study, especially for the rarer conditions under evaluation, need further confirmation. Future research should investigate the overall benefits and the cost savings of using tele-ultrasound to perform US "at children's bedsides", under remote guidance of expert radiologists.

The Orthanc Ecosystem for Medical Imaging.

Science.gov (United States)

Jodogne, Sébastien

2018-05-03

This paper reviews the components of Orthanc, a free and open-source, highly versatile ecosystem for medical imaging. At the core of the Orthanc ecosystem, the Orthanc server is a lightweight vendor neutral archive that provides PACS managers with a powerful environment to automate and optimize the imaging flows that are very specific to each hospital. The Orthanc server can be extended with plugins that provide solutions for teleradiology, digital pathology, or enterprise-ready databases. It is shown how software developers and research engineers can easily develop external software or Web portals dealing with medical images, with minimal knowledge of the DICOM standard, thanks to the advanced programming interface of the Orthanc server. The paper concludes by introducing the Stone of Orthanc, an innovative toolkit for the cross-platform rendering of medical images.

Security protection of DICOM medical images using dual-layer reversible watermarking with tamper detection capability.

Science.gov (United States)

Tan, Chun Kiat; Ng, Jason Changwei; Xu, Xiaotian; Poh, Chueh Loo; Guan, Yong Liang; Sheah, Kenneth

2011-06-01

Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.

Socioeconomic trends in radiology

International Nuclear Information System (INIS)

Barneveld Binkhuysen, F.H.

1998-01-01

For radiology the socioeconomic environment is a topic of increasing importance. In addition to the well-known important scientific developments in radiology such as interventional MRI, several other major trends can be recognized: (1) changes in the delivery of health care, in which all kinds of managed care are developing and will influence the practice of radiology, and (2) the process of computerization and digitization. The socioeconomic environment of radiology will be transformed by the developments in managed care, teleradiology and the integration of information systems. If radiologists want to manage future radiology departments they must have an understanding of the changes in the fields of economics and politics that are taking place and that will increasingly influence radiology. Some important and recognizable aspects of these changes will be described here. (orig.)

Performance analysis of algorithms for retrieval of magnetic resonance images for interactive teleradiology

Science.gov (United States)

Atkins, M. Stella; Hwang, Robert; Tang, Simon

2001-05-01

We have implemented a prototype system consisting of a Java- based image viewer and a web server extension component for transmitting Magnetic Resonance Images (MRI) to an image viewer, to test the performance of different image retrieval techniques. We used full-resolution images, and images compressed/decompressed using the Set Partitioning in Hierarchical Trees (SPIHT) image compression algorithm. We examined the SPIHT decompression algorithm using both non- progressive and progressive transmission, focusing on the running times of the algorithm, client memory usage and garbage collection. We also compared the Java implementation with a native C++ implementation of the non- progressive SPIHT decompression variant. Our performance measurements showed that for uncompressed image retrieval using a 10Mbps Ethernet, a film of 16 MR images can be retrieved and displayed almost within interactive times. The native C++ code implementation of the client-side decoder is twice as fast as the Java decoder. If the network bandwidth is low, the high communication time for retrieving uncompressed images may be reduced by use of SPIHT-compressed images, although the image quality is then degraded. To provide diagnostic quality images, we also investigated the retrieval of up to 3 images on a MR film at full-resolution, using progressive SPIHT decompression. The Java-based implementation of progressive decompression performed badly, mainly due to the memory requirements for maintaining the image states, and the high cost of execution of the Java garbage collector. Hence, in systems where the bandwidth is high, such as found in a hospital intranet, SPIHT image compression does not provide advantages for image retrieval performance.

Computer assisted radiology

International Nuclear Information System (INIS)

Lemke, H.U.; Jaffe, C.C.; Felix, R.

1993-01-01

The proceedings of the CAR'93 symposium present the 126 oral papers and the 58 posters contributed to the four Technical Sessions entitled: (1) Image Management, (2) Medical Workstations, (3) Digital Image Generation - DIG, and (4) Application Systems - AS. Topics discussed in Session (1) are: picture archiving and communication systems, teleradiology, hospital information systems and radiological information systems, technology assessment and implications, standards, and data bases. Session (2) deals with computer vision, computer graphics, design and application, man computer interaction. Session (3) goes into the details of the diagnostic examination methods such as digital radiography, MRI, CT, nuclear medicine, ultrasound, digital angiography, and multimodality imaging. Session (4) is devoted to computer-assisted techniques, as there are: computer assisted radiological diagnosis, knowledge based systems, computer assisted radiation therapy and computer assisted surgical planning. (UWA). 266 figs [de

Conversion to use of digital chest images for surveillance of coal workers' pneumoconiosis (black lung).

Science.gov (United States)

Levine, Betty A; Ingeholm, Mary Lou; Prior, Fred; Mun, Seong K; Freedman, Matthew; Weissman, David; Attfield, Michael; Wolfe, Anita; Petsonk, Edward

2009-01-01

To protect the health of active U.S. underground coal miners, the National Institute for Occupational Safety and Health (NIOSH) has a mandate to carry out surveillance for coal workers' pneumoconiosis, commonly known as Black Lung (PHS 2001). This is accomplished by reviewing chest x-ray films obtained from miners at approximately 5-year intervals in approved x-ray acquisition facilities around the country. Currently, digital chest images are not accepted. Because most chest x-rays are now obtained in digital format, NIOSH is redesigning the surveillance program to accept and manage digital x-rays. This paper highlights the functional and security requirements for a digital image management system for a surveillance program. It also identifies the operational differences between a digital imaging surveillance network and a clinical Picture Archiving Communication Systems (PACS) or teleradiology system.

Organizational decentralization in radiology.

Science.gov (United States)

Aas, I H Monrad

2006-01-01

At present, most hospitals have a department of radiology where images are captured and interpreted. Decentralization is the opposite of centralization and means 'away from the centre'. With a Picture Archiving and Communication System (PACS) and broadband communications, transmitting radiology images between sites will be far easier than before. Qualitative interviews of 26 resource persons were performed in Norway. There was a response rate of 90%. Decentralization of radiology interpretations seems less relevant than centralization, but several forms of decentralization have a role to play. The respondents mentioned several advantages, including exploitation of capacity and competence. They also mentioned several disadvantages, including splitting professional communities and reduced contact between radiologists and clinicians. With the new technology decentralization and centralization of image interpretation are important possibilities in organizational change. This will be important for the future of teleradiology.

The transmission and interpretation of emergency department radiographs.

Science.gov (United States)

James, J J; Grabowski, W; Mangelsdorff, A D

1982-08-01

Twenty-five radiographic studies representative of the spectrum of trauma cases that might present to an emergency department were selected from actual cases presenting at Brooke Army Medical Center (BAMC) in San Antonio, Texas. The studies were then transmitted from a local television studio via satellite back to BAMC and three other Army hospitals. A panel of 29 physicians (11 radiologists, 7 emergency physicians, and 11 others from various specialty areas) viewed the images on commercial grade television sets and attempted to make a diagnosis. The diagnostic accuracy of the radiologists (86%) was significantly better than that of the other two groups (77% each). However, given the overall expense of a teleradiology network, this difference in accuracy - especially when translated into clinically significant errors - might not justify the establishment of such a network in terms of cost-effectiveness.

Is there an increase in radiation exposure to the population due to diagnostic dental radiography. 2

International Nuclear Information System (INIS)

Spens, E.

1983-01-01

Orthodontic cases were examined to assess the superficial and genetically significant gonadal doses accumulated by the patients. During the period of examination, the radiodiagnostic services showed a retrograde tendency. At an average number of 6 radiographs per patient and terminated case the mean superficial dosis in the maxillofacial region amounted to 0.039 Sv, and the mean genetically significant gonadal dosis to 0.0063 mSv. Consequently, the stochastic-somatic radiation risk was greater than the genetic one. From the relatively low frequency of teleradiographs (2.3%) and on the basis of statistical data indications for the need for teleradiological working places in the ambulatory orthodontic care in the GDR are deduced. According to a trend analysis of the yearly frequency distribution of radiographic techniques used for the visualization of the tooth system an increased utilization of orthopantomography in orthodontics, is necessary

The evolving radiology landscape: the importance of effective leadership

International Nuclear Information System (INIS)

Boland, Giles W.L.; Guimaraes, Alexander S.; Mueller, Peter R.

2009-01-01

Advances in technology and imaging techniques have propelled radiology into the centre of diagnostic and therapeutic medicine. However, all this success has come at a price, with radiology departments persistently struggling to keep up with increasing demand. In response, radiologists in many countries are giving up an increasing proportion of their traditional workload, often driven by teleradiology, causing them to become less visible within their organizations. As such, radiologists now risk being viewed as commodities by their peers. The failure to meet the increasing stakeholder expectations is, at least in part, due to lack of radiology leadership. While the drivers for the radiology profession and the organizational structures for radiologists vary from country to country, this article will discuss the characteristics of good leadership and how these can be used to ensure radiologists remain centre stage in the provision of high-quality clinical care in any healthcare environment. (orig.)

The evolving radiology landscape: the importance of effective leadership

Energy Technology Data Exchange (ETDEWEB)

Boland, Giles W.L.; Guimaraes, Alexander S.; Mueller, Peter R. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

2009-10-15

Advances in technology and imaging techniques have propelled radiology into the centre of diagnostic and therapeutic medicine. However, all this success has come at a price, with radiology departments persistently struggling to keep up with increasing demand. In response, radiologists in many countries are giving up an increasing proportion of their traditional workload, often driven by teleradiology, causing them to become less visible within their organizations. As such, radiologists now risk being viewed as commodities by their peers. The failure to meet the increasing stakeholder expectations is, at least in part, due to lack of radiology leadership. While the drivers for the radiology profession and the organizational structures for radiologists vary from country to country, this article will discuss the characteristics of good leadership and how these can be used to ensure radiologists remain centre stage in the provision of high-quality clinical care in any healthcare environment. (orig.)

Ergonomics in radiology

Energy Technology Data Exchange (ETDEWEB)

Goyal, N. [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom)], E-mail: nimitgoyal@doctors.org.uk; Jain, N.; Rachapalli, V. [Department of Radiology, University Hospital of Wales, Cardiff (United Kingdom)

2009-02-15

The use of computers is increasing in every field of medicine, especially radiology. Filmless radiology departments, speech recognition software, electronic request forms and teleradiology are some of the recent developments that have substantially increased the amount of time a radiologist spends in front of a computer monitor. Computers are also needed for searching literature on the internet, communicating via e-mails, and preparing for lectures and presentations. It is well known that regular computer users can suffer musculoskeletal injuries due to repetitive stress. The role of ergonomics in radiology is to ensure that working conditions are optimized in order to avoid injury and fatigue. Adequate workplace ergonomics can go a long way in increasing productivity, efficiency, and job satisfaction. We review the current literature pertaining to the role of ergonomics in modern-day radiology especially with the development of picture archiving and communication systems (PACS) workstations.

Ergonomics in radiology

International Nuclear Information System (INIS)

Goyal, N.; Jain, N.; Rachapalli, V.

2009-01-01

The use of computers is increasing in every field of medicine, especially radiology. Filmless radiology departments, speech recognition software, electronic request forms and teleradiology are some of the recent developments that have substantially increased the amount of time a radiologist spends in front of a computer monitor. Computers are also needed for searching literature on the internet, communicating via e-mails, and preparing for lectures and presentations. It is well known that regular computer users can suffer musculoskeletal injuries due to repetitive stress. The role of ergonomics in radiology is to ensure that working conditions are optimized in order to avoid injury and fatigue. Adequate workplace ergonomics can go a long way in increasing productivity, efficiency, and job satisfaction. We review the current literature pertaining to the role of ergonomics in modern-day radiology especially with the development of picture archiving and communication systems (PACS) workstations

Medical Ethics in Radiology

International Nuclear Information System (INIS)

Kim, Kyung Won; Park, Jae Hyung; Yoon, Soon Ho

2010-01-01

According to the recent developments in radiological techniques, the role of radiology in the clinical management of patients is ever increasing and in turn, so is the importance of radiology in patient management. Thus far, there have been few open discussions about medical ethics related to radiology in Korea. Hence, concern about medical ethics as an essential field of radiology should be part of an improved resident training program and patient management. The categories of medical ethics related with radiology are ethics in the radiological management of patient, the relationship of radiologists with other medical professionals or companies, the hazard level of radiation for patients and radiologists, quality assurance of image products and modalities, research ethics, and other ethics issues related to teleradiology and fusion imaging. In order to achieve the goal of respectful progress in radiology as well as minimizing any adverse reaction from other medical professions or society, we should establish a strong basis of medical ethics through the continuous concern and self education

Licence template for mobile handling and storage of radioactive substances for the nondestructive testing of materials

International Nuclear Information System (INIS)

Lange, A.; Schumann, J.; Huhn, W.

2016-01-01

The Technical Committee ''Radiation Protection'' (Fachausschuss ''Strahlenschutz'') and the Laender Committee ''X-ray ordinance'' (Laenderausschuss ''Roentgenverordnung'') have appointed a working group for the formulation of licence templates for the nationwide use of X-ray equipment or handling of radioactive substances. To date, the following licence templates have been adopted: - Mobile operation of X-ray equipment under technical radiography to the coarse structural analysis in material testing; - Mobile operation of a handheld X-ray fluorescence system; - Mobile operation of a flash X-ray system; - Operation of an X-ray system for teleradiology The licence template ''Mobile handling and storage of radioactive substances for the nondestructive testing of materials'' is scheduled for publication. The licence template ''Practices in external facilities and installations'' is currently being revised. The licence template ''Mobile handling and storage of radioactive substances for the nondestructive testing of materials'' is used as an example to demonstrate the legal framework and the results of the working group.

Comprehensive evaluation of a digital imaging network

International Nuclear Information System (INIS)

Mun, S.K.; Benson, H.; Elliott, L.P.; Horii, S.

1988-01-01

The authors' institution has installed a comprehensive PACS network involving a dozen work stations and ten imaging systems with electronic archiving and teleradiology capability based on the CommView (AT and T) system and its fiberoptic network. Diagnostic reporting stations are placed in neuroradiology, abdominal imaging, general radiology, and ultrasound service. Other review stations are located in intensive care units, radiation medicine, the emergency room, and other sites. Clinical acceptance of such technology varies depending on a number of factors: image quality, image data volume, service style, and personal preference. The general acceptance depends on the work station performance, network response time, and work station environment. Clinical acceptance by radiologists and referring physicians was evaluated. The evaluation project included work-station performance, network performance, system interface, RIS interface, and development of training methods and implementation strategy for other sites. A cost analysis and a study of administrative impact are integral parts of the comprehensive evaluation project

PDA-phone-based instant transmission of radiological images over a CDMA network by combining the PACS screen with a Bluetooth-interfaced local wireless link.

Science.gov (United States)

Kim, Dong Keun; Yoo, Sun K; Park, Jeong Jin; Kim, Sun Ho

2007-06-01

Remote teleconsultation by specialists is important for timely, correct, and specialized emergency surgical and medical decision making. In this paper, we designed a new personal digital assistant (PDA)-phone-based emergency teleradiology system by combining cellular communication with Bluetooth-interfaced local wireless links. The mobility and portability resulting from the use of PDAs and wireless communication can provide a more effective means of emergency teleconsultation without requiring the user to be limited to a fixed location. Moreover, it enables synchronized radiological image sharing between the attending physician in the emergency room and the remote specialist on picture archiving and communication system terminals without distorted image acquisition. To enable rapid and fine-quality radiological image transmission over a cellular network in a secure manner, progressive compression and security mechanisms have been incorporated. The proposed system is tested over a code division Multiple Access 1x-Evolution Data-Only network to evaluate the performance and to demonstrate the feasibility of this system in a real-world setting.

A QR code based zero-watermarking scheme for authentication of medical images in teleradiology cloud.

Science.gov (United States)

Seenivasagam, V; Velumani, R

2013-01-01

Healthcare institutions adapt cloud based archiving of medical images and patient records to share them efficiently. Controlled access to these records and authentication of images must be enforced to mitigate fraudulent activities and medical errors. This paper presents a zero-watermarking scheme implemented in the composite Contourlet Transform (CT)-Singular Value Decomposition (SVD) domain for unambiguous authentication of medical images. Further, a framework is proposed for accessing patient records based on the watermarking scheme. The patient identification details and a link to patient data encoded into a Quick Response (QR) code serves as the watermark. In the proposed scheme, the medical image is not subjected to degradations due to watermarking. Patient authentication and authorized access to patient data are realized on combining a Secret Share with the Master Share constructed from invariant features of the medical image. The Hu's invariant image moments are exploited in creating the Master Share. The proposed system is evaluated with Checkmark software and is found to be robust to both geometric and non geometric attacks.

A QR Code Based Zero-Watermarking Scheme for Authentication of Medical Images in Teleradiology Cloud

Directory of Open Access Journals (Sweden)

V. Seenivasagam

2013-01-01

Full Text Available Healthcare institutions adapt cloud based archiving of medical images and patient records to share them efficiently. Controlled access to these records and authentication of images must be enforced to mitigate fraudulent activities and medical errors. This paper presents a zero-watermarking scheme implemented in the composite Contourlet Transform (CT—Singular Value Decomposition (SVD domain for unambiguous authentication of medical images. Further, a framework is proposed for accessing patient records based on the watermarking scheme. The patient identification details and a link to patient data encoded into a Quick Response (QR code serves as the watermark. In the proposed scheme, the medical image is not subjected to degradations due to watermarking. Patient authentication and authorized access to patient data are realized on combining a Secret Share with the Master Share constructed from invariant features of the medical image. The Hu’s invariant image moments are exploited in creating the Master Share. The proposed system is evaluated with Checkmark software and is found to be robust to both geometric and non geometric attacks.

Training Midwives to Perform Basic Obstetric Point-of-Care Ultrasound in Rural Areas Using a Tablet Platform and Mobile Phone Transmission Technology-A WFUMB COE Project.

Science.gov (United States)

Vinayak, Sudhir; Sande, Joyce; Nisenbaum, Harvey; Nolsøe, Christian Pállson

2017-10-01

Point-of-care ultrasound (POCUS) has become a topical subject and can be applied in a variety of ways with differing outcomes. The cost of all diagnostic procedures including obstetric ultrasound examinations is a major factor in the developing world and POCUS is only useful if it can be equated to good outcomes at a lower cost than a routine obstetric examination. The aim of this study was to assess a number of processes including accuracy of images and reports generated by midwives, performance of a tablet-sized ultrasound scanner, training of midwives to complete ultrasounds, teleradiology solution transmissions of images via internet, review of images by a radiologist, communication between midwife and radiologist, use of this technique to identify high-risk patients and improvement of the education and teleradiology model components. The midwives had no previous experience in ultrasound. They were stationed in rural locations where POCUS was available for the first time. After scanning the patients, an interim report was generated by the midwives and sent electronically together with all images to the main hospital for validation. Unique software was used to send lossless images by mobile phone using a modem. Transmission times were short and quality of images transmitted was excellent. All reports were validated by two experienced radiologists in our department and returned to the centers using the same transmission software. The transmission times, quality of scans, quality of reports and other parameters were recorded and monitored. Analysis showed excellent correlation between provisional and validated reports. Reporting accuracy of scans performed by the midwives was 99.63%. Overall flow turnaround time (from patient presentation to validated report) was initially 35 min but reduced to 25 min. The unique mobile phone transmission was faultless and there was no degradation of image quality. We found excellent correlation between final outcomes of the

Web-based tool for subjective observer ranking of compressed medical images

Science.gov (United States)

Langer, Steven G.; Stewart, Brent K.; Andrew, Rex K.

1999-05-01

In the course of evaluating various compression schemes for ultrasound teleradiology applications, it became obvious that paper based methods of data collection were time consuming and error prone. A method was sought which allowed participating radiologists to view the ultrasound video clips (compressed to varying degree) at their desks. Furthermore, the method should allow observers to enter their evaluations and when finished, automatically submit the data to our statistical analysis engine. We have found the World Wide Web offered a ready solution. A web page was constructed that contains 18 embedded AVI video clips. The 18 clips represent 6 distinct anatomical areas, compressed by various methods and amounts, and then randomly distributed through the web page. To the right of each video, a series of questions are presented which ask the observer to rank (1 - 5) his/her ability to answer diagnostically relevant questions. When completed, the observer presses 'Submit' and a file of tab delimited test is created which can then be imported to an Excel workbook. Kappa analysis is then performed and the resulting plots demonstrate observer preferences.

A complete image management and communications network for the neuroradiology service at Georgetown University Hospital

International Nuclear Information System (INIS)

Horii, S.C.; Muraki, A.; Mun, S.K.; Clark, L.; Schellinger, M.D.; Mallon-Ingeholm, M.L.

1989-01-01

A complete image management and communications system has been installed at Georgetown University Hospital (GUH). The network is based on the AT ampersand T CommView System. In the Neuroradiology Division, this network supports a multiscreen workstation with access to multiple imaging modalities such as CT and MRI from both the hospital and a remote imaging center. In addition, the radiologist can access these images from various workstations located throughout the hospital as well as from remote sites such as the home. Among the radiology services supported by the network, neuroradiology has the greatest need for such a system with extensive daily requirements involving the remote imaging center and on-line consultation around the clock. By providing neuroradiology with all available communication links, the radiologist can monitor, diagnose, and consult. The efficiency and effectiveness of the system's capabilities with regard to remote and teleradiology (RVS) operations have been studied for the neuroradiology service. This paper discusses the current clinical acceptance and use, problems in implementation, and ways these difficulties are being surmounted

Performance of asynchronous transfer mode (ATM) local area and wide area networks for medical imaging transmission in clinical environment.

Science.gov (United States)

Huang, H K; Wong, A W; Zhu, X

1997-01-01

Asynchronous transfer mode (ATM) technology emerges as a leading candidate for medical image transmission in both local area network (LAN) and wide area network (WAN) applications. This paper describes the performance of an ATM LAN and WAN network at the University of California, San Francisco. The measurements were obtained using an intensive care unit (ICU) server connecting to four image workstations (WS) at four different locations of a hospital-integrated picture archiving and communication system (HI-PACS) in a daily regular clinical environment. Four types of performance were evaluated: magnetic disk-to-disk, disk-to-redundant array of inexpensive disks (RAID), RAID-to-memory, and memory-to-memory. Results demonstrate that the transmission rate between two workstations can reach 5-6 Mbytes/s from RAID-to-memory, and 8-10 Mbytes/s from memory-to-memory. When the server has to send images to all four workstations simultaneously, the transmission rate to each WS is about 4 Mbytes/s. Both situations are adequate for radiologic image communications for picture archiving and communication systems (PACS) and teleradiology applications.

Standards for the secure data interchange in teleradiology put into practice for image and report distribution

International Nuclear Information System (INIS)

Eichelberg, M.; Riesmeier, J.; Thiel, A.; Jensch, P.; Emmel, D.; Haderer, A.; Ricke, J.; Stohlmann, L.; Bernarding, J.

2002-01-01

The use of telemedicine is becoming indispensable for a continuous and economical delivery of a high quality of care. However, data protection requirements have to be considered. For the selection of solutions, vendor-independent components based on standards are a prerequisite for a seamless integration into the existing, often heterogeneous, IT infrastructure. The ''Internet protocol'' TCP/IP and the DICOM standard with it's new security extensions form the basis for an internationally standardized and accepted procedure for a secure interchange of radiological images beyond platform boundaries. (orig.) [de

IHE, Solution for integration of information systems and PACS

Directory of Open Access Journals (Sweden)

Milad Janghorban Lariche

2014-10-01

Full Text Available PACS is used as a way to store images and matches well with the workflow in the radiology department and can spread to other parts of hospital. Integration with other PACS and other hospital systems like radiology information system (RIS, hospital information system (HIS, and electronic patient records has been completely done, but there are still problems. PACS also provide good conditions for setting up Tele-radiology. The next step for PACS is where hospitals and health care organizations share photos in integrated electronic patient record. Among the different ways for sharing photos between different hospitals, IHE (integrating the health care enterprise standard indexes the cross-enterprise document sharing profile (XDS and allows sharing photos from various hospitals even if their PACS has different brands and different vendors. Application of XDS is useful for sharing images between health care organizations without duplicating them in a central archive. Images need to be indexed in a central registry. In the XDS profile, IHE defines an indexing mechanism for printing and indexing images in the central document registry. IHE also defines mechanisms to be used by each hospital to retrieve images, regardless of storing them in hospital PACS.

[The integration of telemedicine concepts in the regional care of rural areas: Possibilities, limitations, perspectives].

Science.gov (United States)

van den Berg, Neeltje; Schmidt, S; Stentzel, U; Mühlan, H; Hoffmann, W

2015-04-01

In rural areas with a low population density and (imminent) gaps in regional health care, telemedicine concepts can be a promising option in supporting the supply of medical care.Telemedicine connections can be established between different health care providers (e.g., hospitals) or directly between health care providers and patients.Different scenarios for the implementation of telemedicine have been developed, from the monitoring of chronically ill patients to the support of acute care. Examples of frequently applied telemedicine concepts are teleradiology, telemedicine stroke networks, and the telemedicine monitoring of patients with heart failure. The development of concepts for other indications and patient groups is apparently difficult in Germany; one reason could be that research institutions are involved in only a small number of projects. However, the participation of research institutes would be of importance in creating more scientific evidence. The development of appropriate evaluation designs for analyzing the effectiveness of telemedicine concepts and economic effects is an important task and challenge for the future. Mandatory evaluation criteria should be developed to provide a basis for the translation of positively evaluated telemedicine concepts into routine care.

Licence template for mobile handling and storage of radioactive substances for the nondestructive testing of materials; Mustergenehmigung zur ortsveraenderlichen Verwendung und Lagerung radioaktiver Stoffe im Rahmen der zerstoerungsfreien Materialpruefung

Energy Technology Data Exchange (ETDEWEB)

Lange, A. [Niedersaechsisches Ministerium fuer Umwelt, Energie und Klimaschutz (Germany); Schumann, J. [Landesamt fuer Arbeitsschutz, Gesundheitsschutz und technische Sicherheit, Berlin (Germany); Huhn, W.

2016-07-01

The Technical Committee ''Radiation Protection'' (Fachausschuss ''Strahlenschutz'') and the Laender Committee ''X-ray ordinance'' (Laenderausschuss ''Roentgenverordnung'') have appointed a working group for the formulation of licence templates for the nationwide use of X-ray equipment or handling of radioactive substances. To date, the following licence templates have been adopted: - Mobile operation of X-ray equipment under technical radiography to the coarse structural analysis in material testing; - Mobile operation of a handheld X-ray fluorescence system; - Mobile operation of a flash X-ray system; - Operation of an X-ray system for teleradiology The licence template ''Mobile handling and storage of radioactive substances for the nondestructive testing of materials'' is scheduled for publication. The licence template ''Practices in external facilities and installations'' is currently being revised. The licence template ''Mobile handling and storage of radioactive substances for the nondestructive testing of materials'' is used as an example to demonstrate the legal framework and the results of the working group.

Telemedicine-based system for quality management and peer review in radiology.

Science.gov (United States)

Morozov, Sergey; Guseva, Ekaterina; Ledikhova, Natalya; Vladzymyrskyy, Anton; Safronov, Dmitry

2018-06-01

Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective. A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images. The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

Picture archiving and communication system developments expected in the 1990s

Science.gov (United States)

Drew, Philip G.; Lorah, Lawrence D.; Lydon, Michael J.; Novak, Elliott D.

1993-01-01

Among the applications for high-bandwidth systems are medical picture archiving and communication systems (PACS). Viewed in the light of developments anticipated ten years ago when these systems were first discussed, progress has been disappointingly slow. However, with the recognition that teleradiology, digital archives, and computed radiography can be regarded as PAC subsystems, and that systems confined to a single modality can be regarded as mini-PACS, it becomes clear that development of PAC systems has made remarkable progress. Growing from modest size today, the markets for PAC systems and subsystems in the U.S. is likely to exceed $600 million by the end of the decade, a market of the same magnitude as those for CT, MRI, and catheterization lab equipment. This paper discusses the forces that have stimulated growth of PAC systems - among them, the opportunity to provide better service to patients and referring physicians, a chance to expand effective service area, and a possible solution to the ubiquitous problems of lost films - as well as the impediments that have retarded growth - among them, technical limitations, especially of the radiologists' workstations, and cost. A review of these forces allows prediction of likely developments in the 1990s.

PACS in Töölö hospital.

Science.gov (United States)

Kinnunen, J; Pohjonen, H

2001-07-01

A 3-year PACS project was started in 1997 and completed in 1999 with filmless radiology and surgery. An efficient network for transferring images provides the infrastructure for integration of different distributed imaging systems and enables efficient handling of all patient-related information on one display station. Because of the need for high-speed communications and the massive amount of image data transferred in radiology, ATM (25, 155 Mbit/s) was chosen to be the main technology used. Both hardware and software redundancy of the system have been carefully planned. The size of the Dicom image library utilizing MO discs is currently 1.2 TB with 300 GB RAID capacity. For the increasing amount of teleradiologic consultations, a special Dicom gateway is planned. It allows a centralized and resilient handling and routing of received images around the hospital. Hospital-wide PACS has already improved the speed and quality of patient care by providing instant access to diagnostic information at multiple locations simultaneously. The benefits of PACS are considered from the viewpoint of the entire hospital: PACS offers a method for efficiently transporting patient-related images and reports to the referring physicians.

Telemedicine and rural health care applications

Directory of Open Access Journals (Sweden)

Smith Anthony

2005-01-01

Full Text Available Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication.

Radiologic image compression -- A review

International Nuclear Information System (INIS)

Wong, S.; Huang, H.K.; Zaremba, L.; Gooden, D.

1995-01-01

The objective of radiologic image compression is to reduce the data volume of and to achieve a lot bit rate in the digital representation of radiologic images without perceived loss of image quality. However, the demand for transmission bandwidth and storage space in the digital radiology environment, especially picture archiving and communication systems (PACS) and teleradiology, and the proliferating use of various imaging modalities, such as magnetic resonance imaging, computed tomography, ultrasonography, nuclear medicine, computed radiography, and digital subtraction angiography, continue to outstrip the capabilities of existing technologies. The availability of lossy coding techniques for clinical diagnoses further implicates many complex legal and regulatory issues. This paper reviews the recent progress of lossless and lossy radiologic image compression and presents the legal challenges of using lossy compression of medical records. To do so, the authors first describe the fundamental concepts of radiologic imaging and digitization. Then, the authors examine current compression technology in the field of medical imaging and discuss important regulatory policies and legal questions facing the use of compression in this field. The authors conclude with a summary of future challenges and research directions. 170 refs

The RETAIN project: DICOM teleradiology over an ATM-based network. Radiological Examinations Transfer on an ATM Integrated Network.

Science.gov (United States)

Heautot, J F; Eichelberg, M; Gibaud, B; Tréguier, C; Lemoine, D; Scarabin, J M; Piqueras, J; Carsin, M; Gandon, Y

2000-01-01

The RETAIN project (Radiological Examinations Transfer on an ATM Integrated Network) has aimed at testing videoconferencing and DICOM image transfers to get advice about difficult radiological cases over an asynchronous transfer mode (ATM)-based network, which affords a more comfortable interface than narrow-band networks and allows exchange of complete image series using the DICOM format of studies. For this purpose, an experimental ATM network was applied between six university hospitals in four different countries. An assessment of the functionalities of the system was performed by means of log-file analysis, video recording of the sessions and forms filled out by the participants at the end of each session. Questionnaires were answered by the users at the end of the project to bring out perspectives of utilisation and added value. We discussed 43 cases during 20 sessions. For technical or organisational problems, only 20 of the 36 planned sessions took place. The throughput over ATM (10.5 Mbit/s, 20 times faster than six ISDN B-channels) was adequate. Despite the experimental configuration of the network, the system was considered as satisfactory by all the physicians. In 72 % of the sessions, the expected result (answer to the question) was gained. By common consent, videoconferencing was unanimously regarded as a prominent tool in improving the interaction quality. Asynchronous transfer mode is an efficient method for fast transferring of radiologic examinations in DICOM format and for discussing them through high-quality videoconferencing.

Multimedia communications and services for the healthcare community

Science.gov (United States)

Robinson, James M.

1994-11-01

The NYNEX Media Broadband Service Trials in Boston examined the use of several multiple media applications from healthcare in conjunction with high speed fiber optic networks. As part of these trials, NYNEX developed a network-based software technology that simplifies and coordinates the delivery of complex voice, data, image, and video information. This permits two or more users to interact and collaborate with one another while sharing, displaying, and manipulating various media types. Different medical applications were trialed at four of Boston's major hospitals, ranging from teleradiology (which tested the quality of the diagnostic images and the need to collaborate) to telecardiology (which displayed diagnostic quality digital movies played in synchronicity). These trials allowed NYNEX to uniquely witness the needs and opportunities in the healthcare community for broadband communications with the necessary control capabilities and simplified user interface. As a result of the success of the initial trials, NYNEX has created a new business unit, Media Communications Services (MCS), to deliver a service offering based on this capability. New England Medical Center, as one of the initial trial sites, was chosen as a beta trial candidate, and wanted to further its previous work in telecardiology as well as telepsychiatry applications. Initial and subsequent deployments have been completed, and medical use is in progress.

IHE profiles applied to regional PACS

International Nuclear Information System (INIS)

Fernandez-Bayo, Josep

2011-01-01

PACS has been widely adopted as an image storage solution that perfectly fits the radiology department workflow and that can be easily extended to other hospital departments. Integrations with other hospital systems, like the Radiology Information System, the Hospital Information System and the Electronic Patient Record are fully achieved but still challenging aims. PACS also creates the perfect environment for teleradiology and teleworking setups. One step further is the regional PACS concept where different hospitals or health care enterprises share the images in an integrated Electronic Patient Record. Among the different solutions available to share images between different hospitals IHE (Integrating the Healthcare Enterprise) organization presents the Cross Enterprise Document Sharing profile (XDS) which allows sharing images from different hospitals even if they have different PACS vendors. Adopting XDS has multiple advantages, images do not need to be duplicated in a central archive to be shared among the different healthcare enterprises, they only need to be indexed and published in a central document registry. In the XDS profile IHE defines the mechanisms to publish and index the images in the central document registry. It also defines the mechanisms that each hospital will use to retrieve those images regardless on the Hospital PACS they are stored.

Archival storage solutions for PACS

Science.gov (United States)

Chunn, Timothy

1997-05-01

While they are many, one of the inhibitors to the wide spread diffusion of PACS systems has been robust, cost effective digital archive storage solutions. Moreover, an automated Nearline solution is key to a central, sharable data repository, enabling many applications such as PACS, telemedicine and teleradiology, and information warehousing and data mining for research such as patient outcome analysis. Selecting the right solution depends on a number of factors: capacity requirements, write and retrieval performance requirements, scaleability in capacity and performance, configuration architecture and flexibility, subsystem availability and reliability, security requirements, system cost, achievable benefits and cost savings, investment protection, strategic fit and more.This paper addresses many of these issues. It compares and positions optical disk and magnetic tape technologies, which are the predominant archive mediums today. Price and performance comparisons will be made at different archive capacities, plus the effect of file size on storage system throughput will be analyzed. The concept of automated migration of images from high performance, high cost storage devices to high capacity, low cost storage devices will be introduced as a viable way to minimize overall storage costs for an archive. The concept of access density will also be introduced and applied to the selection of the most cost effective archive solution.

History of PACS in Asia

International Nuclear Information System (INIS)

Inamura, Kiyonari; Kim, Jong Hyo

2011-01-01

First, history of PACS (picture archiving and communication system for medical use) in Japan is described in two parts: in part 1, the early stage of PACS development from 1984 to 2002, and in part 2 the matured stage from 2002 to 2010. PACS in Japan has been developed and installed by local manufacturers by their own technology and demand from domestic hospitals. Part 1 mainly focuses on quantitative growth and part 2 on qualitative change. In part 2, integration of PACS into RIS (radiology information system), HIS (hospital information system), EPR (electronic patient record), teleradiology and IHE (integrating healthcare enterprise) is reported. Interaction with other elements of technology such as moving picture network system and three dimensional display is also discussed. Present situation of main 4 large size hospitals is presented. Second, history of PACS in Korea is reported. Very acute climbing up of filmless PACS diffusion was observed from 1997 to 2000. The reasons for such evolution are described and discussed. Also changes of PACS installation and system integration with other systems such as HIS and role of them in radiological diagnoses in Korea since 2002 are described. Third, history in China is investigated by checking international academic journals in English and described as far as events are logically linked and consistently meaningful.

PACS 2000: quality control using the task allocation chart

Science.gov (United States)

Norton, Gary S.; Romlein, John R.; Lyche, David K.; Richardson, Ronald R., Jr.

2000-05-01

Medical imaging's technological evolution in the next century will continue to include Picture Archive and Communication Systems (PACS) and teleradiology. It is difficult to predict radiology's future in the new millennium with both computed radiography and direct digital capture competing as the primary image acquisition methods for routine radiography. Changes in Computed Axial Tomography (CT) and Magnetic Resonance Imaging (MRI) continue to amaze the healthcare community. No matter how the acquisition, display, and archive functions change, Quality Control (QC) of the radiographic imaging chain will remain an important step in the imaging process. The Task Allocation Chart (TAC) is a tool that can be used in a medical facility's QC process to indicate the testing responsibilities of the image stakeholders and the medical informatics department. The TAC shows a grid of equipment to be serviced, tasks to be performed, and the organization assigned to perform each task. Additionally, skills, tasks, time, and references for each task can be provided. QC of the PACS must be stressed as a primary element of a PACS' implementation. The TAC can be used to clarify responsibilities during warranty and paid maintenance periods. Establishing a TAC a part of a PACS implementation has a positive affect on patient care and clinical acceptance.

PACS and diagnostic imaging service delivery-A UK perspective

International Nuclear Information System (INIS)

Sutton, Laurence N.

2011-01-01

This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

Assessment of the usefulness of telemammography for the second reading in screening mammography

International Nuclear Information System (INIS)

Okuda, Itsuko; Nakajima, Yasuo; Okazaki, Hiroko; Shimamoto, Hiroshi; Okamoto, Kyoko; Kanemaki, Yoshihide; Irimoto, Masahiro

2010-01-01

We assessed the usefulness of telemammography by soft-copy diagnosis. A wide area network for teleradiology was set up incorporating seven institutions located in two prefectures. A total of 1053 subjects were enrolled. The first reading was performed using hard-copy images at the institution where mammography was undertaken. The second reading using hard-copy images was then performed. These images were transferred to our institution, where a second reading based on soft-copy images was performed. The result of soft-copy diagnosis were then compared with those of the hard-copy diagnosis. The diagnosis concordance rate, which was higher than category 3, was evaluated. Category 1 or 2 accounted for 956 cases at the stage of the second hard-copy diagnosis, of which category 1 or 2 accounted for 930 cases analyzed in the second soft-copy diagnosis. A category higher than 3 accounted for 97 cases at the second hard-copy diagnosis, of which a category higher than 3 accounted for 75 cases at the stage of the second soft-copy diagnosis. The κ-value for the diagnosis concordance rate was 0.751. The diagnostic concordance between hard-copy diagnosis and soft-copy diagnosis was good. Diagnostic accuracy showed no significant difference between the two. We conclude that soft-copy diagnosis by telemammography is useful, and that its application is desirable for screening mammography. (author)

Development of a secure and cost-effective infrastructure for the access of arbitrary web-based image distribution systems

International Nuclear Information System (INIS)

Hacklaender, T.; Demabre, N.; Cramer, B.M.; Kleber, K.; Schneider, H.

2004-01-01

Purpose: To build an infrastructure that enables radiologists on-call and external users a teleradiological access to the HTML-based image distribution system inside the hospital via internet. In addition, no investment costs should arise on the user side and the image data should be sent renamed using cryptographic techniques. Materials and Methods: A pure HTML-based system manages the image distribution inside the hospital, with an open source project extending this system through a secure gateway outside the firewall of the hospital. The gateway handles the communication between the external users and the HTML server within the network of the hospital. A second firewall is installed between the gateway and the external users and builds up a virtual private network (VPN). A connection between the gateway and the external user is only acknowledged if the computers involved authenticate each other via certificates and the external users authenticate via a multi-stage password system. All data are transferred encrypted. External users get only access to images that have been renamed to a pseudonym by means of automated processing before. Results: With an ADSL internet access, external users achieve an image load frequency of 0.4 CT images per second. More than 90% of the delay during image transfer results from security checks within the firewalls. Data passing the gateway induce no measurable delay. (orig.)

Digital X-ray Imaging in Dentistry

International Nuclear Information System (INIS)

Kim, Eun Kyung

1999-01-01

In dentistry, Radio Visio Graphy was introduced as a first electronic dental x-ray imaging modality in 1989. Thereafter, many types of direct digital radiographic systems have been produced in the last decade. They are based either on charge-coupled device (CCD) or on storage phosphor technology. In addition, new types of digital radiographic system using amorphous selenium, image intensifier etc. are under development. Advantages of digital radiographic system are elimination of chemical processing, reduction in radiation dose, image processing, computer storage, electronic transfer of images and so on. Image processing includes image enhancement, image reconstruction, digital subtraction, etc. Especially digital subtraction and reconstruction can be applied in many aspects of clinical practice and research. Electronic transfer of images enables filmless dental hospital and teleradiology/teledentistry system. Since the first image management and communications system (IMACS) for dentomaxillofacial radiology was reported in 1992, IMACS in dental hospital has been increasing. Meanwhile, researches about computer-assisted diagnosis, such as structural analysis of bone trabecular patterns of mandible, feature extraction, automated identification of normal landmarks on cephalometric radiograph and automated image analysis for caries or periodontitis, have been performed actively in the last decade. Further developments in digital radiographic imaging modalities, image transmission system, imaging processing and automated analysis software will change the traditional clinical dental practice in the 21st century.

Development of a secure and cost-effective infrastructure for the access of arbitrary web-based image distribution systems; Entwicklung einer sicheren und kostenguenstigen Infrastruktur zum Zugriff auf beliebige webbasierte Bildverteilungssysteme

Energy Technology Data Exchange (ETDEWEB)

Hacklaender, T.; Demabre, N.; Cramer, B.M. [Klinik fuer Radiologie, HELIOS-Klinikum Wuppertal (Germany); Kleber, K.; Schneider, H. [VISUS Technology Transfer GmbH, Bochum (Germany)

2004-08-01

Purpose: To build an infrastructure that enables radiologists on-call and external users a teleradiological access to the HTML-based image distribution system inside the hospital via internet. In addition, no investment costs should arise on the user side and the image data should be sent renamed using cryptographic techniques. Materials and Methods: A pure HTML-based system manages the image distribution inside the hospital, with an open source project extending this system through a secure gateway outside the firewall of the hospital. The gateway handles the communication between the external users and the HTML server within the network of the hospital. A second firewall is installed between the gateway and the external users and builds up a virtual private network (VPN). A connection between the gateway and the external user is only acknowledged if the computers involved authenticate each other via certificates and the external users authenticate via a multi-stage password system. All data are transferred encrypted. External users get only access to images that have been renamed to a pseudonym by means of automated processing before. Results: With an ADSL internet access, external users achieve an image load frequency of 0.4 CT images per second. More than 90% of the delay during image transfer results from security checks within the firewalls. Data passing the gateway induce no measurable delay. (orig.)

Digital X-ray Imaging in Dentistry

Energy Technology Data Exchange (ETDEWEB)

Kim, Eun Kyung [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Dankook University, Yongin (Korea, Republic of)

1999-08-15

In dentistry, Radio Visio Graphy was introduced as a first electronic dental x-ray imaging modality in 1989. Thereafter, many types of direct digital radiographic systems have been produced in the last decade. They are based either on charge-coupled device (CCD) or on storage phosphor technology. In addition, new types of digital radiographic system using amorphous selenium, image intensifier etc. are under development. Advantages of digital radiographic system are elimination of chemical processing, reduction in radiation dose, image processing, computer storage, electronic transfer of images and so on. Image processing includes image enhancement, image reconstruction, digital subtraction, etc. Especially digital subtraction and reconstruction can be applied in many aspects of clinical practice and research. Electronic transfer of images enables filmless dental hospital and teleradiology/teledentistry system. Since the first image management and communications system (IMACS) for dentomaxillofacial radiology was reported in 1992, IMACS in dental hospital has been increasing. Meanwhile, researches about computer-assisted diagnosis, such as structural analysis of bone trabecular patterns of mandible, feature extraction, automated identification of normal landmarks on cephalometric radiograph and automated image analysis for caries or periodontitis, have been performed actively in the last decade. Further developments in digital radiographic imaging modalities, image transmission system, imaging processing and automated analysis software will change the traditional clinical dental practice in the 21st century.

Japanese experience of telemedicine in oncology.

Science.gov (United States)

Mizushima, H; Uchiyama, E; Nagata, H; Matsuno, Y; Sekiguchi, R; Ohmatsu, H; Hojo, F; Shimoda, T; Wakao, F; Shinkai, T; Yamaguchi, N; Moriyama, N; Kakizoe, T; Abe, K; Terada, M

2001-05-01

We started telemedicine projects from 1990 with a telepathology system within Tsukiji Campus of National Cancer Center. In 1994, we connected Tsukiji Campus and Kashiwa Campus by 6 Mbps optical fiber leased line using IP protocol for data transmission, for teleconference, telepathology, and teleradiology projects. We also started connection of regional cancer centers and are now forming a cancer center network of 14 cancer centers. We are at present organizing 130 teleconferences per year with an attendance of more than 16000 people as summary. We have also used a high-resolution image transferring system, such as SHD (2000 pixelsx2000 pixels resolution) system on one side, and an economical telemedicine system using JAVA and a WWW browser (NCC_image) on the other side. We think that providing information is another field of telemedicine. We began the experimental gopher and WWW service in 1993. We are now providing official up-to-date cancer information for patients and healthcare professionals. We are getting more than 400000 hits per month. We are also providing a teleconference video session which is held every week on the Internet using a Real Video system with synchronized slide presentation on the WWW browser. We are also organizing a Cancer Image Reference Database System including DICOM images with viewer software. This paper is a summary of the telemedicine projects performed at the National Cancer Center.

History of PACS in Asia.

Science.gov (United States)

Inamura, Kiyonari; Kim, Jong Hyo

2011-05-01

First, history of PACS (picture archiving and communication system for medical use) in Japan is described in two parts: in part 1, the early stage of PACS development from 1984 to 2002, and in part 2 the matured stage from 2002 to 2010. PACS in Japan has been developed and installed by local manufacturers by their own technology and demand from domestic hospitals. Part 1 mainly focuses on quantitative growth and part 2 on qualitative change. In part 2, integration of PACS into RIS (radiology information system), HIS (hospital information system), EPR (electronic patient record), teleradiology and IHE (integrating healthcare enterprise) is reported. Interaction with other elements of technology such as moving picture network system and three dimensional display is also discussed. Present situation of main 4 large size hospitals is presented. Second, history of PACS in Korea is reported. Very acute climbing up of filmless PACS diffusion was observed from 1997 to 2000. The reasons for such evolution are described and discussed. Also changes of PACS installation and system integration with other systems such as HIS and role of them in radiological diagnoses in Korea since 2002 are described. Third, history in China is investigated by checking international academic journals in English and described as far as events are logically linked and consistently meaningful. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Acceptable levels of digital image compression in chest radiology

International Nuclear Information System (INIS)

Smith, I.

2000-01-01

The introduction of picture archival and communications systems (PACS) and teleradiology has prompted an examination of techniques that optimize the storage capacity and speed of digital storage and distribution networks. The general acceptance of the move to replace conventional screen-film capture with computed radiography (CR) is an indication that clinicians within the radiology community are willing to accept images that have been 'compressed'. The question to be answered, therefore, is what level of compression is acceptable. The purpose of the present study is to provide an assessment of the ability of a group of imaging professionals to determine whether an image has been compressed. To undertake this study a single mobile chest image, selected for the presence of some subtle pathology in the form of a number of septal lines in both costphrenic angles, was compressed to levels of 10:1, 20:1 and 30:1. These images were randomly ordered and shown to the observers for interpretation. Analysis of the responses indicates that in general it was not possible to distinguish the original image from its compressed counterparts. Furthermore, a preference appeared to be shown for images that have undergone low levels of compression. This preference can most likely be attributed to the 'de-noising' effect of the compression algorithm at low levels. Copyright (1999) Blackwell Science Pty. Ltd

Clinical results of HIS, RIS, PACS integration using data integration CASE tools

Science.gov (United States)

Taira, Ricky K.; Chan, Hing-Ming; Breant, Claudine M.; Huang, Lu J.; Valentino, Daniel J.

1995-05-01

Current infrastructure research in PACS is dominated by the development of communication networks (local area networks, teleradiology, ATM networks, etc.), multimedia display workstations, and hierarchical image storage architectures. However, limited work has been performed on developing flexible, expansible, and intelligent information processing architectures for the vast decentralized image and text data repositories prevalent in healthcare environments. Patient information is often distributed among multiple data management systems. Current large-scale efforts to integrate medical information and knowledge sources have been costly with limited retrieval functionality. Software integration strategies to unify distributed data and knowledge sources is still lacking commercially. Systems heterogeneity (i.e., differences in hardware platforms, communication protocols, database management software, nomenclature, etc.) is at the heart of the problem and is unlikely to be standardized in the near future. In this paper, we demonstrate the use of newly available CASE (computer- aided software engineering) tools to rapidly integrate HIS, RIS, and PACS information systems. The advantages of these tools include fast development time (low-level code is generated from graphical specifications), and easy system maintenance (excellent documentation, easy to perform changes, and centralized code repository in an object-oriented database). The CASE tools are used to develop and manage the `middle-ware' in our client- mediator-serve architecture for systems integration. Our architecture is scalable and can accommodate heterogeneous database and communication protocols.

The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

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Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

2014-12-01

We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction.

Science.gov (United States)

Hanna, Tarek N; Shekhani, Haris; Lamoureux, Christine; Mar, Hanna; Nicola, Refky; Sliker, Clint; Johnson, Jamlik-Omari

2017-03-01

To assess the practice environment of emergency radiologists with a focus on schedule, job satisfaction, and self-perception of health, wellness, and diagnostic accuracy. A survey drawing from prior radiology and health care shift-work literature was distributed via e-mail to national societies, teleradiology groups, and private practices. The survey remained open for 4 weeks in 2016, with one reminder. Data were analyzed using hypothesis testing and logistic regression modeling. Response rate was 29.6% (327/1106); 69.1% of respondents (n = 226) were greater than 40 years old, 73% (n = 240) were male, and 87% (n = 284) practiced full time. With regard to annual overnight shifts (NS): 36% (n = 118) did none, 24.9% (n = 81) did 182 or more, and 15.6% (n = 51) did 119. There was a significant association between average NS worked per year and both perceived negative health effects (P impact on memory (P job enjoyment and number of annual NS (P job" for radiologists who work no NS is 2.21 times greater than for radiologists who work at least 119 NS, when shift length is held constant. Radiologists with 11+ years of experience who work no NS or 1 to 100 NS annually have lower odds of feeling overwhelmed when compared with those working the same number of NS with job satisfaction and negative health self-perception. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Computer hardware for radiologists: Part I

International Nuclear Information System (INIS)

Indrajit, IK; Alam, A

2010-01-01

Computers are an integral part of modern radiology practice. They are used in different radiology modalities to acquire, process, and postprocess imaging data. They have had a dramatic influence on contemporary radiology practice. Their impact has extended further with the emergence of Digital Imaging and Communications in Medicine (DICOM), Picture Archiving and Communication System (PACS), Radiology information system (RIS) technology, and Teleradiology. A basic overview of computer hardware relevant to radiology practice is presented here. The key hardware components in a computer are the motherboard, central processor unit (CPU), the chipset, the random access memory (RAM), the memory modules, bus, storage drives, and ports. The personnel computer (PC) has a rectangular case that contains important components called hardware, many of which are integrated circuits (ICs). The fiberglass motherboard is the main printed circuit board and has a variety of important hardware mounted on it, which are connected by electrical pathways called “buses”. The CPU is the largest IC on the motherboard and contains millions of transistors. Its principal function is to execute “programs”. A Pentium ® 4 CPU has transistors that execute a billion instructions per second. The chipset is completely different from the CPU in design and function; it controls data and interaction of buses between the motherboard and the CPU. Memory (RAM) is fundamentally semiconductor chips storing data and instructions for access by a CPU. RAM is classified by storage capacity, access speed, data rate, and configuration

Computer hardware for radiologists: Part I

Directory of Open Access Journals (Sweden)

Indrajit I

2010-01-01

Full Text Available Computers are an integral part of modern radiology practice. They are used in different radiology modalities to acquire, process, and postprocess imaging data. They have had a dramatic influence on contemporary radiology practice. Their impact has extended further with the emergence of Digital Imaging and Communications in Medicine (DICOM, Picture Archiving and Communication System (PACS, Radiology information system (RIS technology, and Teleradiology. A basic overview of computer hardware relevant to radiology practice is presented here. The key hardware components in a computer are the motherboard, central processor unit (CPU, the chipset, the random access memory (RAM, the memory modules, bus, storage drives, and ports. The personnel computer (PC has a rectangular case that contains important components called hardware, many of which are integrated circuits (ICs. The fiberglass motherboard is the main printed circuit board and has a variety of important hardware mounted on it, which are connected by electrical pathways called "buses". The CPU is the largest IC on the motherboard and contains millions of transistors. Its principal function is to execute "programs". A Pentium® 4 CPU has transistors that execute a billion instructions per second. The chipset is completely different from the CPU in design and function; it controls data and interaction of buses between the motherboard and the CPU. Memory (RAM is fundamentally semiconductor chips storing data and instructions for access by a CPU. RAM is classified by storage capacity, access speed, data rate, and configuration.

Temporal Scalability of Dynamic Volume Data using Mesh Compensated Wavelet Lifting.

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Schnurrer, Wolfgang; Pallast, Niklas; Richter, Thomas; Kaup, Andre

2017-10-12

Due to their high resolution, dynamic medical 2D+t and 3D+t volumes from computed tomography (CT) and magnetic resonance tomography (MR) reach a size which makes them very unhandy for teleradiologic applications. A lossless scalable representation offers the advantage of a down-scaled version which can be used for orientation or previewing, while the remaining information for reconstructing the full resolution is transmitted on demand. The wavelet transform offers the desired scalability. A very high quality of the lowpass sub-band is crucial in order to use it as a down-scaled representation. We propose an approach based on compensated wavelet lifting for obtaining a scalable representation of dynamic CT and MR volumes with very high quality. The mesh compensation is feasible to model the displacement in dynamic volumes which is mainly given by expansion and contraction of tissue over time. To achieve this, we propose an optimized estimation of the mesh compensation parameters to optimally fit for dynamic volumes. Within the lifting structure, the inversion of the motion compensation is crucial in the update step. We propose to take this inversion directly into account during the estimation step and can improve the quality of the lowpass sub-band by 0.63 dB and 0.43 dB on average for our tested dynamic CT and MR volumes at the cost of an increase of the rate by 2.4% and 1.2% on average.

Specification and evaluation of a regional PACS in the SaxTeleMed project

Science.gov (United States)

Lemke, Heinz U.; Niederlag, W.; Heuser, H.

2002-05-01

During the early development phase of PACS, its implementation was mainly a matter of the radiological department of a hospital. This is changing rapidly and PACS planning and realization is increasingly seen in the context of a hospital-wide approach. With a growth of networking amongst healthcare institutions and the growing relevance of teleradiological scenarios, new strategies must be followed which take not only local but also regional and global aspects of PACS into consideration. One such regional PACS project was initiated by the Ministry of Social Welfare of the Free State of Saxony in Germany. This 'reference model program for the digitization of imaging procedures and communication of images between hospitals in the free state of Saxony' (SaxTeleMed) covers seven regional projects distributed throughout Saxony. Each regional project is organized around so called lead hospitals, which network with other cooperating hospitals and medical practices. The regional reference projects are designed to be largely independent from one another. In some instances, however, a network connection between reference projects is also considered. Altogether, 39 hospitals and medical centers are involved in the model program. The aim of this program is to test the technical, organizational, legal and economic problems in the area of digitization and networking within the free State of Saxony. With the knowledge gained it is expected to improve future investment decisions in healthcare and above all to implement secure systems.

PACS: the second time around

International Nuclear Information System (INIS)

Foord, Keith

1999-01-01

Conquest Hospital was a Picture Archiving and Communication Systems development site, designed to inform the specification of low cost systems and to provide information on benefits and drawbacks. The American College of Radiologists/National Electrical Manufacturers Association 2.0 protocol was used for image management. The Regional Health Authority sponsored the system, initially installed in mid 1992. It used a high-speed dedicated optical fibre distributed data interface network and for teleradiology an Integrated Services Digital Network solution. Image and other data were captured and archived satisfactorily. Image reporting folders were manually constructed and sent to reporting viewstations. Radiologists were able to directly request 'ad hoc' images from archive. The reporting function of the associated but unlinked radiology information system was satisfactory. Identification was made of data transfer, ergonomic, single point of failure and many other issues. These informed re-specification and the commercial approach for a Digital Images Communication in Medicine/Hyper Text Mark-up Language Picture Archiving and Communication System, the first stages of which have been whole hospital re-networking, Intranet introduction, installation of new Computed Radiography/Fluorography and Computed Tomography/Magnetic Resonance Imaging segments and a new Radiology Information System. The Picture Archiving and Communication System is now seen as part of a full Electronic Patient Record system. Networking and provision of high quality Personal Computer hardware for data review are seen as a corporate responsibility and a hospital overhead, no longer borne by individual projects. Our present work is synergistic with the procurement of a new Clinical Information System and the further development of the hospital Intranet

Facilitating Stroke Management using Modern Information Technology.

Science.gov (United States)

Nam, Hyo Suk; Park, Eunjeong; Heo, Ji Hoe

2013-09-01

Information technology and mobile devices may be beneficial and useful in many aspects of stroke management, including recognition of stroke, transport and triage of patients, emergent stroke evaluation at the hospital, and rehabilitation. In this review, we address the contributions of information technology and mobile health to stroke management. Rapid detection and triage are essential for effective thrombolytic treatment. Awareness of stroke warning signs and responses to stroke could be enhanced by using mobile applications. Furthermore, prehospital assessment and notification could be streamlined for use in telemedicine and teleradiology. A mobile telemedicine system for assessing the National Institutes of Health Stroke Scale scores has shown higher correlation and fast assessment comparing with face-to-face method. Because the benefits of thrombolytic treatment are time-dependent, treatment should be initiated as quickly as possible. In-hospital communication between multidisciplinary team members can be enhanced using information technology. A computerized in-hospital alert system using computerized physician-order entry was shown to be effective in reducing the time intervals from hospital arrival to medical evaluations and thrombolytic treatment. Mobile devices can also be used as supplementary tools for neurologic examination and clinical decision-making. In post-stroke rehabilitation, virtual reality and telerehabilitation are helpful. Mobile applications might be useful for public awareness, lifestyle modification, and education/training of healthcare professionals. Information technology and mobile health are useful tools for management of stroke patients from the acute period to rehabilitation. Further improvement of technology will change and enhance stroke prevention and treatment.

[Mobile IT: Possibilities and barriers of mHealth].

Science.gov (United States)

Böckmann, B

2016-04-01

The increasing availability of mobile devices and corresponding applications, both for providers and patients, often leads to speculation that mHealth, as the combination of mobile devices and health services is often called, would revolutionize the use of information technology (IT) in healthcare. On the other hand users, providers and operators providing such solutions are often confronted with completely new challenges. This article assesses the options and potential of mHealth and also takes a critical look at potential obstacles. As this field is very broad this critical analysis is illustrated by means of three exemplary application areas: mHealth in radiology, the influence of mHealth on research and mHealth as an enabler of new services, always with examples from other countries.The use of mHealth in radiology currently often develops empirically from existing applications in a relatively unstructured way and benefiting from the dynamic development of mobile technology. The possibilities range from viewing images at the bedside via mobile accessibility of radiologists up to teleradiology. In research there is a huge potential in solutions that actively involve patients with their own mobile devices but the field of data protection is still perceived in Germany as problematic so that only a few research institutions are actively addressing these options. The concept of mHealth allows physicians, hospitals and other service providers to invent entirely new services and a start-up scene is beginning to be established with business models becoming successful particularly with exchanges at the interface with established suppliers.

The evolution of publication hotspots in the field of telemedicine from 1962 to 2015 and differences among six countries.

Science.gov (United States)

Wang, Yanjun; Zhao, Ye; Zheng, Jianzhong; Zhang, Ailian; Dong, Haiyuan

2018-04-01

Introduction Telemedicine has been implemented in many countries and has captured the attention of many researchers. Herein, we aim to quantify publication hotspots in the field of telemedicine, analyse their evolution, compare them in different countries, and provide visual representations. Methods We used software tools to process PubMed entries for a 54-year period and identified publication hotspots using keyword frequency analysis. We employed a keyword co-occurrence analysis, principal component analysis, multidimensional scaling analysis, and network visualization technology. Results The number of Medical Subject Heading (MeSH) terms increased with time. The most common subcategories of telemedicine between 1962 and 2015 were Remote Consultation, Teleradiology, and Telepathology. The most popular information communication technologies in telemedicine publications were related to the Internet and cell phones. The topics of Patient Satisfaction, Treatment Outcomes, and Home Care Services associated with telemedicine were highlighted after the 1990s. Use frequency of the terms Cell Phones and Self-Care increased drastically in the past six years, and the publication focus in six countries that had the highest output was different. Knowledge network maps and perceptual maps show the relationship between high-frequency MeSH terms. Discussion The telemedicine field has experienced significant growth and expansion in knowledge and innovation in the last 54 years. Publication hotspots for telemedicine lean towards clinical treatment, home care services, and personal care, and countries emphasize publishing in areas related to their national characteristics. This study quantitatively discusses publication hotspots, provides an objective and systematic understanding of this field, and suggests directions for future telemedicine research.

Extreme compression for extreme conditions: pilot study to identify optimal compression of CT images using MPEG-4 video compression.

Science.gov (United States)

Peterson, P Gabriel; Pak, Sung K; Nguyen, Binh; Jacobs, Genevieve; Folio, Les

2012-12-01

This study aims to evaluate the utility of compressed computed tomography (CT) studies (to expedite transmission) using Motion Pictures Experts Group, Layer 4 (MPEG-4) movie formatting in combat hospitals when guiding major treatment regimens. This retrospective analysis was approved by Walter Reed Army Medical Center institutional review board with a waiver for the informed consent requirement. Twenty-five CT chest, abdomen, and pelvis exams were converted from Digital Imaging and Communications in Medicine to MPEG-4 movie format at various compression ratios. Three board-certified radiologists reviewed various levels of compression on emergent CT findings on 25 combat casualties and compared with the interpretation of the original series. A Universal Trauma Window was selected at -200 HU level and 1,500 HU width, then compressed at three lossy levels. Sensitivities and specificities for each reviewer were calculated along with 95 % confidence intervals using the method of general estimating equations. The compression ratios compared were 171:1, 86:1, and 41:1 with combined sensitivities of 90 % (95 % confidence interval, 79-95), 94 % (87-97), and 100 % (93-100), respectively. Combined specificities were 100 % (85-100), 100 % (85-100), and 96 % (78-99), respectively. The introduction of CT in combat hospitals with increasing detectors and image data in recent military operations has increased the need for effective teleradiology; mandating compression technology. Image compression is currently used to transmit images from combat hospital to tertiary care centers with subspecialists and our study demonstrates MPEG-4 technology as a reasonable means of achieving such compression.

Natural display mode for digital DICOM-conformant diagnostic imaging.

Science.gov (United States)

Peters, Klaus-Ruediger; Ramsby, Gale R

2002-09-01

The authors performed this study to investigate the verification of the contrast display properties defined by the digital imaging and communication in medicine (DICOM) PS (picture archiving and communication system [PACS] standard) 3.14-2001 gray-scale display function standard and their dependency on display luminance range and video signal bandwidth. Contrast sensitivity and contrast linearity of DICOM-conformant displays were measured in just-noticeable differences (JNDs) on special perceptual contrast test patterns. Measurements were obtained six times at various display settings under dark room conditions. Display luminance range and video bandwidth had a significant effect on contrast perception. The perceptual promises of the standard could be established only with displays that were calibrated to a unity contrast resolution, at which the number of displayed intensity steps was equal to the number of perceivable contrast steps (JNDs). Such display conditions provide for visual perception information at the level of single-step contrast sensitivity and full-range contrast linearity. These "natural display" conditions also help minimize the Mach banding effects that otherwise reduce contrast sensitivity and contrast linearity. Most, if not all, conventionally used digital display modalities are driven with a contrast resolution larger than 1. Such conditions reduce contrast perception when compared with natural imaging conditions. The DICOM-conformant display conditions at unity contrast resolution were characterized as the "natural display" mode, and, thus, the authors a priori recommend them as being useful for making a primary diagnosis with PACS and teleradiology and as a standard for psychophysical research and performance measurements.

Varying performance in mammographic interpretation across two countries: Do results indicate reader or population variances?

Science.gov (United States)

Soh, BaoLin P.; Lee, Warwick B.; Wong, Jill; Sim, Llewellyn; Hillis, Stephen L.; Tapia, Kriscia A.; Brennan, Patrick C.

2016-03-01

Aim: To compare the performance of Australian and Singapore breast readers interpreting a single test-set that consisted of mammographic examinations collected from the Australian population. Background: In the teleradiology era, breast readers are interpreting mammographic examinations from different populations. The question arises whether two groups of readers with similar training backgrounds, demonstrate the same level of performance when presented with a population familiar only to one of the groups. Methods: Fifty-three Australian and 15 Singaporean breast radiologists participated in this study. All radiologists were trained in mammogram interpretation and had a median of 9 and 15 years of experience in reading mammograms respectively. Each reader interpreted the same BREAST test-set consisting of sixty de-identified mammographic examinations arising from an Australian population. Performance parameters including JAFROC, ROC, case sensitivity as well as specificity were compared between Australian and Singaporean readers using a Mann Whitney U test. Results: A significant difference (P=0.036) was demonstrated between the JAFROC scores of the Australian and Singaporean breast radiologists. No other significant differences were observed. Conclusion: JAFROC scores for Australian radiologists were higher than those obtained by the Singaporean counterparts. Whilst it is tempting to suggest this is down to reader expertise, this may be a simplistic explanation considering the very similar training and audit backgrounds of the two populations of radiologists. The influence of reading images that are different from those that radiologists normally encounter cannot be ruled out and requires further investigation, particularly in the light of increasing international outsourcing of radiologic reporting.

Telemedicine in Alentejo

Science.gov (United States)

Bayer, Steffen; Gonçalves, Luís; Barlow, James

2014-01-01

Abstract Alentejo covers a third of Portugal, yet it is home to only 5% of the population. Residents of the region are poorer, older, and less educated than the rest of the country. There is a shortage of physicians in several specialties. The low population density, a concentration of specialized services, and a poor public transportation network all create barriers to access. Telemedicine was introduced in 1998 to help address these challenges. In this article, we provide an overview of the program and its current status, focusing on infrastructure, services, and activity volume. We also discuss the impact the program has had from the perspectives of patients and healthcare professionals. From 1998 to 2011, there were 132,546 episodes of service using telemedicine, including real-time teleconsultations, teleradiology, teleultrasound, and telepathology. At present, the network includes 20 primary care units and five hospitals, covering almost 30,000 km2 and 500,000 people. Units have high-resolution videoconferencing equipment, access to patients' clinical records, an image archive, and peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are available in 15 medical specialties and areas, ranging from neurology to pediatric surgery. In 2008, regional health authorities started a tele-education program, and by the end of 2011, 876 healthcare professionals, across 52 locations, had participated in remote learning sessions. More than a decade since telemedicine was introduced in Alentejo, it is now an integral part of everyday service provision. A comprehensive assessment of the costs and consequences of the program is currently underway. PMID:24180419

Improvement in photoconductor film properties by changing dielectric layer structures

International Nuclear Information System (INIS)

Kim, S; Oh, K; Lee, Y; Jung, J; Cho, G; Jang, G; Cha, B; Nam, S; Park, J

2011-01-01

In recent times, digital X-ray detectors have been actively applied to the medical field; for example, digital radiography offers the potential of improved image quality and provides opportunities for advances in medical image management, computer-aided diagnosis and teleradiology. In this study, two candidate materials (HgI 2 and PbI 2 ) have been employed to study the influence of the dielectric structure on the performance of fabricated X-ray photoconducting films. Parylene C with high permittivity was deposited as a dielectric layer using a parylene deposition system (PDS 2060). The structural and morphological properties of the samples were evaluated field emission scanning electron microscopy and X-ray diffraction. Further, to investigate improvements in the electrical characteristics, a dark current in the dark room and sensitivity to X-ray exposure in the energy range of general radiography diagnosis were measured across the range of the operating voltage. The electric signals varied with the dielectric layer structure of the X-ray films. The PbI 2 film with a bottom dielectric layer showed optimized electric properties. On the other hand, in the case of HgI 2 , the film with a top dielectric layer showed superior electric characteristics. Further, although the sensitivity of the film decreased, the total electrical efficiency of the film improved as a result of the decrease in dark current. When a dielectric layer is deposited on a photoconductor, the properties of the photoconductor, such as hole-electron mobility, should be considered to improve the image quality in digital medical imaging application. In this study, we have thus demonstrated that the use of dielectric layer structures improves the performance of photoconductors.

Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

Science.gov (United States)

Hanlon, William B.; Valtchinov, Vladimir I.; Davis, Scott D.; Lester, James; Khorasani, Ramin; Carrino, John A.; Benfield, Andrew

2000-05-01

Efforts to develop Picture Archiving and Communications Systems (PACS) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. Clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial PACS or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

Digital image envelope: method and evaluation

Science.gov (United States)

Huang, H. K.; Cao, Fei; Zhou, Michael Z.; Mogel, Greg T.; Liu, Brent J.; Zhou, Xiaoqiang

2003-05-01

Health data security, characterized in terms of data privacy, authenticity, and integrity, is a vital issue when digital images and other patient information are transmitted through public networks in telehealth applications such as teleradiology. Mandates for ensuring health data security have been extensively discussed (for example The Health Insurance Portability and Accountability Act, HIPAA) and health informatics guidelines (such as the DICOM standard) are beginning to focus on issues of data continue to be published by organizing bodies in healthcare; however, there has not been a systematic method developed to ensure data security in medical imaging Because data privacy and authenticity are often managed primarily with firewall and password protection, we have focused our research and development on data integrity. We have developed a systematic method of ensuring medical image data integrity across public networks using the concept of the digital envelope. When a medical image is generated regardless of the modality, three processes are performed: the image signature is obtained, the DICOM image header is encrypted, and a digital envelope is formed by combining the signature and the encrypted header. The envelope is encrypted and embedded in the original image. This assures the security of both the image and the patient ID. The embedded image is encrypted again and transmitted across the network. The reverse process is performed at the receiving site. The result is two digital signatures, one from the original image before transmission, and second from the image after transmission. If the signatures are identical, there has been no alteration of the image. This paper concentrates in the method and evaluation of the digital image envelope.

Digital radiography in space.

Science.gov (United States)

Hart, Rob; Campbell, Mark R

2002-06-01

With the permanent habitation of the International Space Station, the planning of longer duration exploration missions, and the possibility of space tourism, it is likely that digital radiography will be needed in the future to support medical care in space. Ultrasound is currently the medical imaging modality of choice for spaceflight. Digital radiography in space is limited because of prohibitive launch costs (in the region of $20,000/kg) that severely restrict the volume, weight, and power requirements of medical care hardware. Technological increases in radiography, a predicted ten-fold decrease in future launch costs, and an increasing clinical need for definitive medical care in space will drive efforts to expand the ability to provide medical care in space including diagnostic imaging. Normal physiological responses to microgravity, in conjunction with the high-risk environment of spaceflight, increase the risk of injury and could imply an extended recovery period for common injuries. The advantages of gravity on Earth, such as the stabilization of patients undergoing radiography and the drainage of fluids, which provide radiographic contrast, are unavailable in space. This creates significant difficulties in patient immobilization and radiographic positioning. Gravity-dependent radiological signs, such as lipohemarthrosis in knee and shoulder trauma, air or fluid levels in pneumoperitoneum, pleural effusion, or bowel obstruction, and the apical pleural edge in pneumothorax become unavailable. Impaired healing processes such as delayed callus formation following fracture will have implications on imaging, and recovery time lines are unknown. The confined nature of spacecraft and the economic impossibility of launching lead-based personal protective equipment present significant challenges to crew radiation safety. A modified, free-floating radiographic C-arm device equipped with a digital detector and utilizing teleradiology support is proposed as a

Adoption of telemedicine: from pilot stage to routine delivery

Directory of Open Access Journals (Sweden)

Zanaboni Paolo

2012-01-01

Full Text Available Abstract Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1 the process of adoption of telemedicine in comparison with other technologies; and 2 the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify

[The new law on radiation protection as a consequence of the EU safety standard of 2013].

Science.gov (United States)

Layer, G

2017-07-01

The transformation of a European guideline (2013/59/Euratom) from 2013 into national law requires adaptation of the national statutory regulations. This year, all areas of protection from ionizing radiation will be subject to the new radiation protection law (StrlSchG). Through this, the German X‑ray and Radiation Protection Acts will be combined to form a higher level of authority. The main parts of the StrlSchG will receive a new classification and will be organized according to the exposure scenario: radiation protection in planned exposure scenarios, radiation protection in emergency exposure scenarios, radiation protection in existing exposure scenarios, and the regulation of overall exposure scenarios. The most important or modified regulated points for radiology are concerned with early recognition, where the application of X‑ray or nuclear radiation is permitted in principle under certain conditions; the consultation of medical physics experts in all diagnostic investigative procedures involving radiation and applications for radiological intervention that are linked to high doses in the person under investigation; teleradiology, another special case of the application of X‑rays in humans that requires approval, now with the "required" technical qualification in radiation protection, formerly with the "full" technical qualification, in addition to research, the simplified approval procedure being substituted with a notification procedure.Furthermore, in contrast to previous regulations, those tasked with radiation protection can contact the regulators directly in the case of conflict, which indicates considerable reinforcement of their authority.The only dose limit that will be considerably reduced is the organ-specific equivalent dose of the eye lens, where the highest value will be reduced from 150 to 20 mSv per year in those who are exposed to radiation professionally.

Image and diagnosis quality of X-ray image transmission via cell phone camera: a project study evaluating quality and reliability.

Directory of Open Access Journals (Sweden)

Hans Goost

Full Text Available INTRODUCTION: Developments in telemedicine have not produced any relevant benefits for orthopedics and trauma surgery to date. For the present project study, several parameters were examined during assessment of x-ray images, which had been photographed and transmitted via cell phone. MATERIALS AND METHODS: A total of 100 x-ray images of various body regions were photographed with a Nokia cell phone and transmitted via email or MMS. Next, the transmitted photographs were reviewed on a laptop computer by five medical specialists and assessed regarding quality and diagnosis. RESULTS: Due to their poor quality, the transmitted MMS images could not be evaluated and this path of transmission was therefore excluded. Mean size of transmitted x-ray email images was 394 kB (range: 265-590 kB, SD ± 59, average transmission time was 3.29 min ± 8 (CI 95%: 1.7-4.9. Applying a score from 1-10 (very poor - excellent, mean image quality was 5.8. In 83.2 ± 4% (mean value ± SD of cases (median 82; 80-89%, there was agreement between final diagnosis and assessment by the five medical experts who had received the images. However, there was a markedly low concurrence ratio in the thoracic area and in pediatric injuries. DISCUSSION: While the rate of accurate diagnosis and indication for surgery was high with a concurrence ratio of 83%, considerable differences existed between the assessed regions, with lowest values for thoracic images. Teleradiology is a cost-effective, rapid method which can be applied wherever wireless cell phone reception is available. In our opinion, this method is in principle suitable for clinical use, enabling the physician on duty to agree on appropriate measures with colleagues located elsewhere via x-ray image transmission on a cell phone.

Can ICTs contribute to the efficiency and provide equitable access to the health care system in Sub-Saharan Africa? The Mali experience.

Science.gov (United States)

Bagayoko, C O; Anne, A; Fieschi, M; Geissbuhler, A

2011-01-01

The aim of this study is to demonstrate from actual projects that ICT can contribute to the balance of health systems in developing countries and to equitable access to human resources and quality health care service. Our study is focused on two essential elements which are: i) Capacity building and support of health professionals, especially those in isolated areas using telemedicine tools; ii) Strengthening of hospital information systems by taking advantage of full potential offered by open-source software. Our research was performed on the activities carried out in Mali and in part through the RAFT (Réseau en Afrique Francophone pour la Télémédecine) Network. We focused mainly on the activities of e-learning, telemedicine, and hospital information systems. These include the use of platforms that work with low Internet connection bandwidth. With regard to information systems, our strategy is mainly focused on the improvement and implementation of open-source tools. Several telemedicine application projects were reviewed including continuing online medical education and the support of isolated health professionals through the usage of innovative tools. This review covers the RAFT project for continuing medical education in French-speaking Africa, the tele-radiology project in Mali, the "EQUI-ResHuS" project for equal access to health over ICT in Mali, The "Pact-e.Santé" project for community health workers in Mali. We also detailed a large-scale experience of an open-source hospital information system implemented in Mali: "Cinz@n". We report on successful experiences in the field of telemedicine and on the evaluation by the end-users of the Cinz@n project, a pilot hospital information system in Mali. These reflect the potential of healthcare-ICT for Sub-Saharan African countries.

Emergency radiology in Canada: a national survey

International Nuclear Information System (INIS)

Torreggiani, W.C.; Nicolaou, S.; Lyburn, I.D.; Harris, A.C.; Buckley, A.R.

2002-01-01

To document the existing radiology services available to emergency physicians in hospitals across Canada and to preview future trends and needs. Questionnaires (n = 130) regarding the type, availability and satisfaction with radiology services were distributed to radiologists and emergency physicians at 65 hospitals across Canada. Fifty-three (41%) questionnaires were returned, and 45 (35%) completed questionnaires from 35 hospitals were used for analysis (24 from radiologists and 21 from emergency physicians). Plain radiographs were available in all hospitals at all times. Ultrasonography, intravenous pyleograms and computed tomography (CT) were available in all departments during normal working hours; after hours, CT was unavailable in 1 hospital and ultrasonography was unavailable in 2. Focused assessment with sonography for trauma (FAST) was routinely performed for blunt abdominal trauma in 6 centres, and 10 centres had teleradiology services. Regarding the quality of emergency service, 7 of 45 responded 'poor,' 4 'average,' 14 'good,' and 17 of 45 rated service 'excellent.' Interestingly, most radiologists answered 'good' or 'excellent,' and most of the 'poor' responses came from emergency physicians. Regarding staff coverage after 5 pm, 34 hospitals provided CT services, 20 had ultrasonography staff available, and there was radiology nursing coverage in 14 hospitals. Clinical details on requisitions were generally rated 'adequate' or 'poor.' Although most radiograph reports were available within 48 hours, some took longer. Hot-seat reporting was available in 11 centres. During normal working hours, radiologists were the first to read films in 5 of 35 hospitals. After hours, emergency physicians were the first to read films in all hospitals, but only 14 hospitals indicated they were 'formally' trained to do so. This survey documents the strengths and weaknesses of the radiology services available to emergency physicians. The perceptions of emergency physicians

State of the art in telemedicine - concepts, management, monitoring and evaluation of the telemedicine programme in Alentejo (Portugal).

Science.gov (United States)

Oliveira, Tiago Cravo; Branquinho, Maria José; Gonçalves, Luís

2012-01-01

Alentejo - one of five Portuguese continental regions - faces major problems impacting the health and social system of the region. Here, the low population density, the low educational and income level as well as an aging population have to be mentioned. Faced with the task of ensuring equal access to healthcare for all its inhabitants, the regional health authorities created the telemedicine program. From 1998 until 2000, the program developed in an experimental fashion, with teleconsultations involving a number of providers: primary health care centers, regional hospitals, and central hospitals. Between 2000 and 2010, there were a total of 135,000 telemedicine acts including teleconsultations, teleradiology (computerised tomography and x-rays), ultrasound telemedicine and telepathology. Presently, the network comprises 20 health centers and 6 hospitals, covering 4 districts. The platform is composed of high resolution videoconferencing equipment, software with patients' clinical records, an image archive, and a number of peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are provided by fifteen medical specialties, across 3 district hospitals, ranging from neurology to pediatric surgery. In 2008, health authorities started the telelearning program, initially using point to point videoconferencing, and by the end of 2010, 848 healthcare professionals, across 52 locations, had participated in remote learning sessions, covering topics from chronic wound treatment, to infection control, to medical error. As of 2011, point to multipoint telelearning is also in operation. This paper provides an overview of the telemedicine program in Alentejo, including both infrastructure and operations. Preliminary results of an ongoing evaluation of the impact of teleconsultations on key indicators of the regional healthcare system are also presented (including current utilization and plans for future expansion). This article builds on the experience

DICOM image secure communications with Internet protocols IPv6 and IPv4.

Science.gov (United States)

Zhang, Jianguo; Yu, Fenghai; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen

2007-01-01

Image-data transmission from one site to another through public network is usually characterized in term of privacy, authenticity, and integrity. In this paper, we first describe a general scenario about how image is delivered from one site to another through a wide-area network (WAN) with security features of data privacy, integrity, and authenticity. Second, we give the common implementation method of the digital imaging and communication in medicine (DICOM) image communication software library with IPv6/IPv4 for high-speed broadband Internet by using open-source software. Third, we discuss two major security-transmission methods, the IP security (IPSec) and the secure-socket layer (SSL) or transport-layer security (TLS), being used currently in medical-image-data communication with privacy support. Fourth, we describe a test schema of multiple-modality DICOM-image communications through TCP/IPv4 and TCP/IPv6 with different security methods, different security algorithms, and operating systems, and evaluate the test results. We found that there are tradeoff factors between choosing the IPsec and the SSL/TLS-based security implementation of IPv6/IPv4 protocols. If the WAN networks only use IPv6 such as in high-speed broadband Internet, the choice is IPsec-based security. If the networks are IPv4 or the combination of IPv6 and IPv4, it is better to use SSL/TLS security. The Linux platform has more security algorithms implemented than the Windows (XP) platform, and can achieve better performance in most experiments of IPv6 and IPv4-based DICOM-image communications. In teleradiology or enterprise-PACS applications, the Linux operating system may be the better choice as peer security gateways for both the IPsec and the SSL/TLS-based secure DICOM communications cross public networks.

Adoption of telemedicine: from pilot stage to routine delivery

Science.gov (United States)

2012-01-01

Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and

Teleradiology for remote consultation using iPad improves the use of health system human resources for paediatric fractures: prospective controlled study in a tertiary care hospital in Italy.

Science.gov (United States)

Zennaro, Floriana; Grosso, Daniele; Fascetta, Riccardo; Marini, Marta; Odoni, Luca; Di Carlo, Valentina; Dibello, Daniela; Vittoria, Francesca; Lazzerini, Marzia

2014-07-28

The growing cost of health care and lack of specialised staff have set e-Health high on the European political agenda. In a prospective study we evaluated the effect of providing images for remote consultation through an iPad on the number of in-hospital orthopaedic consultations for children with bone fractures. Children from 0 to 18 years diagnosed with a bone fracture by the radiologist during the hours when an orthopaedic service is provided only on-call were eligible for enrollment. Cases were enrolled prospectively during September and October 2013. A standard approach (verbal information only, no X-Ray provided remotely) was compared to an experimental approach (standard approach plus the provision of X-ray for remote consultation through an iPad). The primary outcome was the number of orthopaedic in-hospital consultations that occurred. Other outcomes included: immediate activation of other services; time needed for decision-making; technical difficulties; quality of images and diagnostic confidence (on a likert scale of 1 to 10). Forty-two children were enrolled in the study. Number of in-hospital consultancies dropped from 32/42 (76.1%) when no X-ray was provided to 16/42 (38%) when the X-rays was provided (p iPad and on the standard system for X- Ray visualisation resulted in a non statistically significant difference in the quality of images (average score 9.89 ± 0.37 vs 9.91 ± 0.30; p = 0.79), and in non statistically significant difference in diagnostic confidence (average score 9.91 ± 0.32 vs 9.92 ± 0.31; p = 0.88). Remote X-ray consultation through Aycan OsiriX PRO and iPad should be considered as a means for reducing the need of in-hospital orthopaedic consultation during on-call times, and potentially decrease the cost of care for the health system. In the future, alternative systems less expensive than Aycan OsiriX PRO should be further developed and tested.

Design and implementation of an anatomical web interface

International Nuclear Information System (INIS)

Barker, T.M.; Young, J.

1996-01-01

and may be viewed by staff and students at QUT. The opportunities for the application of these techniques for in-house PACS and teleradiology applications immediately becomes apparent

Standards for the secure data interchange in teleradiology put into practice for image and report distribution; Standards fuer den sicheren Datenaustausch in der Teleradiologie am Beispiel der Bild- und Befundverteilung

Energy Technology Data Exchange (ETDEWEB)

Eichelberg, M.; Riesmeier, J. [OFFIS e.V., Bereich IuK-Systeme im Gesundheitswesen, Oldenburg (Germany); Thiel, A.; Jensch, P. [Fachbereich Informatik, Carl-von-Ossietzky-Univ., Oldenburg (Germany); Emmel, D.; Haderer, A.; Ricke, J.; Stohlmann, L. [Klinik fuer Strahlenheilkunde, Charite-Campus-Virchow-Klinikum der Humboldt-Univ. zu Berlin (Germany); Bernarding, J. [Medizinische Informatik, Universitaetsklinikum Benjamin Franklin (UKBF), Freie Univ. Berlin (Germany)

2002-02-01

The use of telemedicine is becoming indispensable for a continuous and economical delivery of a high quality of care. However, data protection requirements have to be considered. For the selection of solutions, vendor-independent components based on standards are a prerequisite for a seamless integration into the existing, often heterogeneous, IT infrastructure. The ''Internet protocol'' TCP/IP and the DICOM standard with it's new security extensions form the basis for an internationally standardized and accepted procedure for a secure interchange of radiological images beyond platform boundaries. (orig.) [German] Um auch in Zukunft eine kostenguenstige und qualitativ hochwertige Patientenversorgung gewaehrleisten zu koennen, ist der Einsatz von Telemedizin unabdingbar. Dabei sind jedoch immer die Belange des Datenschutzes zu beruecksichtigen. Bei der Auswahl der Loesungen sind herstelleruebergreifende und auf Standards basierende Komponenten Voraussetzung fuer eine nahtlose Integration in die bestehende, oft heterogene EDV-Infrastruktur. Das ''Internetprotokoll'' TCP/IP und der DICOM-Standard mit seinen neuen Sicherheitserweiterungen bilden die Grundlage fuer ein weltweit standardisiertes und akzeptiertes Verfahren zum sicheren Austausch radiologischer Bilddaten ueber Plattformgrenzen hinweg. (orig.)

Overview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future.

Science.gov (United States)

Weinstein, Ronald S; Graham, Anna R; Richter, Lynne C; Barker, Gail P; Krupinski, Elizabeth A; Lopez, Ana Maria; Erps, Kristine A; Bhattacharyya, Achyut K; Yagi, Yukako; Gilbertson, John R

2009-08-01

Telepathology, the practice of pathology at a long distance, has advanced continuously since 1986. Today, fourth-generation telepathology systems, so-called virtual slide telepathology systems, are being used for education applications. Both conventional and innovative surgical pathology diagnostic services are being designed and implemented as well. The technology has been commercialized by more than 30 companies in Asia, the United States, and Europe. Early adopters of telepathology have been laboratories with special challenges in providing anatomic pathology services, ranging from the need to provide anatomic pathology services at great distances to the use of the technology to increase efficiency of services between hospitals less than a mile apart. As to what often happens in medicine, early adopters of new technologies are professionals who create model programs that are successful and then stimulate the creation of infrastructure (ie, reimbursement, telecommunications, information technologies, and so on) that forms the platforms for entry of later, mainstream, adopters. The trend at medical schools, in the United States, is to go entirely digital for their pathology courses, discarding their student light microscopes, and building virtual slide laboratories. This may create a generation of pathology trainees who prefer digital pathology imaging over the traditional hands-on light microscopy. The creation of standards for virtual slide telepathology is early in its development but accelerating. The field of telepathology has now reached a tipping point at which major corporations now investing in the technology will insist that standards be created for pathology digital imaging as a value added business proposition. A key to success in teleradiology, already a growth industry, has been the implementation of standards for digital radiology imaging. Telepathology is already the enabling technology for new, innovative laboratory services. Examples include STAT

Telehealth in the developing world: current status and future prospects

Directory of Open Access Journals (Sweden)

Scott RE

2015-02-01

Full Text Available Richard E Scott,1,2 Maurice Mars11Department of TeleHealth, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa; 2NT Consulting - Global e-Health Inc., Calgary, AB, CanadaAbstract: In a setting of constant change and confusing terminology, telehealth continues to gain ground in both developed and developing countries within the overarching milieu of e-health. Evidence shows telehealth has been used in essentially all countries of the world, but is embedded in few. Uses and needs of telehealth vary between the developed and developing world; the latter struggles with both communicable diseases and noncommunicable diseases, and with very few resources. Common clinical applications include teleconsultation, telecardiology (transmission of ECGs, teleradiology, and teledermatology. Many telehealth projects exist throughout Latin America and the Caribbean, Asia, and Africa, but there is little published evidence and only isolated examples of sustained programs, although several sustained humanitarian networks exist. Application of mobile solutions (m-health is on the rise in many developing countries. Telehealth is still not integrated into existing health care systems globally. Reasons vary: lack of proven large-scale operations, poor evidence base, inadequate implementation, lack of attention to the “soft side” of implementation (readiness, change management, and many others. For the developing world, reasons can be more pragmatic, including limited resources, unreliable power, poor connectivity, and high cost for the poverty stricken – those most in need. Telehealth is poised to improve health and health care in the developing world, driven by both altruistic and profit motives. But to have the desired effect, telehealth must address very specific and evidence-based health “needs” of each facility, region, or country; the shortage of health workers and specialist services; and the required skills upgrading and training

Open Source software and social networks: Disruptive alternatives for medical imaging

International Nuclear Information System (INIS)

Ratib, Osman; Rosset, Antoine; Heuberger, Joris

2011-01-01

and exchange information is a new model that is particularly suitable for some specific groups of healthcare professional and for physicians. It has also changed the expectations of how patients wish to communicate with their physicians. Conclusion: Emerging disruptive technologies and innovative paradigm such as Open Source software are leading the way to a new generation of information systems that slowly will change the way physicians and healthcare providers as well as patients will interact and communicate in the future. The impact of these new technologies is particularly effective in image communication, PACS and teleradiology.

Open Source software and social networks: Disruptive alternatives for medical imaging

Energy Technology Data Exchange (ETDEWEB)

Ratib, Osman, E-mail: osman.ratib@hcuge.ch [Department of Medical Imaging and Information Sciences, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1205 Geneva (Switzerland); Rosset, Antoine; Heuberger, Joris [Department of Medical Imaging and Information Sciences, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1205 Geneva (Switzerland)

2011-05-15

communicate and exchange information is a new model that is particularly suitable for some specific groups of healthcare professional and for physicians. It has also changed the expectations of how patients wish to communicate with their physicians. Conclusion: Emerging disruptive technologies and innovative paradigm such as Open Source software are leading the way to a new generation of information systems that slowly will change the way physicians and healthcare providers as well as patients will interact and communicate in the future. The impact of these new technologies is particularly effective in image communication, PACS and teleradiology.

Open Source software and social networks: disruptive alternatives for medical imaging.

Science.gov (United States)

Ratib, Osman; Rosset, Antoine; Heuberger, Joris

2011-05-01

is a new model that is particularly suitable for some specific groups of healthcare professional and for physicians. It has also changed the expectations of how patients wish to communicate with their physicians. Emerging disruptive technologies and innovative paradigm such as Open Source software are leading the way to a new generation of information systems that slowly will change the way physicians and healthcare providers as well as patients will interact and communicate in the future. The impact of these new technologies is particularly effective in image communication, PACS and teleradiology. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Intraoperative digital radiography for diagnosis of non-palpable breast lesions; Digitale intraoperative Praeparateradiographie bei diagnostischen Exzisionen nicht palpabler Laesionen der Brust

Energy Technology Data Exchange (ETDEWEB)

Diekmann, F.; Grebe, S.; Hamm, B. [Humboldt-Univ., Berlin (Germany). Inst. fuer Radiologie; Bick, U. [Humboldt-Univ., Berlin (Germany). Inst. fuer Radiologie; Chicago Univ., IL (United States). Dept. of Radiology; Winzer, K.J. [Humboldt-Univ., Berlin (Germany). Klinik fuer Allgemein-, Viszeral-, Gefaess- und Thoraxchirurgie; Paepke, S. [Humboldt-Univ., Berlin (Germany). Abt. fuer Frauenheilkunde und Geburtshilfe

2000-12-01

Purpose: A procedure for performing intraoperative digital radiography of diagnostic breast specimens directly in the operating suite with teleradiologic assessment by a radiologist is presented. The efficiency of this procedure is compared with that of conventional magnification mammography performed in the radiology department. Material and Methods: Thirty-six specimen radiographs obtained by conventional magnification mammography were compared with 38 intraoperative digital magnification radiographs (DIMA Soft P42 prototype, Feinfocus Inc., Garbsen). The radiographs were assessed for lesion conspicuity and time savings for the surgeon, anesthesiologist, and radiologist. Results: The new procedure identified all 38 labeled pathological lesions, and the conventional technique likewise had a detection rate of 100% (36/36). The new technique resulted in considerable time savings for the surgeon and the radiologist. The duration of surgery was shorter and the time interval from removal of the specimen to reporting of the results was reduced from about 23 min to about 13 min. A single radiograph was sufficient for complete visualization of the specimen in all cases. Conclusion: Digital intraoperative specimen radiography considerably reduces the time of surgery depending on the local conditions and is highly accurate in locating a suspicious area within the tissue. (orig.) [German] Ziel: Es wird die Moeglichkeit vorgestellt, digitale intraoperative Praeparateradiographie bei diagnostischen Exzisionen direkt im OP-Trakt mit teleradiologischer Begutachtung durch den Radiologen durchzufuehren. Die Leistungsfaehigkeit des Verfahrens wurde mit der konventionellen Vergroesserungsmammographie im Roentgeninstitut verglichen. Material und Methode: Es wurden 36 Praeparateaufnahmen, die mit der herkoemmlichen konventionellen Vergroesserungsmammographie durchgefuehrt worden waren, mit 38 intraoperativen digitalen Vergroesserungsaufnahmen (DIMA Soft P42, Fa. Feinfocus, Garbsen

WAP - based telemedicine applications

International Nuclear Information System (INIS)

Hung, K.; Zhang, Y.T.

2001-01-01

Telemedicine refers to the utilization of telecommunication technology for medical diagnosis, treatment, and patient care. Its aim is to provide expert-based health care to remote sites through telecommunication and information technologies. The significant advances in technologies have enabled the introduction of a broad range of telemedicine applications, which are supported by computer networks, wireless communication, and information superhighway. For example, some hospitals are using tele-radiology for remote consultation. Such a system includes medical imaging devices networked with computers and databases. Another growing area is patient monitoring, in which sensors are used to acquire biomedical signals, such as electrocardiogram (ECG), blood pressure, and body temperature, from a remote patient, who could be in bed or moving freely. The signals are then relayed to remote systems for viewing and analysis. Telemedicine can be divided into two basic modes of operations: real-time mode, in which the patient data can be accessed remotely in real-time, and store-and-forward mode, in which the acquired data does not have to be accessed immediately. In the recent years, many parties have demonstrated various telemedicine applications based on the Internet and cellular phone as these two fields have been developing rapidly. A current, recognizable trend in telecommunication is the convergence of wireless communication and computer network technologies. This has been reflected in recently developed telemedicine systems. For example, in 1998 J. Reponen, et al. have demonstrated transmission and display of computerized tomography (CT) examinations using a remote portable computer wirelessly connected to a computer network through TCP/IP on a GSM cellular phone. Two years later, they carried out the same tests with a GSM-based wireless personal digital assistant (PDA). The WAP (Wireless Application Protocol) Forum was founded in 1997 to create a global protocol

How many CT detector rows are necessary to perform adequate three dimensional visualization?

International Nuclear Information System (INIS)

Fischer, Lars; Tetzlaff, Ralf; Schoebinger, Max; Radeleff, Boris; Bruckner, Thomas; Meinzer, H.P.; Buechler, M.W.; Schemmer, Peter

2010-01-01

Introduction: The technical development of computer tomography (CT) imaging has experienced great progress. As consequence, CT data to be used for 3D visualization is not only based on 4 row CTs and 16 row CTs but also on 64 row CTs, respectively. The main goal of this study was to examine whether the increased amount of CT detector rows is correlated with improved quality of the 3D images. Material and Methods: All CTs were acquired during routinely performed preoperative evaluation. Overall, there were 12 data sets based on 4 detector row CT, 12 data sets based on 16 detector row CT, and 10 data sets based on 64 detector row CT. Imaging data sets were transferred to the DKFZ Heidelberg using the CHILI teleradiology system. For the analysis all CT scans were examined in a blinded fashion, i.e. both the name of the patient as well as the name of the CT brand were erased. For analysis, the time for segmentation of liver, both portal and hepatic veins as well as the branching depth of portal veins and hepatic veins was recorded automatically. In addition, all results were validated in a blinded fashion based on given quality index. Results: Segmentation of the liver was performed in significantly shorter time (p < 0.01, Kruskal-Wallis test) in the 16 row CT (median 479 s) compared to 4 row CT (median 611 s), and 64 row CT (median 670 s), respectively. The branching depth of the portal vein did not differ significantly among the 3 different data sets (p = 0.37, Kruskal-Wallis test). However, the branching depth of the hepatic veins was significantly better (p = 0.028, Kruskal-Wallis test) in the 4 row CT and 16 row CT compared to 64 row CT. The grading of the quality index was not statistically different for portal veins and hepatic veins (p = 0.80, Kruskal-Wallis test). Even though the total quality index was better for the vessel tree based on 64 row CT data sets (mean scale 2.6) compared to 4 CT row data (mean scale 3.25) and 16 row CT data (mean scale 3.0), these

Radiology system evolution in the new millennium.

Science.gov (United States)

Nauert, R C

2001-01-01

establish executive focus and priorities. These should be woven into operational and capital budgets to reflect expectations of the revenues, expenses and investments tied to the plan. While formidable, all of these objectives are realistic and can be accomplished if the right decisions are made. Initially, the entity's principle business objective is to formulate and begin implementation of methodical yet aggressive strategies for growth that are sensitive to sustaining high levels of quality patient care. The next phase features mergers with large, independent radiology practices in key geographic areas and successful acquisition of smaller practices. The objective of the final phase is to aggressively expand into select metropolitan areas with regional coverage and full teleradiology capabilities. High levels of market strength and financial performance are necessary to succeed. Passive limitations to small geographic areas and narrow practices will undermine their market position and dissolve financial strength with no hope of recovery. Only the dominant systems will survive and prosper.

Tele-education as method of medical education.

Science.gov (United States)

Masic, Izet; Pandza, Haris; Kulasin, Igor; Masic, Zlatan; Valjevac, Salih

2009-01-01

-surgery, tele-radiology and other specific telemedicine applications should be introduced to the curricula. Telemedicine and distance learning are best suited for medical education and doctor-to-doctor consultation--first contact between doctor and a patient should stay face-to-face when possible. In this paper, we present the results of the project Introduction and Implementation of Distance Learning at the Medical Faculty of University of Sarajevo and compare it with the following expected outcomes: development and integration of information technology in medical education; creation of flexible infrastructure which will enable access to e-learning to all students and teaching staff; improvement of digital literacy of academic population; ensuring high educational standards to students and teaching staff; helping medical staffto develop "life-long learning" approach in work and education.

Position paper: recommendations for a digital mammography quality assurance program V4.0.

Science.gov (United States)

Heggie, J C P; Barnes, P; Cartwright, L; Diffey, J; Tse, J; Herley, J; McLean, I D; Thomson, F J; Grewal, R K; Collins, L T

2017-09-01

In 2001 the ACPSEM published a position paper on quality assurance in screen film mammography which was subsequently adopted as a basis for the quality assurance programs of both the Royal Australian and New Zealand College of Radiologists (RANZCR) and of BreastScreen Australia. Since then the clinical implementation of digital mammography has been realised and it has become evident that existing screen-film protocols were not appropriate to assure the required image quality needed for reliable diagnosis or to address the new dose implications resulting from digital technology. In addition, the advantages and responsibilities inherent in teleradiology are most critical in mammography and also need to be addressed. The current document is the result of a review of current overseas practice and local experience in these areas. At this time the technology of digital imaging is undergoing significant development and there is still a lack of full international consensus about some of the detailed quality control (QC) tests that should be included in quality assurance (QA) programs. This document describes the current status in digital mammography QA and recommends test procedures that may be suitable in the Australasian environment. For completeness, this document also includes a review of the QA programs required for the various types of digital biopsy units used in mammography. In the future, international harmonisation of digital quality assurance in mammography and changes in the technology may require a review of this document. Version 2.0 represented the first of these updates and key changes related to image quality evaluation, ghost image evaluation and interpretation of signal to noise ratio measurements. In Version 3.0 some significant changes, made in light of further experience gained in testing digital mammography equipment were introduced. In Version 4.0, further changes have been made, most notably digital breast tomosynthesis (DBT) testing and QC have

Integrating telemedicine and telehealth: putting it all together.

Science.gov (United States)

Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

2008-01-01

Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care

Telemedicine Services for the Arctic: A Systematic Review

Science.gov (United States)

Walderhaug, Ståle; Hartvigsen, Gunnar

2017-01-01

another 219 papers, leaving 203 relevant papers. After a full-text assessment, 36 articles were left, which were critically analyzed. The inter-rater agreement was measured using Cohen Kappa test, and disagreements were resolved through discussion. Conclusions Despite the increasing number of fishermen and other seafarers, Arctic and maritime working conditions are mainly characterized by an absence of access to health care facilities. The condition is further aggravated for fishermen and seafarers who are working in the Arctic regions. In spite of the existing barriers and challenges, some telemedicine services have recently been successfully delivered in these areas. These services include teleconsultation (9/37, 24%), teleradiology (8/37, 22%), teledermatology and tele-education (3/37, 8%), telemonitoring and telecardiology (telesonography) (1/37, 3%), and others (10/37, 27%). However, the use of telemedicine in relation to search and rescue (SAR) services is not yet fully exploited. Therefore, we foresee that these implemented and evaluated telemedicine services will serve as underlying models for the successful implementation of future search and rescue (SAR) services. PMID:28659257

Use of film digitizers to assist radiology image management

Science.gov (United States)

Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

1996-05-01

were generated for each outside study to be interpreted and a medical record number assigned if none existed. All digitized outside films were archived in the PACS archive for later review or comparison use. The request generated by the RIS requesting a diagnostic interpretation was placed at the PACS workstation to alert the radiologists that unread images had arrived and a box was added to the workstation user interface that could be checked by the radiologist to indicate that a report had been dictated. The digitizer system solved several problems, unavailable films in the emergency room, teleradiology, and archiving of outside studies that had been read by University of Florida radiologists. In addition to saving time for outside film management, we now store the studies for comparison purposes, no longer lose emergency room films, generate diagnostic reports on emergency room films in a timely manner (important for billing and reimbursement), and can handle the distributed nature of our business. As changes in health care drive management changes, existing tools can be used in new ways to help make the transition easier. In this case, adding digitizers to an existing PACS network helped solve several image management problems.

The new law on radiation protection as a consequence of the EU safety standard of 2013; Das neue Strahlenschutzgesetz als Auswirkung der EU-Grundnormen von 2013

Energy Technology Data Exchange (ETDEWEB)

Layer, G. [Klinikum Ludwigshafen gGmbH, Zentralinstitut fuer Diagnostische und Interventionelle Radiologie, Ludwigshafen (Germany)

2017-07-15

The transformation of a European guideline (2013/59/Euratom) from 2013 into national law requires adaptation of the national statutory regulations. This year, all areas of protection from ionizing radiation will be subject to the new radiation protection law (StrlSchG). Through this, the German X-ray and Radiation Protection Acts will be combined to form a higher level of authority. The main parts of the StrlSchG will receive a new classification and will be organized according to the exposure scenario: radiation protection in planned exposure scenarios, radiation protection in emergency exposure scenarios, radiation protection in existing exposure scenarios, and the regulation of overall exposure scenarios. The most important or modified regulated points for radiology are concerned with early recognition, where the application of X-ray or nuclear radiation is permitted in principle under certain conditions; the consultation of medical physics experts in all diagnostic investigative procedures involving radiation and applications for radiological intervention that are linked to high doses in the person under investigation; teleradiology, another special case of the application of X-rays in humans that requires approval, now with the ''required'' technical qualification in radiation protection, formerly with the ''full'' technical qualification, in addition to research, the simplified approval procedure being substituted with a notification procedure. Furthermore, in contrast to previous regulations, those tasked with radiation protection can contact the regulators directly in the case of conflict, which indicates considerable reinforcement of their authority. The only dose limit that will be considerably reduced is the organ-specific equivalent dose of the eye lens, where the highest value will be reduced from 150 to 20 mSv per year in those who are exposed to radiation professionally. (orig.) [German] Die Umsetzung einer

[System of telesonography with synchronous teleconsultations and asynchronous telediagnoses (Togo)].

Science.gov (United States)

Adambounou, K; Farin, F; Boucher, A; Adjenou, K V; Gbeassor, M; N'dakena, K; Vincent, N; Arbeille, P

2012-01-01

successfully for 2 days during the 9(th) Congress of the French-speaking Black Africa Society of Radiology (SRANF in French) held from 4 till 6 May 2011 at the hotel EDA OBA. During this seminar, 4 ultrasound teleconsultations were performed from the hotel by eminent African radiologists. This preliminary study, although limited in the number of patients, allowed us to assess the technical features of our telesonography system. Togo, a developing country with a very modest infrastructure for information and communication, was an ideal site for a first test of this platform. Our system of remote ultrasound requires the local patient center to be equipped simply with a 2D ultrasound machine. The cost is quite low, in comparison to the asynchronous techniques requiring 3D devices. The high cost of 3D or 4D ultrasound machines and their fragility make it difficult to install them at the isolated sites and was a serious obstacle in the development of this system. If the center already has a 2D device and a computer, the cost to equip it with the remaining communications materials is 1,500 €. The experience in Togo clearly highlighted the possibility of teletraining and complete teleradiology with our system. The next stage of this work will seek to validate the results of this preliminary experience on a larger sample with more precise assessment criteria in 2012. The results will allow the widespread dissemination and routine use of this system in developing countries.