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Telemedicine Peter Corr University of Natal S Africa. Overview Lecture Links . Peter Corr. I am a professor of radiology working in South Africa. I have been involved with telemedicine projects in Africa for the last five years

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TelemedicinePeter Corr University of Natal S Africa

  • Overview

  • Lecture

  • Links

Peter corr l.jpg
Peter Corr

  • I am a professor of radiology working in South Africa. I have been involved with telemedicine projects in Africa for the last five years

  • What excites me about telemedicine is its potential impact in providing diagnosis and consultation in developing countries

Overview l.jpg

  • History

  • Goals

  • Definitions

  • Applications

  • Hardware &software requirements

  • Pitfalls

  • Future directions

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History of Telemedicine

  • First used in the sixties to transmit chest radiographs from Boston airport to Massachusetts General Hospital radiologists for reporting

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  • Digitise- process to convert analogue data (continuous) into digital data (discrete)

  • Bit-smallest piece of digital information

  • Byte- a group of 8 bits used to represent a value or character

  • Baud- number of bits transmitted in 1 second

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  • Lossless compression- no alteration of original image after reconstruction

  • DICOM- a standard for interconnecting digital imaging devices

  • telemedicine- the electronic transmission of medical images from one site to another for interpretation and consultation

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Goals of Telemedicine

  • To provide consultation and interpretation in regions of demonstrated need

  • To provide specialist services in hospitals without on site support

  • To promote educational opportunities for physicians

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  • radiology

  • ultrasound

  • surgery

  • opthalmology

  • pathology

  • dermatology

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Radiology Applications

  • Plain radiographs

  • Computerised tomography (CT)

  • Ultrasound

  • Magnetic resonance (MR)

  • Angiograms

  • Nuclear medicine

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  • Specialist advice without the patient having to travel to the central hospital

  • Cost saving in transport and patient accommodation

  • Better utilisation of specialist resources

  • Educational opportunities

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  • Incorrect diagnoses

  • Cost of hardware

  • Need good telecommunication network

  • Training of staff

  • Medicolegal concerns- patient confidentiality

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Image Acquisition

  • Digitiser to transfer hardcopy images into digital images

  • requires resolution of 2kX2kX12bits resolution

  • Nedd to compress data to reduce transmission time

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Image Transmission

  • Telephone lines are very slow but inexpensive at 64 kilobytes per second (baud)

  • ISDN telephone lines- intergrated service digital network is faster 256kb

  • ATM- asynchronous transfer mode >1Mb

  • Satellite- very fasy but expensive

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Image Display

  • High quality resolution monitors essential for reading images

  • resolution of 2kX2kX12bit required

  • Good screen luminance

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Applications- Ultrasound

  • Ultrasound-image files are small <100kb and static images are easy to transmit

  • Fetal ultrasound teleconsultation shows promise

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Applications- CT/MR Imaging

  • CT and MR imaging are small files <100kb and are easily transmitted for consultation

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  • Surgery- used for transmitting angiograms to vascular surgeons for consultation

  • Opthalmology- slit lamp and retinal images transmitted to opthalmologist using a retinal camera

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  • Histology slides can be transmitted to pathologists using a digital camera attached to a microscope

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Hardware & Software

  • Standards- American College of Radiology

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  • Cost- digitizers are expensive

  • Telecommunications limited in many parts of Africa and Asia- satellite shows promise

  • Medicolegal issues- patient confidentiality

  • Training of physicians

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Future Directions

  • Digital cameras may replace digitizers and are much cheaper

  • Wireless communications are rapidly expanding in developing countries

  • Internet II may provide sufficient bandwidth for telemedicine

  • Offers many educational opportunities

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  • American College of Radiology

  • University of Iowa Health Web

  • Radiological Society of North America