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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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peter corr
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
Overview
  • History
  • Goals
  • Definitions
  • Applications
  • Hardware &software requirements
  • Pitfalls
  • Future directions
history of telemedicine
History of Telemedicine
  • First used in the sixties to transmit chest radiographs from Boston airport to Massachusetts General Hospital radiologists for reporting
definitions
Definitions
  • 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
definitions6
Definitions
  • 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
goals of telemedicine
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
applications
Applications
  • radiology
  • ultrasound
  • surgery
  • opthalmology
  • pathology
  • dermatology
radiology applications
Radiology Applications
  • Plain radiographs
  • Computerised tomography (CT)
  • Ultrasound
  • Magnetic resonance (MR)
  • Angiograms
  • Nuclear medicine
advantages
Advantages
  • 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
disadvantages
Disadvantages
  • Incorrect diagnoses
  • Cost of hardware
  • Need good telecommunication network
  • Training of staff
  • Medicolegal concerns- patient confidentiality
image acquisition
Image Acquisition
  • Digitiser to transfer hardcopy images into digital images
  • requires resolution of 2kX2kX12bits resolution
  • Nedd to compress data to reduce transmission time
image transmission
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
image display
Image Display
  • High quality resolution monitors essential for reading images
  • resolution of 2kX2kX12bit required
  • Good screen luminance
applications ultrasound
Applications- Ultrasound
  • Ultrasound-image files are small <100kb and static images are easy to transmit
  • Fetal ultrasound teleconsultation shows promise
applications ct mr imaging
Applications- CT/MR Imaging
  • CT and MR imaging are small files <100kb and are easily transmitted for consultation
applications17
Applications
  • Surgery- used for transmitting angiograms to vascular surgeons for consultation
  • Opthalmology- slit lamp and retinal images transmitted to opthalmologist using a retinal camera
pathology
Pathology
  • Histology slides can be transmitted to pathologists using a digital camera attached to a microscope
hardware software
Hardware & Software
  • Standards- American College of Radiology
pitfalls
Pitfalls
  • Cost- digitizers are expensive
  • Telecommunications limited in many parts of Africa and Asia- satellite shows promise
  • Medicolegal issues- patient confidentiality
  • Training of physicians
future directions
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
links
Links
  • American College of Radiology
  • University of Iowa Health Web
  • Radiological Society of North America
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