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Telemedicine Peter Corr University of Natal S Africa

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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Telemedicine Peter Corr University of Natal S Africa

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  1. TelemedicinePeter Corr University of Natal S Africa • Overview • Lecture • Links

  2. 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

  3. Overview • History • Goals • Definitions • Applications • Hardware &software requirements • Pitfalls • Future directions

  4. History of Telemedicine • First used in the sixties to transmit chest radiographs from Boston airport to Massachusetts General Hospital radiologists for reporting

  5. 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

  6. 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

  7. 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

  8. Applications • radiology • ultrasound • surgery • opthalmology • pathology • dermatology

  9. Radiology Applications • Plain radiographs • Computerised tomography (CT) • Ultrasound • Magnetic resonance (MR) • Angiograms • Nuclear medicine

  10. 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

  11. Disadvantages • Incorrect diagnoses • Cost of hardware • Need good telecommunication network • Training of staff • Medicolegal concerns- patient confidentiality

  12. Image Acquisition • Digitiser to transfer hardcopy images into digital images • requires resolution of 2kX2kX12bits resolution • Nedd to compress data to reduce transmission time

  13. 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

  14. Image Display • High quality resolution monitors essential for reading images • resolution of 2kX2kX12bit required • Good screen luminance

  15. Applications- Ultrasound • Ultrasound-image files are small <100kb and static images are easy to transmit • Fetal ultrasound teleconsultation shows promise

  16. Applications- CT/MR Imaging • CT and MR imaging are small files <100kb and are easily transmitted for consultation

  17. Applications • Surgery- used for transmitting angiograms to vascular surgeons for consultation • Opthalmology- slit lamp and retinal images transmitted to opthalmologist using a retinal camera

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

  19. Hardware & Software • Standards- American College of Radiology

  20. Pitfalls • Cost- digitizers are expensive • Telecommunications limited in many parts of Africa and Asia- satellite shows promise • Medicolegal issues- patient confidentiality • Training of physicians

  21. 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

  22. Links • American College of Radiology • University of Iowa Health Web • Radiological Society of North America

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