1 / 22

Teleradiology

Teleradiology. Jo ël Chabriais, MD, MS. Teleradiology - Telewhat?. One propose a segmentation: Teleteaching Telelearning Teleexpertise Teleconsultation Telediagnosis TeleXXX My purpose: teleradiology in daily radiological practice (telediagnosis ± teleexpertise). Teleradiology - Why?.

lilli
Download Presentation

Teleradiology

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Teleradiology Joël Chabriais, MD, MS

  2. Teleradiology - Telewhat? • One propose a segmentation: • Teleteaching • Telelearning • Teleexpertise • Teleconsultation • Telediagnosis • TeleXXX • My purpose: teleradiology in daily radiological practice (telediagnosis ± teleexpertise)

  3. Teleradiology - Why? • In some area there is a lack of radiologists. • Sometime it could be financially accurate to have only one radiologist on duty for several radiological facilities. • Boston experimentation: a contract with an Israeli and an Asian Hospitals to have only daytime reading. • Access to specialized expertise.

  4. Teleradiology in France • Some applications dedicated to neurosurgery: • Point to point, • Specific, • Launched at the beginning of the nineties, • Expensive and not easy to use. • New projects dedicated to general radiology.

  5. Teleradiology projects in France • Auvergne • Aquitaine • Brittany • Lorraine • …

  6. Teleradiology in Cantal • Mountainous area: transportation difficulties (winter). • Lack of radiologists. • Three main hospitals in the département: • Only one have senior full time radiologists, • One have an half time radiologist, • The last one have only interim radiologists, • Frequency of duty is too high in each hospital. • Sometime specialized second advice could be necessary -> patient records have to be sent to university hospitals.

  7. The projects • Send examinations to “on duty” radiologist home. • One radiologist on duty for all three hospitals. • Along the day, ability to send examination from one hospital to another directly from daily used working tools to daily used working tools. • Simplicity of use. • Security. • Federate all imaging departments of the département to manage them as an unique entity.

  8. Cantal

  9. Implementation Radiologist home H CT / MRI Aurillac Duty server DICOM viewer « on duty » DMZ Mediation server Internet Access

  10. H H H Aurillac Saint-Flour Mauriac Domicile radiologue Domicile radiologue Domicile radiologue CT / IRM modality modality DICOM Viewer « on duty » DICOM Viewer « on duty » DICOM Viewer « on duty » DICOM Viewer « on duty » DICOM Viewer « on duty » Duty Server DMZ Mediation Server Inter-hospital project - Cantal Internet Access

  11. Security Principle Other facility or on duty radiologist home Local networkt of the main facility (Aurillac) Main facility DMZ Decryption / Encryption Mediation server Gateway Gateway https channel DICOM Application DICOM Application DICOM Network

  12. Difficulties • Several different HIS/RIS (one per hospital). • No PACS at this time (probably one at Aurillac in two or three years). • Management of reports make on duty.

  13. Auvergne

  14. Mauriac St-Flour Aurillac ??? Cantal Today, Cantal Medical Imaging Federation

  15. ??? ??? Clermont-Rerrand Mauriac St-Flour ??? Puy-de-Dôme Aurillac ??? ??? ??? ??? ??? Moulins Puy-en-Velay Cantal ??? ??? Allier Haute Loire Tomorrow, Auvergne Medical Imaging network? University Hospital

  16. Hospitals in Auvergne

  17. Auvergne Medical Imaging Network • Each département will have its own network with nodal point in the main hospital at the préfecture (main town of the département). • All four networks will be federated on Clermont-Ferrand University Hospital (CHU). • At the CHU a server will be able to: • Give access to images in the DMZ, • Import images in the local PACS, • Send images to the right specialist “on duty” home for advice.

  18. Brittany Inter-hospital project H H H RENNES Vitré Saint-Brieuc CT / IRM modality modality STAR-IE STAR-IE STAR-IE DMZ Mediation Server MEGALIS Internet Access

  19. Which needs for such projects? • Receive request with images for daytime work as well as on duty at home. • Send a report from home to the right hospital • Deal with several different HIS/RIS/PACS for a Radiologist on duty? • Ensure security and patient privacy on home computer • …

  20. Identified issues • Security • Privacy • Second advice request (teleconferencing?) • Image streaming • Reporting: • DICOM SR? (needs of templates for reporting and for second advice) • HL7 CDA? (in France no product CDA ready) • .doc, .rtf, .pdf? (not secure formats) • …

  21. Other questions • Identify what is in DICOM, HL7 or IHE domain • Is there matter for work item proposals in DICOM?

  22. The topic is open for discussion

More Related