IntroductionIf we look at the definition of telematics and its applications in radiology, we will find a wide range of contributing tools from computer hardware, software, network technique, and signal/image processing [1]. Since the present status and cost-effectiveness of PACS is presented in a separate contribution of the symposium, the current paper focuses on cost-effectiveness and benefit in patient care of teleradiology applications [2]. The presentation is divided into three parts:1. The first part demonstrates the current situation of teleradiology in Germany. The evaluation is the result of a questionnaire sent to approximately 4500 radiologist (ANARAD study) [3]. 2. The second part presents the result of a cost±benefit analysis of three different teleradiology applications in the framework of the KAMEDIN project [4,5]. 3. The third part presents the results of a cost±benefit analysis of teleradiology applications in neurosurgical emergency cases at the University of Greifswald [6].
ANARAD studyIn the ANARAD study a questionnaire was sent to 4500 radiologists at the beginning of 1997 [3]. The return rate was approximately 10 % with half of the answers coming from hospital radiologists and half from radiologists from private institutes. The major part of answers came from radiologists specializing in diagnostic radiology where some of them had additional specialties (possibility of multiple answers: diagnostic radiology 96 %; nuclear medicine 48 %; interventional radiology 39 %; neuroradiology 27 %; pediatric radiology 19 %; radiotherapy 5 %; others 5 %). The evaluation of the technical equipment was done separately for small and big institutes (small institutes with four physicians or less, big institutes with five physicians or more). No significant differences were found in the use of PCs (ca. 80 %) and in the use of networks (ca. 50 %). Significant differences exist in the use of the DICOM standard with 14 % in small institutes and 48 % in big institutes, the use of workstations with 45 % in small institutes and 64 % in big institutes, and the installation of PACS systems with 3 % in small institutes and 19 % in big institutes. The evaluation of the different modalities yield transmissions of CT images by teleradiology in 36 % and transmissions of MR images in 18 %. Eight percent were images from other modalities, and 11 % did not answer the question. An interesting result was the answer that only approximately 50 % of German radiologists feel themselves well informed about teleradiology, and the others have no or poor information. The most important requirements for the current situation of teleradiology are standardization of communications protocol and a definite attachment of the report to the images. Important requirements are data security, stable systems, optimized image quality, and payment for the teleradiology service. Less important requirements are optimized data transfer rates (small differences in transmission speed), interfaces to RIS, additional special functions of the teleradiology ...
