Teleradiology applications with DICOM-e-mail

Abstract

For the connection of several partners to a Dicom-e-mail based teleradiology network concepts were developed to allow the integration of different teleradiology applications. The organisational and technical needs for such an integration were analysed. More than 60 institutions including 23 hospitals in the Rhein-Neckar-Region, Germany were connected. The needed functionality was grouped in six teleradiology applications (emergency consultation, tele-guided examinations, expert consultations, cooperative work, scientific cooperations and homework with on call services) and their technical and organisational needs according to availability, speed of transfer, workflow definitions and data security needs was analysed. For the local integration of teleradiology services the setup and workflow is presented for a standalone teleradiology workstation and a server based teleradiology gateway. The line type needed for different groups of applications and users is defined. The security concept and fallback strategies are laid out, potential security problems and sources of errors are discussed. The specialties for the emergency teleradiology application are presented. The DICOM-e-mail protocol is a flexible and powerful protocol that can be used for a variety of teleradiology applications. It can meet the conditions for emergency applications but is limited if synchronous applications like teleconferences are needed.

European Teleradiology now and in the future: results of an online survey

“…There is also a demand for further harmonisation of legislation regarding the processing of health data in cross-border healthcare services: a European directive is required to further guarantee the safety of patients. The ESR has published several documents in which they have expressed their vision and concerns about teleradiology and have also provided guidelines and recommendations for the development and use of teleradiology services within the EU [1, 32–34]. …”

The Use of Teleradiology in Turkey: Current Situation and Attitudes of Radiologists

“…In our study, it was revealed that 41.6% of the participants did not use teleradi-ology systems and we consider that the main reasons and lack of financial support and technical problems. 7,[10][11][12] It was also found that DICOM was the most commonly transmitted format (63.3%), as revealed in the European and Swiss survey. 7,10 In our study, the most common reason for the use of teleradiology outsourcing was revealed as secondary readings and expert consultation, and the most common disadvantages were revealed as insufficient integration of clinical history and lack of contact with the radiologist.…”

“…7,[10][11][12] It was also found that DICOM was the most commonly transmitted format (63.3%), as revealed in the European and Swiss survey. 7,10 In our study, the most common reason for the use of teleradiology outsourcing was revealed as secondary readings and expert consultation, and the most common disadvantages were revealed as insufficient integration of clinical history and lack of contact with the radiologist. Of all the participants, 27% declared a lack of integration of clinical history, 27% stated a lack of contact, and 58.8% declared inaccurate clinical data leading to inadequate interpretation.…”

“…Interestingly, a lack of integration of clinical history and a lack of contact were also revealed as the most important drawbacks the use of teleradiology outsourcing in Europe. 7,10 The participants also stated that a lack of contact with the radiologist is likely to impede the diagnostic progress of the patients, particularly in emergency cases. 13,14 These problems are serious threats for the effectivity and quality of teleradiology practices.…”

“…7,9,10 Therefore, we foresee a promising future for teleradiology since Information Technology (IT) applications are becoming less and less costly with increasing speed and accuracy. 6 Furthermore, smart card technology can be a practical solution for the integration of the clinical data of the patients into a simple and portable card which could eliminate the necessity for transferring bulky documents across hospitals/centers and also enable a data storage system for recording the updates in the clinical progress of the patients.…”