Teleradiology Concepts and Models

TeleRadiology

Dr. S.F.B.NazirConsultant Radiologist

Teleradiology - Telewhat?

Teleradiology - Telewhat?

One propose a segmentation:TelediagnosisTeleteachingTelelearningTeleexpertiseTeleconsultationTeleXXX

My purpose: teleradiology in daily radiological practice (telediagnosis ± teleexpertise)

One propose a segmentation:TelediagnosisTeleteachingTelelearningTeleexpertiseTeleconsultationTeleXXX

My purpose: teleradiology in daily radiological practice (telediagnosis ± teleexpertise)

Teleradiology – Basic Concepts

Teleradiology – Basic Concepts

For Viewing and Reporting

For Viewing and Reporting

Teleradiology - Why?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.

Eg: A contract with TeleRadiology Service Provider Company(Our Company) with any Hospital or Diasnostic center in India or even at International Levels - Daytime Reporting or Night Hawks.

Access to specialized expertise.

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.

Eg: A contract with TeleRadiology Service Provider Company(Our Company) with any Hospital or Diasnostic center in India or even at International Levels - Daytime Reporting or Night Hawks.

Access to specialized expertise.

TeleradiologyTeleradiology

Lack of radiologists.Lack of full time radiologists, half time radiologist,

Sometime specialized second advice could be necessary -> patient records can be sent for second opinions.

Lack of radiologists.Lack of full time radiologists, half time radiologist,

Sometime specialized second advice could be necessary -> patient records can be sent for second opinions.

The projectsThe projects

Send examinations to “on duty” radiologist Home.

One radiologist on duty for all Multiple hospitals.

Ability to send examination (radiology images – like x-rays, CT scan, MRI or any patient data) from one hospital to another or to reporting center directly from daily used working tools.

Simplicity of use.Security.

Send examinations to “on duty” radiologist Home.

One radiologist on duty for all Multiple hospitals.

Ability to send examination (radiology images – like x-rays, CT scan, MRI or any patient data) from one hospital to another or to reporting center directly from daily used working tools.

Simplicity of use.Security.

DMZ

H

AurillacCT / MRI

Mediationserver

Dutyserver

Radiologist home

Internet Access

DICOM viewer« on duty »

ImplementationImplementation

DMZ

H

Aurillac

CT / IRM

MediationServer

DutyServer

Internet Access

Domicile radiologue

DICOM Viewer« on duty »

H

Saint-Flour

modality

DICOM Viewer

« on duty »

H

Mauriac

modality

DICOM Viewer

« on duty »Domicile radiologue

DICOM Viewer

« on duty »

Domicile radiologue

DICOM Viewer« on duty »

Inter-hospital project - Sample

Inter-hospital project - Sample

Mediation server

Decryption/ Encryption

Gateway

DICOMApplication

DICOMNetwork

Gateway

https channel

Local network of the main facility(Aurillac)

Main facility DMZOther facility oron duty radiologist home

Security PrincipleSecurity Principle

DICOMApplication

DifficultiesDifficulties

Several different HIS/RIS (one per hospital).

No PACS in Hospitals.Management of reports.

Several different HIS/RIS (one per hospital).

No PACS in Hospitals.Management of reports.

Medical Imaging Network

Medical Imaging Network

Each hospital department will have its own network with nodal point in the main hospital.

All four networks will be federated on Main Server.

Main 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 or Our center for reporting.

Each hospital department will have its own network with nodal point in the main hospital.

All four networks will be federated on Main Server.

Main 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 or Our center for reporting.

Which needs for such projects?

Which needs for such projects?

Receive request with images for reporting at home and / Main Office.

Send a report from home / Office to the right hospital

Deal with several different HIS/RIS/PACS for a Radiologist on duty?

Ensure security and patient privacy on home computer and server.

…

Receive request with images for reporting at home and / Main Office.

Send a report from home / Office to the right hospital

Deal with several different HIS/RIS/PACS for a Radiologist on duty?

Ensure security and patient privacy on home computer and server.

…

Identified issuesIdentified issuesSecurityPrivacySecond advice request (teleconferencing?)

Image streamingReporting:

DICOM SR (Structured Report)? (needs of templates for reporting and for second advice)

HL7 CDA? (in Europe - CDA ready).doc, .rtf, .pdf? (not secure formats)…

SecurityPrivacySecond advice request (teleconferencing?)

Image streamingReporting:

DICOM SR (Structured Report)? (needs of templates for reporting and for second advice)

HL7 CDA? (in Europe - CDA ready).doc, .rtf, .pdf? (not secure formats)…

Other questionsOther questions

Identify what is in DICOM, HL7 or IHE domain

Identify what is in DICOM, HL7 or IHE domain

Some Possible TeleRad Models

Some Possible TeleRad Models

The topic is open for discussion