teleradiology joël chabriais, md, ms. teleradiology - telewhat? one propose a segmentation: ...
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Teleradiology - Telewhat?
Teleradiology - Telewhat?
One propose a segmentation:TeleteachingTelelearningTeleexpertiseTeleconsultationTelediagnosisTeleXXX
My purpose: teleradiology in daily radiological practice (telediagnosis ± teleexpertise)
One propose a segmentation:TeleteachingTelelearningTeleexpertiseTeleconsultationTelediagnosisTeleXXX
My purpose: teleradiology in daily radiological practice (telediagnosis ± teleexpertise)
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.
Boston experimentation: a contract with an Israeli and an Asian Hospitals to have only daytime reading.
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.
Boston experimentation: a contract with an Israeli and an Asian Hospitals to have only daytime reading.
Access to specialized expertise.
Teleradiology in France
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.
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.
Teleradiology projects in France
Teleradiology projects in France
AuvergneAquitaineBrittanyLorraine…
AuvergneAquitaineBrittanyLorraine…
Teleradiology in Cantal
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.
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.
The projectsThe projectsSend 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.
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.
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 - Cantal
Inter-hospital project - Cantal
Mediation server
Decryption/ Encryption
Gateway
DICOMApplication
DICOMNetwork
Gateway
https channel
Local networkt 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 at this time (probably one at Aurillac in two or three years).
Management of reports make on duty.
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.
Today, Cantal Medical Imaging Federation
Today, Cantal Medical Imaging Federation
Aurillac
Mauriac
???
St-Flour
Cantal
Tomorrow, Auvergne Medical Imaging
network?
Tomorrow, Auvergne Medical Imaging
network?Clermont-
Rerrand
???
???
???
Puy-de-Dôme
Aurillac
Mauriac
???
St-Flour
Cantal
Puy-en-Velay
???
???
???
Haute Loire
Moulins
???
???
???
Allier
UniversityHospital
Auvergne Medical Imaging Network
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.
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.
DMZ
H
RENNES
CT / IRM
MediationServer
STAR-IE
MEGALISInternet Access
H
Vitré
modality
STAR-IE
H
Saint-Brieuc
modality
STAR-IE
Brittany Inter-hospital project
Brittany Inter-hospital project
Which needs for such projects?
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
…
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
…
Identified issuesIdentified issues
SecurityPrivacySecond advice request (teleconferencing?)
Image streamingReporting:
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)…
SecurityPrivacySecond advice request (teleconferencing?)
Image streamingReporting:
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)…
Other questionsOther questions
Identify what is in DICOM, HL7 or IHE domain
Is there matter for work item proposals in DICOM?
Identify what is in DICOM, HL7 or IHE domain
Is there matter for work item proposals in DICOM?