The Implementation of an Economic Teleradiology Solution and Its Application to Neonatal and Pediatric Critical Care Medicine

Abstract 227 Poster Session III, Monday, 5/3 (poster 91)

The use of radiographic images transmitted to remote sites can improve quality of care by providing near instantaneous consultation and diagnostic decision making even from across great distance. In neonatal and critical care pediatric practice, there is the need for timely evaluation of radiographs from remote sites. The use of telemedicine to transmit radiographic images in neonatal and critical care medicine is not new. Teleradiology as a commercial application extends back at least 10 years. Criticisms of the technology include the cost of initial startup, continuing expenditures necessary to maintain the equipment, lack of portability, and recurring monthly use fees of high speed digital lines for transmission of high quality images to remote sites. Furthermore, the technology is usually only cost effective for radiologists. In this project, we demonstrate implementation using low cost commonly available equipment to perform similar function over the internet. For this study, the quality of neonatal radiographic film in 300 dpi format using a 256 gray scale progressive JPG compression import standard radiographic film in 300 dpi format using a 256 gray scale progressive JPG compression algorithm. The scanner was adapted to scan film using an 8.5X11 inch white paper background "film adapter" (Unisource, USA). The scan was digitized to a Compaq Deskpro (Compaq, Pittsfield, MA) computer. Images were sent via Outlook Express, an email program, through a pre-existing hospital ethernet internet connection, downloaded using a standard 28.8 Kbps dialup on a pre-existing home phone line, and viewed on a standard home personal computer using a combination of Outlook Express and Internet Explorer 4.0 (Microsoft, Redmond, WA). Scan time, amount of time to send and retrieve image, image quality, and cost factors were analyzed and included in the table below. Depending on practice demands, a neonatologist or pediatric critical care specialist could even evaluate radiographs from multiple hospital sites using a laptop computer "from the road". The cross platform compatibility could allow consultation with a remote specialist with only a "standard" personal computer. A technique involving "off-the-shelf" equipment produced a reasonably detailed, expedient, and cost effective teleradiology solution.

Table 1 No caption available