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Radiologists
See the (Internet) Light
(HealthScout)
-- While the Internet has become a standard means of exchanging
photographs by everyone from grade-school kids to grandmothers,
many in the medical community have been slow to sign on.
In particular,
radiologists have been apprehensive about sending images over
the Internet, concerned about everything from image quality to
patient confidentiality. So they have continued to use more traditional
and more expensive dedicated telecommunications lines to transfer
computed tomography (CT) scans and magnetic resonance images (MRI)
that help evaluate a variety of medical conditions.
But since
it can be hard to even order a new brand of typewriter ribbon
in the field of medicine without the support of a published study,
research was needed, and a team of radiologists at Ohio's Cleveland
Clinic Foundation stepped up to the task.
They concluded
that the Internet is not only a radiology image-friendly environment,
but it is far more efficient than the present technology.
Their findings,
presented at a meeting of the Radiological Society of North America
(RSNA) in Chicago last month, compared the speed and reliability
of electronically transmitting CT and MRI scans three ways: via
a dedicated high-speed telecommunications line, via a slower line
supplied by the local phone company and over the Internet between
two personal computers using an Internet service provider.
Hospitals
and physicians typically use either dedicated lines or local phone
company lines.
The study
showed that the quality of the images was the same on all telecommunications
systems, with no loss of information. In addition, the transmission
speed of the three methods was comparable, although Internet speed
varied, depending on the time of day.
"We found
the Internet performed very well. There wasn't any loss of speed
compared to what we were already getting [with the dedicated phone
lines]," says Dr. Michael P. Recht, a musculoskeletal radiologist
and head of the Section of E-Radiology at the Cleveland Clinic
Foundation, Ohio.
"There was
a little bit of variability in our system, but when we improved
our bandwidth, that was taken care of. We had not lost images
during transmission and there was no image degradation," he says.
Recht says
the Internet offers a substantial cost savings.
"At Cleveland
Clinic Foundation, for instance, we would have to pay $7,000 a
month for a high-speed telecommunications line to one specific
clinic, and the local phone company's fees are per-minute long-distance
charges, which can add up," he says.
"Obviously,
those costs are prohibitive, especially for many smaller and remote
hospitals and clinics, which often are even more likely to benefit
from sending images digitally for second opinions. Conversely,
Internet service provider fees typically are fixed, and much more
affordable," he says.
To address
confidentiality concerns, most medical facilities encrypt data
and restrict access, Recht says. And in 2002, U.S. law will regulate
how private information, such as medical images and records, is
sent over the Internet.
Dr. David
Levin, chairman of the Department of Radiology at Thomas Jefferson
University Hospital in Philadelphia, says the Internet soon will
become the standard for transmitting radiological images.
He says, "Let's
say you're a neurosurgeon, and you send your patient to us for
an MRI scan of the brain. We do the MRI and interpret it, do a
report and then transmit that report back to the surgeon. But
the surgeon may want to look at the MRI himself, particularly
if he's going to operate.
"So if this
technology works out, we could, instead of printing out film,
just send the images right over the Internet, and he could pull
them right up on his own PC and look at the images right there.
It would allow for much faster and cheaper communication of images."
"I think that's
going to be the wave of the future," Levin says.
Reference
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