Design and evaluation of a telediagnosis system

Telemedicine can be defined as the capability to provide medical services over a distance using the combination of telecommunication and computer technologies with medical expertise. Telediagnosis is a form of telemedicine. The main purpose of telediagnosis is to seek the second opinion from, or to confirm a primary diagnosis by remote specialists. This paper proposed a telediagnosis system that supports interactive teleconferencing and medical multimedia information management. Such system has been developed, and installed at National Taiwan University Hospital (NTUH) and Chin-shan Healthcare Center. The information required for diagnosis including a patient's personal data, chief complaints, laboratory test results, medical images and videos is essentially a multimedia data from different sources. We designed a multimedia database system to manage the patient information efficiently, and to manipulate the information uniformly by using the Structured Query Language (SQL). In addition to the database management, a friendly graphical user interface allows an operator to acquire, view, and manipulate the information easily. There were 320 telediagnoses during the period from July 1995 to June 1996. The evaluation of this system was performed, and the results showed that 96% (306) of patients reported that they were able to see and hear well through this system. Referral physicians reported that the effect of communication was acceptable in 98.7% of telediagnoses. The specialists reported that the effect of communication was acceptable for 99.7% of telediagnoses. The referral physicians totally agreed with the diagnosis suggested by the specialists in 80.4% of telediagnoses. Based on the evalution results, the system is practical for telediagnosis, and can effectively help the rural physicians improve the quality of diagnosis.