Chapter 6: ISDN in Medicine and Health Care

Teleradiology

A major component of today's medical diagnostics is the growing radiological capability to look carefully and deeply within the human body. The images produced include Computerized Tomography (CT or CAT) scans, Ultrasound, Nuclear Medicine, Magnetic Resonance Imaging (MRI), and of course the traditional X-ray. All except X-rays, in fact, originate as digital files viewed on ultra-high-resolution computer screens. In addition, many X-rays, although they begin as photographic film, are being scanned into digital files for storage or transportability.

The ability to transmit these files - to specialized radiologists for analysis and diagnosis, to remote experts for consultation, to surgeons preparing for an operation, to expert technicians for image enhancement, and more - not only saves time and travel, but dramatically expands the circle of expertise available to the care of any patient. Unfortunately, the enormous size of these digital images (as much as 10-20 megabits and more each) has traditionally limited their availability to those directly linked to the higher speeds of a backbone network.

Yet ISDN has begun to answer specific needs, and to save time when time is critical. With the increased speeds of ISDN, even diagnostic-quality images are now transmitted beyond a hospital complex for emergency diagnosis, remote consultation, or timely review and comparison.

At Richland Memorial Hospital in Richland, SC, for example, radiologists affiliated with the hospital receive good quality radiological images at their homes through ISDN BRI connections. Instead of rushing to the hospital in pre-dawn hours to look at an accident victim's x-ray or CT scan, key images are transmitted to a high-resolution monitor at a radiologist's home, where he or she can prepare an initial diagnosis while still in robe and slippers. The system uses Macintosh-based ICON video-capture boards and software with Gandalf routers. The images are good enough to let doctors consult with emergency room physicians, and decide whether a trip to the hospital is, in fact, necessary.