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Remote Reporting in Radiology: characteristics and problems

Author(s): Mehdi Yousefi | Ali Hekmatnia | Afshin Niakan

Journal: Iranian Journal of Radiology
ISSN 1735-1065

Volume: 6;
Issue: S1;
Start page: 90;
Date: 2009;
Original page

"nIn this paper we review that how we can implement a remote reporting system. "n Methods that we advice in this article experienced in sepahan Imaging Center for 40 days  with about 50 MRI cases every day. "n First we studied on remote reporting system that has not any interference with health care system standards. "nIn chosen standard items, accessibility, timely and cost benefits parameters considered and tried to adjust the process as observe the standards. We need these bases for implementing this system. "nHardware: Internet Connection ,Server "n Software: Standard PACS server, Teleradiology System "nFirst need connection between computers, that For Long distance, internet to be more economic. There are two available types of high speed Internet connection. Leased line DSL that is too expensive and ADSL connection by phone Line. The size of any MRI Dicom files is about 50 MB size so after RAR(Roshal Archive a file compression format) compression it would be about 20 MB size. With 1Mbps ADSL line download one patient study files would take 2.6 minute (128 kBps) and user can download all of today patients files in about 2 hours. but always our service provider  shared ADSL lines with another persons in this status download one study will take 2 times more. In this state it is better for radiologist that download all studies Dicom files and view them after that. The next part is Teleradiology system. The MRI study of any patient stored on PACS system storage and we need Teleradiogy system for sharing Images on web. A standard Teleradiology system makes images accessible in two types: Online: Radiologist can see the images without download them in internet browser. Some of Teleradiology systems compress images in lossy jpeg format so some high frequency information is lost. We need images in Dicom MONOCHROME type with facilities for changing contrast and brightness and etc. In Dicom File: when speed is not suitable or we need image processing we need Dicom source files, that we can download and open them with any Dicom standard viewer. Teleradiology system compresses Dicom files in RAR and makes it accessible for downloading. We tried to use remote desktop connection so loosed images quality against waste many time. The next step was providing radiologist report Radiologist can type reports in Teleradiology system as Structured Report(SR) where it saved in Dicom server(Teleradiology system must Support this option) Also for someone that want to use Dictaphone, they can use electronic voice boxes like yahoo voice box. They work with low internet speed connections. All the needed clinical history also merged with Images as SR (Structured Report).  
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