Internet Consultations from a Remote Pacific Island: Impact of Digitized Radiologic Images on Referral Decisions |
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| Authors: | Jinha M Park Lynne Ruess Faheem Hussain David Y Oshiro Donald A Person |
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| Institution: | (1) Department of Radiology, Tripler Army Medical Center, Honolulu, Hawaii;(2) Information Management Division, Tripler Army Medical Center, Honolulu, Hawaii;(3) Departments of Clinical Investigation and Pediatrics, Tripler Army Medical Center, Honolulu, Hawaii;(4) Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Maryland;(5) Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland;(6) Department of Radiology, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, Hawaii 96859;(7) Present address: Department of Radiology, UCLA Medical Center, 10833 Le Conte Avenue, 951721, Los Angeles, California 90095-1721;(8) Present address:Department of Radiology, Bldg 4-2817, Womack Army Med Center, Ft. Bragg, NC 28310, USA;(9) Present address: Department of Radiology, Baystate Medical Center, 780 Chestnut St., Springfield, MA 01107, USA |
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| Abstract: | A study was carried out to determine whether digitized radiologic images added valuable information to Internet consultations from a remote Pacific Island. Chuuk State Hospital (Federated States of Micronesia) has limited film screen radiology, minimal ultrasound capability, and no radiologist. Providers initiate Web-based referrals for consultation or patient transfer. Digitized images (via low-cost digital camera or flatbed scanner) were uploaded to a Web site. Images were assessed for impact on referral decisions. A radiologist scored image quality and confidence (scale: 1–7). Of 97 referrals with images that were reviewed, 74 (76%) image sets were abnormal, 20 (20%) were normal, and 3 (4%) were indeterminate. Median scores were 4 for image quality and 5 for diagnostic confidence. In most cases with abnormal radiology (52/74, 70%), images were considered valuable. Radiologic images digitized with a low-cost camera or flatbed scanner provided valuable information for decision making in an Internet-based consultation and referral process from a remote, impoverished Pacific Island jurisdiction, despite relatively low image quality.The views expressed herein are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or the US Government. |
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| Keywords: | Telemedicine teleradiology internet communications PACS image capture |
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