Article

Journal of Digital Imaging

, Volume 17, Issue 4, pp 253-257

Internet Consultations from a Remote Pacific Island: Impact of Digitized Radiologic Images on Referral Decisions

  • Jinha M. ParkAffiliated withDepartment of Radiology, Tripler Army Medical CenterPresent address: Department of Radiology, UCLA Medical Center
  • , Lynne RuessAffiliated withDepartment of Radiology, Tripler Army Medical CenterDepartment of Radiology and Radiological Sciences, Uniformed Services University of the Health SciencesDepartment of Pediatrics, Uniformed Services University of the Health SciencesDepartment of Radiology, Tripler Army Medical Center Email author 
  • , Stephen C. O’ConnorAffiliated withDepartment of Radiology, Tripler Army Medical CenterPresent address: Department of Radiology, Baystate Medical Center
  • , Faheem HussainAffiliated withDepartment of Radiology, Tripler Army Medical CenterPresent address:Department of Radiology, Bldg 4-2817, Womack Army Med Center
  • , David Y. OshiroAffiliated withInformation Management Division, Tripler Army Medical Center
  • , Donald A. PersonAffiliated withDepartments of Clinical Investigation and Pediatrics, Tripler Army Medical CenterDepartment of Pediatrics, Uniformed Services University of the Health Sciences

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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.

Keywords

Telemedicine teleradiology internet communications PACS image capture.