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

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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.

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Authors and Affiliations

  1. Department of Radiology, Tripler Army Medical Center, Honolulu, Hawaii

    Jinha M. Park MD, PhD, Lynne Ruess MD, Stephen C. O’Connor MD & Faheem Hussain MD

  2. Information Management Division, Tripler Army Medical Center, Honolulu, Hawaii

    David Y. Oshiro BS

  3. Departments of Clinical Investigation and Pediatrics, Tripler Army Medical Center, Honolulu, Hawaii

    Donald A. Person MD

  4. Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Maryland

    Lynne Ruess MD

  5. Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland

    Lynne Ruess MD & Donald A. Person MD

  6. Department of Radiology, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, Hawaii 96859

    Lynne Ruess MD

  7. Present address: Department of Radiology, UCLA Medical Center, 10833 Le Conte Avenue, 951721, Los Angeles, California 90095-1721

    Jinha M. Park MD, PhD

  8. Present address:Department of Radiology, Bldg 4-2817, Womack Army Med Center, Ft. Bragg, NC 28310, USA

    Faheem Hussain MD

  9. Present address: Department of Radiology, Baystate Medical Center, 780 Chestnut St., Springfield, MA 01107, USA

    Stephen C. O’Connor MD

Authors
  1. Jinha M. Park MD, PhD
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  2. Lynne Ruess MD
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  3. Stephen C. O’Connor MD
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  4. Faheem Hussain MD
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  5. David Y. Oshiro BS
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  6. Donald A. Person MD
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Corresponding author

Correspondence to Lynne Ruess MD.

Additional information

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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Park, J.M., Ruess, L., O’Connor, S.C. et al. Internet Consultations from a Remote Pacific Island: Impact of Digitized Radiologic Images on Referral Decisions. J Digit Imaging 17, 253–257 (2004). https://doi.org/10.1007/s10278-004-1022-6

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  • DOI: https://doi.org/10.1007/s10278-004-1022-6

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