An Interactive Medical Support System for Dermatology in Rural Areas

Abstract

A shortage of doctors in rural areas of Japan, especially specialists, has been a serious problem for several years. This has created a need for alternative forms of care in these areas, and telemedicine is a potential solution for this problem. However, in spite of a governmental policy to provide nationwide coverage with a fiber optic cable network, there are some areas where it cannot be accessed in Japan. Several types of telemedicine have been developed. Although there is always a doctor at the main terminal, at the remote terminal there may only be a patient, only a doctor, doctor and patient, and sometimes family. Of these possibilities, interactive telemedicine systems focusing on support for the remote doctor have received little attention. We developed a 1Mbps, multimedia, two-way communication system that can be used between rural medical institutions that are short of medical specialists and the nearest university hospital, where medical specialists are always present. We are currently using this online, telemedicine auxiliary system in our dermatology department. This equipment not only does two-way communication using MPEG4, but can rotate the display of the remote terminal from the university side, as well as adjust the zoom and direction of the camera. Moreover, the system has software capable of writing and drawing pictures and characters accessible on the personal computer screen at the opposite location. This system is in use in the mountainous areas and islands of Shimane Prefecture. It is also used for the instruction of interns undergoing training at rural hospitals.