Towards a general purpose, scaleable workstation for remote medical consultations. Experiences from use of VIDA–a still image system for the provision of low-cost telemedicine

Image quality, compression and segmentation in medicine

This review considers image quality in the context of the evolving technology of image compression, and the effects image compression has on perceived quality. The concepts of lossless, perceptually lossless, and diagnostically lossless but lossy compression are described, as well as the possibility of segmented images, combining lossy compression with perceptually lossless regions of interest. The different requirements for diagnostic and training images are also discussed. The lack of established methods for image quality evaluation is highlighted and available methods discussed in the light of the information that may be inferred from them. Confounding variables are also identified. Areas requiring further research are illustrated, including differences in perceptual quality requirements for different image modalities, image regions, diagnostic subtleties, and tasks. It is argued that existing tools for measuring image quality need to be refined and new methods developed. The ultimate aim should be the development of standards for image quality evaluation which take into consideration both the task requirements of the images and the acceptability of the images to the users.

A review of telemedicine

Moving the information instead of the patient is often sufficient and telemedicine is a useful and potentially powerful tool which fulfils this idea. It has changed the classical form of health-care delivery by providing those people living in rural and remote areas with comparable services to those in urban areas. Equally, remote hospitals can obtain specialist consultations and diagnosis without the need for the patient to travel. We have reviewed the present status of telemedicine and its future possibilities.

A unified multimedia database system to support telemedicine

A unified approach to managing multimedia medical databases in a telemedicine system is proposed. In order to manage, search, and display patient information more efficiently, we define a patient information package (PIP) as a concise data set of a patient's medical information from each visit. By means of PIP's, both patient-oriented and problem-oriented query strategies, which are most frequently used in daily clinical practice and medical education, can be accommodated. We also provide a unified methodology for accessing various types of patient medical records as well as design two types of user interfaces, high-quality data display and web-based interface, for different medical service purposes. The PIP-based management of databases has been successfully implemented between the National Taiwan University (NTUH), Taipei, and the Chinshan health care center, Chinshan, Taiwan, for teleconsultation, telediagnosis, and tele-education.

Remote interpretation of microbiology specimens based on transmitted still images

A pilot study was carried out to examine the feasibility of the remote interpretation of microbiology specimens, that is, micro-organisms grown on agar in Petri dishes. The objective of our study was to decide whether still images contained enough information for microbiology specialists to identify the microorganisms accurately. A representative sample of microbiology specimens grown on the most commonly used agar media was used. Still images were captured using a video camera and a PC-based system. The results from a pilot study with the first video camera were discouraging, the interpretations differing in five out of 22 specimens; results with a second video camera were also disappointing. Images were then captured on photographic film, at a considerably higher resolution than images captured by the digitizer board in the PC. Again, however, the results were disappointing. We conclude that interpretation of microbiology specimens based exclusively on visual information is problematical. Remote microbiology interpretation in the future will require images of higher information content (e.g., including three-dimensional information), and will probably require additional information as well, from other senses, such as smell.