gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Teleradiology in neurosurgical emergencies: New technologies for rapid and safe teleconsultation

Teleradiologie für neurochirurgische Notfälle: Neue Technologien für schnelle und sichere Telekonsultationen

Meeting Abstract

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  • corresponding author U. Hubbe - Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • E. Pelikan - Klinikrechenzentrum, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 020

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc275.shtml

Published: April 11, 2007

© 2007 Hubbe et al.
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Outline

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Objective: For the management of neurosurgical emergencies, especially trauma cases, teleradiological submission of CT scans is essential to achieve a rapid teleconsultation from the next neurosurgical center. The main decision, that has to be made, is whether the patient has to be admitted to the neurosurgical department (usually by helicopter), whether he can be treated in the peripheral hospital or whether there is no treatment possible anymore. The system for teleradiological image transmission has to be fast and safe (according system uptime and data security). We etablished a new modular system which provides a maximum delay of 15 min from initiation of the teleconsultation to the transmission of the decision.

Methods: The system consists of a network connecting 8 peripheral hospitals (satellites) to the neurosurgical department (center). For cost effectiveness we chose a modular construction based on well established internet standards for communication and security. Therefore the system was flexible and open for support of already existing different DICOM Clients. Different data communication services are implemented: DICOM communication (Internet / ISDN), via VPN (based on IPSec), DICOM E-Mail combined with GnuPG and secure web-access. For this, a redundant network server system consisting of two independent servers in two locations, has been installed in the center. The transmitted image data can be integrated in the local PACS System. The neurosurgeon on call is supported by a mini notebook connected to the network by an UMTS mobile connection.

Results: Since 14.06.2004 the system is online and working stable. About 15 consultations per week are performed resulting in submission of more than 160.000 images (for more than 2.100 consultations) since the beginning. The limit of 15 minutes initiation of the teleconsultation to the answer of the center could be held. Meanwhile additional satellites have been connected to the network. Additionally an interconnection to other teleradiological networks in Baden-Wuerttemberg has been established.

Conclusions: The teleconsultation network we established, has proven to be stable, safe and effective. The system is well accepted by the users and simplifies the management of neurosurgical emergencies in the far south west of Baden-Wuerttemberg. The system has established a broad basis for future integration of additional satellites because of its open concept based on internet standards and platform independency.