Walz M, Bolte R, Lehmann K J, Lütgemeier J, Georgi M
Department of Clinical Radiology, Faculty of Clinical Medicine Mannheim University of Heidelberg, Klinikum Mannheim, Germany.
Stud Health Technol Inform. 1999;64:208-16.
The teleradiology system KAMEDIN (German Telekom), installed on HP-Unix- and NT-Workstations, was evaluated in different scenarios and a cost-benefit-analysis was performed. CT examinations were transferred from a PACS workstation (GE) to KAMEDIN using DICOM-3 protocol. Teleconferences were realized with an intensive care unit by LAN, with a radiology department at 5 km. distance by ISDN, and with an on duty radiologist 22 km. away by ISDN. On average, 36 CT slices per patient were transferred. Overall costs (costs for hardware, software, support, ISDN-fees, and staff) were compared to possible cost reduction, mainly concerning transportation and films. These three scenarios could be realized during daily routine work. Differing in their amount of transportation cost reduction, two applications (intensive care unit, radiologist on duty) showed a break-even at 1817, respectively 528 teleconferences/year. Improvement of cost-effectiveness can be obtained on the conditions that existing hardware will be used and that the automatic data transfer will be improved. Combining all optimisation factors, the break-even decreased to a minimum of 167, respectively 77 teleconferences/year. The optimisation of patient management is an additional--but in this study, not yet counted--advantage of teleradiology.
安装在惠普Unix和NT工作站上的远程放射学系统KAMEDIN（德国电信公司）在不同场景下进行了评估，并进行了成本效益分析。CT检查通过DICOM-3协议从PACS工作站（通用电气公司）传输到KAMEDIN。通过局域网与重症监护病房、通过ISDN与5公里外的放射科以及通过ISDN与22公里外的值班放射科医生实现了电话会议。平均每位患者传输36层CT图像。将总体成本（硬件、软件、支持、ISDN费用和人员成本）与可能的成本降低进行了比较，主要涉及运输和胶片成本。这三种场景可在日常工作中实现。在运输成本降低幅度方面存在差异，其中两种应用（重症监护病房、值班放射科医生）分别在每年1817次和528次电话会议时实现收支平衡。在使用现有硬件并改进自动数据传输的条件下，可以提高成本效益。综合所有优化因素，收支平衡次数降至每年最少167次和77次电话会议。优化患者管理是远程放射学的一个额外优势——但在本研究中尚未计算在内。
