A TELEMEDICINE SYSTEM FOR REMOTE COOPERATIVE MEDICAL IMAGING DIAGNOSIS

Telemedicine is changing the classical form of health care delivery, b y providing efficient solutions to an increasing number of new situati ons: here we consider those which require some type of computer-suppor ted cooperative work (CSCW) between health care professionals located in different clinical sites. This paper presents the design and develo pment of a telemedicine system for remote computer-supported cooperati ve medical imaging diagnosis. The main and novel component of our syst em is a new CSCW distributed architecture, comprised by a collaborativ e toolkit to add audioconferencing, telepointing, window sharing, user 's a,ordination and application synchronization facilities, either to existing or new medical imaging diagnosis applications. In comparison with existing CSCW products, mainly based on centralized architectures , our distributed toolkit is specially designed for telemedicine appli cations: to allow different levels of sharing between participants, to improve user feedback in highly interactive user interfaces, and to o ptimize the required communication bandwidth in order to implement a t elemedicine CSCW application on almost any telecommunication network. This telemedicine CSCW system has been applied to build a cooperative medical imaging diagnosis application, in which two doctors, located i n different hospitals, need to achieve a cooperative diagnosis on haem odynamic studies using cardiac angiography images. The design of the g raphical user interface for this kind of telemedicine CSCW systems, a critical component which conforms any telemedicine application, is als o addressed with a new methodological approach, to assure the system u sability and final user acceptance. The telemedicine cardiac angiograp hy pilot has been implemented, tested and evaluated within the Researc h Project 'FEST-Framework for European Services in Telemedicine' funde d by the EU AIM Programme.