THE IMPLEMENTATION OF TELEMEDICINE WITHIN A COMMUNITY CANCER NETWORK

Telemedicine is being used by physicians at the member hospitals of th e Jefferson Cancer Network (JCN) for consultations regarding the diagn osis and management of cancer patients. The technology employed for th is telemedicine system was chosen to meet three related specifications : low capital and operating cost, internal maintainability by communit y hospital data processing staffs, and compatibility with the existing technologic infrastructure. The solution selected is the ubiquitous d esktop personal computer and associated software, and Integrated Servi ces Digital Network (ISDN) communications links. The overall performan ce of this technology has been very satisfactory; ISDN communications has sufficient bandwidth for the transfer of patient data, including t ext reports, radiographs, and pathology slide images. The presence of the radiologist's interpretation along with the radiographic images al lows the presentation of the images on these systems to be acceptable for review purposes. The video frame rates of these systems (12 to 15 frames per second) is adequate, particularly given the ''talking heads '' nature of the video presentations. Furthermore, the quality of the video image (resolution, size, frame rate) is secondary to the quality of the presentation of the medical information displayed and the capa bility for mutual annotation of the patient data during the consultati on.