TELEMEDICINE USING A DESK-TOP CONFERENCE SYSTEM (PHOENIX) IN KYUSHU, JAPAN

Objective: The Kyushu area of southwestern Japan has several mountains and 157 inhabited islands. We assessed the feasibility of implementin g a desktop conference (DTC) system to improve medical care in this ar ea. Telecommunications Technology and Equipment: The Phoenix DTC syste m (NTT Corporation, Tokyo, Japan) for personal computers includes a mi crophone, speaker, color CCD camera, and appropriate software. We used a digital camera for still pictures and image-analysis software for r adiographs and CT and MRI films. The system was installed on a Pentium 133 MHz computer, which was connected by ISDN line at a 128 kbps data rate to a clinic on a small island where one physician cares for 1000 residents, two small nursing offices where each nurse tends 1000 resi dents, two nursing homes, a hospital in a mountainous area, and the re sidence of a patient with atopic dermatitis. Connections were made onc e a week for a period of 6 months. Results: The transmitted still pict ures; e.g., senile nevus, atopic dermatitis, chickenpox, and a radiogr aph of a suspected fracture, were useful for diagnosis and clinical de cision making. We received and responded to inquiries from residents o f the participating nursing homes on nutrition, senile depression, nev us, decubitus ulcers, urinary tract infection, and protection against Legionella infection. We also used the system to deliver lectures on p ediatrics to nurses; provided case discussions on diaphragmatic hernia tion and subtentorial tumor; and had on-line presentation of a patient with beta-thalassemia using presentation software. Conclusion: The DT C system used in the present study seemed technically satisfactory and useful in improving medical care in remote sites of Japan.