CONCEPT AND APPLICABILITY OF THE KAMEDIN TELERADIOLOGY SYSTEM IN VIEWOF A COST-BENEFIT-ANALYSIS

Introduction: Different concepts and applications of teleradiology sys tems have been realised. However, their cost-effectiveness is still qu estionable. Therefore, a cost-benefit anylsis of three different scena rios of the new teleradiology system Kamedin (Kooperatives Arbeiten un d rechnergestutzte Medizinische Diagnostik auf innovativen Netzen der Deutschen Telekom) was performed. Methods: CT examinations were transm itted from an Advantage Windows (CE) workstation to a Kamedin workstat ion using DICOM 3 protocol. Afterwards a teleconference was establishe d with a Kamedin workstation in the intensive care unit within the hos pital via FDDI/Ethernet, with an external workstation in a radiology d epartment 6 km away via ISDN and with a Kamedin PC located with radiol ogist on duty 22 km away via ISDN. On average, 36 CT slices per patien t were transferred. A break-even analysis was performed with respect t o costs of hardware, software, support, use of ISDN and staff, as well as benefits like the decrease in transportation or film documentation costs. Results: Owing to the different reductions in transportation c osts, two applications (intensive care unit and external PC) showed a break-even of 1817 and 528 teleconferences/year, respectively. Further optimisation of cost-effectiveness is possible on condition that exis ting hardware can be used and an automatic data transfer without staff control is available. When all optimisation factors were combined, th e break-even decreased to a minimum of 167 and 77 teleconferences/year , respectively. Conclusion: Teleconferences with high image quality ca n be set up between workstations and PCs using the Kamedin system. Dep ending on the possible decrease in transportation costs, teleconferenc ing is cost-effective under certain conditions. Teleradiology has addi tional advantages, such as the acceleration and optimisation of patien t management.