A simple telemedicine system using a digital camera

Radiographs on a viewing box were photographed at a remote hospital in Sout h Africa using a digital camera with a resolution of 1024 x 768 pixels at 2 4-bit colour depth. The resultant images were stored in JPEG format and tra nsmitted as email attachments to be read on a PC monitor by radiologists in Durban and Cape Town. Twenty-seven images were received, of which 23 were of diagnostic quality (85%). The mean file size was 120 kByte. For quality control purposes, 100 chest radiographs were photographed at a base hospita l and read by a radiologist blinded to the diagnosis. In this study 96 imag es were of diagnostic quality (96%) and the correct diagnosis was made in 9 0 cases (94%). Incorrect readings were made in six cases (6%): small pulmon ary nodules (less than 1 cm in diameter) were missed in five cases and in o ne case early apical tuberculosis was missed. Digital camera technology per mits simple, inexpensive telemedicine. Limited spatial resolution is a conc ern when reading chest images with small pulmonary nodules and infiltrates.