Teleradiology as a foundation for an enterprise-wide health care delivery system

An effective, integrated telemedicine system has been developed that allows (a) teleconsultation between local primary health care providers (primary care physicians and general radiologists) and remote imaging subspecialists and (b) active patient participation related to his or her medical conditi on and patient education. The initial stage of system development was a tra ditional teleradiology consultation service between general radiologists an d specialists; this established system was expanded to include primary care physicians and patients. The system was developed by using a well-defined process model, resulting in three integrated modules: a patient module, a p rimary health care provider module, and a specialist module. A middle agent layer enables tailoring and customization of the modules for each specific user type. Implementation by using Java and the Common Object Request Brok er Architecture standard facilitates platform independence and interoperabi lity. The system supports (a) teleconsultation between a local primary heal th care provider and an imaging subspecialist regardless of geographic loca tion and (b) patient education and online scheduling. The developed system can potentially form a foundation for an enterprise-wide health care delive ry system. In such a system, the role of radiologist specialists is enhance d from that of a diagnostician to the management of a patient's process of care.