WS126 On-line atlas as a tool for teledermatology

Workshops

systems, ‘DNA-chip’ technology and combinatorial chemistry. Industry now has an unprecedented opportunity to develop novel therapeutic strategies for the treatment of human disease which embrace small molecule drug discovery, protein therapeutics and gene therapy. Intelligent utilisation of these platform technologies will result in customization of treatment regimens and monitoring as well as more effective semi-ethical medicines and a move towards disease prevention.

-

s105

Telemedicine

accessed using HTTP to achieve better performance and avoid the overhead involved by starting common gateway interface processes. For the user, only a WWW browser is required. The acceptance of our WWW-server is surprisingly high. Nowadays we register over 15,000 accesses to our Dermatology on-line atlas per day from all over the world.

Still image-based dermatological diagnosis in a semi-rural setting

WS127

P.V. Harrison. Queen

Telemedicine WS125

Telemedicine - An overview

R. Wootton. Institute University,

Belfast

of Telemedicine BT9 TAB, UK

and Telecare,

QueenS

Telemedicine can be defined as medicine practised at a distance. Historically, much of telemedicine has been “high tech” and centred on hospitals. For example, teleradiology and telepathology. However, there are currently great opportunities for telemedicine in the primary care sector, partly because of the continuing fall in the cost of the technology. Teledermatology is an obvious area for primary care telemedicine. There are a number of potential benefits in terms of improved access etc, and also some potential drawbacks. Despite much teledermatology activity - for example, in the USA-there is little scientific evidence for its cost-effectiveness. There are two fundamentally different approaches to teledermatology, depending on whether the information is prerecorded and then sent to the dermatologist for subsequent evaluation (so called store-and-forward telemedicine), or whether the evaluation is done interactively (i.e. real-time telemedicine). The information transmitted can also vary, usually being either still pictures or video. A number of groups around the world have teledermatology research trials in progress and evidence of efficacy is beginning to emerge. However, it is not yet clear which technique or techniques are preferable, or even whether teledermatology has significant advantages over conventional dermatology in the primary care sector. Given the current fashion for “evidence-based medicine” there is little chance of the NHS adopting teledermatology without formal proof of cost-effectiveness.

WSI 26 On-line atlas as a tool for teledermatology T.L. Diepgen, J. Bauer, M. Simon, A. Bittorf. Dept. Dermatology Germany

Friedrich-Alexander-University,

Victoria

Hospital,

Morecambe

LA4 5NN,

UK

of Erlangen,

The World Wide Web (WWW) is becoming the major way of acquiring information in all scientific disciplines as well as in business. It is very well suitable for fast distribution and up to date teaching resources. However, to date most teaching applications on the Web do not use its full power by integrating interactive components. We have set up a computer based training (CBT) framework for Dermatology which consists of dynamic lecture scripts, case reports, an atlas and a quiz system. All these components heavily rely on an underlying image database that permits the creation of dynamic documents. We used a demon process that keeps the database open and can be

Increasing dermatological referrals, within a diverse geographical area in the Morecambe Bay region, have led to local difficulties in waiting list management. Previous work has indicated the usefulness of conventional photographic images in screening for various dermatological problems, particularly skin tumours (1). and we have also illustrated the benefit of a mobile telemedicine system for managing dermatological referrals (2, 3). As a prelude to an ISDN-based still image system, we have utilised conventional photographic images as a waiting list management module over a 6 month period. Two hundred and ten patients (92 males and 118 females), were managed from high resolution photographic images, eliminating in most individuals a need for an initial dermatological clinic visit. Patient satisfaction was good, diagnoses accurate, and the waiting list was reduced by over 75% within the study period. On the basis of this work, we are introducing a digital system in the Morecambe Bay area to improve speed of data transfer and reduce running costs of the system. References [ 11 Harrison P V and Lyon C C. Telemed 96, London [2] Lyon C C and Harrison P V. Telemed 96, London. [3] 3 Lyon C C et al. BAD 1997, Harrogate WS128

=

The UK multicentre teledermatology study1

H.E. Gore. Dermatology Hospital

Group

Trust,

Department, Craigavon Portadown, UK

Area

I will discuss the results to date of the UK Multicentre Teledermatology Study. The primary aim of the study is to evaluate the diagnostic accuracy of teledermatology. Videoconferencing equipment was used in three Health Centres and three Hospitals. Dermatological patients were referred for a consultation with a remote dermatologist by videolink, followed by a (conventional) face to face consultation. Comparison of diagnosis was made. To date 348 patients have been included, with 422 dermatological conditions. There was accurate diagnostic correlation between the two types of consultation in 65% of cases. In 6% of cases a wrong diagnosis was obtained by teleconsultation. In the other cases, diagnosis by teleconsultation was differential, or not possible, or a condition was missed. When a video camera of higher quality was used accuracy rates improved. Telemedicine requires rigorous evaluation before it can be widely introduced as a tool for health care. I suggest that there