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ISDN/Medical Imaging
Department of Veterans Affairs
Silver Spring, MD
USA

Year: 1993
Status: Laureate
Category: Medicine
Nominating Company: MCI Telecommunications Corporation

Until recently, crucial X-rays and images of slides were not stored in information systems. The Department of Veterans Affairs Medical Imaging System now provides physicians with access to images in patient charts and in information systems throughout the hospital. Images can also be transmitted.
The effective delivery of health care is dependent on a wide range of
medical images. Manual and computer--based medical records ordinarily do
not contain image data, leaving the physician to deal with a fragmented
patient record widely scattered throughout the hospital. The Medical
Imaging System developed by the Dept. of Veterans Affairs (VA) makes
medical images (such as x--rays, microscopic slides, endoscopic views,
and ultrasound scans) available directly to physicians as an integrated
component of the patient's computerized data. This imaginative system
integrates state--of--the--art workstations, networking, and optical
disk storage technology with existing government developed software to
improve service to VA patients, simplify information retrieval
procedures, and improve communications among VA clinicians. Specific
technical accomplishments include (1) the development of a low cost,
high resolution, true color image workstation suitable for use
throughout VA hospitals and (2) the integration and networking of these
workstations into the VA's existing hospital information system (DHCP).
As a result of these two accomplishments, comprehensive patient data
including both images and text can be efficiently examined by hospital
physicians.

The DHCP Medical Imaging System is currently installed in two V.A.
medical centers, with five additional sites being installed in the
coming year. ISDN telecommunications capability has been installed to
connect these first two sites to allow cost--effective remote
teleconsultation by expert physicians as well as system support by
developers.

System impacts on care providers and patients include: (1) it improves
the quality of patient care by providing all patient data, reducing the
possibility of error based on lack of data or nonstandard terminology
used to describe images; (2) it increases communication among
clinicians, improving continuity of care when multiple specialists are
involved (3) its reduces physician time spent searching for data; (4) it
aids patients in understanding their problems; (S) it allows
consultation with physicians at other sites; (6) it assists in physician
education; and (7) it may ultimately change the patterns of medical
practice.