A scalable teleradiology information system

The University of California, Los Angeles (UCLA) has launched a global teleradiology project to provide subspecialist consultation to remote regions with the intent to deliver higher quality health care and contain the rising cost of health care. The initial client site at Melbourne, Florida has been in operation since Feb. 1995. Potential future sites include South and Central American and Asian Pacific regions. The teleradiology infrastructure for supporting this project consists of (1) a cost-effective telecommunication network, (2) an image management system, and (3) a complete information system which contains relevant patients' demographic and clinical support data. This infrastructure must be scalable to incorporate unlimited future sites. Of the three, the information system component is the least understood. It must meet four clinical requirements using various state-of-the-art database technologies: (1) it must manage patient data that are dispersed among multiple distributed databases; (2) it must be extremely reliable; (3) it should capture, index and display, for the consulting radiological subspecialist, all relevant information, including imaging required for optimal decision-making; and (4) it must also provide a effective means of reporting findings, impressions and conclusions to the referring physician.