A distributed system for medical consultation and education

Pathology is an image intensive discipline which utilizes sensed data to render diagnostic decisions and to engage in a broad spectrum of research ranging from the molecular to the macroscopic. The interaction with images is generally personal, subjective, and limited to some degree by geography. Given the nature of the diagnostic process and the medical impact of an incorrect assessment, improvements in it might be realized if the process were less subjective and open to multiple viewers. Digital computer networks transcend many of the barriers associated with analog modes of communication, but while the technology continues to evolve, significant obstacles persist which prevent individuals located at disparate imaging facilities from interacting effectively. Particularly problematic in this regard is the fact that there are presently no true standards regarding the architecture, operating system, and graphic user interface (GUI) of interacting machines. The authors' goal was to develop an inexpensive means by which digital information and computer resources could be shared among distant clinical and research facilities irrespective of these parameters. They present a prototypic network of heterogeneous computer architectures which has been configured to assist investigators located at remote sites to archive, display, manipulate and share medical information such as health-related images and clinical reports. Since the inception of the network in November, 1994, the network has managed more than one thousand interactive imaging sessions and its medical databases are accessed at a rate of more than 300 queries/day by users around the globe. The network is presently being evaluated by a consortium of imaging sites throughout the health care community to explore its potential role in broader range digital consultation and distance learning applications.