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A feasibility study of the use of telemedicine in a rural school clinic

We evaluated the feasibility of fingerprint scanners in combination with smartcards (Fig 1) for personal identification of teleradiologists and the transmission of encrypted TCP/IP data via satellite between the university hospital of Innsbruck and the rural hospital of Reutte. PCs running the Windows NT 4.0 operating system were used for the data handling. We examined security technology in teleradiological consultations, with a focus on data protection and user-friendliness. Emergency computerized tomography scans were sent to the local picture archiving and communications system (PACS) in Reutte. From there the images were encrypted and sent from a transmission box via satellite from Reutte to Innsbruck. There the images and the electronic patient record were decrypted and after identification through fingerprint scanners the radiologist was able to open the patient record from Reutte and sign with a digital signature to confirm the final report before it was sent back to Reutte. The security technology enables encrypted communication over a wide-area network, which fulfils the requirements of data protection. The implementation in the local RIS and PACS structures shows the need to use international standards. The results will be a part of the telemedicine guidelines in Tyrol. They will be valuable for deciding between the different technical possibilities for information integration in health-care.