I was at the Telemed 96 'Medicine on the Superhighway'
conference at the Sheraton Skyline
at Heathrow a couple of weeks ago.

(Boast boast! This is an excellent venue, with pool and cocktail bar etc.
Also a great conference dinner. Delegates from all over).

We had a 6:30 am teleconference with the Chinese University, Hong Kong
and a hospital in Beijing!
Used a First Virtual teleconferencing system over ISDN.

There were lots of interesting presentations on tele everything,
including the work here on tele-psychiatry (interviewing via
a video link), and home telecare (eg. panic buttons for the elderly).
Home telecare is being pioneered in the US, as one nurse pointed out they
are too scared to go into the inner cities! They had a remoto door
opening device to let the emergency nurse/doctor into the house.


I'll be happy to report a bit more fully on telemedicine, if anyone
is interested.

Anyway, the talk of most interest on tele-dermatology
(which I think you are referring to) was:

"A portable digital imaging system in dermatology: diagnostic and educational
applications"
This was a very good talk from Dr. CC Lyon, a dermatology
registrar at Morecambe. FAX: +44 1524 832 218
They have a very simple, elegant system which they put together themsleves.
Low cost, and they understand how it works.
It is a laptop with Adobe Photochop and a Kodak DC40 digital camera.
Resolution 756x504 pixels.
From my notes:
Dr. Lyon pointed out that Morecambe was on the slip road of
the Information Superhighway.
His Dept. operate 2 outreach clinics in health centres over a wide area.
Have had a 40% increase in referrals.
IF he has to refer back to a consultant from the outreach clinic,
this can save the patient a 100 mile round trip to be told the
lesion is benign.

With Calmanisation, a consultant opinion must always now be available
to a registrar in training. So without either a consultant coming  with hm,
or a tele- link he would be unable to attend at these clinics.
The intention if the tele-dermatoloy link is not to replace the outreach
clinic, ie. a dermatologist will always travel out.
The registrar in the outreach clinic gets feedback.


They use TIFF file format, which is 1.1Mbytes raw and compresses
to 65kbytes with JPEG for transmission.

They don't use the NHSnet at the moment, buth Dr. Lyons dis say they
would be willing to use it in future.
There is clinical agreement of doctors in 90 to 96% of cases.


The system was bought for them by the Station House Surgery in Kendal
(not the NHS)




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Another tele-dermatology talk  was from Northern Ireland
(the conference was run by Richard Wootons telemedicine group at Queens).
"Preliminary results from the Northern IReland arms of the UK Multicentre
Teledermatology Trial : effectof camera performace on
diagnostic accuracy"
By Dr. Helen Gore, Institute of Telemedicine, Queens Belfast.

A bigger study, comparing a one CCD and a better 3CCD camera,
and their diagnostic accuracy.


John Hearns


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