title: [Possible applications of the KAMEDIN teleradiology system with special reference to an economic analysis].
abstract: BACKGROUND
  Different concepts and applications of teleradiology systems have been realised. However, their cost-effectiveness is still questionable. Therefore, a cost-benefit analysis of three different scenarios of the new teleradiology system Kamedin (Kooperatives Arbeiten und rechnergestützte Medizinische Diagnostik auf innovativen Netzen der Deutschen Telekom) was performed.
  
  
  METHODS
  CT examinations were transmitted from an Advantage Windows (GE) workstation to a Kamedin workstation using DICOM 3 protocol. Afterwards a teleconference was established with a Kamedin workstation in the intensive care unit within the hospital via FDDI/Ethernet, with an external workstation in a radiology department 6 km away via ISDN and with a Kamedin PC located with radiologist on duty 22 km away via ISDN. On average, 36 CT slices per patient were transferred. A break-even analysis was performed with respect to costs of hardware, software, support, use of ISDN and staff, as well as benefits like the decrease in transportation or film documentation costs.
  
  
  RESULTS
  Owing to the different reductions in transportation costs, two applications (intensive care unit and external PC) showed a break-even of 1817 and 528 teleconferences/year, respectively. Further optimisation of cost-effectiveness is possible on condition that existing hardware can be used and an automatic data transfer without staff control is available. When all optimisation factors were combined, the break-even decreased to a minimum of 167 and 77 teleconferences/ year, respectively.
  
  
  CONCLUSIONS
  Teleconferences with high image quality can be set up between workstations and PCs using the Kamedin system. Depending on the possible decrease in transportation costs, teleconferencing is cost-effective under certain conditions. Teleradiology has additional advantages, such as the acceleration and optimisation of patient management.
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Stadt Mannheim, Fakultät für Klinische Medizin Manneheim der Universität Heidelberg.
authors.forename: K J
authors.initials: KJ
authors.lastname: Lehmann
authors.forename: M
authors.initials: M
authors.lastname: Walz
authors.forename: R
authors.initials: R
authors.lastname: Bolte
authors.forename: M
authors.initials: M
authors.lastname: Georgi
authors.forename: M
authors.initials: M
authors.lastname: Schinkmann
authors.forename: C
authors.initials: C
authors.lastname: Busch
mesh_terms: D003195:Computer Communication Networks / Q000191:economics / Q000295:instrumentation; D003199:Computer Systems / Q000191:economics; D003362:Cost-Benefit Analysis / Q000639:trends; D003422:Critical Care / Q000191:economics; D003936:Diagnosis, Computer-Assisted / Q000191:economics / Q000295:instrumentation; D005544:Forecasting; D005858:Germany; D006801:Humans; D012985:Software Design; D019112:Teleradiology / Q000191:economics* / Q000295:instrumentation