title: Internet consultations from a remote Pacific island: impact of digitized radiologic images on referral decisions.
abstract: A study was carried out to determine whether digitized radiologic images added valuable information to Internet consultations from a remote Pacific Island. Chuuk State Hospital (Federated States of Micronesia) has limited film screen radiology, minimal ultrasound capability, and no radiologist. Providers initiate Web-based referrals for consultation or patient transfer. Digitized images (via low-cost digital camera or flatbed scanner) were uploaded to a Web site. Images were assessed for impact on referral decisions. A radiologist scored image quality and confidence (scale: 1-7). Of 97 referrals with images that were reviewed, 74 (76%) image sets were abnormal, 20 (20%) were normal, and 3 (4%) were indeterminate. Median scores were 4 for image quality and 5 for diagnostic confidence. In most cases with abnormal radiology (52/74, 70%), images were considered valuable. Radiologic images digitized with a low-cost camera or flatbed scanner provided valuable information for decision making in an Internet-based consultation and referral process from a remote, impoverished Pacific Island jurisdiction, despite relatively low image quality.
authors.affiliation: Department of Radiology, Tripler Army Medical Center, Honolulu, Hawaii 96859, USA.
authors.forename: Jinha M
authors.initials: JM
authors.lastname: Park
authors.forename: Lynne
authors.initials: L
authors.lastname: Ruess
authors.forename: Stephen C
authors.initials: SC
authors.lastname: O'Connor
authors.forename: Faheem
authors.initials: F
authors.lastname: Hussain
authors.forename: David Y
authors.initials: DY
authors.lastname: Oshiro
authors.forename: Donald A
authors.initials: DA
authors.lastname: Person
mesh_terms: D006801:Humans; D020407:Internet; D008849:Micronesia; D011856:Radiographic Image Enhancement; D011873:Radiology Information Systems; D012017:Referral and Consultation; D019114:Remote Consultation; D019112:Teleradiology