title: Telematics in medicine: a network infrastructure to optimize processes in cardiology and heart surgery.
abstract: OBJECTIVE
  During the past 2 decades, cardiac surgery has developed into a high-tech field. Increasing numbers of urgent surgical procedures mean that the time interval from diagnosis to surgical treatment must become ever shorter. Optimizing inconvenient and slow processes such as postal correspondence by using internet services is therefore mandatory in current cardiosurgical practice, and this includes the electronic transfer of patient data and diagnostic imaging material [12]. This study focuses on the internet connection of several cardiac referral centers to a cardiosurgical institution.
  
  
  METHODS
  Eleven cath lab centers were connected to a cardiosurgical center by internet. Auser program was especially developed to optimize connecting processes with the department. Data conversion was based on HL7 codes and angiograms were based on CD-ROM mediums and the DICOM standard. An online registration based on the HL7 communications standard was provided.
  
  
  RESULTS
  All cath lab centers were successfully connected to the cardiosurgical institution. Angiography data were transmitted within 30 +/- 15minutes. The time interval from diagnosis to decision for surgery decreased from 36 +/- 13 hours to 1 +/- 0.5 hours (p = 0.01). Urgent or emergent surgery could be provided after 18 +/- 19 hours, compared to 56 +/- 35 hours before (p = 0.02).
  
  
  CONCLUSIONS
  Special programs transmitting data via the internet significantly reduces the time interval from diagnosis to surgical treatment. Standardizing data transmitting processes from referral centers markedly optimizes cardiological and cardiosurgical treatments and could thereby improve survival rates and reduce costs.
authors.affiliation: Department of Thoracic and Cardiocascular Surgery, University Hospital Muenster, Muenster, Germany. gregor.huelsken@ukmuenster.de
authors.forename: G
authors.initials: G
authors.lastname: Hülsken
authors.forename: M
authors.initials: M
authors.lastname: Rothenburger
authors.forename: C
authors.initials: C
authors.lastname: Etz
authors.forename: A
authors.initials: A
authors.lastname: Löher
authors.forename: C
authors.initials: C
authors.lastname: Schmid
authors.forename: H H
authors.initials: HH
authors.lastname: Scheld
mesh_terms: D006328:Cardiac Catheterization; D002309:Cardiology / Q000458:organization & administration*; D003195:Computer Communication Networks / Q000592:standards; D006801:Humans; D020407:Internet; D017216:Telemedicine; D013903:Thoracic Surgery