title: Teleconferencing using multimedia messaging service (MMS) for long-range consultation of patients with neurosurgical problems in an acute situation.
abstract: BACKGROUND
  : We present our initial experience using a simple and relatively cost effective system using existing mobile phone network services and conventional handphones with built in cameras to capture carefully selected images from hard copies of scan images and transferring these images from a hospital without neurosurgical services to a university hospital with tertiary neurosurgical service for consultation and management plan.
  
  
  METHODS
  : A total of 14 patients with acute neurosurgical problems admitted to a general hospital in a 6 months period had their images photographed and transferred in JPEG format to a university neurosurgical unit. This was accompanied by a phone conference to discuss the scan and the patients' condition between the neurosurgeon and the referring physician. All images were also reviewed by a second independent neurosurgeon on a separate occasion to asses the agreement on the diagnosis and the management plan.
  
  
  RESULTS
  : There were nine patients with acute head injury and five patients with acute nontraumatic neurosurgical problems. In all cases both neurosurgeons were in agreement that a diagnosis could be made on the basis of the images that were transferred. With respect to the management advice there were differences in opinion on three of the patients but these were considered to be minor.
  
  
  CONCLUSIONS
  : Accurate diagnosis can be made on images of acute neurosurgical problems transferred using a conventional camera phone and meaningful decisions can be made on these images. This method of consultation also proved to be highly convenient and cost effective.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Kuala Lumpur, Malaysia. vwaran@ummc.edu.my
authors.forename: Vicknes
authors.initials: V
authors.lastname: Waran
authors.forename: Benedict M
authors.initials: BM
authors.lastname: Selladurai
authors.forename: Nor Faizal Ahmad
authors.initials: NF
authors.lastname: Bahuri
authors.forename: George John K Thomas
authors.initials: GJ
authors.lastname: George
authors.forename: Grace P S
authors.initials: GP
authors.lastname: Lim
authors.forename: Myo
authors.initials: M
authors.lastname: Khine
mesh_terms: D000208:Acute Disease; D001927:Brain Diseases / Q000175:diagnosis*; D040421:Cell Phone; D006259:Craniocerebral Trauma / Q000175:diagnosis*; D006769:Hospitals, General; D006785:Hospitals, University; D006801:Humans; D008296:Malaysia; D019212:Multimedia; D009493:Neurosurgery; D017216:Telemedicine / Q000295:instrumentation*