Teleradiology
Teleradiologie in Accordance with X-ray Ordinance
Teleradiology is the imaging examination of a person under the responsibility of a specialized physician (usually a radiologist), without the need to be in the same location as the patient. The responsible radiologist is in direct contact via electronic file transfer (for example, encrypted Internet tunneling or phone connection) with the requesting and implementing entity. This form of teleradiology is defined in § 2 of the X-ray Ordinance (RöV) and is also called “Teleradiology in Accordance with X-ray Ordinance”.
Teleconsultation
The second major application of teleradiology is teleconsultation. In this form of teleradiology there is always a responsible radiologist present at the place of the examination. In particularly difficult or debatable cases the responsible radiologist can seek a second opinion to attain diagnostic findings, e.g. from a specialist from a university hospital. The electronic transmission of image data eliminates the still widespread delivery of images, for example via cab. Since there is always a responsible radiologist at the place of the examination, the legal hurdles are considerably lower than in the so called “Teleradiology in Accordance with X-ray Ordinance”.
Standardization of Teleradiology
For the image transfer within the scope of teleradiology (as of 2006) nowadays proprietary solutions are practically no longer used, but standard DICOM protocols. Unlike in the past, it is no longer required that both communication partners use teleradiology software from the same manufacturer. However, some configurations (such as AE title, ports, host name or IP address, router setting) must be made prior to the initial communication, therefore problems can arise especially in sporadic teleconsultation with changing partners.
To solve this problem, in May 2004 the German Radiological Society has adopted a recommendation for standardization of teleradiology. According to this recommendation the use of OpenPGP-Encrypted DICOM emails for image transmission should become standard procedure in teleradiology.
