Hospitals in Trento region impatient to benefit from real time tele-oncology facility

Heidelberg 19 September 1999At the Italian research institute ITC-irst in Povo in the Province of Trento, an inter-hospital network has been developed for teleconsultation in oncology. The system allows two or more physicians to simultaneously share digital clinical records with multimedia patient data in real time. The Wide Area Network (WAN) infrastructure will interconnect one central hospital and four district clinics. The teleconsultation service will be made accessible from different hospital departments, enabling oncologists to advice on treatment plans, to conduct follow-up sessions, and remotely support clinical research within the peripheral cancer units in the region of Trento.

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The Province of Trento is funding the project of Professor Claudio Eccher and his team to build a teleconsultation system for distribution and exchange of multimedia patient records via an Intranet. The service can be used for both asynchronous, pre-recorded teleconsultation and for real time synchronous multi-point teleconsultation. The system is based on a client-server architecture and consists of a Windows NT server, a Microsoft SQL or Software Query Language server, and an Internet Information server. Native as well as custom applications have been designed in the Microsoft Windows environment to provide the system with functional features.

The core of the teleconsultation network is formed by the multimedia digital patient record, which has been structured as a series of HTML pages. Via a distributed relational database, the physicians are able to download or store medical records. The clinicians have access to the system by means of a Web browser. The system offers a set of built-in collaborative and personal tools to facilitate a synchronised surfing during the remote consultation session. Features include a whiteboard with drawing facilities, point-to-point digital audio-conference, a chat service, a local notepad, and an integrated e-mail service.

The lay-out of the clinical record has been determined in close collaboration with the physicians who will use the system in the near future for the remote oncology sessions. At the start of a "virtual meeting", the server accepts the connection requests and establishes the connection between the participants, enabling the multiple teleconsultation to run simultaneously. The research team has written the server programme in Visual C++ with use of an MFC library and COM technology. Visual Basic has been applied for the ActiveX controls in order to carry out dedicated tasks from the inside of the HTML medical record.

At present, the teleconsultation system has past the laboratory tests which have been organised together with the participating hospital physicians, to assess the functionality of the network. The next step will be to implement the system in a clinical setting, in order to test its usability in the different hospital departments. In any case, the ITC-irst research team firmly believes that this Intranet-based solution has the potential to support a "multi-disciplinary distributed virtual oncological meeting".


Leslie Versweyveld

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