Physicians since a long time have made use of medical images on film, a rather slow and expensive way of image distribution. The Steinbeis-Transferzentrum Medizinische Informatik (TZMI) in Heidelberg was selected among the European IT prize finalists 1997 because of their CHILI teleradiology system which offers a cost reducing and faster solution for medical image delivery over computer networks or ISDN lines. CHILI can improve the cooperation between radiologists and clinicians via teleconferencing and patients in rural areas suffering from complicated disease are able to get consultation from experts without having to face a dangerous transport. Additionally, CHILI can be enhanced with new functions for advanced image analysis tasks, such as 3-D reconstructions or operation planning.
Basically, CHILI constitutes a general purpose radiology workstation with teleradiology functions. Its modular structure enables the software to be adapted to the individual users requirements. The digitally transmitted radiological images can be presented simultaneously at different sites for the purpose of interpretation, analysis and consultation. Images are integrated from different sources, such as CT, MR, video camera and ultrasound scanners. The image data transfer from the imaging modality is largely automatic and connected as much as possible but not necessarily with the DICOM protocol. Only three mouse clicks are needed to submit complete studies to another CHILI workstation.
All personal data included in the image files are stored in the CHILI patient database and protected by special encryption programs. The privacy and integrity of these data are based on the regulations of the German Federal Bureau of Information Technology Security (BSI) and the IT Security Manual of the Commission of the European Union. In case of transmission, the data are shipped in encrypted form for which the receiver's public key is used. A digital signature and a checksum procedure confirm the security process. For the digital signature and data decryption the user needs his private key. The exchange of public keys happens automatically and communication partners are certified by a trust centre which is the TZMI in Heidelberg.
Teleradiology conferencing starts with a simple telephone call using a hands-free speakerphone. The CHILI application is activated by the users and a red telephone icon rings. A mouse click on this icon establishes the contact. The participating partners can display the shared images and perform different operations. All interactive manipulations of the communicating parties are executed synchronously whereas a telepointer is showing the mouse position of the partner actually conversing. The images can be presented in original size, enlarged, or in sets of four or six on the same screen and be printed afterwards.
The researchers at TZMI have experienced that with the introduction of CHILI, savings can be made in film material, transportation of patients, staff and the sharing of resources, that outweigh the resulting costs of the ISDN lines. And moreover, since the system is modular, customers only have to pay for the modules they need at the moment. For further spicy news, we invite you to the CHILI web site.