The new teleradiology system KAMEDIN: concept and application in consideration of cost-benefit-analysis

In recent years, different concepts and systems of teleradiology applications have been realized. In general these systems are connected to local networks using ISDN. While the DICOM-3 protocol has become an accepted, uniform standard for radiological images and for radiological workstations, in teleradiology different protocols and image formats are still used. Conversion sometimes causes troubles and requests the possibility of communication between the different systems. On the other hand the cost-benefit-relation of a teleradiology system depends on the number of possible communication partners and on the realization of different aspects of data transfer with the same system (e.g. image transfer, teleconference with PC or workstation). The evaluation of economic efficiency of telemedical applications is effected by many factors. Besides the "hard cost factors", which can easily be assessed by monetary aspects (e.g. costs for hardware, software and transport), there also exist a lot of "soft factors". Their assessment is more difficult. The patient's convenience, improvement of communication between sites and fastening of diagnosis or treatment are some examples of th "soft factors". Thus calculation of "break-even" analysis is mainly based on the "hard cost factors". In our study a cost-benefit analysis of the new teleradiology system KAMEDIN (Kooperatives Arbeiten und rechnergestützte Medizinische Diagnostik auf innovativen Netzen der Deutschen Telekom) was performed. For transmission of CT examinations, three different scenarios were realized (communication with an intensive care unit within the hospital, with an external radiology department and wit a radiologist on duty outside the hospital). Break-even analysis was done for each of the different scenarios.