Reports from the Scientific Forum
Cyberspace Channels for Health Care
IAEA Helps Bring Nuclear Medicine to Those Without
Telemedicine promises everything from consultations over the internet to transboundary surgery on patients. When it comes to nuclear medicine, the Agency is making sure the developing world is not locked out of cyberspace.
Today nuclear medical techniques are used to diagnose conditions in most branches of medicine. In developed countries, one-third of all hospitalised patients undergo some nuclear medicine investigation. Now "tele-nuclear-medicine" links that use the internet are being set up in Africa and Latin America. The links facilitate remote diagnosis and ensure that patients there can benefit from the latest diagnostic innovations. Advances in this field were on display at the IAEA Scientific Forum, attended by experts and delegates from around the world.
Doctor-Patient Interconnections
At its most basic, telemedicine is about bringing doctors closer to patients though cyberspace. Take for example, the Namibia/South Africa/United Kingdom tele-nuclear-medicine network. Namibia has only one nuclear physicist. The telemedicine network means that when he takes holidays, patients do not have to wait for a diagnosis. Their medical images and data can be securely transmitted to Cape Town doctors for analysis.
"Tele-nuclear-medicine is to become an essential component of modern health care," says Prof. Keith Britton, Head of Department of Nuclear Medicine at St. Bartholomew's Hospital, London, and moderator of the Forum's nuclear medicine session. One crucial function it provides is the opportunity for a second opinion, he said. Peer review, quality assurance and quality control can be sought because of technology that allows information to be transferred and exchanged anywhere in the world. As in Namibia's case, it can also bring much needed peer support to an isolated doctor.
Other benefits of tele-nuclear medicine include the ability to perform remote maintenance and repairs on equipment, as well as providing a training and interactive self-study tool for technologists and medical professionals.
IAEA-Supported Initiatives
Prof. Britton said the challenge for tele-nuclear-medicine was to show that it can be "efficient and cost effective" and "an organ for change and betterment in developing countries". IAEA initiatives over the past seven years are working to demonstrate this. The Agency has supported:
- The tele-linking of nuclear medicine facilities between and within several of its Member States, including Austria, Belgium, Namibia, South Africa, the United Kingdom and Zambia;
- A new project for a tele-nuclear-medicine network in 16 Latin American countries; and
- The development of internet-based study materials for teaching and training in nuclear medicine.
Web technology is a perfect tool for distributing nuclear medicine information, according to Dr. Tawatchai Chaiwatanarat from Chulalongkorn University in Thailand. Nuclear medicine relies on graphics, images, numerical data and text. The image files are small in size and the software developed can handle static as well as dynamic, moving graphics.
Hurdles Remain, Solutions Seen
The technology, however, is not without its financial, legal, and ethical hurdles. Participants at the forum raised questions concerning legal liabilities (and responsibility, in the case of incorrect diagnosis), fee-for-service, security of patient information and the level of infrastructure needed.
Prof. Ajit Padhy from the IAEA's Technical Cooperation Department, said the minimal equipment required was a gamma camera, a good internet connection, computer and telemedicine software.
Dr. Valentin Fidler of the Ljubljana University, Slovenia gave a keynote presentation on the development of regional tele-medicine software for efficient low-cost communication. A concluding panel discussion included an account of experiences in Namibia and South African, by Prof. Annare Ellman, Tygerberg Hospital, South Africa; and experiences in Chile by Prof. Bobadilla Lopez, Chilean Nuclear Energy Commission.