FR2736450A3 - Communication and processing of medical data for remote diagnosis - has scanner and keyboard at enquiry stations to provide data sent over computer network to remote adviser stations - Google Patents

Abstract

The remote diagnosis system has a number of enquiry stations (1-6) connected by a computer communication network (7,8,9) to a number of adviser stations (10). The enquiry stations are provided with an imaging device (1) providing an image of samples or documents (2), a digital encoder (3) comprising an analog-to-digital converter, a digital compression circuit and an interface to the communication network. The advisor stations have a high resolution display connected to the network through an interface. The image data includes an identifier for the image, of the enquirer and of the adviser. These identifiers are used to address messages across the network. A central database is also accessible from every terminal on the network.

Description

TELEMEDICINE SYSTEM
The present invention relates to a system for communication and processing of medical data, such as pathological, hematological, radiological or dermatological data allowing remote diagnosis.

 In the treatment of a disease, the diagnosis that a doctor makes is fundamental since on this one will depend the relevance of the treatment and the cure of the patient. The great diversity of cases, the geographic isolation or the lack of information from a doctor can make this diagnosis uncertain, and the analyzes of a laboratory or the use of information networks allowing to request a diagnosis, to compare or confirm, will take some time which may be inconsistent with the urgency of a case.

 The present invention makes it possible to solve the above drawbacks by proposing a telemedicine system which allows a doctor using a post-applicant of the system according to the invention to obtain an accurate and reliable diagnosis in real time.

 Indeed, the present invention relates to a telemedicine system comprising one or more post-requesters (or transmitters) transmitting data to one or more post-consultant (or receivers) which is characterized in that each post-requester comprises optical means for taking images, a digital encoder, a digital compressor and a means of interface with a communication network, and is in contact with one or more consultant stations comprising, a means of interface with said communication network, a digital decoder and a high resolution screen.

 Another important characteristic of the present invention is that the data transmitted between the requesting stations and the consulting stations are high definition digital images compressed with a bit stream composed of a series of binary codes identifying the images transmitted as well as the station -applicant and the post (s) -consultant (s).

 Preferably, all communications are managed by a central office distributing data in both directions between the network of applicant stations and that of consultant stations, connecting these two networks with a network of experts, and storing the information exchanged so as to build a database.

 The present invention also covers post-applicant, post-consultant and post-expert devices used in such a system.

 The system according to the invention thus makes it possible to obtain a reliable diagnosis in real time and reliably, regardless of the degree of isolation of the diagnostic requester.

 The present invention will be better understood and additional advantages will appear on reading the description which follows, illustrated by FIG. 1 which represents a complete telemedicine system according to the invention.

 The exemplary embodiment of the invention which is described below relates to a telepathology system, but can be used by all the specialties of human as well as animal medicine.

As this figure shows, the doctor or the diagnostic applicant using the telepathology system according to the invention has at their disposal an image capture means 1. These image sensors can be equipped with suitable interfaces making it possible to be connected to source images of the X-ray type (XRAY), MRI, scanner, electrocardiogram, ultrasound device, or to intermediate images of radiography, microscopic or macroscopic views. These image sensors can be of several kinds:
Opto-mechanical image sensors use light routed through conventional lenses and allow the use of a microscope (for example "Leica") to obtain more or less high magnification views as well as CCD cameras (for "Coupled Charge" Device "in English) allowing the digitalization of the images. In this example, the macrozoom" Leica "makes it possible to obtain macroscopic views and to zoom, and the negatoscope makes it possible to illuminate traditional radiological images whose views will be taken up by the macrozoom.

 In the fiber optic image sensor, light is routed through optical fibers. The fiber optic zoom microscope is a two-objective stage with zoom allowing to take pictures of microscopic slides with a continuous magnification due to the zoom. The fiber optic zoom macroscope is a single objective stage with zoom allowing to take pictures of operating parts directly on the macroscopy bench. The fiber optic dermatoscope consists of a fiber optic cable terminated by a zoom lens and allows, by its maneuverability, its small size and its definition, to take dermatological shots. It can obviously be extended to other fields of medicine.

 It should be noted that these last three workstations can use the same interface box, and the same bundle of optical fibers, only the objectives and the plates being suitable for particular uses.

 The applicant can thus capture one or more images of a sample 2 to be analyzed. According to an important characteristic of the present invention, this image is digitized and compressed in the coder 3 to be transmitted to a multimedia and processing system. This encoder is controlled by a microprocessor and includes the appropriate components, that is to say an analog / digital converter and a digital compressor. The applicant controls the microprocessor using the keyboard 4 and screen 5, as well as the input of image identification data, display on screen 5, printing using printer 6, and all the other types of functions executed by the microprocessor of the encoder 3.

 This post-requester advantageously includes a memory means allowing deferred sending by request packets.

 Preferably, the requesting station will be equipped with a PC Standard Multimedia type microcomputer, having, in addition to conventional functions, elements enabling them to record and reproduce sounds, images and to read a CD-ROM.

A preferred embodiment of the requesting station according to the invention and which will evolve as a function of technical progress is:
- a processor of the "DX 2/66" type,
- 32 MB RAM memory,
- a 500 MB disc + CD-ROM,
- a card available under the brand "MATROX MAGIC 'allowing to acquire very high definition images and to which the image sensors are connected,
- two 17 "color monitors with 1280 x 1024 definition, one for displaying the image, the other for user dialogue.

 In addition, the coder 3 of this diagnostic requesting station can include an interface means with other local stations (coupler allowing to exchange data with other similar stations or complementary stations, recording of patients, management laboratory, or heterogeneous central computer systems of the hospital).

The encoder 3 can be equipped with other means of interface with a communication system with the outside (Telecommunication Card whose characteristics depend on the network used), such as for example the telephone, networks of the ISDN type (Digital Integrated Network of
Service) like "NUMERIS" fez or "INTERNER 't), cable, fiber optics, satellite or any other type of communication network, allowing it to send in real time or delayed one or more images to be digitized in a high definition format accompanied by data identifying the images, the diagnostic request, the identity of the position-applicant and the consultant position (s).

 The applicant can be a confirmed specialist who wishes to have his diagnosis validated by a national or international expert of the type of lesion considered, a technician in the operating room who deals with shots in the case of extemporaneous examinations under the responsibility of the surgeon a beginner specialist replacing the holder during absences, or a shooting technician, for antennas in medically emerging countries and which do not have confirmed or sufficient numbers of pathologists.

 Data transmission and processing is not limited to images, but also concerns sounds, graphs or curves (electrocardiogram, ultrasound, etc.).

 Preferably, all requests are received by a central office 7 which, according to the identification data accompanying the requests, distributes them to the terminals of specialists (post-consultants) or experts. This central office keeps in memory the information which passes through it in order to constitute a database which can be consulted by applicants, specialists, and all interested persons. This exchange is connected to a network 8 of applicants as well as to a network 9 of specialists.

 The latter are equipped with consultant stations 10 each provided with a decoder for the data received in compressed digital format, with a high-resolution screen 11 allowing the real-time or deferred display of the images received, with a keyboard allowing for example formalize the diagnosis before sending it back with one or more images to the applicant directly or via the central office 7.

The consultant post according to the invention will be equipped and may be modified or supplemented according to the evolution of the materials, at a minimum of:
- a processor of the "DX 2/66" type,
- 32 MB RAM memory,
- a 500 MB disc + CD-ROM,
- a 17 "color monitor with 1280 x 1024 definition, if this post-consultant is connected locally, a local network coupler must be added to it, and if it is connected with the outside, a telecommunications card whose characteristics depend on the network used.

 This system therefore makes it possible to collect the opinion of one or more specialists in the lesion concerned in real or deferred time, depending on needs and urgency, requests can be stored and shipped in packages. Another advantage of the system according to the invention is that the applicant can request the opinion of a particular specialist from the directory at his disposal, which offers great flexibility of use.

 The station 10 of each specialist consulted can contain a memory in which the latter can constitute his own database of image, information and diagnostics.

 The recipient can be a specialist who diagnoses extemporaneous from his office, a consultant center located in a given country comprising doctors who subcontract for medically emerging countries, or even a confirmed national or international expert with whom any doctor can ask for advice.

 An additional network 12 equivalent to network 9 can allow specialists to consult via central 7 one or more experts from the medical field concerned by the request. These experts are equipped with receivers equivalent to the specialists' receivers. Thus any diagnosis can be confirmed by an expert, this to further secure the diagnosis used at the end of the chain by the doctor treating the patient concerned.

 Thus, thanks to this system according to the invention and to the precision and speed of execution of orders, the presence of the specialist on site is no longer compulsory, the doubt is removed for difficult cases. Indeed, a specialist can, from the workstation of his laboratory, receive the image that a surgeon sends him from the hospital establishment. Thus the contribution of this system is fundamental in the case of extemporaneous examination, that is to say practiced during a surgical intervention. The comfort and the medical security of the patient are increased.

 Another advantage of the system according to the invention is the reduction in the numerous costs which it generates. Image compression allows transmission at reduced cost, by freeing the doctor from unqualified tasks, he fully values his working time, by reducing diagnostic times, he shortens any hospital stay by allowing immediate diagnosis during extemporaneous exams, and it eliminates the risk of reoperation.

 In addition, this system solves many problems such as the opening up of the general practitioner or the lack of specialists. It also makes it possible to confirm the diagnosis by expert, the credibility of the local doctor, the continuing education of general practitioners and new links between health actors.

 It can be seen that the system according to the invention offers numerous advantages and can be applied widely to all fields of medicine and in particular to ophthalmology, stomatology, anatomopathology, dermatology, cytology, general radiology, radiology-mammography, gastroenterology, etc ...

Claims (10)

 1. Telemedicine system comprising one or more requesting workstations (1,2,3,4,5,6) exchanging medical data with one or several consulting workstations (1 O), characterized in that each posted requester has a means of taking of medical data images (1), a digital coder (3) comprising an analog / digital converter, a digital compressor and a means of interface with a communication network (7, 8, 9) and is in contact with a or several of the consultant stations (10) comprising a means of interface with said communication network (7, 8, 9), a digital decoder and a high resolution screen (11).  2. Telemedicine system according to claim 1, characterized in that the medical data transmitted by the digital coders (3) of the requesting post and the consulting post are compressed high definition digital images and / or graphs, as well as '' a bit stream composed of a series of binary codes identifying each of the transmitted images and / or graphs, and identifying the calling station and the consulting station (s).  3. Telemedicine system according to one of the preceding claims, characterized in that the consultant stations and the applicant stations transmit in the direction of each other via a digital transmission link.  4. telemedicine system according to any one of the preceding claims, characterized in that the communication network comprises a central (7) between the stations-seekers and the stations-consultants of the system, which distributes the data transmitted from the stations-seekers to the consultant stations with the addresses corresponding to those registered in the series of codes issued at the same time as the medical data by the applicant stations.  5. System according to any one of the preceding claims, characterized in that the exchange (7) is also in contact with a network (12) of expert stations (13) of the same type as the consultant stations (10) and allows the connection between the consultant positions and the expert positions.  6. System according to any one of claims 4 and 5, characterized in that it stores the data exchanged passing through it, so as to constitute a database accessible from all types of stations.  7. Post-applicant for diagnostic medical consultations, characterized in that it comprises a means for taking medical data (1), a digital coder (3) comprising an analog / digital converter, a digital compressor and an interface means with a communication network (7,8,9,12), and transmits compressed high definition digital images and / or graphs as well as a bit stream composed of a series of binary codes identifying each of the transmitted images and identifying the applicant positions as well as the consultant position (s).  8. Post-applicant for medical consultations according to claim 7, characterized in that the means for taking medical data is an optical means for taking images (1) comprising an opto-mechanical image sensor using the light routed via CCD lenses and cameras for digitizing images.  9. Post-applicant for medical consultations according to claim 7, characterized in that the means for taking medical data is an optical means for taking images (1) comprising a fiber optic image sensor.  10. Medical consultant post, characterized in that it comprises a means of interface with a communication network, a digital decoder (10) and a high resolution screen (11).