Kuopio, Finland...Real Time and Store-and-Forward Teledermatology

Since late 1994, teledermatology has been deployed between M”ntyharju Municipal Health Center, Mikkeli Central Hospital, and Kuopio University Hospital. Supported in part by contributions from the Etel”-Savo Hospital District and the Finnet telephone companies, it is an ISDN-mediated system running at 128 to 384 Kbps, using PictureTel 2000 equipment with far-end camera control and autofocus.

User Perceptions of Teledermatology Using Interactive Video

Before deploying a full-blown teledermatology system, we wanted to assure that the technology would be accepted by patients and physicians. Using the same patients -- but different dermatologists -- for both exams, we compared traditional in-person to 2-way interactive televideo (IATV) examinations. The study was done "in-house" at the Baltimore VAMC, where all video visits were transmitted between the examining room and the the physician station at 384 Kbps (1/4 T1) or 1.544 Mbps (T1), over an internal T1 line. During the two month trial in the Fall of 1995, 109 consenting clinic patients had their skin problems evaluated first over the telemedicine system (see callout), then in person, by four rotating dermatologists. A trained nurse-escort accompanied the patients for the IATV exams, 61% of which were conducted at full T1, and 39% at 1/4 T1. Patients and physicians completed a 12-item questionnaire with responses based on a 4-point Likert scale [strongly agree; agree; disagree; strongly disagree]