DORIS module for screening of diabetes-induced retinopathy

The objective of this subproject in the OFU collaboration was to create a high-quality, practical telemedicine solution for fundus photography with regard to operation and widespread use in the health network.

The objective of the subproject "DORIS module for screening of diabetes-induced retinopathy" in the OFU collaboration was to create a high-quality, practical telemedicine solution for fundus photography with regard to operation and widespread use in the health network. The telemedicine solution depends on connection to the health network and software for exchanging patient information and fundus images as well as medical and computer equipment.

 

In the project we assessed fundus cameras with digital cameras from different suppliers based on technical specifications and functionality. The main requirements for the equipment were

  • field of view ≥ 50 degrees
  • simple user interface for the fundus camera
  • good digital image quality
  • the digital camera controls synchronization with the fundus camera
  • Standard storage format (TIFF, JPEG)
  • Rapid transfer between digital camera and PC
  • Cost - as low as possible
  • PC Storage capacity of 10GB

The requirements specification for the software (the DORIS module) was prepared in collaboration between ophthalmologists at UNN, the NST and Well Diagnostics.

 

On the basis of the specification Well Diagnostics developed the software "DORIS Professional Fundus station" integrated with the communication solution "DORIS Communicator".

 

In October 2002, the NST conducted an acceptance test on the whole solution. The acceptance test was approved by 2 ophthalmologists (UNN and NSS). The project resulted in a telemedicine solution which consists of a fundus camera model NF-505, connected with digital camera model D1x, both manufactured by Nikon. The digital camera has an image resolution of 5.47 megapixels. The digital camera is synchronized with the fundus camera, and has software which transfers the images directly to the PC. The program on the PC is called Nikon Capture. To enable rapid transfer, the PC and digital camera are linked with a Firewire IEEE 1394 connection. The Nikon Capture software and DORIS are integrated, so that the images taken with the fundus camera are attached to a referral form (patient information) for transfer in the health network.

The recipient doctor needs a PC with the DORIS Professional Fundus station software to read and reply to the referrals.

 

There are currently 2 telemedicine systems which are ready to be installed in the health network.

The major challenge is to develop a funding/fee structure which also covers the resources and expenses for the primary health service. It is important to recognize that the service provided is still a specialist health service, but that some of the participant staff are in the municipal health service, as this is the most practical organizational model. It is still the specialist who is in charge of the clinical aspects of the service. The NST is now investigating possible funding and fee structures for this service.

Project manager

Monika Johansen, e-mail: Monika.Alise.Johansen@telemed.no, tel.: +47 906 84 407.

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