Borderless teleradiology heats up with CHILI

Although teleradiology is one of the most advanced areas of telemedicine, unresolved issues of system compatibility inhibit broader adoption.

While the DICOM standard is a prerequisite in most teleradiology schemes, it is not universally sufficient. Other open issues include security and synchronous teleconferencing capabilities.

"Users without a DICOM radiological workstation would benefit from the ability to join a teleradiology network without requiring any special tools," said Dr. Uwe Engelmann, project manager of the STZ Medizinische Informatik (STZ-MI) in Heidelberg, Germany.

Many teleradiology systems are monolithic in their software design and cannot be adapted to the user's actual environment. Existing radiological systems cannot be extended with additional software components. Consequently, new applications usually require a new workstation that must be connected and integrated into the existing infrastructure.

Englemann has devised a family of software components for teleradiology and PACS called CHILI. The system grew out of the MEDICUS project, a colloboration between the STZ-MI and the German Cancer Research Center in Heidelberg that was aimed at creating a general-purpose radiology workstation equipped with teleconferencing features.

The system has been designed as a component-based architecture. The most powerful communication protocol for data exchange and teleconferencing is the CHILI protocol, which includes a strong data security concept. In addition to its own secure protocol, the system offers several different communication methods:

?DICOM
?classic e-mail
?Remote Copy functions
?File Transfer Protocol
?HyperText Transfer Protocol/Secure
?CD-ROMs for offline communication

These transfer methods allow the user to send images to nearly anyone with a computer and a network.

"The drawbacks of non-CHILI protocols are that teleconferences are not possible, and the user must take reasonable precautions for data privacy and security," Englemann said. "The CHILI PlugIn mechanism enables the users or third parties to extend the system capabilities by adding powerful image postprocessing functions or interfaces to other information systems."

As a result, the CHILI system, which has more than 60 installations in Germany and the U.S., is not used merely in emergencies. Instead, it is used in daily routine as a multifunctional, multimodality workstation with advanced features for teleradiology and telecardiology.