Chinese teleradiology scales great wall of technology

Telemedicine in China has evolved since the spring of 1995, when a student at Beijing University dispatched an SOS e-mail over the Internet ( http://www.radsci.ucla.edu/telemed/zhuling/ ), pleading for help for another student who was suffering from a serious though unknown disease.

The message was widely distributed through various Internet newsgroups and an international discussion ensued. Within two months, hundreds of e-mail replies were received, helping Chinese physicians make the correct diagnosis (thallium poisoning), and demonstrating telemedicine's potential to use medical resources from anywhere in the world to solve clinical problems.

Soon after that incident, telemedicine, including teleradiology, began to play a more expansive role in Chinese medicine.

Another major step was taken recently when U.S. and Chinese communication companies (ViperSat and Shanghai Telemedicinet) reached an agreement to install a satellite telemedicine network linking 200 hospitals in mainland China over the next 18 months.

The network's goal is to deliver medical expertise from China's major medical centers to remote medical facilities throughout the country by enabling distant review of medical images and patient charts, and by facilitating direct teleconsultation and diagnosis.

The first phase of the project, which connects 20 sites to a hub in Shanghai, began operation at the end of October.

High-end medical equipment, including telemedicine systems, currently congregates in Beijing, Shanghai, and other leading cities. In the countryside, however, the opposite is true; most rural areas have little if any medical equipment of any sort.

The challenge, then, is to deliver the benefits of modern medicine to locations that are usually last in line to receive them, using applications that will work even in the most difficult environments and will perform reliably every day.

"There is great potential for telemedicine applications in China," said Dr. Zhao Yongguo, a clinical radiologist at the Bristol Royal Infirmary in the U.K. "With the accelerated construction of broadband networks and wide adoption of information technology in the country, telemedicine provides opportunities and challenges for Chinese physicians."

While telemedicine can ensure that the country's limited medical resources are used with maximum efficiency, the health authorities need to bring telemedicine in line with their medical reform programs to promote better health standards for the nation, Yongguo said.

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