Polish neurosurgical teleconsulting system gets high marks

Poland may be a late entrant in the telemedicine sweepstakes, but one application used there is paying off for neurosurgical patients in communities outside Warsaw. It uses personal computers and telephone lines to link patients and physicians with specialists in urban centers.

"Until the mid-1990s, there was little research in this field. But, presently, Polish telemedicine projects can be found in telecardiology, telepathology, and teleradiology," said Dr. Mariusz Glowacki of the Kliniki Neurochirurgii in Warsaw.

Glowacki was involved in the first system of image transmission and neurosurgical telecommunication in Poland. The goal was to develop a faster, more efficient neurosurgical teleconsulting network to improve acute neurosurgical patient care, reduce transport costs, and avoid unnecessary occupation of neurosurgical beds.

"The system enables proper qualification for emergency neurosurgical treatment and monitoring of the treatment performed in remote hospitals," he said.

CT images are transmitted directly from CT scanners located in remote hospitals in Ciechanow and Ostroleka via 56 Kb modem/telephone lines to personal computers running Windows and network software in the neurosurgery department at the Polish Academy of Sciences in Warsaw. A study consisting 18 images can be transmitted over phone lines in about five minutes.

To date, more than 1000 CT images have been transmitted, among them:

?260 control examinations
?190 related to neurotrauma
?180 spontaneous intracerebral hemorrhage
?130 neuro-oncology
?70 subarachnoidal hemorrhage
?50 hydrocephalus
?30 related to cerebral ischemia
?40 without any intracranial pathologies

"With the Applied Neurosurgical Teleconsulting System, better availability of neurosurgical consultation has been achieved," he said.

The system has also significantly improved acute neurosurgical patient care through reduced transport expenses.

"Transfer of appropriate patients has been accelerated, and unnecessary transfer has been almost eliminated," Glowacki said. "Approximately 70% of consulted patients avoided unnecessary transportation thanks to the teleconsulting system."