Optimisation and evaluation of an asynchronous transfer mode teleradiology co-operative system: the experience of the EMERALD and the BONAPARTE projects

This paper describes the work carried out to optimise and evaluate in clinical routine a multimedia telemedicine application for co-operative imaging diagnosis. This research has been attained within the framework of two European research projects, namely the EMERALD 1] and the BONAPARTE 2]. A user-centred telemedicine application was developed on an existing advanced broadband multimedia teleradiology platform to exploit the possibilities offered by Asynchronous Transfer Mode (ATM) technology to support real-time teleconsultation services for medical imaging. The evaluation of this telemedicine system in both projects has been performed with the aim of (1) characterising and optimising the ATM teleradiology platform, minimising the bandwidth requirements without degrading the quality of service offered to users and (2) evaluating the telemedicine system usability to improve the fulfillment of user's needs. The assessment outcomes have provided insights into technical limitations of broadband multimedia technologies for an optimum usage of a teleradiology co-operative diagnosis systems and the organisational difficulties and limitations involved in setting-up these new advanced telemedicine services to achieve the expected clinical benefits.