MINISYMPOSIUM Médecins Sans Frontières teleradiology history Saskia Spijker Received: 21 November 2013 /Accepted: 5 February 2014 # Springer-Verlag Berlin Heidelberg 2014 Additional radiology support to Médecins Sans Frontières (MSF) field teams has always been greatly valued by clinicians. MSF recognises that creating a user-friendly platform for teleradiology and promoting this service assists clinicians in MSF medical programs to interpret images and support patient management. Teleradiology within MSF has evolved throughout the years from an ad hoc, informal service via e-mail to a struc- tured and monitored service via two Web platforms: the first is an internal MSF Web-based platform via Collegium Telemedicus; the second is a PACS-based platform via a commercial teleradiology company (vRad, Minneapolis, MN). Both rely on volunteer radiologists at no cost to MSF beyond those associated with Internet transmission. Of those MSF missions that have access to radiology services, most are utilising Ministry of Health facilities with film and chemistry. Digital images of film radiographs are obtained by photographing the radiographs on a viewing box with a digital camera. The variation in quality of these images prompted the development of a step-by-step protocol on how to best capture a digital image of a radiograph. In 2010, this internal protocol was developed and is available to all MSF missions utilising this method. These JPEG images are then attached to a case profile and transmitted via Collegium Telemedicus for reporting. JPEG files are usually 200– 300 kB in size. MSF missions that utilise computed radiography imaging can transmit images as DICOM files directly via PACS software to vRad PACS for reporting. These DICOM images remain higher in quality than the JPEG files; however at 10 MB per X-ray image, this service requires a higher- quality Internet connection (Fig. 1). Alternatively, computed radiography images are sometimes exported as JPEG files from the computed radiography software and transmitted via Collegium Telemedicus. The uptake of teleradiology within MSF continues to grow. In 2012 a total of 637 examinations were transmitted for consultation across the two platforms. While the vast majority of radiology cases for reporting are plain films, CT, MRI and US scans are occasionally transmitted for reporting. Conflicts of interest None Fig. 1 Digital radiograph with teleradiology setup at a Médecins Sans Frontières program in sub-Saharan Africa S. Spijker Médecins Sans Frontières International, Amsterdam, the Netherlands S. Spijker (*) Plantage Middenlaan 14, Amsterdam 1018 DD, the Netherlands e-mail: [email protected] Pediatr Radiol (2014) 44:655 DOI 10.1007/s00247-014-2925-0

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MINISYMPOSIUM

Médecins Sans Frontières teleradiology history

Saskia Spijker

Received: 21 November 2013 /Accepted: 5 February 2014# Springer-Verlag Berlin Heidelberg 2014

Additional radiology support to Médecins Sans Frontières(MSF) field teams has always been greatly valued by clini-cians. MSF recognises that creating a user-friendly platformfor teleradiology and promoting this service assists cliniciansin MSF medical programs to interpret images and supportpatient management.

Teleradiology within MSF has evolved throughout theyears from an ad hoc, informal service via e-mail to a struc-tured and monitored service via twoWeb platforms: the first isan internal MSF Web-based platform via CollegiumTelemedicus; the second is a PACS-based platform via acommercial teleradiology company (vRad, Minneapolis,MN). Both rely on volunteer radiologists at no cost to MSFbeyond those associated with Internet transmission.

Of those MSF missions that have access to radiologyservices, most are utilising Ministry of Health facilities withfilm and chemistry. Digital images of film radiographs areobtained by photographing the radiographs on a viewing boxwith a digital camera. The variation in quality of these imagesprompted the development of a step-by-step protocol on howto best capture a digital image of a radiograph. In 2010, thisinternal protocol was developed and is available to all MSFmissions utilising this method. These JPEG images are thenattached to a case profile and transmitted via CollegiumTelemedicus for reporting. JPEG files are usually 200–300 kB in size.

MSF missions that utilise computed radiography imagingcan transmit images as DICOM files directly via PACS soft-ware to vRad PACS for reporting. These DICOM imagesremain higher in quality than the JPEG files; however at10 MB per X-ray image, this service requires a higher-quality Internet connection (Fig. 1). Alternatively, computedradiography images are sometimes exported as JPEG filesfrom the computed radiography software and transmitted viaCollegium Telemedicus.

The uptake of teleradiology withinMSF continues to grow.In 2012 a total of 637 examinations were transmitted forconsultation across the two platforms. While the vast majorityof radiology cases for reporting are plain films, CT, MRI andUS scans are occasionally transmitted for reporting.

Conflicts of interest None

Fig. 1 Digital radiograph with teleradiology setup at a Médecins SansFrontières program in sub-Saharan Africa

S. SpijkerMédecins Sans Frontières International,Amsterdam, the Netherlands

S. Spijker (*)Plantage Middenlaan 14, Amsterdam 1018 DD, the Netherlandse-mail: [email protected]

Pediatr Radiol (2014) 44:655DOI 10.1007/s00247-014-2925-0