Tele-dermatological Service System between Korea-China-Europe ...
Tele-dermatological Service System between Korea-China-Europe Using TEIN
This abstract covers the progress and result of a project, ‘Establishing a
teledermatological service system between Korea-China-Europe using TEIN,’ for the
Telemedicine has several definitions. In general telemedicine involves the practice of
delivering health care over a distance using telecommunication equipment as simple as
telephone, fax machine or as complex as personal computers and full motion interactive
multimedia. Other definitions are the use of telecommunication technologies to provide
medical information and services, the use of electronic information and communication
technologies to provide and support health care when distance separates the participants,
the use of medical information exchanged from one site to another via electronic
communication for the health and education of the patient or health care provider and
for the purpose of improving patient care and a process, rather than a technology:
telemedicine connects patients and health care professionals in a chain of care.
Teledermatology is the use of telemedicine for dermatological consultations. During a
teledermatological consultation, a dermatologist evaluates clinical and laboratory data,
makes a diagnosis, and prescribes therapy for patients located at a distance. Ultimately,
the goal is to provide care for dermatology patients in underserved areas, improve the
quality of care, and decrease the cost of care.
There are two main types of dermatological consultations. One method is the store-and-
forward technology. This technique is more convenient due to the fact that there is no
need of a consulting physician at the same time as the referring physician and
patient. The other technique, called the real-time video conferencing technique, is done
live via telemedicine equipment. The major advantage to using this type of technology
is that the consulting physician can ask the patient and referring physician any questions
that may be essential to making a diagnosis and carrying out treatment. Both
technologies use two very useful instruments, a dermatoscope and microscope.
The final goal of this two-year project is to establish a teledermatological service system
between Korea and Austria through TEIN. This system can integrate international
dermatologic resources and increase academic exchange and the chances of
international research cooperation in this area.
Dermatologists from three institutes of Korea, Pusan National University Hospital, Inje
University Hospitals in Pusan and Seoul, dermatologists from Medical University of
Graz (Uni-Graz), Austria and IT engineers from Inje University and Uni-Graz
participated in this project. In addition to these members, more than 200 dermatologists
from European countries and other continents registered in the informal association of
teledermatology and they are willing to participate in this project indirectly by
submitting and examining their clinical dermatological cases.
Working with Austrian counterpart was mainly being carried out by discussion via e-
mail and visiting Uni-Graz of a primary investigator (PI) of this project.
The goal of the first year of this project was to develop a prototype of
teledermatological service system between Korea and Austria. This store-and-forward
type of teledermatology system has been tested with test data to check its feasibility
Four kinds of works have been carried out for this goal in the first year. The first work
was to let the dermatologists of three participating institutes in Korea to connect their
dermatologic workstations to TEIN. Three institutes were surveyed for the connection,
but no institute was connected to TEIN. Now, these institutes are connected to TEIN by
leasing dedicated lines from Korea Telecom.
The second work was to allow the European counterpart, dermatologists and IT
engineers of Uni-Graz, to be connected to TEIN. The university hospital of Uni-Graz
was confirmed that it has been connected to TEIN via GEANT, European backbone
network, and ACO-net, Austria research network.
To develop a standard specification for international teledermatology by participating
dermatologists and IT engineers was the third work and its implementation into
software was the fourth thing. Two specifications were considered to be developed; the
first one was a simple specification for test purpose for first year’s prototype
teledermatology system and the second was for the final standard. The first one has
been developed and implemented into software already. The draft of the second
specification is under development by participants.
The prototype of an international teledermatological service system has been developed
and is running on a server at Uni-Graz. It allows users to submit and examine
dermatological cases in web-based environment, so no special software is required for
It provides two kinds of operating modes, client and expert. Client mode allows users to
submit new requests to the system and the examinations are carried out in expert mode.
The dermatological case request contains patient’s information such as image files for
the interesting region of the skin disease, age, sex, location, side, clinical history,
diagnosis, question and preferred expert. The request can be sent to the specified expert
or all of the experts registered to the system. The system also shows the current status of
the processing for the requested cases. Once an expert logged in the system in expert
mode, it shows the requested cases to the expert. The expert examines the submitted
case by selecting one case in the list of submitted cases. The system shows all
information of a patient attached to the requested case as well as thumbnails of
submitted image. The examined case is stored with expert’s diagnosis and can be
viewed by the requested client.
In the second year clinical dermatologists will use the upgraded system with real
dermatologic patients’ data to test the system and find problems. This system will be
debugged with feedback from the users and upgraded by improving user interface and
system performance. In addition, security level of the patients’ data will be improved in
the second year because it may cause legal and ethic problems.
China will be included in this service system if an appropriate network between China
and Korea will be available in the second year.
Many benefits are expected with the successful achievement of this project in medical
area and industrial field. First of all, it will increase the level of dermatological service
by reducing misdiagnosis through this teledermatological service system because many
dermatological experts who have various experiences from many countries can provide
exam for the rare cases. It also provides us with techniques required for establishing and
operating other telemedicine system for the aged society. It will be a good alternative
for patients because it does not require long waiting time and complex procedures of
reception-exam-payment-prescription at a hospital. It will also increase mutual
understanding between Korea and European countries and chances of joint research