TM

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Erik Stålberg

Health & Medicine

TheThe
integratedintegrated
EMG-labEMG-lab
StålbergStålberg

IInformationnformation
Administrative Referrals
Booking
Economy
Statistics
Examination Signals
Results
Conclusion
Knowledge Strategies
Anatomy
Methods
Reference values
Education
Conference
IT in Neurophysiology
TTechnologyechnology
Recording Equipment
Local net
Intranet
Internet
Video – ISDN
Modem

Case flow
REFERRAL
Scanner
Scrutinize
Booking
Examination
Report: Dictate/Type
Type report
Confirm report
FAX
Print report
E-mail
E-mail
REPORT
Server
Stålberg

IT in NeurophysiologyIT in Neurophysiology
booking
adm statistics
referral
calling
OFFICE
Ref values
analysis
John Doe
John Doe
report
storage
Monday EMG
John Doe
EMG
research
TELEMEDICINE

Network in the EMG labNetwork in the EMG lab
Stålberg
EMG eq
Dos/Win
Server
Office / Win
EMG eq
Dos/Win
Internet

Server - advantagesServer - advantages
• Same program for all users
• easy to update
• easy backup
Stålberg

Server - disadvantageServer - disadvantage
• Vulnerable (breakdown, theft…)
• Integrity
Stålberg

Printers
WG-server
WG
Computer network in the Uppsala labComputer network in the Uppsala lab
KP
Color printers
Secretary/BMA
Printers
R&D
Intranet
Stålberg
administration
scanners

TeleneurophysiologyTeleneurophysiology
in the Uppsala region - earlier methodsin the Uppsala region - earlier methods
Physicians office
Local
network
Server
EEG
ENeG,
Evoked Pot
ENeG
EP
EEG
modem
Acute EEG
Interpretation
mail
Disc / paper
Satellite UAS
Internet
Stålberg

TM for EEG and neurography via hospital intranetTM for EEG and neurography via hospital intranet
NT server
GävleGävle
NT server
UppsalaUppsala
NT server
ÖrebroÖrebro
NT server
EEG-data
HudiksvallHudiksvall
EEG recording
EEG/EMG -
work station
EEG/EMG -
work station
Stålberg

VIDEO CONFERENCE SYSTEMVIDEO CONFERENCE SYSTEM
DOCUMENT- CAMERA
LAN H323/T120
WIN 95/NT
VIDEO CONFERENCE SYSTEM
Camera
8
Mikroph
4
>=ISDN H320 384 Kbit/s
signals
databases LAN

Collaboration
Canada
Germany
Sweden
Hungary
Slovenia
Turkey
Japan
Australia
Finland

2b or not 2b?
• Exam under remote video-supervision
• Signals compressed for telephone
• Decentralized analysis and quality control
Stålberg,2002

Video-guided EMG-investigation
Consultant Investigation at a remote hospital
2-way TV and sound

11111N =
Same muscle/different investigators
NAME
StefanPeoLenaErikArne
Mean+-2SEAMPMEA
550,0
500,0
450,0
400,0
350,0
300,0
250,0
200,0
150,0
100,0
50,0
0,0
phys phys engtechn eng

Strategy YouSir
92.7
Ref value
(CV)
Reporting
Ref value
(CV)
Reporting
Interpret
(EMG)
Interpret
(CV)
Interpret
(EMG)
Anatomy
DB
DD
VISIO
NS
VISIONS
VISIONS
VISIONS
VISIONSVISIONS
VISIONS
VISIO
NS
VISIONS
VISIONS
VISIONS
VISIONSVISIONS
VISIONS
the digital 'smörgåsbord'the digital 'smörgåsbord'
Litterature
Anatomy
DB

Our TM partners
Canada
Germany
Sweden
Hungary
Slovenia
Turkey
Japan
Australia
Finland
Norway
Baltic countries
Russia

Future
• TM wll develop
– national service, helpdesk
• Smaller equipment
– net-meeting, messenger, mobile telephon
• Home- monitoring
• Routines for international collaboration
– Between individer
– Between groups

TM consequencesTM consequences
PositivePositive
• Dayly routine-kamera och biosignaler
– Time saving (waiting list, reports)
– One team
– Qyality is distributed
– Expert available
• Daglig routine- video conferenses
– Rounds, seminars
• Teaching
– Lectures, conferences, konferenser
• Research
– international collaboration Stålberg

Factors for success of TMFactors for success of TM
• Defined idea
• Consensus among partners
• TM is driven by medical needs and by
available technology
• Defined plans for evaluation
Stålberg

• security
– integrity, sekrecy
– Teknical errors (loss or distrosion of data)
• Initial cost
• Technical back up
• Compatibility between equpment
Stålberg
TM consequencesTM consequences
to considerto consider

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