The article describes a teleradiology system intended to provide a user-friendly environment for exchanging images and working cooperatively on them. With the development of a hospital-wide picture archiving and communication system (PACS), the University Hospital of Geneva and several other health institutions in the region became interested in teleradiology. Because of the heterogeneous needs of the potential participants, the following requirements were identified: (1) remote consultation and interpretation of images; and (2) cooperative interpretation of medical images, allowing real-time interaction between physicians. To satisfy these needs, a multipoint teleradiology system has been implemented that incorporates an innovative image display and manipulation software program known as OSIRIS, which supports the full spectrum of imaging modalities. Images and data are transmitted over the public telecommunications Integrated Services Digital Network (ISDN). To accommodate different computing environments at the various locations, platform-independent software has been designed that has the same "look and feel" for PC-Windows, Macintosh, and UNIX-X11 work-stations. The teleradiology system can be used in two modes: synchronous (cooperative) or asynchronous. Special efforts have been made in the development of the synchronous mode. Within the European Telemed Project, a specific protocol has been designed to allow cooperative work between remotely located workstations.
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