This paper describes the communication concept for a regional stroke network for the exchange of medical images and reports. The data transfer is realized with regular e-mail (SMTP). DICOM images are sent as DICOM compliant attachments. Private key encryption is used to ensure data security and privacy. All used protocols are standardized or de-facto standards and allow vendor-independent communication. Different problems and options of the concept realization are discussed.

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Provision of global healthcare requires global interoperability of medical services Therefore, the creation of a Virtual EuroMediterranean Hospital for a real integration is proposed. Preoperative planning, intra-operative navigation and minimally-invasive surgery require a digital and virtual environment supporting the perception of the physician. An integrated satellite-internet platform allows for e-learning, real-time telemedicine and medical assistance. Due to the distributed character of the virtual hospital the implementation of Grid-enabled technologies and services becomes important. Keywords Real-time telemedicine AE Satellite-based networks AE Health grid 1 Introduction Telemedicine aims at equal access to medical expertise irrespective of the geographical location of the person in need; it promises equally good healthcare at any time from any location: best healthcare for everyone, anytime, anywhere. New developments in information and communication technologies (ICT) have enabled the transmission of medical images in sufficiently high quality to allow for telediagnosis. At the same time, however, these innovative developments in ICT over the last decade bear the risk of creating and amplifying a digital divide in the world, creating a disparity between the North and the South of the Mediterranean. The digital divide in the field of health care has a direct impact in the daily life of the citizens and on their quality of life. In recent years, different institutions have launched several EuroMediterranean telemedicine projects (amongst others the successful EMISPHER project [1]). All these projects have demonstrated how the digital divide is only part of a more complex problem: the need for integration. Therefore, provision of the same advanced technologies to all states in Europe and its neighbouring regions, should be the final goal to contribute to better integration, bridging the digital divide and thus reducing the disparity in quality of life. Based on successful experiences in the implementation of previous telemedicine projects, an open Euro-Mediterranean consortium proposes the Virtual Euro-Mediterranean Hospital (VEMH) initiative. VEMH aims to facilitate and accelerate the interconnection and interoperability of the various services being developed (by different organisations at different sites) through real integration. This integration must take into account the social, human and cultural dimensions and strive towards common approaches but open and respectful of cultural differences: multi-lateral cooperation instead of aid. MethodsThe EU is committed to realise by 2008 a number of steps forward in the area of e-health: electronic health records, electronic health insurance cards, Europe-wide patient identifiers, interoperability of the various cards, medical e-learning for health professionals, harmonisation of reimbursement and liability issues, as well as a European public health portal for citizens. For the realization of global healthcare dedicated telemedicine and e-health services a...

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