Remote Diagnosis Using A Cooperative Worstation Technology, Ergonomics And Psychology

Abstract

Communication between physicians and between members of the health care teams as a whole represents a capital element of the quality of care provided. The development of multi-media workstations and new public networks of telecommunication can modify the mode of relation classically in usage between physicians.Tele-diagnosis in particular, is made possible, by physicians cooperating together through the communicating workstations.We wish to report here on the functioning of an experimental station developed in the field of obstetrics, particularly to help midwives in the interpretation of fetal echography. We also intend to underline the ergonomical problems that occur with this new mode of information processing. 1) 1.1) Aims. Computer tools and means of telecommunication are available today to make communication possible between health care providers. The development of workstations comprising multi-media interfaces and software means that physicians can consult, archive and index complex documents with such tools as: multi-media data base management, Picture management, Sound elements (voice, noise, audiocommentary), etc...The aim of our work is to develop a multi-media communicating workstation, to define its functionalities in a given environment and to test it for operationality in order to improve it and integrate it in a real working environment.1.2) The medical task. We have chosen to develop this workstation for echography consultation in the course of pregnancy. In France, expectant mothers undergo an echography screening during the third and sixth months of pregnancy. This is where constitutional or genetic anomalies of the foetus can be detected. These examinations are therefore not only systematic and of course part of a routine but are important where diagnosis is concerned.Since they are performed routinely, they are usually carried out by midwives. When an anomaly is noticed or suspected. the expectant mother is called in for further examination a few days later. Results provide extra information for the patient's medical record, which can be referred to on later consultations. If necessary, pictures can be stored in the record.