Multimodal tele-epileptology: Challenges on the way to interoperable medical data

To realize multi-modal data exchange for telemedicine in epilepsy.

TE Ruhr is a multicenter, prospective pilot study. Primary endpoint of the study was the technical implementation of a platform between an epilepsy center and regional neurological departments and international cooperating epilepsy centers, respectively. A multi-professional board was established to develop technical workflows. After completion of the study a survey was conducted among users of the regional arm.

Two workflows were developed, 1) a combination of web-application and use of an established teleradiology network, and 2) a web-application only data exchange. Technical workflow 1 comprised local EEG conversion into to a standard format (.besa) and its shipping as DICOM RAW object. Technically, both workflows could be implemented. Yet, workflow 1 was not realisable in peripheral hospitals. Via workflow 2, 149 consults for 144 patients were completed. Users of the regional arm were satisfied (1.6 on a grading scale of 1-6 (1-very good, 6- very bad)).

Technical feasibility alone does not determine the actual use of telemedicine. Web applications enables multimodal data exchange, but usability is limited due to lack of interoperability.

Genuine interoperability of medical data remains the desired goal for multi modal data exchange.