Point-to-point telemedicine using the ISDN

Two pilot telemedicine trials were established, one using basic-rate ISDN (minor injuries service) and one using primary-rate ISDN (remote fetal scanning). Preliminary results were most encouraging. In the first 10 months of operation, 49 patients with minor injuries were managed successfully using telemedicine. Preliminary calculations suggest that the use of a low-cost telemedicine link was extremely cost-effective in comparison with the cost of providing conventional medical cover. In the first six months of operation the fetal scanning link was used for 39 consultations in 29 patients. In 25 cases (86%) a definitive diagnosis was made using the telemedicine link and physical referral was avoided. However, the current cost of the required hardware (approximately 35,000 pounds per end) is likely to militate against the widespread introduction of the technique, especially since the principal savings are intangible from the perspective of any hospital considering purchase. From the point of view of its use as an information transport system for telemedicine, the ISDN proved reliable (only one failure to establish a connection on demand). Picture quality was acceptable in most cases.