Smart homes - current features and future perspectives.

Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine's current use bears testimony to its effectiveness and potential. Telemedicine's widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits.

https://pediatrics.aappublications.org/content/pediatrics/early/2015/06/23/peds.2015-1517.full.pdf

Telemedicine: Pediatric Applications

The Breast Imaging Reporting and Data System ® (BI-RADS ® ) initiative, instituted by the ACR, was begun in the late 1980s to address a lack of standardization and uniformity in mammography practice reporting. An important component of the BI-RADS initiative is the lexicon, a dictionary of descriptors of specific imaging features. The BI-RADS lexicon has always been data driven, using descriptors that previously had been shown in the literature to be predictive of benign and malignant disease. Once established, the BI-RADS lexicon provided new opportunities for quality assurance, communication, research, and improved patient care. The history of this lexicon illustrates a series of challenges and instructive successes that provide a valuable guide for other groups that aspire to develop similar lexicons in the future.

The ACR BI-RADS® Experience: Learning From History

This technical standard has been revised by the American College of Radiology (ACR), the American Association of Physicists in Medicine (AAPM), and the Society for Imaging Informatics in Medicine (SIIM).

For the purpose of this technical standard, the images referred to are those that diagnostic radiologists would normally interpret, including transmission projection and cross-sectional X-ray images, ionizing radiation emission images, and images from ultrasound and magnetic resonance modalities. Research, nonhuman and visible light images (such as dermatologic, histopathologic, or endoscopic images) are out of scope, though many of the same principles are applicable.

Increasingly, medical imaging and patient information are being managed using digital data during acquisition, transmission, storage, display, interpretation, and consultation. The management of these data during each of these operations may have an impact on the quality of patient care.

This technical standard is applicable to any system of digital image data management, from a single-modality or single-use system to a complete picture archiving and communication system (PACS) to the electronic transmission of patient medical images from one location to another for the purposes of interpretation and/or consultation.

It defines goals, qualifications of personnel, equipment guidelines, specifications of data manipulation and management, and quality control and quality improvement procedures for the use of digital image data that should result in high-quality radiological care. A glossary of commonly used terminology (Appendix A) and a reference list are included.

In all cases for which an ACR practice guideline or technical standard exists for the modality being used or the specific examination being performed, that practice guideline or technical standard will continue to apply when digital image data management systems are used.

Digital mammography is outside the scope of this document. For further information, see the ACR–AAPM–SIIM Practice Guideline for Determinants of Image Quality in Digital Mammography.


The goals of the electronic practice of medical imaging include, but are not limited to:


Initial acquisition or generation and recording of accurately labeled and identified image data.


Transmission of data to an appropriate storage medium from which it can be retrieved for display for formal interpretation, review, and consultation.


Retrieval of data from available prior imaging studies to be displayed for comparison with a current study.


Transmission of data to remote sites for consultation, review, or formal interpretation.


Appropriate compression of image data to facilitate transmission or storage, without loss of clinically significant information.


Archiving of data to maintain accurate patient medical records in a form that:

May be retrieved in a timely fashion


Meets applicable facility, state, and federal regulations


Maintains patient confidentiality





Promoting efficiency and quality improvement.


Providing interpreted images to referring providers.


Supporting telemedicine by making medical image consultations available in medical facilities without on-site medical imaging support.


Providing supervision of off-site imaging studies.


Providing timely availability of medical images, image consultation, and image interpretation by:

Facilitating medical image interpretations in on-call situations


Providing subspecialty support as needed.





Enhancing educational opportunities for practicing radiologists.


Minimizing the occurrence of poor image quality.




Appropriate database management procedures applicable to all of the above should be in place.

/pdf/acr-aapm-siim-technical-standard-for-electronic-practice-of-17uzet0xuy.pdf

ACR–AAPM–SIIM Technical Standard for Electronic Practice of Medical Imaging

Teleradiology—the ability to obtain images in one location, transmit them over a distance, and view them remotely for diagnostic or consultative purposes—has been explored for nearly 50 years and is part of the more encompassing concept of “telemedicine”—the delivery of health care services over a distance. Major advances in telecommunications and computer systems and advances in the ability to capture medical information in digital form have accelerated the ability to apply telemedicine methods in a practical and affordable manner. These enabling factors are especially relevant to radiology, which currently stands out as one of the most technologically and clinically advanced areas for telemedicine applications.

Teleradiology Part I. History and Clinical Applications

Telemedicine is becoming an increasingly important tool in the practice of medicine throughout the world. For radiologists, telemedicine translates to teleradiology. Because an increasing amount of imaging is now archived in a digital format, and with the application of more powerful computers in radiology, digital image transmission between display stations is becoming commonplace. The ability to move large diagnostic image data sets to display stations anywhere in the world using the Internet and other high-speed data links is solving some problems and creating others. Medicine and radiology will be challenged in many ways by the issues created from the application of this burgeoning technology. Our task force was charged with investigating the evolving practice of international teleradiology and with developing a pubic statement to be adopted by the ACR Council (http://www.acr.org). This white paper is our effort to define those issues we believe to be most pertinent to international teleradiology as we know them today. Will these issues be changing? Certainly. For some facets of the issue, there are currently more questions than answers. We describe several scenarios that we believe are acceptable practices of international teleradiology as well as some that are not. We believe that much will be written about international teleradiology in the future as the issues of credentialing, quality assurance, licensure, American Board of Radiology certification, the maintenance of certification, jurisdictional and medical liability issues, patient privacy, fraud and medical ethics are more precisely defined and shaped by state and federal legislation and medical jurisprudence. This white paper is our assessment of what we believe to be the major challenges that exist as of this writing.

Report of the ACR task force on international teleradiology.

The ACR and the Society of Breast Imaging have revised the curriculum for resident and fellow education in breast imaging on the basis of substantial changes in breast imaging practice since the initial curriculum was published in 2000. This curriculum provides guidance to academic chairs, residency program directors, and academic section chiefs in assessing and improving their residency and fellowship training programs and indicates to residents and breast imaging fellows the topics they need to learn and the experience they should try to acquire during their training. Radiologists already in practice also may find the curriculum useful in outlining the material they need to know to remain up to date in the practice of breast imaging.

American College Of Radiology/Society of Breast Imaging curriculum for resident and fellow education in breast imaging

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Report of the ACR task force on international teleradiology.

American College Of Radiology/Society of Breast Imaging curriculum for resident and fellow education in breast imaging