TeleOph: a secure real-time teleophthalmology system.

Teleophthalmology (TeleOph) is an electronic counterpart of today's face-to-face, patient-to-specialist ophthalmology system. It enables one or more ophthalmologists to remotely examine a patient's condition via a confidential and authentic communication channel. Specifically, TeleOph allows a trained nonspecialist in a primary clinic to screen the patients with digital instruments (e.g., camera, ophthalmoscope). The acquired medical data are delivered to the hospital where an ophthalmologist will review the data collected and, if required, provide further consultation for the patient through a real-time secure channel established over a public Internet network. If necessary, the ophthalmologist is able to further sample the images/video of the patient's eyes remotely. In order to increase the productivity of the ophthalmologist in terms of number of patients reviewed, and to increase the efficiency of network resource, we manage the network bandwidth based on a Poisson model to estimate patient arrival at the clinics, and the rate of ophthalmologist consultation service for better overall system efficiency. The main objective of TeleOph is therefore to provide the remote patients with a cost-effective access to specialist's eye checkups at primary healthcare clinics, and at the same time, minimize unnecessary face-to-face consultation at the hospital specialist's center.

A secure and synthesis tele-ophthalmology system.

This paper describes a secure and synthesis ophthalmology telemedicine system, referred to as TeleOph. Under a Secure Socket Layer (SSL) channel, patient prerecorded data can be safely transferred via the Internet. With encrypted videoconference and white-board, the system not only supports hospital-to-clinic consultation, but also supplies hospital-tohospital joint discussion. Based on Directshow technology (Microsoft Corporation, Redmond, WA), video cameras connected to the computer by firewire can be captured and controlled to sample video data. By using TWAIN technology, the system automatically identifies networked still cameras (on fundus and slitlamp devices) and retrieves images. All the images are stored in a selected format (such as JPEG, DICOM, BMP). Besides offline-transferring prerecorded data, the system also supplies online sampling of patient data (real-time capturing from remote places). The system was deployed at Tan Tock Seng Hospital, Singapore and Ang Mo Kio, Singapore, where 100 patients were enrolled in the system for examination. TeleOph can be successfully used for patient consultation, and hospital joint discussion. Meanwhile, TeleOph can supply both offline and online sampling of patient data.