When doctors send their patients to an X-ray department, the images might be captured in a matter of minutes. But physicians can wait hours or days for the results. Until they know what the pictures have to say, they often can’t prescribe a course of treatment.

The same delay happens for magnetic resonance images, computed tomography, ultrasounds, and other forms of diagnostic pictures used to view the inside of the body.
Now, however, doctors can view radiological images seconds after they’re taken, using a new software system and the Internet. Called MediSurf, the software transmits any digitized image to personal computers equipped with Wed browsers such as Explorer or Netscape. Developed in Israel, the software is being tested in North York General Hospital, just outside Toronto.

Because everyday computers can be used without adding special imaging software, MediSurf makes possible a low-cost network for distribution of diagnostic images or long-distance teleradiology. Moreover, the software is written in the JAVA language, meaning it can run on virtually any kind of computer, from PCs to Macintoshes.

Everyone is talking about moving medical images on the Internet, but so far, these are the only people doing it,” said Dr. Raziel Gershater, chief of diagnostic imaging at North York General. He explained that current radiology networks make use of specialized work stations on a local-area network. Such work stations can cost $50,000 to $250,000.

And while there are teleradiology networks that run on standard PCs, they usually require special software to be installed on each PC. This software can cost $15,000 a computer or more.

These steep price tags have prevented many hospitals from establishing networks to transmit radiological images.

By contrast, MediSurf consists of software on a server that can be accessed by any “plain vanilla” desktop computer equipped with a Web browser.

MediSurf’s other North American test site is the Indiana University Medical Center. Two additional beta sites in Europe are scheduled to begin working with the product as well.

Israel’s Algotec Systems Ltd., a maker of a range of radiological equipment, developed the MediSurf software and claims to be the first on the market with a JAVA-based system for teleradiology. JAVA’s technology has appeared only in the past few years, and most of the applications devised for it are text-based or offer low-resolution images.

By contrast, medical images require much higher resolution. “Producing a JAVA-based system that can handle these sophisticated pictures is something of a technological coup,” said Kobi Margolin, marketing manager for Algotec. “Whether or not the [JAVA] technology could be applied for medical diagnostic images, with their very large data content, was unclear when we started out,” said Mr. Margolin. “We actually proved that the technology is now ripe to handle these images.”

A low-cost Intranet, or the Internet, makes it easier to shuttle diagnostic images around a hospital. In addition, family doctors outside a hospital could hook into the network and gain immediate access to image files for their patients. This would amount to tremendous time saving.

In Dr. Gershater’s office, for example, there was a stack of image files. “I’m calling physicians this afternoon to give them the results of the scans,” Dr. Gershater said. “If they had something like MediSurf, they could have called in already and taken a look for themselves.” North York General intends to add text reports to the images.

In a demonstration of MediSurf at the hospital, Dr. Gershater called up CT images of a patient that had been taken just two minutes earlier. Doctors sending their patients to the hospital for radiographic scans could have the same quick access to diagnostic images, via MediSurf and the Internet. Moreover, they could do it on regular office PCs.

“They could look at images on the same machine they do their accounting on,” said Dr. Gershater.What is the quality of images like? The system can handle up to 16-bit images, which produce pictures of a quality better than most physicians would need. Dr. Gershater believes that eight-bit images might be adequate for non-radiologists.

The software does require that a hospital have digitized images available on a network. For numerous hospitals, this will be the bottleneck, since many do not yet have a picture archiving and communication system (PACS). These newly emerging systems store and transmit diagnostic image files in computerized form, taking the place of traditional film.

Nevertheless, most acute-care hospitals are considering implementing a PACS, and as a result, teleradiology via a local-network or the Internet is only a matter of time.

Dr. Gershater is even using the system from his home. With his desktop PC, he can tap into North York General’s Web site, enter the PACS using his security password and view images on the browser.

MediSurf, moreover, can be used to access a wide range of hospital information, as long as the data is in digital form and available on a network. For example, the system could be used to access patient records, lab results and other reports.

The same technology used in MediSurf to fetch and process medical images can be used for all types of medical data,” said Mr. Margolin of Algotec. We are in contact with a number of hospitals and healthcare organizations who are considering it for this purpose.”

Said Dr. Gershater: “It’s the framework on which the total electronic patient record can be built and accessed.”