The communication concept of a regional stroke unit network based on encrypted image transmission and the DICOM-Mail standard

摘要

This paper describes the communication concept for a regional stroke network for the exchange of medical images and reports. The data transfer is realized with regular e-mail (SMTP). DICOM images are sent as DICOM compliant attachments. Private key encryption is used to ensure data security and privacy. All used protocols are standardized or de-facto standards and allow vendor-independent communication. Different problems and options of the concept realization are discussed. Time is one of the most important factors in the diagnosis, therapy and prognosis of apoplexy or stroke (time is brain!). The German federal state Rhineland-Palatinate (Rheinland-Pfalz) took the political decision to support the establishment of a state-wide competence network. The main purpose is to enable fast and reliable distribution of medical images for the purpose of stroke diagnosis and therapy. The first step is establishing (and funding) of a pilot network connecting the referring hospitals in Neustadt and Worms with the competence centers in Ludwigshafen and Mannheim. Basic requirements have been defined in the request for proposals (RFP) which was organized by a health care consultant company (Pergis, Ludwigshafen, Germany) and a group of subcontracted teleradiology experts. Key requirements of the RFP were the following: