ARW

I. Introduction to Telemedicine . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ethics and Telemedicine (Dubravko Orlić). . . . . . . . . . . . . . . . . . . . . 3
Telemedicine: what - why - how (Josipa Kern, Luka Kovačić). . . . . . . . . . . . 8
Legal Outlook
Thinking outside the box helps break through barriers
Provider creativity is needed to craft legal and regulatory breakthroughs that will support
deployment of telemedicine technology and applications (Robert Waters) . . . . . . . . 21

II. Telemedicine as a Modern TeleHealth Care of the 21st Century:
Applications and Design . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Telemedicine (Mohan Bansal) . . . . . . . . . . . . . . . . . . . . . . . . . 29

III. Telemedicine Systems and Infrastructure: Overview of Technologies,
Applications and Design . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Standardization in Medical Informatics (Josipa Kern). . . . . . . . . . . . . . . 57
Requirements and Demands of Telemedicine on Computer
and Communication Infrastructure (Predrag Pale) . . . . . . . . . . . . . . . . 61
Telemedicine in Croatia: Overview of Technologies, Applications
and Design (Mladen Kos, Aljoša Pavelin) . . . . . . . . . . . . . . . . . . . . 69
Establishment and Development of e-Health Information System
in Transitional Countries (Croatian Experience)
(Ranko Stevanović, Ivica Klapan) . . . . . . . . . . . . . . . . . . . . . . . . 84
Integrated business-information systems in the construction
of e-Health (Ljerka Luić) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Two-Way Interactive Telemedicine (Mladen Rakic) . . . . . . . . . . . . . . . 97

IV. Distance Learning and Teaching . . . . . . . . . . . . . . . . . . . . . . . 105
Access to Online Medical Information (Jelka Petrak) . . . . . . . . . . . . . . 107
Telemedicine, Distance Learning and Education (Želimir Jakšić). . . . . . . . . 111
Choosing software platform to build educational site (http://web.mef.hr/)
(Milan Taradi, Sunčana Kukolja Taradi) . . . . . . . . . . . . . . . . . . . . 123
Zagreb University Medical School Website - the Groundwork for Integration
of Information Technologies into Medical Education
(Sunčana Kukolja Taradi). . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Cybermed - The First Interactive Health Portal in Croatia
(Dean Delić, Domagoj Parazajder). . . . . . . . . . . . . . . . . . . . . . . 139
Internet Portals: PLIVAmed.net and PLIVAzdravlje.hr
(Igor Haralović, Ivana Klinar) . . . . . . . . . . . . . . . . . . . . . . . . . 144
Experience with CARNet's "Training the Trainers" Online Precourse
(Sonja Prišćan, Jasna Tingle) . . . . . . . . . . . . . . . . . . . . . . . . . 148
Electronic Health Center (eHC)- Web Site for Continuing Education
of General Practitioners (Jadranka Božikov, Hrvoje Iveković, Josipa Kern,
Denis Mladinić-Vulić, Zdravko Ebling, Josipa Kern, Luka Kovačić) . . . . . . . . 158
emedicine.com: An Online Textbook of Otolaryngology - Head
and Neck Surgery and Facial Plastic Surgery (Arlen D. Meyers) . . . . . . . . . 164
World Wide Web in Continuous Medical Education in
Gastroenterology (Roland Pulanić, Hrvoje Iveković, Dražen Pulanić,
Rajko Ostojić, Željko Lepoglavec, Tomislav Brkić, Marina Premužić,
Silvija Čuković-Čavka, Hrvoje Vražić). . . . . . . . . . . . . . . . . . . . . . 169

V. Analysis of Medical Images and Medical Data Security in Telemedicine . . . . . . . . . . . . . 173
Telemedicine and IT System Security
A Few Words of Introduction (Lucijan Carić) . . . . . . . . . . . . . . . . . . 175
DICOM Standard of Medical Imaging Data
(Jadranka Vuković - Obrovac, Karlo Obrovac) . . . . . . . . . . . . . . . . . . 181
Efficient Management of Medical Images (Mario Kovač) . . . . . . . . . . . . 188

VI. Clinical Use of Telemedicine . . . . . . . . . . . . . . . . . . . . . . . . 193
Introduction to Telepathology (Sven Seiwerth) . . . . . . . . . . . . . . . . . 195
A perspective to telepathology: frozen section diagnosis at a distance
(Martin Oberholzer, Hans-Rudolf Fischer, Heinz Christen, Stefan Gerber,
Marcel Brühlmann, Mike J. Mihatsch, Thomas Gahm, Merion Famos,
Christopher Winkler, Peter Fehr, H. J. Hosch, Latti Bächtold) . . . . . . . . . . 200
Teleradiology (Nada Bešenski, Dag Pavić) . . . . . . . . . . . . . . . . . . . 210
Teleradiology: State-of-the-Art in Clinical Environment
(Davide Caramella). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Teleconsultations in Primary Healthcare (Milica Katić) . . . . . . . . . . . . . 229
The Usefulness of Telemedicine for the Detection of Infection/Inflammation
at the Point of Care (Shlomo Berliner, David Zeltser, Rivka Rotstein,
Meirav Rozenblat, Tamar Mardi, Itzhak Shapira) . . . . . . . . . . . . . . . . 235
Telepsychiatry (Rudolf Gregurek) . . . . . . . . . . . . . . . . . . . . . . . 244
Telemedicine and Old Age Psychiatry (Chris J. Ball). . . . . . . . . . . . . . . 251
Teleneurology (Vida Demarin). . . . . . . . . . . . . . . . . . . . . . . . . 256
Application Software - Neuronet (Zlatko Trkanjec) . . . . . . . . . . . . . . . 260
Telemedicine in Cardiology
(Mihajlo Šesto, Zdravko Batinić, Aleksandar Trbović) . . . . . . . . . . . . . . 264
Telemedicine in Pacing (Božidar Ferek Petrić, Ivo Čikeš) . . . . . . . . . . . . 271
A Virtual Instrument for Acquisition and Analysis of the Phonocardiogram
and its Internet-Based Application (Zhenyu Guo, Chris Moulder, Yongning Zou,
Murray Loew, Louis-Gilles Durand) . . . . . . . . . . . . . . . . . . . . . . 281
Applications of Telemedicine in Gynecology and Perinatal Medicine
(Asim Kurjak, Milan Kos) . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Vaginal Hysterectomy Assisted by a Robot in MexicoPossibilities
of Gynecological Remote Surgery in Telemedicine
(José Luis Mosso Vázquez, Arturo Minor Martínez, Verónica Lara Vaca) . . . . . 296
Teletumor Conferencing in Otolaryngology (Arlen D. Meyers) . . . . . . . . . . 302
Computer-Assisted Surgery and Telesurgery in Otorhinolaryngology
(Ivica Klapan, Željko Vranješ, Ranko Rišavi (†), Ljubimko Šimičić) . . . . . . . . 305
Telemedicine, the New Must for Surgery (Peter M. Schlag,
Tomas K. Moesta, Stefan Rakovsky, Georgi Graschew) . . . . . . . . . . . . . 315
Telesurgery (Dragan Schwarz, Jadranko Barišić) . . . . . . . . . . . . . . . . 323
Telemedicine in Neurosurgery (Josip Paladino, Goran Mrak, Predrag Keros) . . . 331

VII. Developmental TeleProjects in Croatian Medicine . . . . . . . . . . . . . 337
Telemedicine Between Patients, Providers and Purchasers
of Healthcare: Reforming HealthCare System in Croatia (Stipe Orešković) . . . . 339
Croatian Telemedicine Program: Active Multilateral Cooperation
in Telecare Development in the 21st Century (Aljoša Pavelin, Ivica Klapan,
Milica Katić, Nives Klapan) . . . . . . . . . . . . . . . . . . . . . . . . . . 346
Telemedicine on the Mediterranean Islands (Anamarija Margan,
Nadan Rustemović) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364
Real-Time Transfer of Live Video Image in Parallel with Volume 3D-Models
of the Surgical Field in Tele-3D-Computer-Assisted Surgery: Two Different
approaches (Ivica Klapan, Ljubimko Šimičić, Ranko Rišavi (†), Karlo Pasarić,
Vlado Sruk, Dragan Schwarz , Jadranko Barišić) . . . . . . . . . . . . . . . . 374
Direct Manufacturing of Customized Medical Implants
(Pero Raos, Ivica Klapan). . . . . . . . . . . . . . . . . . . . . . . . . . . 386

VIII. Presentation of Various International Telemedicine Strategies . . . . . . . 399
Home is where the healthcare is
As options expand for remote patient management, home telehealth merges
with informatics and disease management
(Deborah R. Dakins) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
Telemedicine in the Urban Area (Ueda Toshio) . . . . . . . . . . . . . . . . . 407
A Prospective Evaluation of ENT Telemedicine in Remote Military
Populations Seeking Specialty Care
(Ted Melcer, Bobbi Crann, William Deniston). . . . . . . . . . . . . . . . . . 411
The United States Army Program for Deployment Telemedicine
(Ronald K. Poropatich, Tommy J. Morris, Gary R. Gilbert, Kevin C. Abbott) . . . . 427
Global Vision on Telemedicine / E-Health (Frank Lievens, Malina Jordanova) . . . 436
Telemedicine Standardization in the NATO Environment (David Lam,
Ronald K. Poropatich, Gary R. Gilbert). . . . . . . . . . . . . . . . . . . . . 444

IX. Telemedicine of the 21st Century . . . . . . . . . . . . . . . . . . . . . . . 453
Virtual Reality in Medicine (Sven Lončarić). . . . . . . . . . . . . . . . . . . 455
CAS in Orthopedics (Branislav Jaramaz) . . . . . . . . . . . . . . . . . . . . 475
Use of Telemedicine in Orthopedic Surgery Computer in Preoperative
Planning in Orthopedic Surgery (Ranko Bilić, Robert Kolundžić) . . . . . . . . . 485
Tele-3D-Computer-Assisted Functional Endoscopic Sinus Surgery:
a New Dimension in the Surgery of the Nose and Paranasal Sinuses
(Ivica Klapan, Ljubimko Šimičić, Ranko Rišavi (†), Nada Bešenski,
Karlo Pasarić, Damir Gortan, Dag Pavić, Željko Vranješ) . . . . . . . . . . . . 494
Robot-Assisted Laparoscopy Technological Development in the
CINVESTAV Mexico (José Luis Mosso Vázquez, Arturo Minor Martínez). . . . . . 505
The Use of Telemedicine and Robotics in Gynecology (Miroslav Kopjar,
Igor Maričić, Ivica Ščurić, Mladen Zadro). . . . . . . . . . . . . . . . . . . . 513

X. Feasibility Study of Investment in Telemedicine . . . . . . . . . . . . . 517
An economic Analysis of Teleconsultation in Otorhinolaryngology
(Trine S. Bergmo) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519
Elements of the Preinvestment Study of the Investment in the
"Adriatic-tele doc" Telemedicine Project Enterprise Viewpoint
(Josipa Petrović Zozoli) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528
Project of Implementing Telemedicine into the Healthcare System in Croatia
and Estimate of Economic Validity (Marijan Ožanić, Vesna Boinović-Grubić) . . . 541