TechTip: Setting up a telemedicine system

TeleMedMail is an open source software developed to simplify the process of sending patient details, including photos, from a hospital or health centre to a specialist for diagnosis or second opinion. One main advantage of TeleMedMail is that it can store the request for information, making it useful for clinics with irregular or dial-up internet connections. Also, the software is written in Java which means it can run on any operating system (requires Java 1.3 or higher).

Getting started

The software is free to download from the TeleMedMail project page on the SourceForge website: http://sourceforge.net/projects/telemedmail

Click on ‘Download’. You are then given a choice to download a compact version of the software (1.3 MB) or the full version (7.6 MB). The file has been compressed to make it quicker and easier to download.

Open the downloaded folder and click on the install icon. Your computer will ask if you want to extract the files, click ‘Yes’ and the computer will automatically extract the install files to a new folder.

Open the new TeleMedMail folder and click on the ‘Install TeleMedMail.bat’ file. Your computer might flash up a security warning asking if you want to run the software, click ‘Run’ to continue.

A window will pop up with the words ‘Enter value’ and suggest a location on your computer to install the software, for example, ‘c:\TeleMedMail’. If this location is acceptable click the ‘Install’ button on the right hand side of the box, or change the location then click ‘Install’. This will load the software onto your computer.

If installation was successful you will see a dialogue box with the words ‘TeleMedMail installation complete’ and there should be a small TeleMedMail icon on your desktop. Click the icon to start the program.

Set Up

The first time you start the program you will be asked to fill in a few details to configure the software. Fill in your email address and the outgoing (SMTP) server address. You can also include a different return address if you want replies to come to another email account, otherwise leave the field marked ‘SMTP username’ blank. You can add multiple email address, just separate them with a comma.

You can also choose which language you want the program to run in although, at the moment, you can only choose between English and Spanish. You can also set the ‘Default Image Directory’ folder which will be the first folder the program opens when you want to attach an image file (e.g. a digital x-ray photo). You can choose the ‘images’ folder created within the TeleMedMail directory or link it to your own ‘My Pictures’ folder, for example. Once you have completed the configuration click ‘Apply’. You can always change these details later from the ‘Edit settings menu’.

Sending patient details

To prepare a new file for a patient click ‘File’, ‘New Case’. There are several fields for the nurse or doctor to fill in, including the name of the referring hospital, the date, case number and basic patient information such as name, age and gender. There is also space for entering patient history, details of any physical exams and investigations already carried out and a provisional diagnosis.

Enter the data as required along with the email addresses of the referring hospital or doctor and of the specialist who is to receive the data.

You can also attach a digital photo relevant to the case, an image of the injury, for example, or skin rash or even an x-ray. Click on the ‘Import Image’ button on the right hand side of the TeleMedMail window. A new window will open where you can browse for the correct image file that goes with the patient’s information. Find the file, click on it and then click ‘Open’. The software will then load the image. TeleMedMail then allows you to ‘Crop’ the image so that only the relevant area of the photo is sent, or ‘Rotate’ the image to face the right way and to ‘Annotate’ the image with detailed comments indicating specific points.

When all the information is entered click ‘Send Email’. A new window will open with the email address of the referring hospital and the receiving specialist. There is also space to add extra information to the receiving doctor. At the top of the window is a small box with ‘Encrypt Case’. When you click this then click ‘Send’ you will be prompted to enter a password. These case files can then only be opened by anyone with the password. Confirm the password in a separate phone call to the specialist. It should also be noted that TeleMedMail will need to be installed on the specialist’s computer too.

Click ‘File’ and ‘Save Case’ to save this file if you want to refer to it at a later date.

For more information go to: www.telemedmail.org

Taking a digital photo of an x-ray
Modern x-ray equipment often automatically takes digital images. There are also specialized scanners to digitize x-rays but it is also possible to take a photo of a traditional x-ray using a digital camera. Ideally, the camera should be on a tripod to make sure there image is not blurred by movement. Then take the picture with the x-ray on a normal x-ray viewing lightbox, although you might have to dim the lights in the room to get a good, sharp photo. Download and save the photo onto the computer in the usual way (usually via the USB cable).

08 April 2009

Copyright © 2014, CTA. Technical Centre for Agricultural and Rural Cooperation (ACP-EU)