Telecardiology through ubiquitous Internet services

Purpose: Implementation of telemedicine in many clinical scenarios improves the quality of care and patient safety. However, its use is hindered by operational, infrastructural and financial limitations. This paper describes the design and deployment of a plug-and-play telemedicine platform for cardiologic applications. Methods: The novelty of this work is that, instead of complex middleware, it uses a common electronic mailbox and its protocols to support the core of the telemedicine information system and associated data (ECG and medical images). A security model was also developed to ensure data privacy and confidentiality. Results: The solution was validated in several real environments, in terms of performance, robustness, scalability and work efficiency. During the past three years it has been used on a daily basis by several small and medium-sized laboratories. Conclusions: The advantage of using an Internet service in opposition to a server-based infrastructure is that it does not require IT resources to set up the telemedicine centre. A doctor can configure and operate the centre with the same simplicity as any other Internet browser application. The solution is currently in use to support remote diagnosis and reports of ECG and Echocardiography in Portugal and Angola. (C) 2012 Elsevier Ireland Ltd. All rights reserved.