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Exploitable results

Telemedical services for ophthalmology are under development, which will contribute to an improvement of the quality of patient care. The reduction of the incidence of blindness due to diabetic retinopathy and glaucoma is a major issue as well as the achievement of cost-savings for health care systems. Synchronous and asynchronous teleconsultation support the exchange of multimedia patient-data among medical partners. One application is telescreening for diabetic retinopathy that provides new screening tools to improve the interdisciplinary co-operation between diabetologists and ophthalmologists. Knowledge-based information systems allow rapid access to specific information. Computer-assisted processing of fundus images will support screening for diabetic retinopathy. Computer-based monitoring systems integrated with electronic patient data management systems will improve the quality of care for patients with diabetic retinopathy and glaucoma. By means of an on-line register for diabetic retinopathy quality assurance in screening for diabetic retinopathy will be achieved. Two kinds of teleconsultation services are provided: synchronous and asynchronous teleconsultation. A preliminary evaluation showed that in 90 % of the synchronous teleconsultations during the test phase the physicians were satisfied. A tool for platform-independent teleconsultation allowing the use of pre-structured documents has been developed. The interface to patient data management systems has been defined, which allows an automatic in- and export of patient data into these electronic patient record systems. The Ophthalmic Knowledge-based Information System (O-KIS) is available as a demonstrator for diabetic retinopathy. The present version of the knowledge-base is realised by hypertext mark-up language (HTML) pages and the use of JAVA scripts. This version is also available on compact disc read only memory (CDROM). The first step in image processing, the assessment of the image quality, was realised. The glaucoma monitor has already been verified by means of more than 3000 perimetric data sets and the complete data sets of 68 patients.