CHILI Newsletter No. 4/2009
DIN 6868-159: A German Standard for Quality Assurance in Teleradiology
This standard has been published in March 2009 at
Beuth-Verlag. Here you can read a summary of a publication to this standard, presented by the authors U. Engelmann and B. Seidel on the occasion of the
CARS 2009.
Teleradiology is probably the most advanced area of telemedicine - at least since the DICOM
standard has become available and daily routine in thousands of installations. The German X-Ray
Ordinance (Röntgenverordnung, RöV) defines and permits the use of teleradiology
for the purpose of primary diagnosis at night and on weekends. The RöV does not address technical issue in great detail.
The German Radiology Standards Committee NAR (Normenausschuss Radiologie), an establishment of the German Standardization Organization DIN and the German Roentgen Society DRG, developed a standard for technical and quality assurance aspects of teleradiology. Dr. Uwe Engelmann, on of the CHILI company founders and first author of the mentioned publication, is member of the NAR himself and head of the working group for developing the standard. Dr. Bernd Seidel, co-author of the publication is director of the NAR.
This standard defines acceptance and constancy tests for teleradiology according to the X-Ray Ordinance in Germany, i.e. it is intended to be applied only to teleradiology setups as defined in the Ordinance. Its scope for example does not cover transmission of (any) images for second opinion or of images produced using technologies other than X-rays (e.g. MRI, Ultrasound).
The standard covers scope, references to other standards, definitions and abbreviations, prerequisites. The main chapters, which include acceptance testing, constancy testing, and documentation, are summarized as follows:
Acceptance Testing
- General requirements: DICOM compatibility, direct telecommunikation between the teleradiologist and those on site fo the radiological examination.
- Documents: Completeness of all required documents and succes of required tests.
- Test media: Test datasets and transmission time.
- Test datasets: A specific test dataset for each body region.
- Compression: Image compressions may be applied without loss of diagnostic image quality (decision of the teleradiologist).
- Transmission time: Images must be available at the receiver's site and the user must be ale to view all images in two different level/window settings within 15 minutes. Push and pull models are distinguished.
- Completeness of data transmission and correctness of textual and structural information.
- Succes and failure feedback: Success or failure of transmissions must be recognized by the teleradiology system.
- Visual correctness: has to be checked by the teleradiologist for every test dataset.
- Stability: The system availability must exceed 98 % p.a.
- Direct telecommunication must be possible within a few seconds.
Constancy Testing
- Operability of the system should be checked with the transmission of an arbitrary dataset;
- Transmission time;
- Completeness of data transmission;
- Image quality has to be checked according to the accepting tests.
The constancy test should be repeated periodically. It is recommended that all tests are performed monthly and operability tests daily.
Outlook
The future will show how this standard will influence teleradiology in Germany. The intention of authors and regulatory authorities is to define a minimal quality of teleradiology systems and to help inspectors and users in establishment and operation of teleradiology setups. The ultimate objective is to help and protect the patients.
All CHILI teleradiogy systems comply with the requirements of this standard and provide functionalities for relieving the technical aspects of acceptance and constancy testing, in particular our teleradiology statistic module.
CHILI GmbH advises our customers on all questions relating the compliance to the standard. We perform the acceptance testing according to DIN 6868-159 ourselves and issue the official certificates.
We would be happy to answer any of your questions relating to this standard or to our products.
Please call us at +49-(0)6221-18079-10 or mail us at
info@chili-radiology.com.
Further Links:
Heidelberg, September 2009
Kind regards from the
CHILI-Team!
. 
