The possibilities of teleradiology to modify the radiological service process in a regional,international and mobile setting were investigated by building new types of technical connectionsand then by evaluating their feasibility.

First a teleradiology link based on low-end technology was built for primary care and hospitalsettings. On evaluation, the total diagnostic agreement between the transmitted images and theoriginal films was 98%.

Then, a work practice-oriented approach was used to gain an understanding of the relationshipbetween the emerging teleradiology work practice and the newly implemented technology.Ethnographically informed fieldwork and cooperative workshops were utilized. According tofindings, articulation work that supports the key tasks is mostly conducted at the receiving site,and radiologists have to rely on much less information in image interpretation. The decisions madeat the sending site influence the outcome.

To study the idea of consultations between different countries, a connection utilizing theInternet was built between university hospitals in Oulu, Reykjavik and Tromsø. After 131 images,a suitable image compression ratio was selected. Image quality and transfer time of the 80 clinicalcase readings were found to be adequate for teleradiology.

A wireless image consultation system for radiological sub-specialist consultations based on aportable computer and a mobile phone with secure access to the hospital network was set up andtested. The transmitted images of 68 patients were acceptable for final diagnosis in 72% of thecases. The wireless link saved the senior radiologist a hospital visit in 24% of the cases.

A smartphone was then used to communicate computed tomography scans in a feasibility studyof 21 patient cases of brain attacks. All transmitted image series were suitable for giving apreliminary consultation to the clinic, and in one case even a final report could be made. In a reallife clinical setting of the study with neuroradiological and neurosurgical emergencies, twodifferent smartphone platforms with electronic patient record integration were built in Europeanresearch projects and evaluated with sets of 115 and 150 patient cases. They were good for finaldiagnosis in 38% and 40% of the cases, respectively. The concept was found to be ready forclinical use.

Finally a survey was made showing the status and trends of the usage of eHealth applicationsin Finland. The results from all the public health care providers and a representative sample ofprivate providers showed that in 2005, teleradiology services were used by 18/21 hospital districtsand the usage of all eHealth applications has progressed throughout the entire health care deliverysystem. Teleradiology services have become an integrated part of eHealth.