IN THE NAME OF GOD ALMIGHTY

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IN THE NAME OF GOD ALMIGHTY

• ??? ???? ?????? ??????

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Dr. MIRZA SHAHID ARSHAD

• INTERNATIONAL MAN OF
• THE YEARS IN MEDICINE
• INTERNATIONAL SCIENTIST
• OF THE YEARS IN MEDICINE
• SURGERY
• IRAN / PAKISTAN

1998-1999 2000-2001
2002 2004
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DR. SHAMSI ALLAMI

• 20 TH CENTURY AWARD FOR
• OUTSTANDING ACHIEVEMENT
• IN
• PAEDIATRICIAN
• TEHRAN UNIVERSITY OF MEDICAL SCIENCES , IRAN.

MEDICINE
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LATEST ON USES OF E-MAIL and 3D PACS IN THE
CLINICAL SETTING                Dr.Mirza Shahid
Arshad,Dr.Shamsi Allami, Dr.Ibrahim
Mansoor 4th INTERNATIONAL CONGRESS OF
E-HEALTH MINISTRY of HEALTH,IRAN W.H.O 7 - 9
SEPT. 2004,Tehran,Iran
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Abstract  In the clinical setting,E-mail holds
out great promise.At the doctor -to-doctor
interface there is evidence thar e-mail is being
used regularly.Many internet  discussion lists
have over 1000 subscribers.Internet conferences
and computer e-mail-assisted group as are
innovative means of offering health and mental
sevices.The use of e-mail discussion groups by
group practioners increases accessibility,convenie
nce and anonymity.E-mail can also help in the
diagnostic fields of medicine e.g exchange of
pathology and radiology images for consultations
and discussions.Newly evolved JPEG compression
process shrinks the image files from a megabyte
to one-tenth the size and makes their transfer by
e-mail much easier.In doctor patient
relationship,they can communicate with each other
that is convenient to each other.We will present
latest on 3D image transfers by e-mail and other
radiological transfers by video format too,and 3D
PACS too.
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Introduction We are truly in an era of
information and communication, communicating and
moving vast amounts of information quickly across
great distances is one of the  most vital needs
in medine today.Doctors and researchers all over
the world are acknowledging now these
facts.Immediate access to the work of colleagues
and a vitrtual library of millions and thousands
of volumes and thousands of papers affords them
the ability to incorporate a body of knowledge
hereto unthinkable.Groups of doctors and
researchers can now conduct interactive 
conferences and discussionswith each other,paying
no heed to physical location,the possibilities
are endless.This paper brings attention to some
critical uses of E-mail services for doctors to
increase their professional skills and patient
care.Also internet being primarily a
communication medium and another focus will be on
the transmission of 3D radio-logical images by
internet.
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MethodsDuring my administration at
Al-ShafaHospital,Gujrat,Pakistan, we started
using E-mail routinely in the clinical settings
e.g.we communicated at doctor-to-doctor interface
to great effect.We also subscribed to internet
discussion lists and realized that E-mail was far
better tha other forms of communication such as
paper,  phone etc. We also started internet
conferences and computer e-mail-assisted groups
offering innovative means of health and mental
health services.We started exchange of
pathological and radiological images for
consultations by Email  making more expert
opinions available,improving diagnosis.We used
the JPEG compression process shrinking the image
files to one tenth their sizes making the
transfer of images much easier.We also
communicated with our patients,thus establishing
a doctor patient relationship by E-mail,thus
allowing patients 24 houraccess to doctors,and we
could keep records of these exchanges.We  also
used PACS(Picture archiving communication system)
at our hospital and by delivering and viewing 3D
images both by e-mail or by PACS we wereableto 
revolutionize medicine in Pakistan.
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ResultsIt is clearly indicated that the benefits
of using E-mail technology in all fields
mentioned above included increased
accessibility,convenience and secrecy.Low paid
physicians even could acquire or send images
anywhere in the world even USA  quickly,diagnoze
them properly,and relay their findings back to
USA or elsewhere,or vice versa via e-mail.There
was no reason why a Pakistani doctor could not
stare deeply into a computer screen and do just
as good a job as a colleague in the USA.PACS and
3d image views made our hospital filmless thus
releiving us of the headaches of
storage,processing,time,staff etc. associated
with radiological films,thus making it very
economic.There is unparalleled ease of use by
PACS and 3D viewers incorporating live images for
saving our work,slab rendering and MIP
viewing,oblique,double oblique and curved MPR,3D
movie capture and multislice viewing and 2D
comparison.
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DiscussionE-mail has become an important way of
work being carried out.However use of e-mail
communication with patients creates also a new
set of dangers which doctors must consider.What
defines the doctor- patient relationship,should
diagnosis be made and delivered by e-mail,how can
privacy and confidentiality be maintained,can
medical marketing be carried out by e-mail.Many
researchers have addressed these issues from a
medicolegal perspective and offered advice on
professional and ethical ways to communicate with
patients via e-mail.A growing number of online
professionals are happy to offer advice and
information to anyone who contacts them through
internet/e-mail,thus enabling doctor-patient
relationship to extend beyond traditional
geographic boundaries.Though these virtual
providers e.g. cannot undertake a physical
examination,prescribe drugs or offer any
follow-up care,a recent edition ofthe Ferguson
report concluded that these doctors are acting as
a valuable resource for patients.
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Many online patients say they are more
comfortable exchanging e-mail with an on-line
doctor they have never met than discussing their
medical concerns with their own physicians.Indeed
a number of medical unions and associations have
expressed concerns about the clinical use of
e-mail in day to day practise and have produced
best practising guidelines for managing
doctor-patient exchanges over the internet.E-mail
also represents another venue of enquiry,which in
addition to phone(mobile and fixed line),fax and
letters take up time.PACS provides data
acquisition,quality control,viewing,archiving,prin
ting Teleradiology,image distribution.HIS/RIS
integration and reports.The revolution in 3d
medical imaging has proved very valuable in many
clinical scenarios.
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ConclusionThis paper has thrown lights on the
benefit of the uses of e-mail in a clinical
setting.It will explode and grow more once
hospital staff and doctors are encouraged to have
their own e-mail and web access and develop their
own web-sites.They should place thier e-mail
contact addresses on their visiting cards and
pads.This is not crtstall ball gazing,all
clinical units having their own web sites will
become the norm in the not too distant future.We
should try to adopt these advances as fast as
possible because they are going to be standards
of practise very soon.Also PACS and.3D viewers
provide superior visualization,minimize the risk
of invasive procedures and improves the speed and
accuracy of treatment planning.