PACS/RIS nation-wide connections in a European candidate country: the case of Croatia

Ever since Croatia became an independent country, great changes in its health care system were imminent. Among many, an introduction of IT and telecommuni-cation technologies lead to the implementation of na-tional teleradiology network in 1998. All CT and MRI modalities in 29 county hospitals and university clinics were connected in a nation-wide network with mini PACS/RIS workstation(s) and POTS as telecommunica-tion infrastructure. In first three years of its use, the network resulted in saving more than 400.000 km of patient transportation. The network is still in use, aver-aging in 70-100 consultations per month. By design, the network’ s center is the National referent center for teleneurosurgery at Neurosurgery department at Clini-cal Hospital Center in Zagreb where most of the cases are submitted for consultations. Since installed systems also enable communication between any two network centers, smaller local “ subnetworks” eventually formed. In most cases, installed workstations became seeds of department-wide PACS networks, covering image dis-tribution on the department level as well as reporting, scheduling and image archiving. In 2001, an island telemedicine project was imple-mented, using essentially the same concept but now based on web technologies. This project connected 13 small healthcare centers on 9 islands by the Croatian coast to more than 30 consultant physicians in large hospitals on the mainland. Both systems are growing by the number of participants and the volume of cases. In 2004 two networks will be seamlessly integrated into one unique system.