Secure Transmission of Urologic Images and Records over the Internet

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Abstract
Purpose: Telemedicine has become a common method for the transmission of images and patient data across long distances. Our goal was to assess the efficiency and accuracy of Photomailer MD™ software, a store-and-forward telemedicine system, in the urologic setting. Methods: Photomailer MD software was loaded on two computers in the host institution, one with a T1 connection to the Internet and the other with a dial-up modem connection (24,000 bits/second), and computers at three remote sites. A total of 14 clinical cases, comprised of digitized histories and radiographic images, were sent to the remote institutions four separate times using the four transmission modes available: nonencrypted, 56-bit encryption, 128-bit encryption, and 128-bit encryption with password. The following data points were recorded: file size before and after encryption, file transmission times, and diagnostic accuracy of the remote urologists. One-way ANOVA was used to compare mean values statistically, while the z-test...