Journal of telemedicine and telecare
-
Multicenter Study
Use of mobile phone cameras for after-hours triage in primary care.
Mobile phone images might be useful in after-hours triage of primary care. We conducted a study to identify population access to mobile phone cameras and to assess the clinical usefulness of mobile phone cameras. The survey was conducted among 480 patients attending two rural New Zealand practices. ⋯ Ten photographable clinical conditions were used to quiz 30 health professionals who were randomized into three groups of 10 each on diagnostic confidence. Images were found to significantly increase diagnostic confidence in all cases except one. It appears that mobile phone cameras are generally acceptable to patients and likely to be of practical use to rural practitioners in a range of clinical scenarios.
-
We reviewed five years' experience of providing ground-to-air medical advice for commercial passenger aircraft. A total of 273 events occurred in-flight where further advice was sought. The most common age group resulting in calls were from those aged 21-30 years, who generated 38 calls (16%). ⋯ Most incidents were managed conservatively in-flight with oxygen and/or other medications. Aircraft diversion occurred on 9% of occasions; cardiovascular and neurological emergencies were the major cause of this. Collaboration between aviation providers should be considered to develop a common database of in-flight emergencies so that contents of medical kits can be standardized in order to improve the quality of care in the air.
-
We investigated the diagnostic agreement between teledermatology based on images from a mobile phone camera and face-to-face (FTF) dermatology. Diagnostic agreement was assessed for two teledermatologists (TD) in comparison with FTF consultations in 58 subjects. In almost three-quarters of the cases (TD1: 71%; TD2: 76%), the telediagnosis was fully concordant with the FTF diagnosis. ⋯ Forty-eight subjects responded to a questionnaire, of whom only 10 had any concerns regarding teledermatology. Thirty-one subjects stated that they would be willing to pay to use a similar service in future and suggested an amount ranging from euro5 to euro50 per consultation (mean euro22) (euro = pound0.7, US $1.4). These results are encouraging as patient acceptance and reimbursement represent potential obstacles to the implementation of telemedicine services.
-
Multicenter Study
Teleradiology in neurosurgery: experience in 1024 cases.
Between June 1995 and June 2000 teleradiology was performed in 1024 neurosurgical cases (945 patients). An analogue image transfer system was used for presentation of computed tomography (CT) and magnetic resonance imaging (MRI) scans from seven referring hospitals in southern Germany. The system used a 19,200 baud modem connection via the ordinary telephone network. ⋯ If each patient had been transferred, then the potential savings for ground transportation were euro339.93 per case (with accompanying physician of the affiliated hospital) or euro373.96 per case (with accompanying experienced ICU physician), respectively (euro1 is US$1.4). The total cost of the image transfer system for all eight hospitals was euro96,000; this was amortised after 282 teleconsultations, which occurred after 15 months of usage. A simple teleradiology system in neurosurgery enables rapid and reliable telephone consultations, mainly on patients with trauma, stroke and intracerebral haematoma at low cost.
-
We conducted a retrospective review to assess the potential for Emergency Nurse Practitioners (ENPs) to deliver telemedicine advice for minor injuries. Over a one-year study period, 835 patients from 15 minor injury units in community hospitals presented to the minor injuries telemedicine service and were seen via videoconferencing by a doctor at the Aberdeen emergency department. ⋯ Assessment of all minor injuries via a telemedicine network by medical staff is unnecessary. An ENP-led service offers a realistic and attractive alternative.