Journal of telemedicine and telecare
-
Over three and a half years there were 200 teleconsultations between emergency nurse practitioners at a minor accident and treatment service and the orthopaedic service of a main hospital. The main problems were fractures (93% of cases). The reasons for consultation fell almost equally into four groups: request for direct ward admission; discussion and decision about treatment; decision about the disposition of a case; and diagnosis. ⋯ Following the teleconsultation, 39% of patients were admitted to hospital, 6% were transferred to the accident and emergency department for a face-to-face consultation, and 56% were discharged and referred to a review clinic. Of the 200 cases, 193 needed teleradiology and the nurse practitioners and the orthopaedic registrars diagnosed all these cases correctly, as judged by the subsequent radiologist's report. Teleconsultations save time and prevent the unnecessary transfer of patients to main hospitals.
-
A telemedicine link was installed between a mining town in Western Australia and clinical specialists in Perth, about 1800 km away. Standard commercial videoconferencing units connected by ISDN at 128 kbit/s were used. ⋯ About one-third of the injuries to mining construction workers were eye problems. In more than 75% of teleconsultations a patient transfer to Perth was avoided.
-
The financial and personal burden of chronic cardiac disease is high. Costs are likely to increase over the next few decades. ⋯ Telehealth has been applied to the capture of symptoms of cardiac disease with electrocardiography and echocardiography, to the management and rehabilitation of recently discharged patients, and in peer-to-peer consultation where remote expertise can facilitate diagnosis. Telehealth promises cost reductions in service delivery, although there is a need for properly controlled cost-effectiveness trials to underpin telehealth with a firm evidence base.
-
We conducted a feasibility study of a mobile unit capable of recording a 12-lead electrocardiogram (ECG) and transmitting it to a receiving hospital workstation. Two ambulances were equipped with the mobile unit and the ECGs recorded were compared with standard ECGs recorded on the hospital ward after admission. In six months, 62 patients participated in the study. ⋯ Comparative hospital and mobile ECGs were available for 31 patients. Although the mobile unit recorded smaller R- and S-wave deflections than on the standard hospital ECGs, the medical and nursing staff were able to differentiate between normal and abnormal tracings. The mobile unit may be useful to triage patients with chest pain before they reach hospital.
-
In order to improve the distance teaching of minimally invasive surgery techniques, an integrated system has been developed. It comprises a telecommunications system, a server, a workstation, some medical peripherals and several computer applications developed in the Minimally Invasive Surgery Centre. The latest peripherals, such as robotized teleoperating systems for telesurgery and virtual reality peripherals, have been added. The visualization of the zone to be treated, along with the teacher's explanations, enables the student to understand the procedures of the operation much better.