Tertiary telemedicine support during global military humanitarian missions.
Tertiary telemedicine support during global military humanitarian missions.
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DOI：
10.1089/tmj.1.1996.2.201
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发表时间：
1996-01-01
期刊：
影响因子：
--
通讯作者：
Zajtchuk, J
中科院分区：
文献类型：
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作者：
Gomez, E;Poropatich, R;Zajtchuk, J
目的：美军医疗部队面临着向世界偏远地区提供最新医学知识和进步的挑战。这项研究详细说明了沃尔特里德陆军医疗中心(WRAMC)在世界各地为这些人道主义任务提供的第三级医疗远程医疗支持。方法：这项研究包括从1993年2月到1996年2月最早部署卫星系统以来，WRAMC收到的所有临床咨询的数据。会诊内容包括会诊类型、会诊专科、会诊响应时间、会诊技术等。结果：共收到来自12个远程医疗会诊站点的240份会诊。咨询使用了“存储转发”技术和交互式视频会议系统的组合。在WRAMC建立了远程医疗服务，包括医疗和技术支助人员，促进了远程医疗会诊的提供。支持了几个同时进行的特派团。咨询的分布包括内科(40%)、外科(36%)、放射科(21%)和牙科(3%)。最常咨询的医学专业是皮肤科(29%)，其次是整形外科(16%)。大多数咨询是常规咨询(88%)。94%的会诊是在预定的远程医疗响应标准内完成的(常规会诊24小时，紧急会诊3小时)。结论：这项研究说明了在支持同时执行医疗任务的三级机构提供响应的远程医疗服务的重要性。获得完整的内科和外科专科对于加强医疗保健的提供至关重要。对这一经验的批判性分析和评估将有助于设计未来评估远程医疗的前瞻性研究。
OBJECTIVE: The U.S. military medical units face the challenge of delivering the latest medical knowledge and advances to remote areas of the world. This study details the tertiary care telemedicine support by Walter Reed Army Medical Center (WRAMC) for these humanitarian missions in several locations worldwide.METHODS: This study encompasses data from all clinical consults received at WRAMC, from the earliest deployment of a satellite-based system in February 1993 through February 1996. The analysis of the consultations include type of consult, medical specialty consulted, response time, and technology used.RESULTS: Two hundred forty consults were received from 12 remote telemedicine sites supporting military medical missions. The consults used a combination of "store-and-forward" technologies and interactive video conferencing systems. Establishment of a telemedicine service at WRAMC, including medical and technical support personnel, facilitated the delivery of telemedicine consultations. Several concurrent missions were supported. The distribution of consults included medicine (40%), surgery (36%), radiology (21%), and dentistry (3%). The most frequently consulted medical subspecialty was dermatology (29%) followed by orthopedic surgery (16%). Most consults were routine (88%). Ninety-four percent of the consults were completed within the predefined telemedicine response criteria (24 hours for routine consults and 3 hours for emergencies).CONCLUSION: The study illustrates the importance of a responsive telemedicine service at a tertiary facility supporting simultaneous medical missions. Access to the complete spectrum of medical and surgical specialties was essential to enhancing the delivery of medical care. The critical analysis and evaluation of this experience will assist in designing future prospective studies for evaluation of telemedicine.