Teleneurology service provided via tablet technology: 3-year outcomes and physician satisfaction
Teleneurology service provided via tablet technology: 3-year outcomes and physician satisfaction
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DOI：
10.22605/rrh4743
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发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
Charles, David
中科院分区：
文献类型：
--
作者：
Harper, Kelly;McLeod, Megan;Charles, David
前言：本研究旨在证明，通过平板电脑技术进行远程神经病学会诊是一种在社区医院处理急性神经急诊的有效且经济有效的手段，并且利用这种技术可以产生很高的社区医生满意度。方法：在39个月的时间里，美国田纳西州范德比尔特大学医学中心为10家缺乏足够神经学覆盖面的社区医院提供远程神经病学服务。一家社区医院的住院医生对治疗任何有神经系统症状的患者都感到不舒服，导致这些患者100%被转移。这个机构现在保留了60%以上的神经科患者。只需不到1200美元，这些医院就能够满足推出这项服务所需的唯一资本支出：购买手持平板电脑。使用双向视频会议、放射图像共享和病历记录，通过平板电脑进行实时远程神经病学会诊。结果：2014年2月至2017年5月，共开展远程神经病学会诊3626次。社区医生与神经科医生合作，成功地管理了社区医院87%的患者。只有13%的患者需要转移到另一家机构接受更高水平的护理。最常见的诊断包括中风(34%)、癫痫(11%)和头痛/偏头痛(6%)。神经科医生回答咨询页面请求并与社区医生联系的平均时间为10.6分钟。91%的社区医生对整体服务感到满意或部分满意。结论：在对神经科患者的评估中，平板电脑是一种比传统远程医疗技术更具成本效益的选择。这些设备通过易用性和低转移率提高了会诊效率，调查结果表明社区医生对此感到满意。
Introduction: This study aimed to demonstrate that teleneurology consultations conducted via tablet technology are an efficient and cost-effective means of managing acute neurologic emergencies at community-based hospitals and that utilizing such technology yields high community physician satisfaction.Method: During a 39-month period, Vanderbilt University Medical Center in Tennessee USA, provided teleneurology services to 10 community-based hospitals that lacked adequate neurology coverage. Hospitalists at one community-based hospital were not comfortable treating any patient with a neurologic symptom, resulting in 100% of those patients being transferred. This facility now retains more than 60% of neurology patients. For less than US$ 1200, these hospitals were able to meet the only capital expenditure required to launch this service: the purchase of handheld tablet computers. Real-time teleneurology consultations were conducted via tablet using two-way video conferencing, radiologic image sharing, and medical record documentation. Community physicians were regularly surveyed to assess satisfaction.Results: From February 2014 to May 2017, 3626 teleneurology consultations were conducted. Community physicians, in partnership with neurologists, successfully managed 87% of patients at the community-based hospital. Only 13% of patients required transfer to another facility for a higher level of care. The most common diagnoses included stroke (34%), seizure (11%), and headache/migraine (6%). The average time for the neurologist to answer a request for consultation page and connect with the community physician was 10.6 minutes. Ninety-one percent of community physicians were satisfied or somewhat satisfied with the overall service.Conclusion: In the assessment of neurology patients, tablets are a more cost-effective alternative to traditional telehealth technologies. The devices promote efficiency in consultations through ease of use and low transfer rates, and survey results indicate community physician satisfaction.