Do You See What I See? Insights from Using Google Glass for Disaster Telemedicine Triage
Do You See What I See? Insights from Using Google Glass for Disaster Telemedicine Triage
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DOI：
10.1017/s1049023x1400140x
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发表时间：
2015-02-01
影响因子：
2.2
通讯作者：
Cone, David C.
中科院分区：
文献类型：
--
作者：
Cicero, Mark X.;Walsh, Barbara;Cone, David C.
介绍：灾难是高风险、低频率的事件。远程医疗可能会为医护人员进行灾难分类提供一个有用的辅助工具。这项研究的目的是确定远程医疗在灾难分诊中的可行性，并确定远程医疗是否会影响分诊的准确性或执行分诊所需的时间。方法：这是一项可行性研究，两名护理人员组成的干预小组使用移动设备Google Glass(谷歌公司；美国加利福尼亚州山景城)与一名非现场医生灾难专家进行交流。在一个商业机场的三年一度的演习中，护理小组对模拟灾难受害者进行了分流。模拟受害者已经预先分配了预期的分诊水平。这位医生与护理团队有一个音频-视频接口，能够远程观察受害者。由两名护理人员组成的控制小组以通常的方式进行灾难分类。两个团队都使用了智能分诊系统(TSG Associates LLP；英格兰哈利法克斯)，该系统将患者分配到红色、黄色、绿色和黑色分诊类别。护理人员被录像，他们进行分诊所需的时间被记录下来。确定了干预组和控制组在分类准确性方面是否存在差异。最后，比较了干预组在使用远程医疗时与不使用远程医疗时对患者进行分诊所需的时间。结果：两个小组对相同的20名患者进行了分诊。两组总体分诊准确率无显著差异(干预组为85.7%，对照组为75.9%；P=0.39)。两名患者接受了远程医疗分诊。对于干预组，接受远程医疗的患者与未接受远程医疗的患者进行分诊的时间有显著差异(35.5秒；95%可信区间，72.5%~143.5秒对18.5秒；95%可信区间，13.4%~23.6秒；P=0.041)。结论：护理人员使用远程医疗评估灾民时，分诊准确率没有增加，而且远程医疗比传统分诊需要更多的时间。现有技术存在一些障碍，如果克服这些障碍，可能会提高远程医疗在应对灾害中的效用。
Introduction: Disasters are high-stakes, low-frequency events. Telemedicine may offer a useful adjunct for paramedics performing disaster triage. The objective of this study was to determine the feasibility of telemedicine in disaster triage, and to determine whether telemedicine has an effect on the accuracy of triage or the time needed to perform triage.Methods: This is a feasibility study in which an intervention team of two paramedics used the mobile device Google Glass (Google Inc; Mountain View, California USA) to communicate with an off-site physician disaster expert. The paramedic team triaged simulated disaster victims at the triennial drill of a commercial airport. The simulated victims had preassigned expected triage levels. The physician had an audio-video interface with the paramedic team and was able to observe the victims remotely. A control team of two paramedics performed disaster triage in the usual fashion. Both teams used the SMART Triage System (TSG Associates LLP; Halifax, England), which assigns patients into Red, Yellow, Green, and Black triage categories. The paramedics were video recorded, and their time required to triage was logged. It was determined whether the intervention team and the control team varied regarding accuracy of triage. Finally, the amount of time the intervention team needed to triage patients when telemedicine was used was compared to when that team did not use telemedicine.Results: The two teams triaged the same 20 patients. There was no significant difference between the two groups in overall triage accuracy (85.7% for the intervention group vs 75.9% for the control group; P=.39). Two patients were triaged with telemedicine. For the intervention group, there was a significant difference in time to triage patients with telemedicine versus those without telemedicine (35.5 seconds; 95% CI, 72.5-143.5 vs 18.5 seconds; 95% CI, 13.4-23.6; P=.041).Conclusion: There was no increase in triage accuracy when paramedics evaluating disaster victims used telemedicine, and telemedicine required more time than conventional triage. There are a number of obstacles to available technology that, if overcome, might improve the utility of telemedicine in disaster response.