Desktop telemedicine in vascular surgery: Some preliminary findings
Desktop telemedicine in vascular surgery: Some preliminary findings
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DOI：
10.1089/tmj.1.1998.4.279
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发表时间：
1998-12-01
期刊：
影响因子：
--
通讯作者：
Callas, PW
中科院分区：
文献类型：
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作者：
Ricci, MA;Knight, SJ;Callas, PW
目的：外科专家普遍没有充分利用远程医疗技术。本报告描述了实时互动视频远程医疗的使用，以增加我们地区服务不足的农村地区血管手术患者的护理。材料和方法：弗莱彻外星人医疗中心（FAHC）和伯灵顿佛蒙特大学的远程医疗系统利用桌面视频会议技术，地面传输速度为384kbps。目前的系统于1996年1月启动，FAHC目前有18个外部站点和多个地点，包括血管实验室、血管造影套房、手术室和一名血管外科医生的家。在手术的前12个月，血管外科医生被要求完成一份问卷，以评估该技术及其在临床护理中的实用性。血管外科医生对远程医疗系统的使用情况通过问卷调查、电话账单和一个特殊的“免费”账单代码进行监测。远程医疗事件分为临床和教育两类。结果：在实施后的26个月里，发生了107起事件，包括临床和教育使用。3名血管外科医生有103项临床用途，包括5项急诊用途。佛蒙特-缅因州联合血管教育会议已经举行了四次。总体而言，血管手术在第一年占所有远程医疗事件的14.2%，在此期间占所有临床事件的30.9%。据报道，远程医疗的使用改善了96%病例的患者护理。第一年，80%的远程医疗使用节省了病人的路程。根据现场临床随访，没有诊断错误，可归因于远程医疗系统的使用。结论：血管外科医生使用实时视频远程医疗具有巨大的潜力，但在广泛采用之前可能需要进行成本效益研究。
Objective: Surgical specialists have generally underutilized telemedicine technologies. This report describes the use of real-time interactive-video telemedicine to augment the care of vascular surgical patients in underserved rural areas within our region.Materials and Methods: The telemedicine system at Fletcher-Alien Health Care (FAHC) and the University of Vermont in Burlington utilizes desktop video conferencing technology with terrestrial transmission at 384 kbps. The current system was initiated in January 1996, and there are at present 18 external sites and multiple locations at FAHC, including the vascular laboratory, angiography suites, operating rooms, and the home of one vascular surgeon. During the first 12 months of operation, the vascular surgeons were asked to complete a questionnaire to evaluate the technology and its usefulness in clinical care. The use of the telemedicine system by the vascular surgeons was monitored by the questionnaires, phone bills, and a special "no charge" billing code. Telemedicine events were classified as clinical or educational.Results: In the 26 months since implementation, 107 events have taken place, including both clinical and educational uses. There were 103 clinical uses by three vascular surgeons, including five emergency uses. A joint Vermont-Maine vascular educational conference has taken place four times. Overall, use by vascular surgery represented 14.2% of all telemedicine events in the first year or 30.9% of all clinical events during that time period. Use of telemedicine was reported to have improved patient care in 96% of the cases. Eighty percent of the telemedicine uses in the first year saved patient travel. There were no diagnostic errors, as determined by in-person clinical follow-up, attributable to the telemedicine system use.Conclusions: Use of a real-time video telemedicine has great potential for vascular surgeons, but cost-effectiveness studies may be needed prior to its widespread adoption.