Evaluation of an accident and emergency teleconsultation service for north-east Scotland

Abstract

We evaluated an accident and emergency teleconsultation service provided to 14 community hospitals in north-east Scotland. Each community hospital was equipped with a videoconferencing system and a document camera to allow transmission of radiographs. The network used 384 kbit/s ISDN connections. A total of 1392 teleconsultations were recorded during a 12-month study period. Seventy-seven per cent of patients (n = 1072) were managed locally and 23% (n = 320) were transferred to Aberdeen. The majority (95%) of teleconsultations were conducted on weekdays, and 90% of these occurred between the hours of 09:00 and 16:00. The mean delay in contacting a doctor was 9 min and the mean consultation time was 10 min. The majority of patients were suffering from fractures or suspected fractures of the limbs. Radiograph transmission was used in 75% of all teleconsultations. A high degree of satisfaction was recorded by all users of the service.

Community hospitals – the place of local service provision in a modernising NHS: an integrative thematic literature review

“…Telemedicine services were provided in some settings, mainly for Accident and Emergency (A&E) and minor injuries, linking GPs and minor injuries unit nurses to A&E specialists [43-47]. Again, there were no comparison groups to evaluate the effectiveness of the care provided.…”

“…Opportunities for mutual learning and addressing structural and organisational barriers, such as inflexible contractual terms and conditions, can overcome these perceived divides [68]. The need for additional training and support was also highlighted in some papers, particularly for those practising in rural setting [47,69]. In Australia, joint academic posts between rural CHs and central academic units had been developed in order to improve recruitment and retention [69]…”

A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities

“…The studies have assessed telemedicine service satisfaction for different groups. Of the 35 studies that assessed satisfaction (n=14, 41.3%) (41,66,73,76,(87)(88)(89)(90)(91)(92)(93)(94)(95)(96) papers have focused on assessing healthcare provider satisfaction, and (n=10, 28.5%) (30,(97)(98)(99)(100)(101)(102)(103)(104)(105) papers examined consumer satisfaction, while (n=11, 37.9%) (31,39,40,82,(106)(107)(108)(109)(110)(111)(112) papers reported both provider and consumer satisfaction of the service.…”

Tele-education in emergency care

“…In fact, early experience of telemedicine has been successful in the visual specialties, such as pathology and radiology,4 5 and in certain telephone-based applications 6. However, the moving image has yet to find a convincing niche in emergency care, despite several initiatives that have used video conferencing to support minor injuries units and peripheral emergency facilities 7 8…”