Experimental telemedicine in orthopaedics

Over three and a half years there were 200 teleconsultations between emergency nurse practitioners at a minor accident and treatment service and the orthopaedic service of a main hospital. The main problems were fractures (93% of cases). The reasons for consultation fell almost equally into four groups: request for direct ward admission; discussion and decision about treatment; decision about the disposition of a case; and diagnosis. The technical quality of the majority of teleconsultations was considered satisfactory. Following the teleconsultation, 39% of patients were admitted to hospital, 6% were transferred to the accident and emergency department for a face-to-face consultation, and 56% were discharged and referred to a review clinic. Of the 200 cases, 193 needed teleradiology and the nurse practitioners and the orthopaedic registrars diagnosed all these cases correctly, as judged by the subsequent radiologist's report. Teleconsultations save time and prevent the unnecessary transfer of patients to main hospitals.

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“…This is similar to the experience of others who have used videoconferencing at 384 kbit/s for orthopaedic consultations [4][5][6] .…”

Section: Technical Qualitysupporting

confidence: 84%

Evaluation of telemedical orthopaedic specialty support to a minor accident and treatment service

2001

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“…(2) What was your overall satisfaction with the teleconsultation? (3) Howeasily could you describe your medical problem?…”

Section: Patient Satisfactionmentioning

confidence: 99%

A prospective study of teleconferencing for orthopaedic consultations

Aarnio¹,

Lamminen²,

Lepistö³

et al. 1999

J Telemed Telecare

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We carried out a prospective study of teleconsulting in orthopaedics. A commercial videoconferencing system was connected by three ISDN lines between the Satakunta Central Hospital in Pori and the Orton Orthopaedic Hospital in Helsinki, 240 km away. A document camera was used to transfer radiographic images and paper documents. Twenty-nine patients who needed an orthopaedic consultation were studied over three months. They were examined by a surgeon in Pori with the aid of teleconferencing and again later in a traditional, face-to-face appointment in Helsinki. Patients and doctors completed questionnaires after the consultations. Technically, the videoconferencing system functioned reliably and the quality of the video was judged to be good. Twenty patients (69%) would not have needed to travel for a face-to-face appointment, because the teleconsultation afforded a definite treatment decision. The orthopaedic surgeons considered all the treatment decisions arising from the teleconsultation good, except in one case which was considered satisfactory. The quality of the radiographic images transferred with the document camera was good or very good in 17 cases and satisfactory in three cases. None of the patients had experienced videoconferencing before; 87% of them thought that teleconsultation was a good or very good method and the rest felt that it was satisfactory. All patients wanted to participate in teleconsultations again and most would have recommended it to other patients.

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“…Trials of telemedicine have beencarriedout insurgery, otolaryngology, pathology, radiology and dermatology [6][7][8][9][10][11][12] . We have used videoconferencing for ophthalmological consultations 13 and continuing medical education.…”

mentioning

confidence: 99%

A feasibility study of realtime teledermatology in Finland

Lamminen

et al. 2000

J Telemed Telecare

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We conducted a feasibility study of teleconsultation in dermatology using low-cost equipment. Patients and their general practitioners took part in consultations from the Primary Health Care Centre in Ikaalinen with a dermatologist 55 km away at the Tampere University Hospital (TAUH). Consultations were performed using standard commercial videoconferencing equipment, a modified document camera and a dermatoscope. A single ISDN line (128 kbit/s) was used for the connection. During the eight months of the study, 25 patients participated in a teledermatology consultation. Their mean age was 45 years (range 4-92). The average time the patient spent in travelling to the videoconsultation (i.e. one way) was 24 min (range 5-65 min). The mean time spent in the teleconsultation was 15 min (range 5-30 min). After the teleconsultation, patients' treatments changed in 19 cases (76%), diagnoses were changed in 13 cases (52%) and 18 patients (72%) did not need to go to the TAUH. The equipment was generally reliable and easy to use. However, the dermatoscope was not very useful and only one of the consultations relied mainly on it. The cost of the teleconsultations for the 18 patients who avoided travel to the TAUH was FM18,627. The total costs for the 18 conventional consultations in the TAUH would have been FM18,034. The main economic benefits of the videoconferencing were attributable to the reduced travelling and hospital costs. The economic benefits of medical education were more difficult to quantify.

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Experimental telemedicine in orthopaedics

Cited by 37 publications

References 11 publications

Evaluation of telemedical orthopaedic specialty support to a minor accident and treatment service

Evaluation of telemedical orthopaedic specialty support to a minor accident and treatment service

A prospective study of teleconferencing for orthopaedic consultations

A feasibility study of realtime teledermatology in Finland

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