Remote tele-mentored ultrasound for non-physician learners using FaceTime : A feasibility study in a low-income country

Robertson, Thomas; Levine, Andrea; Verceles, Avelino C.; Buchner, Jessica; Lantry, James; Papali, Alfred; Zubrow, Marc T.; Colas, L. Nathalie; Augustin, Marc E.; McCurdy, Michael T.

doi:10.1016/j.jcrc.2017.03.028

Cited by 45 publications

(57 citation statements)

References 21 publications

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“…The application of smartphone-based video conference platforms also has proven clinical utility [12]. Robertson et al demonstrated successful communication between intensivists at a tertiary care center and non-physician health care providers in a low-income country, which demonstrated successful ability to both educate POCUS image acquisition techniques as well as allow for appropriate image quality for remote clinical interpretation [14].…”

Section: Discussionmentioning

confidence: 99%

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

et al. 2019

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Reports on the use of various smartphone-based video conference applications to guide point-of-care ultrasound (POCUS) examinations in resource-limited settings have been described. However, the use of an augmented reality-enabled smartphone video conference application in this same manner has not been described. Presented is a case in which such as application was used to remotely guide a point of care ultrasound examination.

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Section: Discussionmentioning

confidence: 99%

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

et al. 2019

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“…In locations where institutional, regional, or national courses are unavailable, the use of mobile health technology to facilitate intensive care education and training is of great interest. A pilot study in Haiti showed that non-physician ultrasound learners, linked to ultrasound instructors in the United States via mobile phone video chat technology, can learn how to obtain clinically useful ultrasound images [58]. Validated e-learning methodologies are also in use to enhance critical care education and capacity in Cambodia, although specific outcomes have yet to be declared [59].…”

Section: Trainingmentioning

confidence: 99%

“…Although several reports were identified describing the successful diagnosis, triage, and management of patients with complex, life-threatening conditions with the use of pointof-care ultrasound, no randomized controlled trial has so far evaluated the impact of ultrasound-guided diagnosis and treatment in resource-limited settings. A Haitian-US study demonstrated that tele-mentoring of non-physicians performing ultrasound in a resource-limited setting was feasible and adequate to make clinical decisions in the majority (89%) of cases [58].…”

Section: Equipmentmentioning

confidence: 99%

Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings

Papali

Adhikari

Dı́az

et al. 2019

Sepsis Management in Resource-Limited Settings

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“…Telemedicine is defined as the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. The incorporation of consumer-level products has significantly reduced costs and has allowed this topic to become much more mainstream [10]. Indeed, consumer devices are demonstrating adequate capability for performing remote patient examinations, with continued improvements each year [10].…”

Section: Introductionmentioning

confidence: 99%

“…The incorporation of consumer-level products has significantly reduced costs and has allowed this topic to become much more mainstream [10]. Indeed, consumer devices are demonstrating adequate capability for performing remote patient examinations, with continued improvements each year [10]. Furthermore, these technologies have advanced to allow hands-free video communication, with the remote viewer having a point-of-view (POV) perspective [11].…”

Section: Introductionmentioning

confidence: 99%

Feasibility Evaluation of Commercially Available Video Conferencing Devices to Technically Direct Untrained Nonmedical Personnel to Perform a Rapid Trauma Ultrasound Examination

Ramsingh

et al. 2019

Diagnostics

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Introduction: Point-of-care ultrasound (POCUS) is a rapidly expanding discipline that has proven to be a valuable modality in the hospital setting. Recent evidence has demonstrated the utility of commercially available video conferencing technologies, namely, FaceTime (Apple Inc, Cupertino, CA, USA) and Google Glass (Google Inc, Mountain View, CA, USA), to allow an expert POCUS examiner to remotely guide a novice medical professional. However, few studies have evaluated the ability to use these teleultrasound technologies to guide a nonmedical novice to perform an acute care POCUS examination for cardiac, pulmonary, and abdominal assessments. Additionally, few studies have shown the ability of a POCUS-trained cardiac anesthesiologist to perform the role of an expert instructor. This study sought to evaluate the ability of a POCUS-trained anesthesiologist to remotely guide a nonmedically trained participant to perform an acute care POCUS examination. Methods: A total of 21 nonmedically trained undergraduate students who had no prior ultrasound experience were recruited to perform a three-part ultrasound examination on a standardized patient with the guidance of a remote expert who was a POCUS-trained cardiac anesthesiologist. The examination included the following acute care POCUS topics: (1) cardiac function via parasternal long/short axis views, (2) pneumothorax assessment via pleural sliding exam via anterior lung views, and (3) abdominal free fluid exam via right upper quadrant abdominal view. Each examiner was given a handout with static images of probe placement and actual ultrasound images for the three views. After a brief 8 min tutorial on the teleultrasound technologies, a connection was established with the expert, and they were guided through the acute care POCUS exam. Each view was deemed to be complete when the expert sonographer was satisfied with the obtained image or if the expert sonographer determined that the image could not be obtained after 5 min. Image quality was scored on a previously validated 0 to 4 grading scale. The entire session was recorded, and the image quality was scored during the exam by the remote expert instructor as well as by a separate POCUS-trained, blinded expert anesthesiologist. Results: A total of 21 subjects completed the study. The average total time for the exam was 8.5 min (standard deviation = 4.6). A comparison between the live expert examiner and the blinded postexam reviewer showed a 100% agreement between image interpretations. A review of the exams rated as three or higher demonstrated that 87% of abdominal, 90% of cardiac, and 95% of pulmonary exams achieved this level of image quality. A satisfaction survey of the novice users demonstrated higher ease of following commands for the cardiac and pulmonary exams compared to the abdominal exam. Conclusions: The results from this pilot study demonstrate that nonmedically trained individuals can be guided to complete a relevant ultrasound examination within a short period. Further evaluation of using telemedicine technologies to promote POCUS should be evaluated.

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Remote tele-mentored ultrasound for non-physician learners using FaceTime : A feasibility study in a low-income country

Cited by 45 publications

References 21 publications

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

Use of a Smartphone-Based Augmented Reality Video Conference App to Remotely Guide a Point of Care Ultrasound Examination

Infrastructure and Organization of Adult Intensive Care Units in Resource-Limited Settings

Feasibility Evaluation of Commercially Available Video Conferencing Devices to Technically Direct Untrained Nonmedical Personnel to Perform a Rapid Trauma Ultrasound Examination

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