Teleotolaryngology: A Retrospective Review at a Military Tertiary Treatment Facility

Haegen, Timothy W.; Cupp, Craig L.; Hunsaker, Darrell H.

doi:10.1016/j.otohns.2004.01.010

Cited by 22 publications

(29 citation statements)

References 14 publications

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“…Our findings are consistent with a large navy study of 883 live interactive telemedicine otolaryngology encounters in which 64% of patients received a diagnosis and treatment plan. 2 Among otolaryngology subspecialties, otology appears to be particularly well suited for telemedicine. Intraprovider concordance rates for telemedicine examination of the ear range from 79% to 85%, 4 and audiologists have been successfully used as telemedicine examiners for otolaryngology.…”

Section: Discussionmentioning

confidence: 99%

Where Does Telemedicine Fit into Otolaryngology? An Assessment of Telemedicine Eligibility among Otolaryngology Diagnoses

McCool

Davies

2018

Otolaryngol.--head neck surg.

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Telemedicine applications are expanding to improve access to specialty care in rural areas. Telemedicine is not routinely used to evaluate new patients in otolaryngology, and it remains unclear which patients could benefit from this technology. This study estimates the rate of telemedicine eligibility among specific otolaryngology diagnoses. We conducted a retrospective cohort study of all ear, nose, and throat consults between August 1, 2013, and July 31, 2015. We paired diagnoses ( International Classification of Disease, Ninth Revision) with office-based procedures ( Current Procedural Terminology) and applied prespecified telemedicine eligibility criteria to encounters retroactively. If a specialized procedure was necessary to reach a diagnosis, the diagnosis was considered ineligible for telemedicine. We found that 62% of otolaryngology encounters would likely be eligible for telemedicine. Patients with inner and middle ear problems were more likely eligible for telemedicine, while patients with problems affecting the larynx and external ear were least likely eligible. Nearly 90% of veterans drove >1 hour round-trip for services. Understanding which otolaryngology problem types are more frequently eligible for telemedicine may assist those who are planning to implement a telemedicine program.

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Section: Discussionmentioning

confidence: 99%

Where Does Telemedicine Fit into Otolaryngology? An Assessment of Telemedicine Eligibility among Otolaryngology Diagnoses

McCool

Davies

2018

Otolaryngol.--head neck surg.

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“…For teleotolaryngology, suitable equipment is required to properly transmit audio-visual data so that otolaryngologist specialists and audiologists can benefit from the data in their examination and treatment of the patient. In addition, the application of teleotolaryngology can help patients to minimize their treatment expenses and to evaluate their treatment in a more efficient manner [15,16]. The possible contributions of mobile health can result in a significant health gain for both the individuals and communities in developing countries.…”

Section: Discussionmentioning

confidence: 99%

An Innovative Smartphone-Based Otorhinoendoscope and Its Application in Mobile Health and Teleotolaryngology

Wu¹,

Wu²,

Chen³

et al. 2014

J Med Internet Res

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BackgroundThe traditional otorhinoendoscope is widely used in the diagnosis of a variety of ear and nose diseases, but only one doctor can use it at a time. It is also very difficult to share observations from one doctor with another doctor. With advances in electronic health technology, the extended potential application of smartphones to support medical practice or mobile health has grown steadily.ObjectiveThe first phase of the study discussed how smartphones may be used for otorhinoscopic imaging and image management via an innovative adaptor. The second phase of the study was to evaluate the diagnostic capability of the smartphone-based otorhinoendoscope, as compared to the traditional otorhinoendoscope, and its application in mobile health and teleotolaryngology.MethodsWe designed a unique adaptor to connect the otorhinoendoscope and smartphone in order to perform smartphone-based otorhinoendoscopy. The main aim was to transform the smartphone into an otorhinoendoscope. We devised a method that would allow us to use the smartphone’s camera to capture otorhinoscopic images. Using a freely available Web-based real-time communication application platform and the 3G (or WIFI) network, the smartphone-based otorhinoendoscope could synchronize the smartphone-based otorhinoscopic image with smartphones, tablet PCs, computer notebooks, or personal computers.ResultsWe investigated the feasibility of telemedicine using a smartphone, tablet PC, and computer notebook. Six types of clinical otorhinoscopic images were acquired via the smartphone-based otorhinoendoscope from six patients, which were examined in this study. Three teleconsultants (doctors A, B, and C) reviewed the six types of clinical otorhinoscopic images and made a telediagnosis. When compared to the face-to-face diagnosis, which was made in-person via a traditional otorhinoendoscope, the three teleconsultants obtained scores of a correct primary telediagnosis 83% (5/6), 100% (6/6), and 100% (6/6) of the time, respectively. When the clinical data were provided, the three teleconsultants obtained a correct secondary telediagnosis score of 100% (6/6), 100% (6/6), and 100% (6/6) of the time, respectively.ConclusionsThe use of previously available technologies in the absence of any additional expensive devices could significantly increase the quality of diagnostics while lowering extraneous costs. Furthermore, this could also increase the connectivity between most isolated family doctors and remote referral centers.

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“…8 Other small-scale or regional telemedicine programs had been implemented in the past as well, such as in Operation Joint Endeavor in Bosnia, 9,10 at Walter Reed Army Medical Center, 11 and at the Naval Medical Center in San Diego. 12,13 However, this program represented the first centralized effort to track and monitor Army telemedicine activities worldwide, with particular emphasis on providers in remote and austere locations.…”

Section: Introductionmentioning

confidence: 99%

Teleconsultation Program for Deployed Soldiers and Healthcare Professionals in Remote and Austere Environments

McManus

Salinas

Morton

et al. 2008

Prehosp. Disaster med.

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Background: In April 2004, the US Army Medical Department approved the use of the Army Knowledge Online (AKO) electronic e-mail system as a teleconsultation service for remote teledermatology consultations from healthcare providers in Iraq, Kuwait, and Afghanistan to medical subspecialists in the United States. The success of the system has resulted in expansion of the telemedicine program to include 11 additional clinical specialty services: (1) burn-trauma; (2) cardiology; (3) dermatology; (4) infectious disease; (5) nephrology; (6) ophthalmology; (7) pediatric intensive care; (8) preventive and occupational medicine; (9) neurology; (10) rheumatology; and (11) toxicology. The goal of the program is to provide a mechanism for enhanced diagnosis of remote cases resulting in a better evacuation system (i.e., only evacuation of appropriate cases). The service provides a standard practice for managing acute and emergent care requests between remote medical providers in austere environments and rear-based specialists in a timely and consistent manner.Methods: Consults are generated using the AKO e-mail system routed through a contact group composed of volunteer, on-call consults. The project manager receives and monitors all teleconsultations to ensure Health Insurance Portability and Accountability Act compliance and consultant's recommendations are transmitted within a 24-hour mandated time period. A subspecialty “clinical champion” is responsible for recruiting consultants to answer teleconsultations and developing a call schedule for each specialty. Subspecialties may have individual consultants on call for specific days (e.g., dermatology and toxicology) or place entire groups on-call for a designated period of time (e.g., ophthalmology).Results: As of May 2007, 2,337 consults were performed during 36 months, with an average reply time of five hours from receipt of the teleconsultation until a recommendation was sent to the referring physician. Most consultations have been for dermatology (66%), followed by infectious disease (10%). A total of 51 known evacuations were prevented from use of the program, while 63 known evacuations have resulted following receipt of the consultants' recommendation. A total of 313 teleconsultations also have been performed for non-US patients.Conclusions: The teleconsultation program has proven to be a valuable resource for physicians deployed in austere and remote locations. Furthermore, use of such a system for physicians in austere environments may prevent unnecessary evacuations or result in appropriate evacuations for patients who initially may have been “underdiagnosed.”

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Teleotolaryngology: A Retrospective Review at a Military Tertiary Treatment Facility

Abstract: Our study demonstrates the ability of telemedicine to function in an general otolaryngology setting.

Cited by 22 publications

References 14 publications

Where Does Telemedicine Fit into Otolaryngology? An Assessment of Telemedicine Eligibility among Otolaryngology Diagnoses

Where Does Telemedicine Fit into Otolaryngology? An Assessment of Telemedicine Eligibility among Otolaryngology Diagnoses

An Innovative Smartphone-Based Otorhinoendoscope and Its Application in Mobile Health and Teleotolaryngology

Teleconsultation Program for Deployed Soldiers and Healthcare Professionals in Remote and Austere Environments

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