ObjectiveTo analyze the value of teleconferencing for patient care and surgical education by assessing the activity of an international academic network.
Summary Background DataThe uses of telemedicine include teleeducation, training, and consulting, and surgical teams are now involved, sharing diagnostic information and opinions without the need for travel. However, the value of telematics in surgery remains to be assessed.
MethodsDuring a 2-year period, weekly surgical teleconferences were held among six university hospitals in four European countries. To assess the accuracy of telediagnosis for surgical cases, 60 randomly selected cases were analyzed by a panel of surgeons. Participants' opinions were analyzed by questionnaire.
ResultsSeventy teleconferences (50 lectures and 271 case presentations) were held. Ninety-five of the 114 participants (83.3%) completed the final questionnaire. Eighty-six percent rated the surgical activity as good or excellent, 75.7% rated the scientific level as good or excellent, 55.8% rated the daily clinical activity as good or excellent, and 28.4% rated the manual surgical technique as good or excellent. The target organ was identified in all the cases; the organ structure and pathology were considered well defined in 93.3%, and the fine structure was considered well defined in 58.3%. Diagnosis was accurate in 17 cases (28.3%), probable in 25 (41.7%), possible but uncertain in 16 (26.7%), and not possible in 2 cases (3.3%). Discussion among the remote sites increased the rate of valuable therapeutic advice from 55% of cases before the discussion to 95% after the discussion. Eighty-six percent of the surgeons expressed satisfaction with telematics for medical education and patient care.
ConclusionsParticipant satisfaction was high, transmission of clinical documents was accurate, and the opportunity to discuss case documentation and management significantly improved diagnostic potential, resulting in an accuracy rate of up to 95%. Teleeducation and teleconsultation in surgery appear to be beneficial.In this information age, the new computer-based communication technologies called telematics offer enormous potential for applications in medical and surgical practice and education.1 The introduction of these tools in surgery has attracted much interest; however, the possibilities of combining increasing computing power 2 with surgeons' objectives and needs have not yet been properly analyzed. First, we must assess the results of telematic applications in medicine and surgery. 3,4 The field of telemedicine involves far more than just the transmission of patient files.5 It involves education, 6,7 training, 8 consulting, 9 and mentoring, 10 -12 and in the near future will include accreditation. 13 Currently, surgical teams are involved in teleconferencing, sharing medical advice and offering second opinions without the need to transfer the patient.14 -16 The time and costs of travel on the part of experts are limiting factors to joint consultations or meet-
282ings.17 Telemedicine s...