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At least 325 records · Page 18Linked to original sources
PubMed1995

Tele-endoscopic otorhinolaryngological examination: preliminary study of patient satisfaction.

OBJECTIVE: Modern telecommunications and computer technologies enable the delivery of expert consultations and remote diagnoses that previously required transportation of patients or medical specialists. The purpose of this study was to determine whether patients are satisfied with one form of telemedicine consultation. METHODS: A general practitioner was trained to perform endoscopic otorhinolaryngological examinations. After the training period, he examined patients at a local health center in Alta, 250 km from Tromsø. Images from the endoscopic examination were transmitted to the otorhinolaryngologist at the University Hospital of Tromsø for real-time consultation. Twenty-six patients, on a randomly selected day, were asked to complete a questionnaire after the tele-endoscopic examination. The questionnaire was returned anonymously by 24 of the patients. RESULTS: Although patients interacted with the specialist only via videoconferencing, the results show that most (23/24) were satisfied with this type of consultation, and they reported more advantages than disadvantages. Twenty-one patients indicated that they would accept another tele-endoscopic consultation if they required examination by an otorhinolaryngologist in the future. CONCLUSION: Although the sample is limited, the results justify continued investigation of this and other types of telemedicine consultations.

Adult↗
PubMed1996

Subspecialty radiology consultation by interactive telemedicine.

This investigation tested the hypothesis that interactive, low-resolution telemedicine is an effective method for radiologists' consultations. The case material consisted of radiographs and digital images from patients with 14 paediatric diseases readily diagnosed by imaging, and 10 matched controls. The original images were first evaluated by a general radiologist, who entered a diagnosis. He or she then discussed the case with a paediatric radiologist who had access to the same images via low-resolution interactive video. Following the consultation the general radiologist could change diagnosis. The experimental subjects were three teams of general and paediatric radiologists. Observer-performance and case-comparison methods were used for analysis. The results showed that the general radiologists' diagnostic accuracy improved after telemedicine consultation with the subspecialist, the area under the ROC curve improving from 0.648 to 0.709. The interactive consultation was judged valuable by all participants. We conclude that low-resolution interactive telemedicine is of value for consultation between generalists and subspecialists in radiology.

Humans↗
PubMed1999

Teleconsultations between general practitioners and ophthalmologists in Finland.

We carried out a study of the value of videoconferencing in consultations between general practitioners (GPs) and ophthalmologists in Finland. We used ISDN lines (128 kbit/s) between the Primary Health Care Centre in Ikaalinen and the ophthalmology clinic at the Tampere University Hospital (TAUH). Questionnaires covering both clinical and technical matters were given to patients and doctors after the consultation. During the 10-month study, consultations were carried out successfully for 23 of 24 patients (96%). Most consultations (84%) took less than 15 min. If we had not had this system, the GP would have made 21 referrals to an ophthalmologist. After teleconsultation, six patients were sent to the TAUH, so the system saved 15 referrals. Twenty-two patients (92%) thought that videoconferencing was a reliable tool for GPs. Our system proved to be a valuable and reliable tool for the GPs in ophthalmology consultations and continuing education.

Evaluation Studies as Topic↗
PubMed2000

A new method for surgical consultations with videoconference.

BACKGROUND: The aim of our prospective study was to examine the technical ability and the medical suitability of a realtime teleconferencing system in surgical consultations. METHOD: A personal computer-based-videoconferencing system was used over an architecture of the IP (Internet Protocol) over ATM (Asynchronous Transfer Mode) area network connecting Satakunta Central Hospital, Pori with a health center in the community of Noormarkku (15 km apart from Pori). A document camera was used for transfering the radiographs and paper documents. The material consisted of 50 patients who needed surgical consultation. The patients were examined by a physician in the health center of Noormarkku, and the surgeon interviewed and observed the physical examination with the aid of teleconference. RESULTS: Technically the videoconferencing system functioned reliably, and the visual quality of the videopicture was good after more powerful personal computers (Pentium II with a 266 MHz prosessor and 64 Megabits RAM-memory) were changed for the videoconferencing system. All patients, except one, saved the travelling to the face-to-face appointment because they got a definite decision of the treatment already at the videoconsultation. According to the opinion of the consulting surgeon, the decision which was made in the teleconference was good or very good, except in one case very poor. The physicians of the health centers were satisfied both with the decisions of the treatment of their patients and with the educational effect of a consultation where two physicians are present at the same time. All patients thought that it was good to be in consultation with two doctors. CONCLUSION: Surgical videoconsultations are a reliable method and a real alternative to sending a patient to a distant place for consultation.

Female↗
PubMed2003

[A telemedical consultation system based on multicast].

That the multicast technology is fit for telemedical consultation application has been developed on the basis of the features analysis of medical consultation action. A scheme of the telemedical consultation application based on the multicast technology has been designed. The features of this scheme are: unrestrained joining in and quitting, simultaneous control over the transport information of doctor and patient, extending, and simulating consultation scene. And the implementation of this scheme is discussed.

Computer Communication Networks↗
PubMed1995

Telephone consultations in general practice: an additional or alternative service?

BACKGROUND: There is conflicting evidence about whether telephone consultations in general practice represent additional or alternative contacts with the general practitioner. AIM: A study set out to assess the characteristics of patients using the telephone to consult the general practitioner and whether telephone consultations were used as an additional or an alternative service to surgery consultations during surgery hours. METHOD: The study took place in one practice that has run a 'phone-in clinic' for five years. A questionnaire on perceptions of and attitudes towards telephone consultations was sent to 259 patients who consulted the general practitioner by telephone and to an age-sex matched group of patients whose medical records indicated that they had never consulted the general practitioner by telephone. For both groups, numbers of repeat prescriptions and consultations in the preceding year were determined from medical records. RESULTS: Those who consulted the doctor by telephone were significantly more likely to be aware of the phone-in clinic, to have a telephone at home, to have children aged under five years at home and to be receiving repeat prescriptions and repeat prescriptions for psychotropic drugs compared with those who had never consulted by telephone. Eleven of 226 patients who consulted be telephone (5%) indicated that they would definitely not have made a surgery appointment or home visit request (that is, they represented additional general practitioner workload) while 120 (53%) used the telephone consultation as an alternative to making a surgery appointment and 22 (10%) used the telephone consultation as an alternative to requesting a home visit. CONCLUSION: It appears that the telephone service was being used largely as an alternative access point to the doctor. General practitioners should not be apprehensive about the possible increase in workload generated by introducing telephone consultations, for example in phone-in clinics.

Attitude to Health↗
PubMedDate not supplied

A cyberclinic in rheumatology.

OBJECTIVE: To evaluate the feasibility of a rheumatology consultation and advisory service using internet and e-mail. METHODS: We placed a detailed rheumatology proforma on our website for general practitioners to complete and e-mail to our outpatients clinic. To study its feasibility, two junior doctors interviewed and completed the proforma for 207 new patients. Based on this information, the consultant provided provisional diagnoses, work up & management plans, which were then compared with those drawn up following face-to-face assessment of the same patients in the outpatients clinic. RESULTS: In most instances the pre- and post-examination diagnoses, work up & management plans were similar. Diagnostic concurrence was noted in 178 (86%) patients; no changes were required in x-rays and other tests requested in 129 (62%) patients; and the suggested treatment (including corticosteroid injections) remained the same in 153 (74%) patients. CONCLUSION: Our results suggest that it is feasible to offer an e-mail or internet based outpatients consultation and advisory service in rheumatology and possibly other disciplines.

Feasibility Studies↗
PubMed1998

Rural telepsychiatry.

Telepsychiatry is the use of telecommunications technology to connect patients and health care providers, permitting effective diagnosis, education, treatment, consultation, transfer of medical data, research, and other health care activities. Telepsychiatry has been used as a partial solution to the problem of limited psychiatric services for clinics and hospitals in remote areas of areas underserved by psychiatrists and other mental health care specialists. In the United States, eastern Oregon's RodeoNet telepsychiatry program and the telemedicine program of the Kansas University Medical Center, which has a psychiatric component, are excellent models. Telepsychiatric applications can be cost-effective, but careful evaluation is needed.

Computer Communication Networks↗