Journal of telemedicine and telecare
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There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. ⋯ A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.
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A literature search was conducted for articles on the role of telemedicine in accident and emergency work. The search yielded 39 relevant papers, which came from 21 independent groups that had used telemedicine in an emergency medicine setting. The articles showed that telemedicine has been applied in a variety of ways from medical advice for paramedics in the disaster setting, to patient follow-up in the fracture clinic. ⋯ Telemedicine has also been suggested as a way for paramedics to communicate with regional coronary care units quickly, hence enabling them to provide pre-hospital thrombolysis in the field when appropriate. The accident and emergency setting is well suited to the application of telemedicine. Larger trials and cost-effectiveness studies are required in this area.
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Multicenter Study
Telemedicine in neurosurgery: teleradiology connections in the Republic of Croatia.
In 1998, a teleradiology system was established in Croatia. It connects 34 CT, MRI and DSA scanners in 29 hospitals with a referral centre in the neurosurgery department in Zagreb. In the first three years of its use, the network saved more than 400,000 km of patient transportation (i.e. without a teleconsultation, all of the patients would have had to be transported to the nearest referral neurosurgical unit). ⋯ The teleradiology system was used less often for lumbar disc disease (4%), hydrocephalus or other neurosurgical disorders (2%). The most valuable results from teleradiology were the decisions about proper and effective patient treatment. In Croatia, the national teleradiology network for neurosurgery has speeded up therapy, avoided unnecessary travelling for patients and reduced costs.
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We have conducted a three-year prospective study of medical incidents on a commercial airline. A telemedicine service was available via an on-board satellite phone. During the study period there were 3364 medical incidents. ⋯ All unstable patients forced a diversion. Doctors on board used the service in more severe cases, whereas laymen used the service in less severe cases. The results of the present study demonstrate the advantage of using simple teleconsultation in cases of medical emergency on board an aircraft.
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We conducted a pilot study to assess the feasibility of tele-follow up in post-operative cases of thyroid and parathyroid diseases. Patients were enrolled after operation at the tertiary hospital in Lucknow who consented to report to the telemedicine centre at Cuttack, approximately 1500 km away. Initially videoconferencing used a single ISDN line (128 kbit/s); subsequently a satellite-based connection (384 kbit/s) was employed. ⋯ There were substantial financial and work-time savings per visit. Tele-follow up is feasible after thyroid and parathyroid surgery for benign thyroid and parathyroid disorders and in patients with low-risk thyroid cancers. The technique ensures satisfactory postoperative follow-up.