Journal of telemedicine and telecare
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We evaluated the accuracy of an electronic stethoscope in the detection of irregular cardiac rhythms. Ten patients with either normal sinus rhythm or atrial fibrillation previously documented by electrocardiogram (ECG) were recruited from a local retirement community. Six senior family medicine resident physicians were asked to assess the cardiac rhythms of the subjects as either regular or irregular, in both a telemedical and an in-person examination. ⋯ The difference was not significant. Physician confidence in telemedical examination did not affect the accuracy of examination. The results of this study suggest that telemedicine-directed auscultation of patients may be just as successful as inperson examination for the detection of cardiac arrhythmias.
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We evaluated the use of tele-education to provide an induction programme for accident and emergency senior house officers (SHOs) in three remote locations, and compared their performance with that of SHOs receiving the same induction programme in the conventional manner. Both groups of doctors performed similarly in a pre-course multiple-choice question (MCQ) paper, and showed comparable improvement following the induction programme lectures. ⋯ Tele-education might allow doctors based in peripheral units similar access to high-quality teaching to that enjoyed by those in larger hospitals. Further experience and evaluation are required to optimize this method of education delivery.
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We studied pre-hospital notification and the quality of data received from ambulance crews transporting seriously ill or injured patients to an accident and emergency department. During a two-month study period, pre-hospital notification was received for 54 patients. However, the department was notified about only 25 of 62 patients (40%) who, on arrival by ambulance, were triaged as emergencies. Despite developing a data protocol for emergency pre-hospital communication and being equipped to receive emergency ambulance calls directly, many such patients still arrived either unannounced or described in insufficient detail to allow appropriate preparations to be made for them.
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A pilot accident and emergency teleconsulting service was established in Scotland. It was based at the accident and emergency department of the main hospital in Aberdeen. There were three peripheral sites in rural Grampian (Peterhead, Turriff and Huntly) and one in the Shetland Isles. ⋯ The majority of patients (89%) received treatment without transportation to the main centre in Aberdeen. The present study demonstrated that accident and emergency teleconsultations can be technically reliable, effective in reducing the number of patient transfers and acceptable to the referring clinicians. As a result, approximately 1.5 million has been made available by the government to develop a national system for Scotland.
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Videoconferencing has been used for continuing medical education (CME) in Nova Scotia since a pilot project to four communities in 1995. The Nova Scotia Telehealth Network was developed after the pilot project. Using the network, the videoconferenced CME programme expanded over the next few years until in, 2000-1, 66 programmes were broadcast to 38 sites. ⋯ However, several aspects could be improved. Faculty members still need encouragement to make visual aids legible by videoconference and to provide handouts. Also, there has been little upgrading of equipment over the past four years and some reduction in the reliability of connections.