Nores J, Athanassiou A, Malone F D, D'Alton M E
Department of Obstetrics and Gynaecology, Tufts University School of Medicine, Boston, MA, USA.
Telemed J. 1997 Fall;3(3):191-5. doi: 10.1089/tmj.1.1997.3.191.
To evaluate the dependability of a live telemedicine link for the transmission of obstetric ultrasonograms using a commercial telephone network.
We established an integrated services digital network (ISDN), consisting of three dedicated telephone lines from three satellite offices, to our central prenatal diagnostic center. All patients had a sonographic evaluation recorded on videotape by a trained sonographer. A live interactive video telemedicine link was then established, and a perinatologist directed the sonographer through the scan. A report was issued on the basis of the telemedicine examination. The number of calls required to obtain satisfactory real-time images was recorded, as were the reasons for suboptimal transmissions. The first 150 transmissions were excluded from this study. The results in the subsequent 100 patients who agreed to participate were analyzed.
We were able to provide obstetric interpretations in all 100 patients scheduled to be examined using the telemedicine link. A single connection was required in 85 cases, two calls in 5 cases, three calls in 8 cases, four calls in 1 case, and five calls in another case. A repeat call was required in 20 cases because of poor image transmission; other repeat calls were caused by failure to connect (5 cases), calls disconnected (2 cases), and no image transmission (2 cases).
The provision of telemedicine services for obstetric ultrasonography in the community is feasible, but the need for repeat connections because of technical failures needs to be incorporated into cost and time analyses in order to provide a measure of the system's efficiency.
评估利用商业电话网络进行产科超声图像传输的实时远程医疗链接的可靠性。
我们建立了一个综合业务数字网（ISDN），由三条从三个卫星办公室到我们中央产前诊断中心的专用电话线组成。所有患者均由一名经过培训的超声检查医师将超声评估记录在录像带上。然后建立实时交互式视频远程医疗链接，由围产医学专家指导超声检查医师进行扫描。根据远程医疗检查出具报告。记录获得满意实时图像所需的通话次数以及传输效果欠佳的原因。本研究排除了前150次传输。对随后同意参与的100例患者的结果进行分析。
在计划使用远程医疗链接检查的所有100例患者中，我们均能够提供产科解读。85例只需单次连接，5例需两次通话，8例需三次通话，1例需四次通话，另1例需五次通话。20例因图像传输不佳需要重复通话；其他重复通话是由于连接失败（5例）、通话中断（2例）和无图像传输（2例）。
在社区提供产科超声远程医疗服务是可行的，但由于技术故障而需要重复连接的情况需要纳入成本和时间分析，以便衡量该系统的效率。
