Tachakra S, Loane M, Uche C U
Accident and Emergency Services, Central Middlesex Hospital, London, UK.
J Telemed Telecare. 2000;6(6):330-4. doi: 10.1258/1357633001936003.
We conducted a follow-up study of patients who had attended a nurse-led minor accident and treatment service (MATS) and who had participated in a teleconsultation. Over three and a half years, 31,510 patients had attended the MATS unit and 1854 patients (5.9%) of these had participated in a teleconsultation. Of the 1854 telemedicine patients, 1199 had been referred to hospital or clinic and 1153 had actually attended. Retrospective examination of the relevant hospital records showed that in 25 cases (2%) the original telediagnosis was considered incorrect at face-to-face review and that treatment was either begun or changed in 264 cases (23%). All patients, including those discharged home after the teleconsultation, were sent a questionnaire about any changes to their injury. Of the 655 patients discharged home, a questionnaire response was obtained from 598 (91%). Following discharge, 43 of these patients had sought help from another health-care provider (the majority from their general practitioner). Of the 46 patients referred to hospital who did not keep their follow-up appointments, questionnaire results were obtained from 35 (76%). Nine of these patients had sought help from another health-care provider (the majority from their general practitioner) but there had been no change in diagnosis or treatment. Our findings suggest that teleconsultations are an effective means of delivering minor injuries care.
我们对参加过护士主导的轻伤事故与治疗服务（MATS）且参与过远程会诊的患者进行了一项随访研究。在三年半的时间里，有31510名患者前往MATS科室就诊，其中1854名患者（5.9%）参与了远程会诊。在这1854名远程医疗患者中，1199名被转诊至医院或诊所，1153名实际前往就诊。对相关医院记录的回顾性检查显示，在面对面复查时，有25例（2%）最初的远程诊断被认为有误，264例（23%）的治疗方案被启动或更改。所有患者，包括远程会诊后出院回家的患者，都收到了一份关于其伤情变化的问卷。在655名出院回家的患者中，收到了598名（91%）的问卷回复。出院后，其中43名患者向另一位医疗服务提供者寻求了帮助（大多数是向他们的全科医生）。在46名被转诊至医院但未按时复诊的患者中，收到了35名（76%）的问卷结果。这些患者中有9名向另一位医疗服务提供者寻求了帮助（大多数是向他们的全科医生），但诊断或治疗并无变化。我们的研究结果表明，远程会诊是提供轻伤护理的一种有效方式。
