A review of telemedicine in vascular surgery.

Telemedicine refers to the delivery of medical care through telecommunications and has been utilized by many medical specialists. In its basic form, telemedicine can involve the use of a telephone or fax. More advanced forms are the transmission of still images, often referred to as "store-and-forward" technology, or real-time two-way interactive video. The former is possible over existing phone lines or the Internet and has enjoyed success in visually oriented disciplines such as radiology and dermatology. The latter requires high bandwidth communication lines and is therefore considerably more expensive. This article reviews the use of telemedicine as applied specifically to vascular surgery. Initial studies indicate that store-and-forward technology can be used to adequately assess and treat wounds in vascular patients. A recent study reported the use of two-way interactive video for remote assessment of a wide variety of vascular patients. Diagnosis and treatment recommendations by the remote physician were found to be comparable to conventional on-site examinations. Patient satisfaction with the telemedicine examination was noted to be extremely high. In conclusion, telemedicine, although not commonly used in vascular surgery, has the potential of increasing patient access to specialty care, while decreasing patient or physician travel. The use of telemedicine in vascular surgery will likely continue to expand as technology improves and costs decrease.