Klaz Itay, Wohl Yonit, Nathansohn Nir, Yerushalmi Nir, Sharvit Sharon, Kochba Ilan, Brenner Sarah
Israel Defense Forces Medical Corps.
Isr Med Assoc J. 2005 Aug;7(8):487-90.
The Israel Defense Forces implemented a pilot teledermatology service in primary clinics.
To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units.
A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction.
Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments.
CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.
以色列国防军在基层诊所开展了一项远程皮肤病学试点服务。
评估计算机化存储转发远程皮肤病学服务在城乡部队中的用户满意度和临床短期效果。
进行了一项为期6个月的多中心前瞻性非对照队列试点试验。初级保健医生使用附带数码照片的文本电子邮件将患者转诊给一名获得委员会认证的皮肤科医生。诊断、治疗和管理方案再反馈给转诊的初级保健医生。患者被要求评估CSAFTD服务的水平、该服务对看皮肤科医生便利性的影响、对隐私的尊重、药物的可获得性、健康改善情况以及总体满意度。初级保健医生评估他们收到的远程皮肤病学会诊的质量、对他们知识的贡献以及他们的总体满意度。
435例CSAFTD转诊病例中，95%（n = 413）仅通过远程诊断即可；22%（n = 95）的转诊病例还需要面对面会诊。城乡诊所的患者对CSAFTD的满意度都很高，农村部队的得分显著更高。农村患者对服务水平、便利性和总体满意度的评分高于城市患者。初级保健医生对服务质量及其对他们知识的贡献感到满意。农村医生对服务水平和总体满意度的评分高于城市医生。远程转诊比面对面预约转诊完成得更高效。
CSAFTD为以色列国防军的城乡军事诊所提供了高效、高质量的医疗服务。
