Smith Anthony C, Williams Judy, Agnew Julie, Sinclair Stephen, Youngberry Karen, Wootton Richard
Centre for Online Health, University of Queensland, Australia.
J Telemed Telecare. 2005;11 Suppl 2:S86-9. doi: 10.1258/135763305775124821.
We conducted a feasibility study to examine whether a paediatric patient at a regional hospital could be assessed by an ear, nose and throat (ENT) specialist via videoconference, therefore saving at least one journey to the tertiary hospital for a pre-admission appointment. A video-otoscope was used with standard videoconference equipment, and realtime images were transmitted at a bandwidth of 384 kbit/s. In all, 13 telepaediatric ENT clinics were conducted between November 2003 and April 2005, and 98 consultations were facilitated for 64 patients. The main reasons for referral were recurrent tonsillitis (25%) and obstructive sleep apnoea (23%). Of the 64 patients examined by telemedicine, 42 (66%) were recommended for surgery and placed on the surgical waiting list. About 12 patients (19%) required travel to the tertiary centre for further investigations and tests not available locally, while four patients (6%) were reviewed via videoconference during a scheduled clinic. Six patients (9%) required no further follow-up after their initial telepaediatric consultation. Videoconferencing is an effective method of assessing ENT conditions of paediatric patients and for pre-screening potential surgical admissions to a tertiary hospital. Careful consideration of a number of economic and logistical factors needs to be made before large investments are made to expand the service.
我们进行了一项可行性研究，以探讨地区医院的儿科患者是否可以通过视频会议接受耳鼻喉科（ENT）专家的评估，从而至少省去一次前往三级医院进行入院前预约的行程。使用了视频耳镜与标准视频会议设备，并以384 kbit/s的带宽传输实时图像。2003年11月至2005年4月期间共开展了13次儿科远程耳鼻喉科门诊，为64名患者提供了98次会诊。转诊的主要原因是复发性扁桃体炎（25%）和阻塞性睡眠呼吸暂停（23%）。在通过远程医疗检查的64名患者中，42名（66%）被建议进行手术并列入手术等候名单。约12名患者（19%）需要前往三级中心进行当地无法进行的进一步检查和测试，而4名患者（6%）在预定门诊期间通过视频会议接受了复查。6名患者（9%）在首次儿科远程会诊后无需进一步随访。视频会议是评估儿科患者耳鼻喉状况以及对三级医院潜在手术入院患者进行预筛查的有效方法。在进行大规模投资以扩大服务之前，需要仔细考虑一些经济和后勤因素。
