Alamartine Eric, Thibaudin Damien, Maillard Nicolas, Sauron Catherine, Mehdi Manolie, Broyet Christian, Mariat Christophe
PRES, université de Lyon, 69000 Lyon, France.
Presse Med. 2010 May;39(5):e112-6. doi: 10.1016/j.lpm.2009.10.014. Epub 2010 Feb 9.
We developed a new system of medical tele-expertise to improve detection and care of chronic renal failure by way of a better communication between general practitioners and specialists. It has been known for long that the incidence of chronic renal failure is increasing while cost of its treatment is very high. Unfortunately, late referral of patients with kidney diseases remains around 30%. Our goal was to help physicians to get access to nephrologists, hence to improve the cure of renal diseases. An early treatment of nephropathies may avoid the evolution to the stage of dialysis.
We created a website with the technical support of the firm Unimedecine. It allowed a secure and fast exchange of medical data, all about the case of a one patient.
General practitioners seemed enthusiastic, but at the end, only a few of them did use the website. The number of connexion remained low throughout a 3-year experience. Questions were about advices but no progressive nephropathy was discovered. The cost of the website was a prohibitive 75 000 euros for 3 years. Therefore, we had no choice that to close the experience.
Telemedicine needs juridical rules and specific finances to work on a long run.
我们开发了一种新的医学远程专家系统，旨在通过改善全科医生与专科医生之间的沟通，提高慢性肾衰竭的检测与治疗水平。长期以来，人们都知道慢性肾衰竭的发病率在上升，而其治疗成本非常高。不幸的是，肾病患者的延迟转诊率仍在30%左右。我们的目标是帮助医生联系肾病专家，从而改善肾病的治疗效果。肾病的早期治疗可能会避免病情发展到透析阶段。
在Unimedecine公司的技术支持下，我们创建了一个网站。该网站允许安全、快速地交换有关某一患者病例的所有医疗数据。
全科医生似乎很感兴趣，但最终只有少数人使用了该网站。在为期3年的实践中，网站的访问量一直很低。咨询的都是建议类问题，未发现进行性肾病。该网站3年的成本高达7.5万欧元，令人望而却步。因此，我们别无选择，只能终止这项实践。
远程医疗需要司法规则和专项资金才能长期有效运行。
