眼科视网膜疾病的试点远程会诊网络。
A pilot teleconsultation network for retinal diseases in ophthalmology.
机构信息
Department of Surgical Sciences, Division of Ophthalmology, University of Insubria, Varese, Italy.
出版信息
J Telemed Telecare. 2011;17(1):20-4. doi: 10.1258/jtt.2010.100305. Epub 2010 Nov 19.
A store-and-forward teleconsultation network was developed as a web application in order to provide second opinions on retinal diseases. The system provided automatic notification messages to the referring doctor and the consulted ophthalmologist by mobile phone message (SMS) and email. Images in the electronic medical record (EMR) could be examined in detail using special magnification software. Of the 19 ophthalmologists who agreed to participate, 17 used the teleconsultation network during the pilot trial (89%). During the four-week study period, a total of 52 EMRs containing 82 images were uploaded by the participating ophthalmologists. In 46 cases (89%), a second opinion was provided by the consulted ophthalmologist. Thirty-three of the cases (72%) were related to macular diseases and anti-VEGF (vascular endothelial growth factor) ophthalmology drugs. At the end of the study period, 18 of the participating ophthalmologists evaluated the cases, using a three-point score (poor, good, very good) for Access, Acceptability, Image Quality and Medical Efficacy. Most cases were rated as very good or good for all four variables. Successful use of the network in future will depend on various technical, policy and human factors. The latter is particularly important and appropriate motivations need to be found in order to promote teleconsultations.
为了提供视网膜疾病的第二诊疗意见,我们开发了一个存储转发远程会诊网络,作为一个网络应用程序。该系统通过手机短信(SMS)和电子邮件自动向转诊医生和咨询眼科医生发送通知消息。电子病历(EMR)中的图像可以使用特殊的放大软件进行详细检查。在同意参与的 19 名眼科医生中,有 17 名(89%)在试点研究期间使用了远程会诊网络。在四周的研究期间,参与的眼科医生总共上传了 52 份包含 82 张图像的 EMR。在 46 例(89%)中,咨询眼科医生提供了第二诊疗意见。其中 33 例(72%)与黄斑疾病和抗 VEGF(血管内皮生长因子)眼科药物有关。在研究结束时,18 名参与的眼科医生对这些病例进行了评估,使用三点评分(差、可接受、好)来评估访问、可接受性、图像质量和医疗效果。对于所有四个变量,大多数病例的评分都非常好或好。未来成功使用该网络将取决于各种技术、政策和人为因素。后者尤为重要,需要找到合适的动机来促进远程会诊。