Wenger T L, Gerdes J, Taub K, Swarr D T, Deardorff M A, Abend N S
1] Division of Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA [2] Section of Clinical Informatics, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
J Perinatol. 2014 Mar;34(3):234-40. doi: 10.1038/jp.2013.159. Epub 2014 Jan 9.
Evaluate whether telemedicine can be used to perform dysmorphology and neurologic examinations in the neonatal intensive care unit (NICU) by determining the examination accuracy, limitations and optimized procedures.
Prospective evaluation of NICU patients referred for subspecialty consultation for dysmorphic features (n=10) or encephalopathy (n=10). A physician at bedside (bedside clinician) performed an in-person examination that was viewed in real time by a remote physician (remote consultant). Standardized examinations were recorded and compared. Subsequently, a qualitative approach established technique adjustments and optimization procedures necessary to improve visualization.
Telemedicine examinations identified 81 of 87 (93%) dysmorphology examination abnormalities and 37 of 39 (92%) neurologic examination abnormalities. Optimization of remote consultant visualization required an active bedside clinician assisting in camera and patient adjustments.
Telemedicine can be used to perform accurately many components of the dysmorphology or neurologic examinations in NICU patients, but physicians must be mindful of specific limitations.
通过确定检查准确性、局限性和优化程序，评估远程医疗是否可用于新生儿重症监护病房（NICU）的畸形学和神经系统检查。
对因畸形特征（n = 10）或脑病（n = 10）而转诊进行专科会诊的NICU患者进行前瞻性评估。床边医生（床边临床医生）进行现场检查，远程医生（远程会诊医生）实时观看。记录并比较标准化检查。随后，采用定性方法确定改善可视化所需的技术调整和优化程序。
远程医疗检查发现87项畸形学检查异常中的81项（93%）和39项神经系统检查异常中的37项（92%）。远程会诊医生可视化的优化需要床边临床医生积极协助进行摄像头和患者调整。
远程医疗可用于准确进行NICU患者畸形学或神经系统检查的许多组成部分，但医生必须注意特定的局限性。
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