Dadlani Ravi, Mani Subramaniyan, A U Jai Ganesh, Mohan Dilip, Rajgopalan Niranjana, Thakar Sumit, Aryan Saritha, Hegde Alangar S
Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India; Department of Neurosurgery, Australian School of Advanced Medicine, Macquarie University, New South Wales, Australia.
Department of Healthcare informatics and Information Technology, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
World Neurosurg. 2014 Sep-Oct;82(3-4):270-83. doi: 10.1016/j.wneu.2014.05.027. Epub 2014 Jun 2.
Telemedicine has always been used as a teleconsultation tool in neurological emergencies (e.g., triage in head injuries, stroke, and cerebrovascular accidents). At Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India, we have been operating two teleconsultation sessions per week for the postoperative patient population, addressing routine follow-up and semiemergent conditions in this cohort of patients. At our center more than 80% of the neurosurgical procedures are conducted in patients traveling more than 1500 km. Telemedicine as a routine tool in clinical medicine has significant financial and psychosocial benefits versus routine outpatient clinics. There are very few reports of telemedicine use in routine outpatient teleconsultations in the available neurosurgical literature; those that are present do not differentiate or analyze the use in routine versus emergency neurosurgery. We discuss the role of this underused resource in the developing countries and retrospectively analyze the clinical data in more than 1500 patients and 3000 teleconsultations during a period of 6 years. We address the financial implications, psychosocial factors, and several other factors that could make this relatively modest technology an indispensible tool in current neurosurgical practice, especially in a developing country like India.
远程医疗一直被用作神经科急症(如头部受伤、中风和脑血管意外的分诊)的远程会诊工具。在印度班加罗尔的斯里·萨提亚·赛高等医学科学研究所,我们每周为术后患者群体开展两次远程会诊,处理该组患者的常规随访和半紧急情况。在我们中心,超过80%的神经外科手术是为行程超过1500公里的患者进行的。与常规门诊相比,远程医疗作为临床医学中的一种常规工具具有显著的经济和社会心理效益。在现有的神经外科文献中,关于远程医疗在常规门诊远程会诊中的应用报道极少;已有的报道并未区分或分析其在常规神经外科手术与急诊神经外科手术中的应用情况。我们讨论了这种未得到充分利用的资源在发展中国家的作用,并回顾性分析了6年间1500多名患者和3000次远程会诊的临床数据。我们探讨了经济影响、社会心理因素以及其他一些因素,这些因素可使这项相对普通的技术成为当前神经外科实践中不可或缺的工具,尤其是在像印度这样的发展中国家。