Yulzari Raphael, Bretler Shlomi, Avraham Yaniv, Sharabi-Nov Adi, Even-Tov Ella, Gilbey Peter
1 Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
2 Otolaryngology, Head & Neck Surgery Unit, Ziv Medical Center, Safed, Israel.
Ann Otol Rhinol Laryngol. 2018 Jan;127(1):46-50. doi: 10.1177/0003489417745089. Epub 2017 Nov 28.
Telehealth can improve access to specialist care. Very few reports of the use of smartphones for teleotolaryngology exist. The objective of this study is to evaluate the use of mobile teleotolaryngology facilitated by a nonotolaryngologist physician.
A prospective study in adult patients attending a general otolaryngology outpatient clinic. The telehealth encounter with a remote otolaryngologist was facilitated by a final-year medical student simulating a general physician prior to the scheduled visit. The patient and the remote otolaryngologist rated their satisfaction with the encounter. The remote otolaryngologist formulated a diagnosis and rated the level of certainty of this diagnosis. Diagnoses from the telehealth encounter and the face-to-face encounter were compared.
Forty-eight patients with an average age of 42.5 years participated in this study. In 79.2% of the consultations, there was concordance between the diagnoses. The average patient and remote otolaryngologist satisfaction with the encounter was 9.5 ± 0.9 and 8.7 ± 1.3, respectively. Twenty-four of the 48 visits (50%) were defined as unnecessary. In the otology group, concordance rates and rates of preventable visits were highest.
Synchronous telehealth consultations, facilitated by a general physician, can be an alternative to visiting a general otolaryngology clinic, especially for otologic patients.
远程医疗可改善专科护理的可及性。关于使用智能手机进行远程耳鼻喉科诊疗的报告极少。本研究的目的是评估由非耳鼻喉科医生协助的移动远程耳鼻喉科诊疗的应用情况。
对在普通耳鼻喉科门诊就诊的成年患者进行一项前瞻性研究。在预定就诊前，由一名即将毕业的医学生模拟全科医生协助患者与远程耳鼻喉科医生进行远程医疗会诊。患者和远程耳鼻喉科医生对会诊的满意度进行评分。远程耳鼻喉科医生做出诊断并对该诊断的确定程度进行评分。比较远程医疗会诊和面对面会诊的诊断结果。
48名平均年龄为42.5岁的患者参与了本研究。在79.2%的会诊中，诊断结果一致。患者和远程耳鼻喉科医生对会诊的平均满意度分别为9.5±0.9和8.7±1.3。48次就诊中有24次（50%）被判定为不必要。在耳科学组中，诊断一致率和可避免就诊率最高。
由全科医生协助的同步远程医疗会诊可以作为替代前往普通耳鼻喉科诊所就诊的方式，尤其是对于耳科患者。
