1 Department of Management Engineering and Internal Consulting, Mayo Clinic , Rochester, Minnesota.
2 Center for Connected Care , Mayo Clinic, Rochester, Minnesota.
Telemed J E Health. 2018 Jul;24(7):481-488. doi: 10.1089/tmj.2017.0121. Epub 2017 Dec 12.
Early work has demonstrated the feasibility and acceptance of newborn resuscitation telemedicine programs (NRTPs). The technology requirements for providing this type of emergency telemedicine service are unclear.
We hypothesized that during NRTP consults, a wired telemedicine cart would provide a more reliable and higher-quality user experience than a consumer-grade wireless tablet.
In this retrospective observational study, six spoke sites used consumer-grade wireless tablets during preintervention and wired coder/decoder (CODEC)-based telemedicine carts during postintervention. Both technologies used the same videoconferencing software. After the telemedicine consult, providers completed surveys assessing connection reliability, user satisfaction, and audio and video quality using a 1-5 Likert scale.
Preintervention, users completed 99 consults and 95 surveys. Postintervention, users completed 73 consults and 192 surveys. Successful connection on first attempt was significantly improved with the wired cart compared with the wireless tablet (82.7% vs. 69.5%, p = 0.01), and the percentage of consults complicated by an unplanned disconnection was reduced (6.4% vs. 14.7%, p = 0.02). User satisfaction and video and audio quality ratings were significantly higher for the wired cart.
The wired telemedicine cart increased connection reliability, which is important given the critical nature and long duration of NRTP consults. Audio-video quality was also improved, allowing for better visualization of the neonate and communication with the care team.
Consumer-grade wireless tablets did not meet the program's technical requirements. Wired telemedicine carts improved reliability, user satisfaction, and audio-video quality. Wired carts may not fully meet NRTP requirements because of cart size and limited mobility.
早期的工作已经证明了新生儿复苏远程医疗计划（NRTP）的可行性和可接受性。提供这种紧急远程医疗服务的技术要求尚不清楚。
我们假设在 NRTP 咨询期间，有线远程医疗推车比消费级无线平板电脑提供更可靠和更高质量的用户体验。
在这项回顾性观察研究中，六个发言地点在干预前使用消费级无线平板电脑，在干预后使用基于有线编解码器（CODEC）的远程医疗推车。这两种技术都使用相同的视频会议软件。远程医疗咨询结束后，提供者使用 1-5 级李克特量表完成评估连接可靠性、用户满意度以及音频和视频质量的调查。
在干预前，用户完成了 99 次咨询和 95 次调查。在干预后，用户完成了 73 次咨询和 192 次调查。与无线平板电脑相比，有线推车首次尝试连接的成功率显著提高（82.7%对 69.5%，p=0.01），且计划外中断的咨询比例降低（6.4%对 14.7%，p=0.02）。用户满意度和视频音频质量评分有线推车明显更高。
有线远程医疗推车提高了连接可靠性，鉴于 NRTP 咨询的关键性质和长时间持续，这一点很重要。音频-视频质量也得到了改善，从而可以更好地观察新生儿并与护理团队进行沟通。
消费级无线平板电脑无法满足该计划的技术要求。有线远程医疗推车提高了可靠性、用户满意度和音频-视频质量。由于推车的尺寸和有限的机动性，有线推车可能无法完全满足 NRTP 的要求。
