Tel Alessandro, Bortuzzo Federico, Pascolo Piero, Costa Fabio, Sembronio Salvatore, Bresadola Vittorio, Baldi Domenico, Robiony Massimo
Department of Maxillofacial Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy.
Department of Information Technology and Communication, Academic Hospital of Udine, Udine, Italy.
Minerva Stomatol. 2020 Aug;69(4):191-202. doi: 10.23736/S0026-4970.20.04274-0. Epub 2020 Mar 20.
Telemedicine can provide valuable strategies to deliver high-quality training to young doctors and students, as well as to discuss complex clinical cases and follow patients. However, in many cases, similar benefits are limited by the costs due to the expensive hardware resources and optimal infrastructure required. This study presents a novel protocol to improve the accessibility of telemedicine services into a modern hospital department. The protocol is referred to as "SEF" (Smart videosurgery, Easy teleteaching, Fast teleassistance) and was developed in an Oral and Maxillofacial Surgery department. The aims of this study were: 1) to provide a solution to the high initial costs of the configuration of a telemedicine network; 2) to support the simultaneous transmission of multiple video streams; 3) to adopt a modular architecture that amplifies the distance of transmission on the basis of the network infrastructure (department, academic hospital, city, region), thus permitting distance delivery of visual content without any quality loss.
A local Wi-Fi network was created to connect a wireless presentation device with smartphones, laptops, tablets, and a visualization platform represented by an interactive whiteboard (IWB), allowing to display multiple video streams at the same time. The SEF Project was applied during nine operations and a sample of 90 students (10 students for each procedure) was chosen to evaluate the impact of distance telementoring on their learning performance, in contrast with traditional surgical education.
The interface was successfully tested in all surgeries without any quality loss for their whole duration. High resolution and fluidity were confirmed in the recorded clips as well. The impact of telementoring system was assessed by groups of 10 students for each procedure who were administered a questionnaire, and a total satisfaction index of 9/10 was achieved.
SEF protocol appeared to be a stable and highly customizable interface, and has the potential to empower many centers with accessible telehealth systems.
远程医疗可为年轻医生和学生提供高质量培训，以及讨论复杂临床病例和随访患者提供有价值的策略。然而，在许多情况下，由于所需的昂贵硬件资源和最佳基础设施，类似的好处受到成本的限制。本研究提出了一种新颖的方案，以提高远程医疗服务在现代医院科室中的可及性。该方案被称为“SEF”（智能视频手术、简易远程教学、快速远程协助），是在口腔颌面外科开发的。本研究的目的是：1）为远程医疗网络配置的高初始成本提供解决方案；2）支持多个视频流的同时传输；3）采用模块化架构，根据网络基础设施（科室、学术医院、城市、地区）扩大传输距离，从而在不损失任何质量的情况下实现视觉内容的远程传输。
创建了一个本地Wi-Fi网络，将无线演示设备与智能手机、笔记本电脑、平板电脑以及由交互式白板（IWB）代表的可视化平台连接起来，允许同时显示多个视频流。SEF项目在9台手术中应用，并选取了90名学生（每个手术10名学生）作为样本，与传统外科教育相比，评估远程指导对他们学习表现的影响。
该界面在所有手术中均成功测试，在整个过程中没有任何质量损失。录制的片段也证实了高分辨率和流畅性。通过对每个手术的10名学生组成的小组进行问卷调查，评估了远程指导系统的影响，总体满意度指数达到了9/10。
SEF方案似乎是一个稳定且高度可定制的界面，有潜力为许多中心提供可及的远程医疗系统。
