Northumbria University, G206, Coach Lane Campus, Newcastle upon Tyne, NE7 7XA, UK.
The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
BMC Pregnancy Childbirth. 2021 Jan 8;21(1):38. doi: 10.1186/s12884-020-03532-4.
The complexity of fetal medicine (FM) referrals that can be managed within obstetric units is dependent on the availability of specialist ultrasound expertise. Telemedicine can effectively transfer real-time ultrasound images via video-conferencing. We report the successful introduction of a fetal ultrasound telemedicine service linking a specialist fetal medicine (FM) centre and a remote obstetric unit.
Over a four-year period from October 2015, all women referred for FM consultation from the obstetric unit were seen via telemedicine, excluding cases where invasive testing, intrauterine therapy or cardiac anomalies were anticipated. The outcomes measured included the indication for FM referral; scan duration and image and sound quality during the consultation. Women's perceptions of the telemedicine consultation and estimated costs to attend the FM centre were measured by a structured questionnaire completed following the first telemedicine appointment during the Phase 1 of the project.
Overall, 297 women had a telemedicine consultation during Phase 1 (pilot and evaluation) and Phase 2 (embedding and adoption) of the project, which covered a 4 year period 34 women completed questionnaires during the Phase 1 of the study. Travel to the telemedicine consultation took a median (range) time of 20 min (4150), in comparison to an estimated journey of 230 min (120,450) to the FM centre. On average, women would have spent approximately £28 to travel to the FM centre per visit. The overall costs for the woman and her partner/ friend to attend the FM centre was estimated to be £439. Women were generally satisfied with the service and valued the opportunity to have a FM consultation locally.
We have demonstrated that a fetal ultrasound telemedicine service can be successfully introduced to provide FM ultrasound of sufficient quality to allow fetal diagnosis and specialist consultation with parents. Furthermore, the service is acceptable to parents, has shown a reduction in family costs and journey times.
在产科单位内能够管理的胎儿医学（FM）转诊的复杂性取决于专科超声专业知识的可用性。远程医疗可以通过视频会议有效地传输实时超声图像。我们报告了成功引入将胎儿超声远程医疗服务链接到专科胎儿医学（FM）中心和远程产科单位的情况。
在 2015 年 10 月至 2019 年四年期间，从产科单位转诊来进行 FM 咨询的所有女性均通过远程医疗进行了检查，排除了需要进行侵袭性检查、宫内治疗或心脏异常的情况。所测量的结果包括 FM 转诊的指征；在咨询期间的扫描持续时间以及图像和声音质量。通过在项目的第一阶段完成的第一次远程医疗预约后填写的结构化问卷来衡量女性对远程医疗咨询的看法以及参加 FM 中心的估计费用。
在项目的第一阶段（试点和评估）和第二阶段（实施和采用）期间，共有 297 名女性进行了远程医疗咨询，涵盖了 4 年的时间。在研究的第一阶段，有 34 名女性完成了问卷。前往远程医疗咨询的平均时间（中位数（范围））为 20 分钟（4150），而估计前往 FM 中心的行程时间为 230 分钟（120,450）。平均而言，每位女性每次就诊前往 FM 中心的旅行费用约为 28 英镑。女性及其伴侣/朋友前往 FM 中心的总费用估计为 439 英镑。女性通常对该服务感到满意，并重视在当地获得 FM 咨询的机会。
我们已经证明，胎儿超声远程医疗服务可以成功引入，以提供足够质量的 FM 超声，从而可以对胎儿进行诊断并与父母进行专科咨询。此外，该服务得到了父母的认可，降低了家庭成本和旅行时间。
