University of Arkansas for Medical Sciences, Little Rock, USA.
Hand (N Y). 2023 Jun;18(4):668-672. doi: 10.1177/15589447211044783. Epub 2021 Sep 27.
Telemedicine consultation can increase patients' access to subspecialty care and decrease the number of unnecessary hospital transfers. In 2014, the Arkansas Hand Trauma Telemedicine Program (AHTTP) was established to extend specialized hand care throughout Arkansas. The purpose of this study is to assess whether transfers are affected when consultation with a hand specialist is performed by phone compared with using a live audiovisual consultation.
We reviewed data from the first year of the AHTTP. Data collection included type of consultation (telephone only or live audiovisual), need for transfer, and type of transfer (general orthopedic or hand specialist).
In 2014, the first year of AHTTP there were 331 hand injuries identified; of those, 298 used the AHTTP with 195 (65%) using telemedicine and 103 (35%) using phone consultation only. The use of video when compared with phone consultation did not significantly affect the decision to transfer ( = .42) or alter the rate of transfer for general orthopedic or hand specialist care ( = .25).
The assessment of both phone and telemedicine modalities showed that there was no significant difference in transfer rates for either consultation, highlighting that communication with a hand surgeon was the key to accurate assessment of the need for transfer.
远程医疗咨询可以增加患者获得专科治疗的机会，并减少不必要的医院转院次数。2014 年，阿肯色州手部创伤远程医疗计划（AHTTP）成立，旨在将专业手部护理服务扩展到阿肯色州各地。本研究的目的是评估与通过电话进行手部专家咨询相比，使用实时视听咨询是否会影响转院。
我们回顾了 AHTTP 成立第一年的数据。数据收集包括咨询类型（仅电话或实时视听）、转院需求以及转院类型（普通骨科或手部专家）。
2014 年，是 AHTTP 的第一年，共发现 331 例手部损伤；其中 298 例使用了 AHTTP，195 例（65%）使用远程医疗，103 例（35%）仅使用电话咨询。与电话咨询相比，使用视频并没有显著影响转院决策（=.42）或改变普通骨科或手部专家治疗的转院率（=.25）。
对电话和远程医疗两种方式的评估表明，两种咨询方式的转院率没有显著差异，这突出表明与手部外科医生的沟通是准确评估转院需求的关键。
