A review of the role of telemedicine in the accident and emergency                department

Keane, M. G.

doi:10.1258/jtt.2009.003008

Cited by 46 publications

(27 citation statements)

References 21 publications

(18 reference statements)

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“…The experience of those attending disasters is that the first priority is to provide physical support to the population and to local health workers – triage, primary and emergency care – rather than virtual support through telemedicine. 17 In such situations, useful telemedicine applications are likely to be similar to those employed in accident and emergency departments 18 with one important difference: following a disaster, health workers have to contend with chaos, with disrupted communications, damaged infrastructure of all kinds, and the non-availability of human resources. That is, in disaster areas, everything is disorganized, disrupted and systems of communication have collapsed.…”

Section: Discussionmentioning

confidence: 99%

In what circumstances is telemedicine appropriate in the developing world?

Wootton

Bonnardot

2010

JRSM Short Reports

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ObjectivesTo review papers reporting actual experience with telemedicine in developing countries and to summarize their findings, including the strength of the evidence.DesignA retrospective review was conducted. Study quality was assessed.SettingFour commonly-used electronic databases.Main outcome measuresStudy quality scores.ResultsFrom a total of 202 potential articles, 38 relevant papers were identified. Thirty-four articles (89%) reported clinical experience and 14 articles (37%) reported the use of telemedicine for educational purposes. The quality of the reports was rather weak (median quality-score 3, on a scale 0–9); only one study, rated at 7, fell into the high quality score band. The fact that almost all studies reported positively in favour of telemedicine suggests a publication bias. Of the 38 articles, 15 (39%) reported the use of real-time telemedicine and 25 (66%) reported the use of asynchronous, or store-and-forward, telemedicine. Email was the most commonly reported modality (half of all studies).ConclusionSome of the longer established telemedicine operations have developed into substantial networks. The review suggests that great potential exists for telemedicine in the developing world. However, some caution is required in future telemedicine work if telemedicine exemplars are to be produced which can be widely copied.

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Section: Discussionmentioning

confidence: 99%

In what circumstances is telemedicine appropriate in the developing world?

Wootton

Bonnardot

2010

JRSM Short Reports

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“…This is encouraging as injury is an increasing cause of concern worldwide and it affects people from resource poor areas – where prognosis is not so good - to a far greater extent [10], [11]. Reviews are available in this domain, but many are descriptive [12]–[14] or context specific [4], [15]. A 2006 review focusing on accident and emergency telemedicine for primary care concluded that most studies conducted until then demonstrated technical feasibility and improved triage with an increasing range of local management, but few cost-effectiveness assessments were available [16].…”

Section: Introductionmentioning

confidence: 99%

“…A 2006 review focusing on accident and emergency telemedicine for primary care concluded that most studies conducted until then demonstrated technical feasibility and improved triage with an increasing range of local management, but few cost-effectiveness assessments were available [16]. Those reviews briefly introduced the role of telemedicine in the emergency department [14], current trends in the development and adoption of tele-medical adjuncts for injury control [17], potential applications/functions of telemedicine for trauma and disaster management, and a review of systems from a US perspective [15]. Successful domains of application identified thus far are the transmission of computed tomography scans for urgent neurosurgical opinion and the transmission and interpretation of radiographs (usually peripheral limb films) for on going support of minor injury units [12], [13].…”

Section: Introductionmentioning

confidence: 99%

Image-Based Medical Expert Teleconsultation in Acute Care of Injuries. A Systematic Review of Effects on Information Accuracy, Diagnostic Validity, Clinical Outcome, and User Satisfaction

et al. 2014

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ObjectiveTo systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects.DesignSystematic review of peer-reviewed journal articles.Data sourcesSearches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals.Eligibility criteriaStudies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded.MethodThe procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently.ResultsOut of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management.ConclusionsImage-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological shortcomings. As in the case of telemedicine in general, user and system quality aspects are poorly documented, both of which affect scale up of such programs.

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“…However, there are several reviews on telemedicine services regarding onshore remote accident and emergency services that have been published [21-24]. For example, Keane [22] conducted a comprehensive review on the success of telemedicine in the scope of accident and emergency. Amadi et al [23] also conducted a review to examine the history and existing applications of telemedicine in pre-hospital environments, where telemedicine is believed to extend the reach of specialist services to handle pre-hospital care of acute emergencies, in cases where treatment delays may affect the clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Telemedicine Services for the Arctic: A Systematic Review

Woldaregay¹,

Walderhaug²,

Hartvigsen³

2017

JMIR Med Inform

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BackgroundTelemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges.ObjectiveThe purpose of this review was to assess and analyze the current status of telemedicine services in the context of maritime conditions, extreme weather (ie, Arctic weather), and remote accidents and emergencies. Moreover, the paper aimed to identify successfully implemented telemedicine services in the Arctic region and in maritime settings and remote emergency situations and present state of the art systems for these areas. Finally, we identified the status quo of telemedicine services in the context of search and rescue (SAR) scenarios in these extreme conditions.MethodsA rigorous literature search was conducted between September 7 and October 28, 2015, through various online databases. Peer reviewed journals and articles were considered. Relevant articles were first identified by reviewing the title, keywords, and abstract for a preliminary filter with our selection criteria, and then we reviewed full-text articles that seemed relevant. Information from the selected literature was extracted based on some predefined categories, which were defined based on previous research and further elaborated upon via iterative brainstorming.ResultsThe initial hits were vetted using the title, abstract, and keywords, and we retrieved a total of 471 papers. After removing duplicates from the list, 422 records remained. Then, we did an independent assessment of the articles and screening based on the inclusion and exclusion criteria, which eliminated another 219 papers, leaving 203 relevant papers. After a full-text assessment, 36 articles were left, which were critically analyzed. The inter-rater agreement was measured using Cohen Kappa test, and disagreements were resolved through discussion.ConclusionsDespite the increasing number of fishermen and other seafarers, Arctic and maritime working conditions are mainly characterized by an absence of access to health care facilities. The condition is further aggravated for fishermen and seafarers who are working in the Arctic regions. In spite of the existing barriers and challenges, some telemedicine services have recently been successfully delivered in these areas. These services include teleconsultation (9/37, 24%), teleradiology (8/37, 22%), teledermatology and tele-education (3/37, 8%), telemonitoring and telecardiology (telesonography) (1/37, 3%), and others (10/37, 27%). However, the use of telemedicine in relation to search and rescue (SAR) services is not yet fully exploited. Therefore, we foresee that these implemented and evaluated telemedicine servic...

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A review of the role of telemedicine in the accident and emergency department

Cited by 46 publications

References 21 publications

In what circumstances is telemedicine appropriate in the developing world?

In what circumstances is telemedicine appropriate in the developing world?

Image-Based Medical Expert Teleconsultation in Acute Care of Injuries. A Systematic Review of Effects on Information Accuracy, Diagnostic Validity, Clinical Outcome, and User Satisfaction

Telemedicine Services for the Arctic: A Systematic Review

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