Telemedicine and Toxicology: Back to the Future?

Skolnik, Aaron B.

doi:10.1007/s13181-013-0313-z

Cited by 11 publications

(15 citation statements)

References 14 publications

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“…Moreover, the data transmission from Glass is of sufficient quality to allow diagnosis of specific toxidromes in clinical environments that lack a bedside toxicology consult service. The importance of this research, therefore, is that HMDs such as Glass can place a remote toxicologist virtually at the bedside with a physician providing direct patient care in any location [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, a simple, unobtrusive HMD such as Glass has the potential to generate revenue (using comparable billing codes used by telestroke services to generate income) that may be applied to toxicology faculty support. Teletoxicology consults can increase the number of bedside consultations for fellows in training, decrease the reliance of fellowship programs on poison control centers, and improve the care of poisoned patients [12,3,13]. By placing an expert at the virtual bedside, Glass can provide additional exposure to a toxicology service with concomitant increases in educational opportunities.…”

Section: Discussionmentioning

confidence: 99%

“…Modern wireless infrastructure, miniaturization of hardware, and improved penetration of cellular phones, computers, and tablets have advanced the use of mobile technology into health-care settings. However, no advanced technologies have yet been deployed to assist in the remote diagnosis and management of the poisoned patient [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Because of their intuitive control and unobtrusive nature, HMDs pose a solution that allows a toxicologist to examine poisoned patients virtually at the bedside, in conjunction with the consulting physician [1,3,5]. Glass and other HMDs, worn like a pair of eyeglasses, project information at eye level through a prism display, provide access to internet-enabled applications, and can function as a head-mounted telephone through a Bluetooth connection to a cellular phone.…”

Section: Introductionmentioning

confidence: 99%

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The Feasibility and Acceptability of Google Glass for Teletoxicology Consults

2015

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Teletoxicology offers the potential for toxicologists to assist in providing medical care at remote locations, via remote, interactive augmented audiovisual technology. This study examined the feasibility of using Google Glass, a head-mounted device that incorporates a webcam, viewing prism, and wireless connectivity, to assess the poisoned patient by a medical toxicology consult staff. Emergency medicine residents (resident toxicology consultants) rotating on the toxicology service wore Glass during bedside evaluation of poisoned patients; Glass transmitted real-time video of patients' physical examination findings to toxicology fellows and attendings (supervisory consultants), who reviewed these findings. We evaluated the usability (e.g., quality of connectivity and video feeds) of Glass by supervisory consultants, as well as attitudes towards use of Glass. Resident toxicology consultants and supervisory consultants completed 18 consults through Glass. Toxicologists viewing the video stream found the quality of audio and visual transmission usable in 89 % of cases. Toxicologists reported their management of the patient changed after viewing the patient through Glass in 56 % of cases. Based on findings obtained through Glass, toxicologists recommended specific antidotes in six cases.Head-mounted devices like Google Glass may be effective tools for real-time teletoxicology consultation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Feasibility and Acceptability of Google Glass for Teletoxicology Consults

2015

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“…In the future, the development of a civilian medical toxicology teleconsultation service to assist both local and volunteer physicians in locations with limited subspecialty care may aid in reaching those in greatest need. Furthermore, while studies have demonstrated the effectiveness of poison centers and medical toxicology consultation services, expansion of toxicologists' teleconsultation capabilities to include electronic main, texting, and video consultation may further improve resource utilization and patient outcomes [12][13][14][15]. Further studies are necessary to determine the feasibility and effectiveness of such programs.…”

Section: Discussionmentioning

confidence: 99%

Wartime Toxicology: Evaluation of a Military Medical Toxicology Telemedicine Consults Service to Assist Physicians Serving Overseas and in Combat (2005–2012)

et al. 2014

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Those medical providers deployed to remote countries and tasked with caring for military personnel must diagnose and treat diseases and nonbattle injuries that result from exposures rarely seen in developed countries. Military providers must also function with limited resources and a lack of access to physician specialists, to include medical toxicologists. There have been limited published approaches to addressing this clinical gap for medical toxicology. To address this void, the US Army Medical Department deployed an electronic mail telemedicine system to provide teleconsultations for remote health-care providers worldwide, including Iraq and Afghanistan. This study aimed to describe the types and the frequency of toxicology teleconsultation and consultant responses using electronic mail to assist physicians serving in resource-limited locations. This was a retrospective observational study in which an unblinded data extractor independently reviewed all medical toxicology email consultations. Using a previously developed data collection worksheet, the extractor recorded the type of question asked by the consultant (overdose case, envenomation, occupational exposure, etc.) and the duration of time from when the teleconsultation was placed until the consultant replied. The extractor also recorded if the patient was adult or pediatric and if the patient was US military, US contractor, or local national. The extractor also recorded how often the toxicologist provided the consulting physician with information, resources, or protocols to aid in the management of future cases. In addition, for clinical teleconsultations, the extractor documented the frequency that the consulted toxicologist (i) provided a differential diagnosis or specific diagnosis, (ii) provided specific management guidelines for a patient, and (iii) recommended to evacuate or not evacuate a patient. The results were analyzed using descriptive statistics. Of the 99 consultations evaluated, the most common consultation was for snake envenomation and antivenom recommendations (n=23, 23 %) followed by accidental chemical exposures (n=14, 14 %), drug testing (n=13, 13 %), and substance abuse (n=10, 10 %). In 41 % of consults, the toxicologist provided a differential diagnosis or specific diagnosis, and in 60 % of cases, the toxicologist provided specific management or evaluation guidelines. In 11 % of cases, the toxicologist recommended for or against evacuation of the patient. In 25 % of consults, the toxicologist provided the consulting physician with information, resources, or protocols to aid in the management of future cases. The most frequent consultations for the military telemedicine consultation service were for direct patient cases, specifically snake envenomation management and accidental chemical exposures. Our results may be used to educate physicians prior to military deployment or international humanitarian efforts and to create toxicology clinical There is no prior publication, conflict of interest, or copyright constraint. Th...

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The Virtual Toxicology Service: Wearable Head-Mounted Devices for Medical Toxicology

Chai

Ranney

et al. 2014

J. Med. Toxicol.

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Telemedicine and Toxicology: Back to the Future?

Cited by 11 publications

References 14 publications

The Feasibility and Acceptability of Google Glass for Teletoxicology Consults

The Feasibility and Acceptability of Google Glass for Teletoxicology Consults

Wartime Toxicology: Evaluation of a Military Medical Toxicology Telemedicine Consults Service to Assist Physicians Serving Overseas and in Combat (2005–2012)

The Virtual Toxicology Service: Wearable Head-Mounted Devices for Medical Toxicology

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