Early experience using telemedicine for neonatal surgical consultations.
OBJECTIVE
Telemedicine affords the opportunity to extend the presence of surgical evaluation to centers without an on-site pediatric surgeon. However, concern for cost, accuracy of diagnosis, and physician acceptance have limited its use.


METHODS
Using a low-cost, desktop computer-based system, this study was designed to test the effectiveness of telemedicine in neonatal surgical consultation.


RESULTS
Early experience with six video-teleconference (VTC) and six store-and-forward consultations are presented. Diagnosis was established accurately in all cases. With the three intestinal cases (jejunal atresia, duplication cyst, and r/o malrotation), diagnostic studies were guided by the images transmitted with the consult. Earlier care could be implemented in other cases. Technical problems were encountered primarily with the VTC modality, which also proved more consuming of physician time.


CONCLUSIONS
Telemedicine was used successfully in each case and proved accurate in diagnosis and guiding further evaluation. This is the first report of the use of telemedicine for surgical consultation in the intensive care nursery.
Department of Surgery, Telemedicine Directorate, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
D K
DK
Robie
C M
CM
Naulty
R L
RL
Parry
C
C
Motta
B
B
Darling
M
M
Micheals
R K
RK
Poropatich
E R
ER
Gomez
D013502:General Surgery; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009359:Neonatology; D011446:Prospective Studies; D011897:Random Allocation; D019114:Remote Consultation / Q000295:instrumentation