title: Evaluation of telemedical support to a free-standing minor accident and treatment service.
abstract: We studied all patients attending a free-standing minor accident and treatment service (MATS) run by emergency nurse practitioners (ENPs). In a six-month period, 5563 patients were seen in the MATS, of whom 2843 (51%) were new attenders. A teleconsultation was carried out with 150 of these patients (2.7% of all cases). The most common reason (39%) was to discuss a radiograph with an accident and emergency consultant. The accuracy of the telemedicine-assisted radiographic diagnosis was checked subsequently by a review panel. The ENPs' working diagnoses (made by viewing the films) had a sensitivity of 90% and a specificity of 96%; this was improved by telemedicine assistance to 97% and 99%, respectively. The telemedicine patients were also surveyed several months after being seen in the MATS; their replies indicated that the telemedicine diagnoses had been correct.
mesh_terms: D000059:Accidents; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D006801:Humans; D008131:London / Q000453:epidemiology; D009722:Nurse Practitioners; D019114:Remote Consultation / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology