title: Clinical consultations using store-and-forward telemedicine technology.
abstract: OBJECTIVE
  To investigate the potential role of a store-and-forward (SAF) telemedicine system in specialty consultations initiated by primary care physicians.
  
  
  METHODS
  In this pilot telemedicine study, patients needing consultations in cardiology, dermatology, endocrinology, and orthopedics had both standard face-to-face (FTF) consultations and SAF consultations.
  
  
  RESULTS
  Fifteen patients had both FTF and SAF consultations, 4 had echocardiograms transmitted for an SAF consultation only, and 1 had an SAF consultation but no FTF appointment. Of 19 diagnoses made, all were essentially the same in both types of consultations; 14 of 15 FTF consultations and 15 of 19 SAF consultations resulted in additional treatment recommendations.
  
  
  CONCLUSIONS
  While it was possible to develop a desktop system for SAF consultations, the equipment was not adequately integrated. Without total digital input, including electronic patient medical records, packaging of information is laborious and impractical. Seamlessly adapting to existing clinical practice is vital. Issues such as increasing work for the physicians or office staff, gathering adequate patient information, and designing a referral process were more difficult than we had anticipated. Patient acceptance was high, but the clinical pilot had very small numbers.
authors.affiliation: Department of Family Medicine, Mayo Clinic Rochester, Minn. 55905, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Houston
authors.forename: J D
authors.initials: JD
authors.lastname: Myers
authors.forename: S P
authors.initials: SP
authors.lastname: Levens
authors.forename: M T
authors.initials: MT
authors.lastname: McEvoy
authors.forename: S A
authors.initials: SA
authors.lastname: Smith
authors.forename: B K
authors.initials: BK
authors.lastname: Khandheria
authors.forename: W K
authors.initials: WK
authors.lastname: Shen
authors.forename: M E
authors.initials: ME
authors.lastname: Torchia
authors.forename: D J
authors.initials: DJ
authors.lastname: Berry
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D010865:Pilot Projects; D019114:Remote Consultation / Q000295:instrumentation* / Q000379:methods*; D016037:Single-Blind Method; D012984:Software; D013038:Specialization; D013673:Technology Assessment, Biomedical; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods; D014481:United States