title: Realtime remote consultation in the outpatient clinic--experience at a teaching hospital.
abstract: We used an outpatients' telemedicine clinic to evaluate remote consultation in a London hospital practice. Video-images were relayed by ISDN at 384 kbit/s between the main hospital site and the sister hospital. Teleconsultation was evaluated in three different specialties: pain management, orthopaedics and general surgery. Medical personnel involved in the consultation consisted of a resident or senior house officer at the remote site and a senior registrar or consultant at the main hospital. A total of 146 consultations was held over a six-month period in the three clinical specialties involved. Questionnaires were completed by 58% of patients and over 90% of the medical personnel involved. The mean scores (on a five-point Likert scale) for physician satisfaction at the main and distant site were 3.6 and 3.8, respectively. On a scale of 0-10, 92% of patients rated the consultation 8-10 and 90% indicated that they would return for a similar consultation. Seventy-three per cent felt that a similar consultation from their referring doctor would have been appropriate. Confidence in the diagnosis was high among the specialists at the main hospital site.
authors.affiliation: Academic Surgical Unit, Imperial College School of Medicine at St Mary's, London, UK. a.wan@ic.ac.uk
authors.forename: A C
authors.initials: AC
authors.lastname: Wan
authors.forename: Y
authors.initials: Y
authors.lastname: Gul
authors.forename: A
authors.initials: A
authors.lastname: Darzi
mesh_terms: D003199:Computer Systems; D005240:Feasibility Studies; D006784:Hospitals, Teaching; D006801:Humans; D009985:Orthopedics; D010044:Outpatient Clinics, Hospital; D059408:Pain Management; D019114:Remote Consultation / Q000295:instrumentation / Q000379:methods*; D013514:Surgical Procedures, Operative