Assessment of telemedicine in surgical education and patient care.
OBJECTIVE
To analyze the value of teleconferencing for patient care and surgical education by assessing the activity of an international academic network.


BACKGROUND
The uses of telemedicine include teleeducation, training, and consulting, and surgical teams are now involved, sharing diagnostic information and opinions without the need for travel. However, the value of telematics in surgery remains to be assessed.


METHODS
During a 2-year period, weekly surgical teleconferences were held among six university hospitals in four European countries. To assess the accuracy of telediagnosis for surgical cases, 60 randomly selected cases were analyzed by a panel of surgeons. Participants' opinions were analyzed by questionnaire.


RESULTS
Seventy teleconferences (50 lectures and 271 case presentations) were held. Ninety-five of the 114 participants (83.3%) completed the final questionnaire. Eighty-six percent rated the surgical activity as good or excellent, 75.7% rated the scientific level as good or excellent, 55.8% rated the daily clinical activity as good or excellent, and 28.4% rated the manual surgical technique as good or excellent. The target organ was identified in all the cases; the organ structure and pathology were considered well defined in 93.3%, and the fine structure was considered well defined in 58.3%. Diagnosis was accurate in 17 cases (28.3%), probable in 25 (41.7%), possible but uncertain in 16 (26.7%), and not possible in 2 cases (3.3%). Discussion among the remote sites increased the rate of valuable therapeutic advice from 55% of cases before the discussion to 95% after the discussion. Eighty-six percent of the surgeons expressed satisfaction with telematics for medical education and patient care.


CONCLUSIONS
Participant satisfaction was high, transmission of clinical documents was accurate, and the opportunity to discuss case documentation and management significantly improved diagnostic potential, resulting in an accuracy rate of up to 95%. Teleeducation and teleconsultation in surgery appear to be beneficial.
Demartines
N
N
Department of Surgery, University Hospital of Basel, Switzerland.
Mutter
D
D
Vix
M
M
Leroy
J
J
Glatz
D
D
Rösel
F
F
Harder
F
F
Marescaux
J
J
D003362:Cost-Benefit Analysis; D004502:Education, Medical, Continuing; D005060:Europe; D013502:General Surgery / Q000193:education; D006785:Hospitals, University; D006801:Humans; D019114:Remote Consultation; D013503:Surgery Department, Hospital; D013514:Surgical Procedures, Operative; D013685:Telecommunications