title: Remote clinical assessment of gastrointestinal endoscopy (tele-endoscopy): an initial experience.
abstract: BACKGROUND
  Gastrointestinal (GI) endoscopy is an effective tool to screen for cancers of the digestive tract. However, access to endoscopy is limited in many parts of South Carolina. This trial is a part of a prospective multi-part study for remote cancer screening in coastal South Carolina. This pilot study was to evaluate the quality of tele-endoscopy for cancer screening.
  
  
  METHODS
  10 patients scheduled for endoscopic procedures were observed simultaneously by the endoscopist and a remote observer connected over a 512 kbps ISDN line. Findings by both were compared for concordance on malignant or premalignant lesions.
  
  
  RESULTS
  The image quality was adequate to support remote diagnosis of GI cancer and abnormal lesions by an experienced observer. However, assessment of the esophagogastric junction for Barrett's esophagus was equivocal.
  
  
  CONCLUSIONS
  Overall, our tele-endoscopy setup shows great promise for remote supervision or observation of endoscopic procedures done by nurse endoscopists. Tele-endoscopy is both adequate and feasible for diagnosis of most gastrointestinal lesions. Subtle lesions still may be missed in our current setup. However, improvements are being made in our setup to address the problem with resolution prior to further evaluation.
authors.affiliation: Coastal Cancer Control Program, Ralph H Johnson VA Medical Center, Charleston, SC, USA.
authors.forename: C Y
authors.initials: CY
authors.lastname: Kim
authors.forename: B
authors.initials: B
authors.lastname: Etemad
authors.forename: T F
authors.initials: TF
authors.lastname: Glenn
authors.forename: H A
authors.initials: HA
authors.lastname: Mackey
authors.forename: G E
authors.initials: GE
authors.lastname: Viator
authors.forename: M B
authors.initials: MB
authors.lastname: Wallace
authors.forename: M S
authors.initials: MS
authors.lastname: Mokhashi
authors.forename: P B
authors.initials: PB
authors.lastname: Cotton
authors.forename: R H
authors.initials: RH
authors.lastname: Hawes
mesh_terms: D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000451:nursing; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D010865:Pilot Projects; D013022:South Carolina; D017216:Telemedicine