title: The comparative impact of video-consultation on neurosurgical health services.
abstract: This study evaluated the impact of telemedicine technology on the provision of neurosurgical health services. We focused on the differences between the use of real time audio-visual teleconferencing and teleradiology versus conventional telephone consultations in the referral of neurosurgical patients from a large district general hospital. All patients requiring emergency neurosurgical consultation were included for randomization into telephone consultation only (Mode A), teleradiology and telephone consultation (Mode B) and video-consultation (Mode C). Measures of effectiveness included diagnostic accuracy and adverse events during the transfer and Glasgow Outcome Score. In a 10-month period, 327 patients were recruited and randomized into the study: the male/female ratio was 2:1 and the number of patients required to be transferred to the neurosurgical unit was 125 (38%). There was a trend towards a more favourable outcome in the video-consultation mode (44%, Mode C), versus teleradiology (31%, Mode B), versus telephone consultation (38%, Mode A). The interim data of this prospective randomized trial suggests that video-consultation may have a favourable impact on emergency neurosurgical consultations.
authors.affiliation: Division of Neurosurgery, Prince of Wales Hospital and United Christian Hospital, The Chinese University of Hong Kong, Hong Kong, China. wpoon@cuhk.edu.hk
authors.forename: W S
authors.initials: WS
authors.lastname: Poon
authors.forename: C H
authors.initials: CH
authors.lastname: Leung
authors.forename: M K
authors.initials: MK
authors.lastname: Lam
authors.forename: S
authors.initials: S
authors.lastname: Wai
authors.forename: C P
authors.initials: CP
authors.lastname: Ng
authors.forename: S
authors.initials: S
authors.lastname: Kwok
mesh_terms: D004630:Emergencies; D006801:Humans; D009422:Nervous System Diseases / Q000175:diagnosis / Q000601:surgery; D009493:Neurosurgery; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D011446:Prospective Studies; D012017:Referral and Consultation; D019114:Remote Consultation; D019112:Teleradiology