Head and neck cancer assessment by flexible endoscopy and telemedicine.
We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total of 42 patients were seen in Aberdeen via videoconferencing for a head and neck cancer assessment. Feasibility was confirmed after the first 20 patients, following positive feedback from all concerned and the absence of any significant clinical or technical problems. A total of 42 journeys was avoided, each journey saving 123 kg CO(2) per person. A preliminary cost analysis showed that the threshold at which tele-ENT became cheaper than travel was a workload of 35 patients/year. The actual workload during the pilot study was 29 patients/year. A national telemedicine service for the initial assessment of potential malignancy has the potential to reduce unnecessary transfers to specialist centres, with accompanying reductions in carbon emissions.
Scottish Centre for Telehealth, Foresterhill Lea, Aberdeen, UK. cathy.dorrian@nhs.net
Cathy
C
Dorrian
Jim
J
Ferguson
Kim
K
Ah-See
Catriona
C
Barr
Kushik
K
Lalla
Marjon
M
van der Pol
Lynda
L
McKenzie
Richard
R
Wootton
D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D017752:Greenhouse Effect; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000191:economics*; D008297:Male; D009313:National Health Programs / Q000191:economics; D010865:Pilot Projects; D012017:Referral and Consultation / Q000191:economics*; D019035:Rural Health Services; D012606:Scotland; D017216:Telemedicine / Q000191:economics*; D014195:Travel / Q000191:economics