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.
Dorrian
Cathy
C
Scottish Centre for Telehealth, Foresterhill Lea, Aberdeen, UK. cathy.dorrian@nhs.net
Ferguson
Jim
J
Ah-See
Kim
K
Barr
Catriona
C
Lalla
Kushik
K
van der Pol
Marjon
M
McKenzie
Lynda
L
Wootton
Richard
R
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