title: Bariatric surgery using a network and teleconferencing to serve remote patients in the Veterans Administration Health Care System: feasibility and results.
abstract: BACKGROUND
  Previously, Midwestern veteran patients had limited bariatric surgery access because they lived long distances from a bariatric surgery center (BSC). The creation and outcomes of a network to increase bariatric surgery access and patient satisfaction with teleconsultation are discussed.
  
  
  METHODS
  Several referring Midwestern Veterans Affairs Medical Centers (VAMCs) performed pre- and postoperative management and were linked by teleconferencing and a computerized patient record system to a single BSC.
  
  
  RESULTS
  Twenty-eight high-risk patients (older, male) residing an average distance of 324.5 miles from the BSC underwent gastric bypass. Eighty-two percent used teleconferencing for the initial surgical consultation with excellent patient satisfaction saving at least 19,000 miles and 69 travel days. Surgical outcomes were equivalent and follow-up was excellent (96.6%) compared with non-Veterans Affairs patients.
  
  
  CONCLUSIONS
  A cooperative network using teleconference and computerized records facilitated bariatric surgery in high-risk, remotely located VA patients with high patient satisfaction and without compromising surgical outcomes.
authors: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. ranjan.sudan@duke.edu
authors: Ranjan
authors: R
authors: Sudan
authors: Mary
authors: M
authors: Salter
authors: Thomas
authors: T
authors: Lynch
authors: Danny O
authors: DO
authors: Jacobs