title: [Interdisciplinary teleconsultation: first practical experiences with 100 patients].
abstract: PROBLEM DEFINITION: Increasing specialization can be observed in the various medical fields and as a consequence there is little professional exchange between ear nose and throat (ENT) specialists and general practitioners. At the same time there has been significant technological development in telemedicine over the last 5 years; however, this potential is not being sufficiently exploited. The objective of this project is to implement a practicable solution for teleconsulation between ENT specialists and general practitioners.
  
  
  METHODS
  The connection is based on a secure broadband internet connection, the corresponding server structure and a video endoscopic system. In the period from 01 January 2011 to 30 June 2012 (18 months) a total of 102 patients were included in the study in which 4 general practitioners and 5 ENT specialists participated. The protocol comprised the following parameters: indications and typical questions, number of patients presenting to the ENT specialist due to the available teleconsultation service (CBO), number of patients referred to the ENT specialist after teleconsultation (CIO), assessment of the quality of the additional expert opinion (LOQ GP), assessment of the accuracy of the specialist physician tele-diagnosis (TDS-FA) and assessment of the impact of the expert physician diagnosis on the general medical treatment (COS).
  
  
  RESULTS
  Teleconsultation was most frequently used for diagnostics on tonsils (37% of the presented cases), the external auditory canal (32%) and the inner nose (15%). Of the patients analyzed were 53.9% presented to the ENT specialist only because the teleconsultation service provided an effortless opportunity and after teleconsultation 40.1% of the patients were referred to the ENT specialist. General practitioners assessed the benefit from the specialist opinion with 64 points. Diagnostic certainty of the specialist opinion, i.e. the validity scale of the diagnosis made, was on average 2.0. In approximately 35.3% of the cases (36 out of 102 patients) participating general practitioners documented a considerable impact of teleconsultation on the diagnosis and/or therapy.
  
  
  CONCLUSIONS
  Teleconsultation between general practitioners and ENT specialists can provide an advantage in treatment quality and patient comfort. According to the experience gained there is a very low risk of diminishing the professional competency of ENT medicine and the involvement of the expert group in the early project stage allows a greater leeway in project implementation. This could also have an impact on future medical performance specifications. According to the ENT experts involved in the project further applications of teleconsultation are very conceivable.
authors.affiliation: International Reference and Development Centre for Surgical Technology (IRDC) Leipzig, Käthe-Kollwitz-Str. 64, 04109, Leipzig, Deutschland. i.gollnick@irdc-leipzig.de
authors.forename: I
authors.initials: I
authors.lastname: Gollnick
authors.forename: M
authors.initials: M
authors.lastname: Frehiwot
authors.forename: E M
authors.initials: EM
authors.lastname: Krause
authors.forename: S
authors.initials: S
authors.lastname: Schaller
authors.forename: E
authors.initials: E
authors.lastname: Limpert
authors.forename: G
authors.initials: G
authors.lastname: Strauß
authors.forename: T
authors.initials: T
authors.lastname: Lipp
authors.forename: M
authors.initials: M
authors.lastname: Scherz
authors.forename: Z
authors.initials: Z
authors.lastname: Injac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D020407:Internet; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000706:statistics & numerical data*; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010348:Patient Care Team / Q000706:statistics & numerical data*; D010865:Pilot Projects; D019114:Remote Consultation / Q000706:statistics & numerical data*; D055815:Young Adult