title: Remote tele-mentored ultrasound for non-physician learners using FaceTime: A feasibility study in a low-income country.
abstract: Ultrasound (US) is a burgeoning diagnostic tool and is often the only available imaging modality in low- and middle-income countries (LMICs). However, bedside providers often lack training to acquire or interpret US images. We conducted a study to determine if a remote tele-intensivist could mentor geographically removed LMIC providers to obtain quality and clinically useful US images.
  
  
  
  Nine Haitian non-physician health care workers received a 20-minute training on basic US techniques. A volunteer was connected to an intensivist located in the USA via FaceTime. The intensivist remotely instructed the non-physicians to ultrasound five anatomic sites. The tele-intensivist evaluated the image quality and clinical utility of performing tele-ultrasound in a LMIC.
  
  
  
  The intensivist agreed (defined as "agree" or "strongly agree" on a five-point Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time.
  
  
  
  Non-physicians can feasibly obtain high-quality and clinically relevant US images using video chat software in LMICs. Commercially available software can connect providers in institutions in LMICs to geographically removed intensivists at a relatively low cost and without the need for extensive training of local providers.
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, 200 N Lothrop St, Montefiore N715, Pittsburgh, PA 15213, United States.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Robertson
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, 3459 Fifth Avenue, 628 NW, Pittsburgh, PA 15213, United States.
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Levine
authors.affiliation: Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD 21201, United States.
authors.forename: Avelino C
authors.initials: AC
authors.lastname: Verceles
authors.affiliation: Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD 21201, United States.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Buchner
authors.affiliation: Uniform Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, United States.
authors.forename: James H
authors.initials: JH
authors.lastname: Lantry
authors.affiliation: Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD 21201, United States; Institute for Global Health, University of Maryland School of Medicine, 685 W. Baltimore Street, Baltimore, MD 21201, United States.
authors.forename: Alfred
authors.initials: A
authors.lastname: Papali
authors.affiliation: Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD 21201, United States; Program in Trauma, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, United States; University of Maryland eCare, University of Maryland Medical System, 110 S. Paca St., 5th Floor, Baltimore, MD 21201, United States.
authors.forename: Marc T
authors.initials: MT
authors.lastname: Zubrow
authors.affiliation: Department of Medicine, St. Luke Family Hospital, Port-au-Prince, Haiti.
authors.forename: L Nathalie
authors.initials: LN
authors.lastname: Colas
authors.affiliation: Department of Medicine, St. Luke Family Hospital, Port-au-Prince, Haiti.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Augustin
authors.affiliation: Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD 21201, United States; University of Maryland School of Medicine, Department of Emergency Medicine, 110 S. Paca St., 6th Floor, Baltimore, MD 21201, United States. Electronic address: mmccurdy@som.umaryland.edu.
authors.forename: Michael T
authors.initials: MT
authors.lastname: McCurdy
mesh_terms: D000328:Adult; D020375:Education, Distance / Q000379:methods / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006205:Haiti; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011203:Poverty; D061108:Social Media / Q000592:standards*; D012984:Software; D017216:Telemedicine / Q000592:standards*; D014463:Ultrasonography; D055815:Young Adult
keywords: Critical care; Global health; Point-of-care ultrasound; Telemedicine