Clinical assessment and management of general surgery patients via synchronous telehealth

Objective This paper describes how a clinical team at Landstuhl Regional Medical Center (LRMC) successfully integrated synchronous telehealth (TH) into their routine clinical practice. Methods and materials Synchronous TH encounters were performed using Polycom® software on surgeons’ computers with...

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Bibliographic Details
Published in:Journal of telemedicine and telecare 2017-02, Vol.23 (2), p.371-375
Main Authors: Cain, Steven M, Moore, Robert, Sturm, Lauren, Mason, Travis, Fuhrman, Caitlin, Smith, Robin, Bojicic, Irfan, Carter, Brandon
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cost Savings
Female
General Surgery - economics
General Surgery - methods
Germany
Humans
Male
Middle Aged
Military Medicine
Surgeons
Surgery
Telemedicine
Telemedicine - economics
Telemedicine - methods
Telemedicine - organization & administration
United States
Young Adult
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Summary:Objective This paper describes how a clinical team at Landstuhl Regional Medical Center (LRMC) successfully integrated synchronous telehealth (TH) into their routine clinical practice. Methods and materials Synchronous TH encounters were performed using Polycom® software on surgeons’ computers with high-definition (HD) cameras on monitors at distant sites and PolyCom HDX9000® Telehealth Practitioner Carts at originating sites. Patients provided consented and were presented to general surgeons by nurses and medical technicians at Army health clinics throughout the European Theater. Results In calendar year (CY) 2014, five general surgeons and two surgical physician assistants (PAs) at Landstuhl Regional Medical Center along with registered nurses (RNs) at six originating clinic sites throughout Europe completed 130 synchronous TH encounters for 101 general surgery patients resulting in 73 completed and 16 recommended surgeries. Eighty-eight percent of patients had a completed or recommended surgery. No surgeries or procedures planned after initial TH evaluation were cancelled. Originating site clinics ranged in distance from 68 miles to 517 miles. Acceptance by providers, patients and clinic staff was high. Conclusion Synchronous TH was effective and safe in evaluating common general surgical conditions. We excluded sensitive and complex conditions requiring a nuanced physical examination. The TH efforts of the general surgery staff have resulted in high-quality, seamless and predictable TH activities that continue to expand into other surgical and medical specialties beyond general surgery. Seven surgeons and two PAs use synchronous TH regularly serving patients over a broad geographic area.
ISSN:1357-633X
1758-1109
DOI:10.1177/1357633X16636245