Frank Janssen1, Mohammed Awadallah1, Awed Alhalabi1, Barbara Körber2, Reinhard Lang3, Mateusz Scibor4, René Handschu5. 1. Department of Neurology, Klinikum Neumarkt, Nürnberger Str. 12, 92318, Neumarkt/Opf, Germany. 2. Emergency Department, Klinikum Neumarkt, Neumarkt/Opf, Germany. 3. Department of Information Technology, Klinikum Neumarkt, Neumarkt/Opf, Germany. 4. Department of Neurology/STENO Network, University of Erlangen-Nuremberg, Erlangen, Germany. 5. Department of Neurology, Klinikum Neumarkt, Nürnberger Str. 12, 92318, Neumarkt/Opf, Germany. rene.handschu@klnikum.neumarkt.de.
Abstract
OBJECTIVE: While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital. METHODS: In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC). In AVC the expert used a mobile telemedicine device and so he could establish audiovisual contact from his home to the emergency room and examine newly admitted patients. Technical and patient details including timing and diagnosis were recorded. Video and audio quality as well as impact of AVC on diagnosis was rated by the EN. RESULTS: Out of about 1200 cases in off peak times, during the study period, 164 AVC including remote video examination were done (13.6%). Also 48 cases were documented by pure TA. Video quality was rated to a medium of 1.7, audio quality to 2.1. In 36 cases the audiovisual consultation was influenced by technical issues leading to cessation of AVC in 8 cases. Duration of teleconsultation was 17.3 min in AVC compared to 8.7 min for TA. The consultation diagnosis in AVC was confirmed in 74.4% of all cases compared to 57.7% in TA. AVC was rated as a valuable contribution to the diagnostic workup in 74.3% of all cases seen. In about 40% of all cases AVC was not possible due to technical or organizational reasons. CONCLUSIONS: Audiovisual consultation seems to be a feasible and useful support in routine neurology back-up service of an acute care hospital. Better mobility of devices and flexibility of service is needed to improve availability and quality of this valuable tool.
OBJECTIVE: While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital. METHODS: In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC). In AVC the expert used a mobile telemedicine device and so he could establish audiovisual contact from his home to the emergency room and examine newly admitted patients. Technical and patient details including timing and diagnosis were recorded. Video and audio quality as well as impact of AVC on diagnosis was rated by the EN. RESULTS: Out of about 1200 cases in off peak times, during the study period, 164 AVC including remote video examination were done (13.6%). Also 48 cases were documented by pure TA. Video quality was rated to a medium of 1.7, audio quality to 2.1. In 36 cases the audiovisual consultation was influenced by technical issues leading to cessation of AVC in 8 cases. Duration of teleconsultation was 17.3 min in AVC compared to 8.7 min for TA. The consultation diagnosis in AVC was confirmed in 74.4% of all cases compared to 57.7% in TA. AVC was rated as a valuable contribution to the diagnostic workup in 74.3% of all cases seen. In about 40% of all cases AVC was not possible due to technical or organizational reasons. CONCLUSIONS: Audiovisual consultation seems to be a feasible and useful support in routine neurology back-up service of an acute care hospital. Better mobility of devices and flexibility of service is needed to improve availability and quality of this valuable tool.
Authors: Askiel Bruno; Katherine M Lanning; Hartmut Gross; David C Hess; Fenwick T Nichols; Jeffrey A Switzer Journal: Stroke Date: 2013-07-09 Impact factor: 7.914
Authors: René Handschu; Angela Wacker; Mateusz Scibor; Camelia Sancu; Stefan Schwab; Frank Erbguth; Patrick Oschmann; David Stark; Lars Marquardt Journal: J Neurol Date: 2015-03-21 Impact factor: 4.849
Authors: Heinrich J Audebert; Christian Kukla; Stephan Clarmann von Claranau; Johannes Kühn; Bijan Vatankhah; Johannes Schenkel; Guntram W Ickenstein; Roman L Haberl; Markus Horn Journal: Stroke Date: 2004-12-29 Impact factor: 7.914
Authors: René Handschu; Mateusz Scibor; Angela Wacker; David R Stark; Martin Köhrmann; Frank Erbguth; Patrick Oschmann; Stefan Schwab; Lars Marquardt Journal: Int J Stroke Date: 2014-08-04 Impact factor: 5.266