Prospective Evaluation of Telemedicine in Remote Naval Populations Seeking Specialty Care.

摘要

Telemedicine technologies, such as Internet and live videoteleconferencing (VTC), have great potential to provide specialty care for naval personnel in remote treatment facilities at sea or onshore. This study focused on the clinical impact of ear/nose/throat (ENT) consultations conducted via live VTC during a planned, 4-month study period in TRICARE Region 9. Also, interviews of physician and non-physician medical personnel assessed their attitudes and recent use of telemedicine. A total of 193 ENT consultations were conducted following referrals from primary providers at remote MTFs. Patients were mostly young, active duty military personnel. Nearly half (45%) of these consultations led to changed diagnosis by ENT specialist relative to initial diagnosis by primary provider. This rate of clinical impact generalized across different ENT conditions (e.g., tonsil, upper respiratory, hearing), age, military status and MTFs. Medical personnel reported positive attitudes on telemedicine technologies and the telemedicine process. Non-physicians reported slightly more positive attitudes than physicians and used telemedicine more often and in more ways than did physicians. These results replicated and extended a recent retrospective study on Region 9 telemedicine. The telemedicine process for specialty ENT care in Region 9 produced robust clinical impact and the medical personnel reacted very favorably.