TELECONSULTATION IN NEUROSURGERY, COMPARING THE MULTIMODAL APPROACH IN IMAGE TRANSFER IN HOSPITAL KUALA LUMPUR: A PROSPECTIVE OBSERVATIONAL STUDY
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Date
2012
Authors
AHMAD ZAMZURI, REMELI
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
Abstract
Teleconsultation involves the transfer of neuroimages such as CT scan which is vital to
facilitate effective and efficient provision of neurosurgical care. It is a computer-based
radiographic image transfer system which enhances verbal communication prior to transfer of a
neurosurgical emergency and the quality of the transmitted images is comparable in resolution
and diagnostic accuracy to the original films.
Materials and methods: A prospective observational study has been conducted in Kuala
Lumpur Hospital for eight months period from 1st December 2009 to 31st July 2010. A total of
372 patients referred from various peripheral hospitals were recruited in this study following a
strict inclusion and exclusion criteria. Three different modes of image transfer were used which
are the Multimedia Messaging Services (MMS), e mail and telehealth system (TH).The aims of
this study is to compare three different modes of image transfer during teleconsultation of
neurosurgical patients between peripheral hospitals and the neurosurgical center in Kuala
Lumpur Hospital which will further guide the management of the patient. Results: There was no difference in regards to the most reliable method of image transfer in
neurosurgery [(p=0.424, TH vs e mail),(p=0.324,e mail vs MMS), (p=0.169,TH vs MMS)].The
Glasgow Outcome Scale of patients managed by the neurosurgeons in HKL were significantly
better against those managed at the peripheral hospitals (p < 0.001 ) and the unnecessary transfer
was minimized to 66%.The diagnostic accuracy improves from 87.8%, 90.7% and 96.5%
whenever the neuroimages were reviewed by the medical officers, clinicians and the radiologists
respectively.
Conclusions: Teleconsultation allows provision of specialist medical care to remote hospitals
through teleconsultation links between hospitals thus improves the health outcome. The system
chosen has to be user friendly, easy access, portability and cost effective.MMS system appeared
handy and portable, while email and TH system requires a high performance computer
networking station. On the other hand, TH system has been shown to be the most comprehensive
method of image transfer in neurosurgical teleconsultation.
Description
Keywords
Neurosurgery