Application of Telemedicine System to Prehospital Medical Control

다국어 초록 (Multilingual Abstract)

Objectives: Although ambulance-based telemedicine has been reported to be safe and feasible, its clinical usefulness has not been well documented, and different prehospital management systems would yield different results. The authors evaluated the feasibility and usefulness of telemedicine-assisted direct medical control in the Korean emergency medical service system.
Methods: Twenty ambulances in the Busan area were equipped with a telemedicine system. Three-lead electrocardiogram, blood pressure, and pulse oximetry data from the patient and audiovisual input from the scene were transferred to a server.
Consulting physicians used desktop computers and the internet to connect to the server. Both requesting emergency medical service (EMS) providers and consulting physicians were asked to fill out report forms and submit them for analysis. Results: In the 41 cases in which telemedicine equipment was used, cellular phones were concomitantly used in 28 cases (68.35%) to compensate for the poor audio quality provided by the equipment. The EMS providers rated the video transmission quality with a 4-point average score (interquartile range [IQR] 2–5) on a 5-point scale, and they rated the biosignal transmission quality as 4 (IQR 3–5). The consulting physicians rated the video quality as 4 (IQR 2.5–4) and the biosignal quality as 4 (IQR 3–4). The physicians’ ratings for usefulness for making diagnosis or treatment decisions did not differ significantly in relation to the method of communication used. Conclusions: Our study did not find any significant advantage of implementing telemedicine over the use of voice calls in delivering on-line medical control. More user-friendly, smaller devices with clear advantages over voice communication would be required before telemedicine can be successfully implemented in prehospital patient care.

참고문헌 (Reference)

• 1 윤대흥, "원격 화상 진료가 무의도 주민의 의료 이용에 미치는 영향" 대한응급의학회 19 (19): 359-365, 2008
• 2 박인철, "멀티미디어 원격진료시스템을 이용한 병원간 응급환자 협의진료 모델" 대한응급의학회 14 (14): 467-474, 2003
• 3 Banitsas K, "Using HSPA to improve the telemedical links on a moving ambulance" 2008 : 739-742, 2008
• 4 Hwang SO, "The current status of the emergency medical system in Korea" 25 (25): 846-848, 2007
• 5 Latifi R, "Telemedicine and telepresence for trauma and emergency care management" 96 (96): 281-289, 2007
• 6 Dhruva VN, "ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction(STATMI)trial" 50 (50): 509-513, 2007
• 7 Campbell PT, "Prehospital triage of acute myocardial infarction : wireless transmission of electrocardiograms to the on-call cardiologist via a handheld computer" 38 (38): 300-309, 2005
• 8 Beuran M, "Prehospital trauma care : a clinical review" 107 (107): 564-570, 2012
• 9 Hollander JE, "On-line telemetry : prospective assessment of accuracy in an all-volunteer emergency medical service system" 2 (2): 280-286, 1995
• 10 Galli R, "Innovation possibilities for prehospital providers" 10 (10): 317-319, 2006
• 11 Yperzeele L, "Feasibility of AmbulanCe-Based Telemedicine (FACT) study:safety, feasibility and reliability of third generation inambulance telemedicine" 9 (9): 110043-, 2014
• 12 Cicero MX, "Do you see what I see? Insights from using google glass for disaster telemedicine triage" 30 (30): 4-8, 2015
• 13 Roine R, "Assessing telemedicine : a systematic review of the literature" 165 (165): 765-771, 2001
• 14 Zanaboni P, "Adoption of telemedicine : from pilot stage to routine delivery" 12 : 1-, 2012
• 15 김동근, "ActiveX 컨트롤을 이용한 웹 기반 실시간 원격진료 시스템의 의료 영상 평가" 대한의료정보학회 9 (9): 1-11, 2003
• 16 Jeroudi OM, "Accuracy of remote electrocardiogram interpretation with the use of Google Glass technology" 115 (115): 374-377, 2015