Head and neck cancer assessment by flexible endoscopy and telemedicine

We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total o...

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Bibliographic Details
Published in:Journal of telemedicine and telecare 2009-04, Vol.15 (3), p.118-121
Main Authors: Dorrian, Cathy, Ferguson, Jim, Ah-See, Kim, Barr, Catriona, Lalla, Kushik, van der Pol, Marjon, McKenzie, Lynda, Wootton, Richard
Format: Article
Language:English
Subjects:
Cost-Benefit Analysis
Endoscopy
Feasibility Studies
Female
Greenhouse Effect
Head & neck cancer
Head and Neck Neoplasms - diagnosis
Head and Neck Neoplasms - economics
Health Services Accessibility - economics
Humans
Laryngoscopes
Laryngoscopy - economics
Male
National Health Programs - economics
Pilot Projects
Referral and Consultation - economics
Rural Health Services
Scotland
Telemedicine
Telemedicine - economics
Travel - economics
Workloads
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Summary:We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total of 42 patients were seen in Aberdeen via videoconferencing for a head and neck cancer assessment. Feasibility was confirmed after the first 20 patients, following positive feedback from all concerned and the absence of any significant clinical or technical problems. A total of 42 journeys was avoided, each journey saving 123 kg CO2 per person. A preliminary cost analysis showed that the threshold at which tele-ENT became cheaper than travel was a workload of 35 patients/year. The actual workload during the pilot study was 29 patients/year. A national telemedicine service for the initial assessment of potential malignancy has the potential to reduce unnecessary transfers to specialist centres, with accompanying reductions in carbon emissions.
ISSN:1357-633X
1758-1109
DOI:10.1258/jtt.2009.003004