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Choi W, Lim Y, Heo T, Lee S, Kim W, Kim SC, Kim Y, Kim J, Kim H, Kim H, Lee T, Kim C. Characteristics and Effectiveness of Mobile- and Web-Based Tele-Emergency Consultation System between Rural and Urban Hospitals in South Korea: A National-Wide Observation Study. J Clin Med 2023; 12:6252. [PMID: 37834896 PMCID: PMC10573876 DOI: 10.3390/jcm12196252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; p < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; p < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; p < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; p = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes.
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Affiliation(s)
- WooSung Choi
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
| | - YongSu Lim
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Tag Heo
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - SungMin Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - Won Kim
- Department of Emergency Medicine, Cheju Halla General Hospital, Jeju 63127, Republic of Korea;
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea;
| | - YeonWoo Kim
- Department of Emergency Medicine, Andong Medical Center, Andong 36743, Republic of Korea;
| | - JaeHyuk Kim
- Department of Emergency Medicine, Mokpo Hangook Hospital, Mokpo 58643, Republic of Korea;
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea;
| | - HyungIl Kim
- Department of Emergency Medicine, Dankook University College of Medicine, Cheonan 31116, Republic of Korea;
| | - TaeHun Lee
- Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea;
| | - Chol Kim
- Department of Emergency Medicine, Saint Carollo General Hospital, Suncheon 57931, Republic of Korea;
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Braun BJ, Grimm B, Hanflik AM, Marmor MT, Richter PH, Sands AK, Sivananthan S. Finding NEEMO: towards organizing smart digital solutions in orthopaedic trauma surgery. EFORT Open Rev 2020; 5:408-420. [PMID: 32818068 PMCID: PMC7407868 DOI: 10.1302/2058-5241.5.200021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
There are many digital solutions which assist the orthopaedic trauma surgeon. This already broad field is rapidly expanding, making a complete overview of the existing solutions difficult.The AO Foundation has established a task force to address the need for an overview of digital solutions in the field of orthopaedic trauma surgery.Areas of new technology which will help the surgeon gain a greater understanding of these possible solutions are reviewed.We propose a categorization of the current needs in orthopaedic trauma surgery matched with available or potential digital solutions, and provide a narrative overview of this broad topic, including the needs, solutions and basic rules to ensure adequate use in orthopaedic trauma surgery. We seek to make this field more accessible, allowing for technological solutions to be clearly matched to trauma surgeons' needs. Cite this article: EFORT Open Rev 2020;5:408-420. DOI: 10.1302/2058-5241.5.200021.
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Affiliation(s)
- Benedikt J Braun
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Germany
| | | | | | - Meir T Marmor
- Department of Orthopaedic Surgery, University of California, San Francisco, California, USA
| | - Peter H Richter
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Germany
| | - Andrew K Sands
- Weill Cornell Medical College, Foot and Ankle Surgery, Downtown Orthopedic Associates, New York Presbyterian Lower Manhattan Hospital, New York, USA
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Fenelon C, Murphy EP, Galbraith JG, O'Sullivan ME. Telesurveillance: Exploring the Use of Mobile Phone Imaging in the Follow-Up of Orthopedic Patients with Hand Trauma. Telemed J E Health 2019; 25:1244-1249. [DOI: 10.1089/tmj.2018.0210] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christopher Fenelon
- Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland
| | - Evelyn P. Murphy
- Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland
| | - John G. Galbraith
- Department of Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland
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Clark AK, Bosanac S, Ho B, Sivamani RK. Systematic review of mobile phone-based teledermatology. Arch Dermatol Res 2018; 310:675-689. [DOI: 10.1007/s00403-018-1862-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 05/30/2017] [Accepted: 08/27/2018] [Indexed: 12/17/2022]
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Jun YJ, Shin D, Choi WJ, Hwang JH, Kim H, Kim TG, Lee HB, Oh TS, Shin HW, Suh HS, Lee AY, Hong JPJ. A Mobile Application for Wound Assessment and Treatment: Findings of a User Trial. INT J LOW EXTR WOUND 2016; 15:344-353. [PMID: 27881691 DOI: 10.1177/1534734616678522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The D+Wound Solution is a mobile phone application (app) that assists users in the assessment and treatment of the wound. The app has 6 components for assessment: need for debridement, infection control, revascularization, and exudate control; whether it is chronic; and finally, the top surface of the skin. These components are named D.I.R.E.C.T. The app makes you review these components as an algorithm to provide a reasonable solution for dressing. It is designed to understand the status of the wound and provide a practical treatment idea for wound care providers. A total of 118 nurses were divided into 2 groups, designated as experienced and less-experienced groups, and surveyed. Both groups found the app to be helpful in making a treatment plan. However, the less-experienced group found it to be significantly more useful in assessing the wound ( P = .026) but difficult to understand the logic. The experienced group found the logic to be significantly easier to understand ( P = .018) and had significantly higher similarities ( P = .015) in treatment protocols compared with the less-experienced group. We may conclude that this app has a logical algorithm resembling experienced wound caregivers and is more useful in the less-experienced group.
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Affiliation(s)
| | | | | | | | - Hoon Kim
- 5 Konyang University Hospital, Daejeon, Korea
| | | | | | - Tae Suk Oh
- 7 Asan Medical Center, University of Ulsan, Seoul, Korea
| | | | - Hyun Suk Suh
- 7 Asan Medical Center, University of Ulsan, Seoul, Korea
| | - A-Young Lee
- 9 Daewoong Pharmaceutical Co, Ltd, Seoul, Korea
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Plant MA, Novak CB, McCabe SJ, von Schroeder HP. Use of digital images to aid in the decision-making for acute upper extremity trauma referral. J Hand Surg Eur Vol 2016; 41:763-8. [PMID: 26634398 DOI: 10.1177/1753193415620177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/10/2015] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study evaluated the use of digital smartphone images in the decision-making for acute upper extremity trauma referrals. Surgeons (n = 15) were presented with ten upper limb trauma scenarios for consideration of immediate transfer. Based on verbal history and with additional images, participants were asked questions regarding diagnosis, injured tissues, recommended management and diagnostic and treatment confidence. Statistical analyses evaluated confidence level changes and relationships between confidence levels and independent variables. Confidence levels for diagnosis and treatment were increased with the provision of smartphone images, and this was statistically significant. The decision to transfer was changed in 22%. The photographs were more useful for amputation versus non-amputation injuries (diagnosis and treatment) and hand versus forearm injuries (diagnosis), and these differences reached statistical significance. Smartphone digital images were shown to be useful for decision-making in acute upper extremity trauma referrals. This improved communication may have implications for health cost savings and patient burden by minimizing unnecessary acute transfers. LEVEL OF EVIDENCE Diagnostic Level III.
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Affiliation(s)
- M A Plant
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - C B Novak
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - S J McCabe
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - H P von Schroeder
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Joseph B, Pandit V, Wynne J, Aziz H, Tang A, Kulvatunyou N, Webster A, O'Keeffe T, Ziemba M, Friese RS, Weinstein RS, Rhee P. Telephotography in trauma: a 2-year clinical experience. Telemed J E Health 2014; 20:342-5. [PMID: 24443926 DOI: 10.1089/tmj.2013.0190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Smartphones can be used to record and transmit high-quality clinical photographs. The aim of this study was to describe our experience with smartphone telephotography in the care of trauma patients. We hypothesized that smartphone telephotography can be safely and effectively implemented on a trauma service. SUBJECTS AND METHODS We performed a 2-year (January 2011-December 2012) prospective analysis of all patient photographs recorded by members of our trauma team at our Level I trauma center. All members of the trauma team recorded patient photographs and e-mailed them to a secure e-mail account. An administrative assistant uploaded a copy of each photgrapho into the patient's electronic medical record. We assessed the number of photographs collected and uploaded, as well as the success, failure, and complication rates. RESULTS Our trauma team sent 7,200 photographs to a secure e-mail account. Of those, 6,120 (85%) were considered, after an initial review, to be of good quality. Of these, 3,320 photographs (54%) were successfully uploaded into a patient's electronic medical record; the remaining 2,800 photographs lacked adequate labeling and could not be uploaded. The average interval to uploading was 3 months. In total, 10 photographs were uploaded into the wrong patient's electronic medical record, for an error rate of 0.003%. We received only three complaints during the study period. CONCLUSIONS Telephotography can be safely and effectively implemented in trauma clinical practice. Fears of Health Insurance Portability and Accountability Act violations are not valid, as the incidence of patient complaints is minimal when telephotography is implemented under strict guidelines and rules. Dedicated administrative personnel are essential for effective implementation of smartphone photography.
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Affiliation(s)
- Bellal Joseph
- 1 Division of Trauma, Critical Care, Emergency Surgery, and Burns, The University of Arizona Medical Center , Tucson, Arizona
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Yu Y, Li J, Liu J. M-HELP: a miniaturized total health examination system launched on a mobile phone platform. Telemed J E Health 2013; 19:857-65. [PMID: 24050610 DOI: 10.1089/tmj.2013.0031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A timely health examination is of great significance for incipient disease detection and prevention. However, conventional examinations generally rely heavily on bulky and expensive instrumentation, which is not easily available. To address technical barriers, an innovative, highly miniaturized, and integrated health examination system-Mobile Health Examination Launched on the Phone (M-HELP)-was developed. MATERIALS AND METHODS Based on the design of a multifunctional Android® (Google, Mountain View, CA) application and the development of different wireless biomedical sensor modules, a mobile phone was incorporated into a central terminal for personal health examination. More than 12 parameters, including electrocardiogram, heart sound, and eye test, as well as others, covered the majority of the crucial parameters in a total health examination and have been successfully established and incorporated into the system. Unlike the conventional examination, the M-HELP system could generate electronic health records and send them to physicians via e-mails or multimedia messages. This significantly simplifies the general health examination with much lower cost and fewer temporal and spatial restrictions. RESULTS For proof of concept, a bench-scale test recruiting 11 volunteer subjects showed that the average time spent on a total health examination with M-HELP system was about 28 min. CONCLUSIONS This article clarifies the basic concept of a total health examination on the platform of a mobile phone, demonstrates the basic features of the M-HELP system with group tests, and suggests the practical future application of the new system and the scientific issues thus raised.
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Affiliation(s)
- Yang Yu
- 1 Department of Biomedical Engineering, School of Medicine, Tsinghua University , Beijing, China
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