Preliminary exploration of theory and practice training of 5G ultrasonic remote consultation in grassroot hospitals

Feasibility and Safety of Percutaneous Puncture Guided by a 5G-Based Telerobotic Ultrasound System: An Experimental Study

PURPOSE

To evaluate the feasibility and safety of percutaneous puncture guided by a 5th generation mobile communication technology (5G)-based telerobotic ultrasound system in phantom and animal experiments.

MATERIALS AND METHODS

In the phantom experiment, 10 simulated lesions were punctured, once at each of two angles for each lesion, under the guidance of a telerobotic ultrasound system and ultrasound-guided freehand puncture. Student's t test was used to compare the two methods in terms of puncture accuracy, total operation duration, and puncture duration. In the animal experiment, under the guidance of the telerobotic ultrasound system, an 18G puncture needle was used to puncture 3 target steel beads in the liver, right kidney, and right gluteal muscle, respectively. The animal experiment had no freehand ultrasound-guided control group. After puncture, a CT scan was performed to verify the position of the puncture needle in relation to the target, and the complications and puncture duration, etc., were recorded.

RESULTS

In the phantom experiment, the mean accuracies of puncture under telerobotic ultrasound guidance and conventional ultrasound guidance were 1.8 ± 0.3 mm and 1.6 ± 0.3 mm (P = 0.09), respectively; therefore, there was no significant difference in the accuracy of the two guide methods. In the animal experiment, the first-attempt puncture success (the needle tip close to the target) rate was 93%. Polypnea occurred during one puncture. No other intraoperative or postoperative complications were observed.

CONCLUSION

Puncture guided by a 5G-based telerobotic ultrasound system has shown good feasibility and safety in phantom and animal experiments.

Effectiveness and feasibility of 5G-based remote interactive ultrasound training in critical care

BACKGROUND

Ultrasound has widely used in various medical fields related to critical care. While online and offline ultrasound trainings are faced by certain challenges, remote ultrasound based on the 5G cloud platform has been gradually adopted in many clinics. However, no study has used the 5G remote ultrasound cloud platform operating system for standardized critical care ultrasound training. This study aimed to evaluate the feasibility and effectiveness of 5G-based remote interactive ultrasound training for standardized diagnosis and treatment in critical care settings.

METHODS

A 5G-based remote interactive ultrasound training system was constructed, and the course was piloted among critical care physicians. From July 2022 to July 2023, 90 critical care physicians from multiple off-site locations were enrolled and randomly divided into experimental and control groups. The 45 physicians in the experimental group were trained using the 5G-based remote interactive ultrasound training system, while the other 45 in the control group were taught using theoretical online videos. The theoretical and practical ultrasonic capabilities of both groups were evaluated before and after the training sessions, and their levels of satisfaction with the training were assessed as well.

RESULTS

The total assessment scores for all of the physicians were markedly higher following the training (80.7 ± 11.9) compared to before (42.1 ± 13.4) by a statistically significant margin (P < 0.001). Before participating in the training, the experimental group scored 42.2 ± 12.5 in the critical care ultrasound competency, and the control group scored 41.9 ± 14.3-indicating no significant differences in their assessment scores (P = 0.907). After participating in the training, the experimental group's assessment scores were 88.4 ± 6.7, which were significantly higher than those of the control group (72.9 ± 10.8; P < 0.001). The satisfaction score of the experimental group was 42.6 ± 2.3, which was also significantly higher than that of the control group (34.7 ± 3.1, P < 0.001).

CONCLUSION

The 5G-based remote interactive ultrasound training system was well-received and effective for critical care. These findings warrant its further promotion and application.

Complaint management system and patient satisfaction in grassroots hospitals

Primary healthcare institutions face limitations in medical resources, leading to concerns from patients and their families regarding the quality of medical services, resulting in complaints against these institutions. This study aims to analyze the causes of complaints and implement improvement measures to enhance the service quality of primary healthcare institutions, increase satisfaction among patients and their families, and reduce the number of complaints. Relevant data were collected, and verified complaints were categorized based on departments, administrative office, and category. Pearson Chi-square test, Spearman correlation analysis, as well as univariate logistic regression were employed to analyze factors influencing patient satisfaction. A complaint-handling process was established, and regulations pertaining to complaints were formulated. Pearson Chi-square test results indicated a significant correlation between satisfaction and departments (P = .016) and administrative office (P = .022). Spearman correlation analysis revealed a significant correlation between satisfaction and departments (ρ = 0.157, P = .017) and administrative office (ρ = 0.151, P = .021). Univariate logistic regression analysis demonstrated a significant correlation between satisfaction and other related complaints in administrative office (OR = 3.321, 95% CI = 1.196-9.218, P = .021). Complaints related to departments and administrative offices are significantly correlated with satisfaction. After the implementation of a complaint management system in primary healthcare institutions, there is a notable improvement in service quality, enhanced patient experience, increased satisfaction, and a reduction in hospital complaints.

Feasibility and Safety of 5G-Based Telerobotic Abdominal Ultrasonography

OBJECTIVE

Telemedicine can offer services to remote patients regardless of the distance. Fifth-generation (5G) mobile networks may make telemedicine practical because of their low latency. This study aimed to evaluate the feasibility and safety of a novel 5G robot-assisted remote abdominal ultrasound (AUS) telemedicine technology in clinical applications in distant locations.

METHODS

We performed 5G-based telerobotic AUS in patients who were located more than 100 km away from the physicians.

RESULTS

The telerobotic AUS had a longer examination time than the conditional bedside AUS; however, the complete examination rate was not inferior. None of the volunteers experienced discomfort during the examination and the examination time was acceptable for all.

CONCLUSION

Our findings confirm the feasibility and safety of 5G-based telerobotic AUS in clinical practice.

Clinical Significance of Action Research-Based Seamless Care to Improve Imaging Efficiency and Patients' Cognition, and Alleviate Patient Anxiety

Objective

The present study was undertaken to assess the clinical significance of action research-based seamless care to improve imaging efficiency and alleviate patient anxiety.

Methods

A total of eighty patients who underwent imaging examinations in our hospital between May 2019 and November 2020 were recruited for this study. The patients were randomly assigned to two groups: the control group receiving routine care and the observation group receiving seamless care based on action research. The random assignment was conducted using a simple random sampling technique, ensuring an equal allocation of participants to each group at a 1:1 ratio, resulting in 40 cases in each group. Outcome measures included imaging examination duration, mean nursing duration, examination cognition, and negative emotion scores.

Results

Seamless care provided shorter imaging examination duration and nursing duration, and better ensured uneventful examinations than routine care (P<0.05). Patients given seamless care exhibited higher examination cognition versus those receiving routine care (P<0.05). Seamless care offered more mitigation of negative emotions for patients than routine care (P<0.05).

Conclusion

Action research-based seamless care effectively improves imaging efficiency and patients' awareness of imaging examinations and contributes to alleviating patients' adverse events.