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Bui C, Parange N, Bezak E, Bidner A. The Role of Telehealth in Ultrasound Training for Remote Learners: A Systematic Review. Telemed J E Health 2024; 30:963-975. [PMID: 38052050 DOI: 10.1089/tmj.2023.0396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Introduction: Remote learners and educators face geographic, professional, and personal barriers that affect their access to quality ultrasound education. The integration of telehealth in ultrasound education enables learners performing ultrasound to receive real-time instruction from an educator at a distant or remote site. However, to date, there has been poor understanding of the efficacy, benefits, shortcomings, and economic impact of telehealth education in comparison to in-person ultrasound training. The aim of this research was to assess current literature on telehealth in ultrasound education and hands-on training, its outcomes and impact, and requirements for future development. Methods: This review examined international literature on telehealth in ultrasound training. The primary author and second investigator were involved in the research and reached consensus on the eligibility criteria, search strategy, included articles, data extraction, and quality assessment. Results: A total of 23 studies were obtained from Medline, Emcare and Scopus. Key themes identified: Most studies saw an equivalent improvement in knowledge and skills through pre and postassessments in both in-person and telehealth sessions. Generally, learners felt comfortable performing ultrasound guided by a remote educator and felt their skills had been advanced across all studies. Educators reported positive feedback, however compared with learners, educators expressed less satisfaction with the telehealth session. Conclusions: This study demonstrated the feasibility of telehealth in ultrasound training for remote learners with little to no experience. Quality studies with comparable outcomes are needed to ascertain the safe and effective application of telehealth in ultrasound training.
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Affiliation(s)
- Catthy Bui
- Department of Allied Health and Human Performance Unit, The University of South Australia, Adelaide, South Australia
| | - Nayana Parange
- Department of Allied Health and Human Performance Unit, The University of South Australia, Adelaide, South Australia
| | - Eva Bezak
- Department of Allied Health and Human Performance Unit, The University of South Australia, Adelaide, South Australia
- Department of Physics, The University of Adelaide, Adelaide, South Australia
| | - Amber Bidner
- Department of Allied Health and Human Performance Unit, The University of South Australia, Adelaide, South Australia
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Zhang YQ, Sun LP, He T, Guo LH, Liu H, Xu G, Zhao H, Wang Q, Wang J, Yang KF, Song GC, Zhou BY, Xu HX, Zhao CK. A 5G-based telerobotic ultrasound system provides qualified abdominal ultrasound services for patients on a rural island: a prospective and comparative study of 401 patients. Abdom Radiol (NY) 2024; 49:942-957. [PMID: 38102443 DOI: 10.1007/s00261-023-04123-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To explore the feasibility of a 5G-based telerobotic ultrasound (US) system for providing qualified abdominal US services on a rural island. METHODS This prospective study involved two medical centers (the tele-radiologist site's hospital and the patient site's hospital) separated by 72 km. Patients underwent 5G-based telerobotic US by tele-radiologists and conventional US by on-site radiologists from September 2020 to March 2021. The clinical feasibility and diagnostic performance of the 5G-based telerobotic abdominal US examination were assessed based on safety, duration, image quality, diagnostic findings, and questionnaires. RESULTS A total of 401 patients (217 women and 184 men; mean age, 54.96 ± 15.43 years) were enrolled. A total of 90.1% of patients indicated no discomfort with the telerobotic US examination. For the examination duration, telerobotic US took longer than conventional US (12.54 ± 3.20 min vs. 7.23 ± 2.10 min, p = 0.001). For image quality scores, the results of the two methods were similar (4.54 ± 0.63 vs. 4.57 ± 0.61, p = 0.112). No significant differences were found between the two methods in measurements for the aorta, portal vein, gallbladder, kidney (longitudinal diameter), prostate, and uterus; however, telerobotic US underestimated the transverse diameter of the kidney (p < 0.05). A total of 504 positive results, including 31 different diseases, were detected. Among them, 455 cases were identified by the two methods; 17 cases were identified by telerobotic US only; and 32 cases were identified by conventional US only. There was good consistency in the diagnosis of 29 types of disease between the two methods (κ = 0.773-1.000). Furthermore, more than 90% of patients accepted the telerobotic US examination and agreed to pay additional fees in future. CONCLUSION The 5G-based telerobotic US system can expand access to abdominal US services for patients in rural areas, thereby reducing health care disparities.
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Affiliation(s)
- Ya-Qin Zhang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Li-Ping Sun
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Tian He
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Le-Hang Guo
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Hui Liu
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Guang Xu
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Hui Zhao
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Qiao Wang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Jing Wang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, 200072, China
| | - Kai-Feng Yang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital Chongming Branch, Shanghai, 200072, China
| | - Guo-Chao Song
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital Chongming Branch, Shanghai, 200072, China
| | - Bo-Yang Zhou
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China.
| | - Chong-Ke Zhao
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, 200032, China.
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Shi R, Rosario J. Paramedic-Performed Prehospital Tele-Ultrasound: A Powerful Technology or an Impractical Endeavor? A Scoping Review. Prehosp Disaster Med 2023; 38:645-653. [PMID: 37622570 PMCID: PMC10548023 DOI: 10.1017/s1049023x23006234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 08/26/2023]
Abstract
Ultrasound with remote assistance (tele-ultrasound) may have potential to improve accessibility of ultrasound for prehospital patients. A review of recent literature on this topic has not been done before, and the feasibility of prehospital tele-ultrasound performed by non-physician personnel is unclear. In an effort to address this, the literature was qualitatively analyzed from January 1, 2010 - December 31, 2021 in the MEDLINE, EMBASE, and Cochrane online databases on prehospital, paramedic-acquired tele-ultrasound, and ten articles were found. There was considerable heterogeneity in the study design, technologies used, and the amount of ultrasound training for the paramedics, preventing cross-comparisons of different studies. Tele-ultrasound has potential to improve ultrasound accessibility by leveraging skills of a remote ultrasound expert, but there are still technological barriers to overcome before determinations on feasibility can be made.
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Affiliation(s)
- Rachel Shi
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Javier Rosario
- University of Central Florida College of Medicine, Orlando, Florida, USA
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Zhou YJ, Guo LH, Bo XW, Sun LP, Zhang YF, Chai HH, Ye RZ, Peng CZ, Qin C, Xu HX. Tele-Mentored Handheld Ultrasound System for General Practitioners: A Prospective, Descriptive Study in Remote and Rural Communities. Diagnostics (Basel) 2023; 13:2932. [PMID: 37761299 PMCID: PMC10530153 DOI: 10.3390/diagnostics13182932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Rural general practitioners (GPs) have insufficient diagnostic information to deal with complex clinical scenarios due to the inequality in medical imaging resources in rural and remote communities. The objective of this study is to explore the value of a tele-mentored handheld ultrasound (tele-HHUS) system, allowing GPs to provide ultrasound (US) services in rural and remote communities. METHODS Overall, 708 patients underwent tele-HHUS examination between March and October 2021 and March and April 2022 across thirteen primary hospitals and two tertiary-care general hospitals. All US examinations were guided and supervised remotely in real time by US experts more than 300 km away using the tele-HHUS system. The following details were recorded: location of tele-HHUS scanning, primary complaints, clinical diagnosis, and US findings. The recommendations (referral or follow-up) based on clinical experience alone were compared with those based on clinical experience with tele-HHUS information. RESULTS Tele-HHUS examinations were performed both in hospital settings (90.6%, 642/708) and out of hospital settings (9.4%, 66/708). Leaving aside routine physical examinations, flank pain (14.2%, 91/642) was the most common complaint in inpatients, while chest distress (12.1%, 8/66) and flank discomfort (12.1%, 8/66) were the most common complaints in out-of-hospital settings. Additionally, the referral rate increased from 5.9% to 8.3% (kappa = 0.202; p = 0.000). CONCLUSIONS The tele-HHUS system can help rural GPs perform HHUS successfully in remote and rural communities. This novel mobile telemedicine model is valuable in resource-limited areas.
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Affiliation(s)
- Yu-Jing Zhou
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China;
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (L.-H.G.); (X.-W.B.); (L.-P.S.); (Y.-F.Z.); (H.-H.C.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Xiao-Wan Bo
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (L.-H.G.); (X.-W.B.); (L.-P.S.); (Y.-F.Z.); (H.-H.C.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Li-Ping Sun
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (L.-H.G.); (X.-W.B.); (L.-P.S.); (Y.-F.Z.); (H.-H.C.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Yi-Feng Zhang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (L.-H.G.); (X.-W.B.); (L.-P.S.); (Y.-F.Z.); (H.-H.C.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Hui-Hui Chai
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (L.-H.G.); (X.-W.B.); (L.-P.S.); (Y.-F.Z.); (H.-H.C.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Rui-Zhong Ye
- Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China;
| | - Cheng-Zhong Peng
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (L.-H.G.); (X.-W.B.); (L.-P.S.); (Y.-F.Z.); (H.-H.C.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Chuan Qin
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China;
- Department of Ultrasound, Karamay Central Hospital, Karamay 834000, China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China;
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Shen YT, Yue WW, Xu HX. Editorial: Ultrasound in Oncology: Application of Big Data and Artificial Intelligence. Front Oncol 2021; 11:819487. [PMID: 35004335 PMCID: PMC8730332 DOI: 10.3389/fonc.2021.819487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 12/07/2022] Open
Affiliation(s)
- Yu-Ting Shen
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Wen-Wen Yue
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
- Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, National Clinical Research Center for Interventional Medicine, Shanghai, China
- *Correspondence: Hui-Xiong Xu,
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