Application of Telemedicine System to Prehospital Medical Control

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Á¶¼®ÁÖ(Cho Suck-Ju) - Pusan National University Hospital Department of Emergency Medicine
±ÇÀÎÈ£(Kwon In-Ho) - Dong-A University College of Medicine Department of Emergency Medicine
Á¤Áø¿ì(Jeong Jin-Woo) - Dong-A University College of Medicine Department of Emergency Medicine

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 ectrocardiogram,
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.

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Telemedicine, Telemetry, Emergency Medical Services, Remote Consultation, Ambulances
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This study applied an ambulance-based telemedicine system to the EMS service of a metropolitan city and found no apparent benefit over conventional cellular phones, partly because of insufficient technology.
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