A telementored trans-rectal ultrasound guided prostate biopsy

The purpose of this project was to demonstrate the efficacy and feasibility of a real-time telementored transrectal ultrasound-guided prostate biopsy. The physician (P) was located at a remote site while the physician's extender (PE) was with the patient at another location. The (P) directed and guided the (PE) through the biopsy procedures utilizing video and audio contact, and viewing electronically transmitted ultrasound images. This procedure occurred at Walter Reed Army Medical Center in Washington, DC where the patient and (PE) were located in a surgical suite, and the (P) was located in another part of the hospital. Audio, video and ultrasound images were transmitted via a simulated T1 line. The success of this procedure demonstrates both feasibility and efficacy of invasive procedures telementored by a (P) from a remote location while the (PE) is with the patient and receiving remote instruction. The achievement of a real-time telementored biopsy has significance in increasing access to care by those populations living in geographically remote areas or urban socioeconomically isolated areas. It also has significance for physicians whose primary clinical responsibilities are in urban or university environments who also desire to provide care to these underserved, difficult to serve or expensive to serve populations. This telementored procedure was the first step in development of a large program with the Medical University of South Carolina. The intent of the program is to conduct prostate screening and biopsy where the physician and patient can maintain visual and audio contact for consultation while the physician is simultaneously viewing ultrasound images and electronic patient records. The overall effectiveness of the program will be evaluated in terms of improvement in clinical process of care, improved health outcomes, improved access to care, and patient/physician satisfaction with the experience.