Development and evaluation of an international teleproctoring program for bronchoscopic procedures

Medical procedures often require proctoring that is traditionally done face-to-face, but this poses a significant carbon footprint and logistical challenges. Little is known about the safety and efficacy of remote "tele"proctoring, particularly in the respiratory field. The aim was to develop, implement, and evaluate a teleproctoring program for bronchoscopy procedures. Seventy-eight targeted lung denervation procedures were performed at UK hospitals; 20 with teleproctoring, with real-time multimodality data streaming to an off-site proctor; and 58 with on-site proctoring. Procedure completion, procedure duration (bronchoscopy, anesthetic, and fluoroscopy), and safety outcomes (adverse events and device deficiencies) were compared between groups. Teleproctoring offered a safe alternative to on-site proctoring, with little difference in completion rates, procedure durations or safety outcomes. Teleproctoring could be a cost-effective, sustainable and efficient alternative to face-to-face proctoring in appropriate centers. Further work could expand this system to allow remote expert advice to facilitate procedures in clinical practice, and for procedural teaching.