Deployment telemedicine: the Walter Reed Army Medical Center experience

This retrospective study analyzed telemedicine consultations from deployed military medical units in Somalia, Haiti, Croatia, and Macedonia to determine the clinical utility of telemedicine consultations. A computerized data-collection sheet was developed and information was abstracted from consultation requests and consultant replies. Questions relating to the consultation request include basic patient demographics, the deployed physician's specialty, questions asked, consultation urgency, specialties requested by the consultation, type of equipment used, history of present illness, and differential diagnosis. Data extracted from the consultant's reply were the consultant's diagnosis and recommendations. Subjective questions included the severity of illness and the degree to which telemedicine affected the diagnosis, treatment, or patient status. Results show that physicians in many different specialties employed telemedicine consultations in a wide range of patients and illnesses. Telemedicine consultations significantly affected the diagnosis in 30%, the treatment in 32%, and the overall patient status in 70% of cases.