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Point-to-point telemedicine using the ISDN
Journal of Telemedicine and Telecare
|January 1, 1996
Summary
Telemedicine trials using Integrated Services Digital Network (ISDN) showed successful management of minor injuries and remote fetal scans, proving cost-effective for minor injuries but facing hardware cost barriers for widespread adoption.
Area of Science:
- Medical Informatics
- Digital Health
- Telemedicine Technology
Background:
- Pilot telemedicine services were established to assess the efficacy of Integrated Services Digital Network (ISDN) for remote healthcare delivery.
- Two distinct applications were trialed: a minor injuries service using basic-rate ISDN and remote fetal scanning using primary-rate ISDN.
Purpose of the Study:
- To evaluate the preliminary results and cost-effectiveness of telemedicine for managing minor injuries.
- To assess the diagnostic accuracy and impact on referrals for remote fetal scanning via telemedicine.
- To determine the reliability and picture quality of ISDN as an information transport system for telemedicine.
Main Methods:
- A minor injuries telemedicine service utilized basic-rate ISDN for patient management.
- A remote fetal scanning service employed primary-rate ISDN for consultations.
- Data on patient numbers, diagnoses, referrals avoided, system reliability, and picture quality were collected and analyzed.
Main Results:
- The minor injuries service successfully managed 49 patients in 10 months, demonstrating significant cost-effectiveness compared to conventional care.
- The fetal scanning service facilitated 39 consultations for 29 patients in six months, achieving a definitive diagnosis in 86% of cases and avoiding physical referrals.
- ISDN proved reliable with only one connection failure, and picture quality was generally acceptable, though high hardware costs (approx. £35,000 per end) present a barrier to widespread adoption.
Conclusions:
- Telemedicine, particularly using ISDN, offers a cost-effective solution for specific healthcare applications like minor injury management.
- Remote fetal scanning via telemedicine is diagnostically effective, reducing the need for physical referrals, but faces economic challenges.
- ISDN is a reliable platform for telemedicine information transport, but hardware costs require consideration for broader implementation.