インスタントメッセージングアプリケーションとスマートグラスを比較して、開発途上国の遠隔医療ソリューションを最適化する緊急脳神経外科紹介
Thangaraj Munusamy1, Ronie Jayapalan2, Abdul Khalil Haafiz Bin Abd Rahman2
1Division of Neurosurgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Neurosurgery, Kings College Hospital NHS Foundation Trust, London, United Kingdom; NIHR Global Health Research Group on Acquired Brain and Spine Injury, United Kingdom.
Objective:
Prompt and precise decision making and management are important in neurosurgery for best outcomes. Emergency neurosurgical referral at the forefront of patients' journey is the most important checkpoint, however usually a junior doctor stands guard here lacking knowledge, skills and confidence. Information is subsequently relayed to the specialist in delayed fashion subject to inadequacies and discrepancies. Our study objective was to determine if telehealth via smart glasses was feasible and effective to overcome the barriers and challenges associated with emergency neurosurgical referrals.
Methods:
A pair of junior doctor and specialist used either WhatsApp or smart glasses during emergency neurosurgical referrals. In WhatsApp referrals, the junior doctor reviews the patient and sends a summary message to the specialist with relevant radiological imaging, whom then responds with a management plan. In smart glasses referrals, they actively interact two-ways until a decision is reached. The next morning, a physical session identified missing or inaccurate information and the plan is amended if necessary. Both referral methods were compared and analyzed to identify differences and statistical significance.
Results:
100 emergency neurosurgical referrals were performed in each arm. Referrals using smart glasses resulted in significantly shorter response times where on average it was 18.7 minutes faster to receive a plan from the specialist. Smart glasses referrals also had significantly less inadequacies compared to WhatsApp referrals. This was consistent for all types of information.
Conclusions:
Emergency neurosurgical referrals using telehealth via smart glasses were feasible and effective, thus offers an alternative solution for adoption by developing countries.
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