Sigmoidoscopy in a nurse-practitioner community clinic using telemedicine

We evaluated the feasibility of remote endoscopy in a community setting. Re altime teleconsultation and telesigmoidoscopy were carried out by a nurse p ractitioner at a community clinic while a colorectal specialist was present at the main hospital. Rigid video-sigmoidoscopes were used and the images were transmitted via ISDN lines at 384 kbit/s. Over three months, 32 patien ts (mean age 35 years; 19 men and 13 women) with bleeding per rectum took p art in the study. Evaluation was carried out using satisfaction questionnai res for the patients, the nurse practitioner and the clinicians. The mean g rade for clarity of intraluminal views was 3.5 (1 poor, 4 excellent). Only two cases had views graded less than 3, due to the presence of excessive fa ecal residue. All the patients were satisfied with the teleconsultation and video-endoscopy and would return for a similar visit. User satisfaction wa s also high on the part of the nurse practitioner and the clinician.