TELEMEDICINE IN NOVA-SCOTIA - REPORT OF A PILOT-STUDY

Objective: To provide and evaluate telemedicine services for rural phy sicians and patients in Nova Scotia. Materials and Methods: As a pilot project, three telemedicine services (videoconference continuing medi cal education [CME], teledermatology, and teleradiology) were provided to four hospitals in Nova Scotia communities. All four sites received CME (a total of 269 physicians, 53 other health care professionals); three sites received teledermatology (66 consultations), and two sites received teleradiology (808 radiologic examinations). At the consulti ng site, 12 faculty members presented 24 one-hour videoconferences, an d there was one consulting radiologist and dermatologist. Each service was evaluated independently. Methods included participant questionnai res; focus groups; numbers and categories of participants or examinati ons; comparison of operational costs, capitol costs (teledermatology a nd teleradiology), and travel costs (CME); technical assessments of ha rdware, software, and telecommunications; assessment of clinical diagn ostic procedures (teledermatology); and comparative study of original and digitized films (teleradiology). Results: Despite growing pains, t he technologies effectively provided the three services: the services were acceptable to referring and consulting physicians and patients. I mprovements in patient care and outcomes comparable to those of tradit ional methods were demonstrated in teleradiology and teledermatology, especially for emergencies. Physician access to CME and patient access to dermatology consultation services were improved. Financial savings were demonstrated for CME, but further investigation is required to d etermine the savings attributable to teleradiology and teledermatology . Conclusions: The telemedicine services supported rural physicians, t heir patients, and their communities. Although telemedicine is not a p anacea for all concerns of rural physicians, the pilot project provide d a strong foundation for further development and study.