Clinical consultations using store-and-forward telemedicine technology

Objective: To investigate the potential role of a store-and-forward (SAF) t elemedicine system in specialty consultations initiated by primary care phy sicians. Materials and Methods: In this pilot telemedicine study, patients needing c onsultations in cardiology, dermatology, endocrinology, and orthopedics had both standard face-to-face (FTF) consultations and SAF consultations. Results: Fifteen patients had both FTF and SAF consultations, 4 had echocar diograms transmitted for an SAF consultation only, and 1 had an SAF consult ation but no FTF appointment. Of 19 diagnoses made, all were essentially th e same in both types of consultations; 14 of 15 FTF consultations and 15 of 19 SAF consultations resulted in additional treatment recommendations. Conclusions: While it was possible to develop a desktop system for SAF cons ultations, the equipment was not adequately integrated. Without total digit al input, including electronic patient medical records, packaging of inform ation is laborious and impractical. Seamlessly adapting to existing clinica l practice is vital. Issues such as increasing work for the physicians or o ffice staff, gathering adequate patient information, and designing a referr al process were more difficult than we had anticipated. Patient acceptance was high, but the clinical pilot had very small numbers.