Telemedicine: A solution to the followup of rural trauma patients?

Background: Outpatient followup of rural trauma patients is problematic for physicians and patients. Our hypothesis was that telemedicine-based follow up of trauma patients discharged to remote areas is feasible and is associa ted with high patient and physician satisfaction. Study Design: We chose 11 counties in Kentucky surrounding a remote telemed icine site as our region of interest. Any adult trauma patient who was disc harged from our Level I trauma center to this geographic region was eligibl e to have routine followup appointment(s) at the TeleTrauma Clinic. Patient s were examined and interviewed with the assistance of a nurse, an electron ic stethoscope, and a close-up imaging instrument. Radiographs performed at the telemedicine site were viewed. patients and physicians completed a sur vey after the appointment. Results: To date, we have conducted 22 telemedicine-based followup assessme nts of trauma patients. The average age and Injury Severity Score were 42 y ears and 18, respectively. Plain radiographs were reviewed in 13 cases. Our patient surveys indicated a high degree of satisfaction with the teleappoi ntment. In 15 of 22 patients, no further clinical followup was arranged. Th e differences in travel distances and times for an appointment at the TeleT rauma Clinic versus an appointment at our Level I trauma center were signif icant. The average and median duration of the appointments was 14 minutes. All telemedicine encounters were done by two physicians, who recorded a hig h level of satisfaction. Conclusions: Our early experience with the outpatient followup of remote tr auma victims by telemedicine is encouraging. Patient surveys indicate a hig h degree of satisfaction. As a result of our favorable experience, telemedi cine-based followup may be expanded to other regions of Kentucky. (J Am Col l Surg 2001;192:447-452. (C) 2001 by the American College of Surgeons).