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A Novel Telemedicine System for Care of Statewide Hand Trauma

机译：一种用于护理全态手术创伤的新型远程医疗系统

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Background: Telemedicine is an evolving tool to increase patients’ access to subspecialty care. Since 2014, Arkansas has been utilizing telemedicine in the evaluation of patients with hand injuries. The purpose of this study is to assess the effect of this novel telemedicine system for the management of hand trauma on patient transfer. Methods: We reviewed data from the first year of the telemedicine program (2014) and compared it to data from the year prior (2013). Data collection from both years included number of hand consults and need for transfer. From the 2014 data, we also recorded the use of telemedicine, type of transfer, distance of transfer, and time to disposition. Results: During 2013 (pre-telemedicine), there were 263 hand traumas identified. In all, 191 (73%) injuries required transfer to a higher level of care, while 72 (23%) were managed locally. In the first year of the telemedicine program (2014), a total of 331 hand injuries were identified. A total of 298 (90%) resulted in telemedicine consultation with 65% (195) utilizing video encounters. After telemedicine consultation, local management was recommended for 164 injuries (55%) while transfer was recommended for 134 (45%). Using telemedicine, there was a significant decrease in the percentage of transfer for hand injuries ( P < .001). Conclusions: The telemedicine program was well utilized and provided patients throughout the state with continuous access to fellowship trained hand surgeons including regions where hand subspecialty care is not available. The program resulted in a significant decrease in the number of hospital transfers for the management of acute hand trauma.
机译：背景：远程医疗是一种不断发展的工具，可以增加患者对亚专业护理的进步。自2014年以来，阿肯色州一直在利用远程医疗在评估手中的患者中。本研究的目的是评估该新型远程医疗系统对患者转移的手术创伤管理的影响。方法：我们从远程医疗计划（2014年）的第一年回顾了数据，并将其与前一年（2013年）的数据进行了比较。两年的数据收集包括手咨询次数，需要转移。从2014年的数据中，我们还记录了远程医疗，转移类型，转移距离和待遇的时间。结果：2013年（前远程医疗），鉴定了263例手中创伤。总之，191（73％）伤害需要转移到更高水平的护理，而72（23％）在本地管理。在远程医疗计划（2014年）的第一年，确定了331个手伤害。共有298名（90％）导致远程医疗咨询，利用视频遭遇。在远程医疗咨询后，建议当地管理层164名伤害（55％），而推荐134（45％）。使用远程医疗，手损伤的转移百分比显着下降（P <.001）。结论：远程医疗计划在整个国家的患者中提供了很好的利用，并在培训训练有素的手外科医生，包括手工亚专业护理的地区的培训训练有素的手工外科医生。该计划导致医院转移数量的显着降低，用于管理急性手术创伤。

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