Abstract
Remote education in medicine has two distinct differences over remote education in other fields. The first is the frequent use of moving images to show techniques and procedures, and the second is the necessity of very high image quality for accurate diagnosis or precise anatomy. The emergence of digital video transport systems (DVTS) has surmounted technological limitations and made remote medical education practical. However, to meet new demands for better quality and wider availability, two additional systems, HD-H.323 and Vidyo, have been developed. Feedbacks from users of these systems are crucial for accurate evaluation and further improvements. We designed questionnaires evaluating image quality, preparations, major problems, and overall satisfaction with each of these systems. These questionnaires, along with answer pads, were administered to 32 participants at the Seventh Asia Telemedicine Symposium, held in Bangkok, Thailand, on December 14, 2013. Of 22 (69%) valid answers on best image quality, nine (41%) chose DVTS, eight (36%) chose HD-H.323, and five (23%) chose Vidyo. Of 27 (84%) valid responses on ease of preparation, 21 (78%) picked Vidyo, six (22%) picked HD-H.323 and none picked DVTS. The biggest problems with DVTS were sound (11/29, 38%) and ease of preparation (8/29, 28%), the biggest problem with HD-H.323 was cost (18/28, 64%), and the biggest problems with Vidyo were sound (8/29, 28%) and cost (8/29, 28%). Overall satisfaction rates were 70% (14/20) for DVTS, 86% (18/21) for HD-H.323, and 77% (20/26) for Vidyo. In conclusion, the three technologies currently used for remote medical education were all satisfactory. Because each has its own advantages and disadvantages, the choice of the most appropriate system should depend on the program being broadcast and the availability of equipment and network at participating stations.
Highlights
Telemedicine can be divided into two categories, one between doctors and patients for remote consultation, and the other between doctors for remote education
Over 10 years of experience with the use of telemedicine for remote education has shown us that remote medical education differs from other types of remote education (Shimizu et al, 2014)
Of 22 (69%) valid answers on best image quality, nine subjects (41%) picked the digital video transport systems (DVTS), eight (36%) picked the HD-H.323, and five (23%) picked the Vidyo system (Figure 1)
Summary
Telemedicine can be divided into two categories, one between doctors and patients for remote consultation, and the other between doctors for remote education. Remote medical education requires the frequent use of moving images to show new techniques and procedures. Remote medical education requires higher-quality images than other types of remote education because image quality for the former should be able to show clear images for accurate diagnosis and precise anatomy. Lack of continuous control can cause the images to become blurred, making them inadequate for medical education. Another major obstacle has been the initial cost of special videoconferencing systems that yield unsatisfactory image quality, or the much higher costs charged to use satellite imaging for better image quality (Rabenstein et al, 2002; Rafiq et al, 2004)
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