Abstract
Telemedicine is perhaps the most rapidly growing area in health care. Approximately 15 million Americans receive medical assistance remotely every year. Yet rural communities face significant challenges in securing subspecialist care. In the United States, 25% of the population resides in rural areas, where less than 15% of physicians work. Current surgery residency programs do not adequately prepare surgeons for rural practice. Telementoring, wherein a remote expert guides a less experienced caregiver, has been proposed to address this challenge. Nonetheless, existing mentoring technologies are not widely available to rural communities, due to a lack of infrastructure and mentor availability. For this reason, some clinicians prefer simpler and more reliable technologies. This article presents past and current telementoring systems, with a focus on rural settings, and proposes aset of requirements for such systems. We conclude with a perspective on the future of telementoring systems and the integration of artificial intelligence within those systems.
Highlights
A set of requirements for such systems
We propose the untapped option of embracing advanced technologies with two broad goals: (a) to leverage distance learning to more efficiently and effectively educate more providers nationally and globally as a longer-lasting and potentially permanent solution to the national and global surgical human resource crises and (b) to empower nonsurgical health care providers by using real-time telementoring to deliver more comprehensive, advanced, and safe care with every intervention possible, which can be used as a tool to support even safer and more efficient regionalization of care
The risks to patient harm are greater, as the lack of a physical presence means that the mentor cannot assist in, or take over, the operation when the operating surgeon requires a demonstration of a technique or cannot complete a specific task [29]
Summary
The suggested solutions to these complex challenges have included greatly increasing training of surgeons, resetting the public’s expectations of care to expect less, and ideally increasing regionalization of acute care/trauma services [4]. We propose the untapped option of embracing advanced technologies with two broad goals: (a) to leverage distance learning to more efficiently and effectively educate more providers nationally and globally as a longer-lasting and potentially permanent solution to the national and global surgical human resource crises and (b) to empower nonsurgical health care providers by using real-time telementoring to deliver more comprehensive, advanced, and safe care with every intervention possible, which can be used as a tool to support even safer and more efficient regionalization of care. The education-versus-service proportions may be balanced for some procedures or may be anywhere along a continuum from pure education (such as simulated patient encounters with no service component) to pure service (such as a mentored lifesaving procedure by a novice, wherein the novice does not understand what they did but were still guided to perform safely)
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