Abstract
IntroductionThe benefits of telepresence in trauma and acute surgical care exist, yet its use in a live, operating room (OR) setting with real surgical cases remains limited.MethodsWe tested the use of a robotic telepresence system in the OR of a busy, level 1 trauma center. After each case, both the local and remote physicians completed questionnaires regarding the use of the system using a five point Likert scale. For trauma cases, physicians were asked to grade injury severity according to the American Association for the Surgery of Trauma (AAST) Scaling System.ResultsWe collected prospective, observational data on 50 emergent and elective cases. 64% of cases were emergency surgery on trauma patients, almost evenly distributed between penetrating (49%) and blunt injuries (51%). 40% of non-trauma cases were hernia-related. A varied distribution of injuries was observed to the abdomen, chest, extremities, small bowel, kidneys, spleen, and colon. Physicians gave the system high ratings for its audio and visual capabilities, but identified internet connectivity and crowding in the operating room as potential challenges. The loccal clinician classified injuries according to the AAST injury grading system in 63% (n=22) of trauma cases, compared to 54% (n=19) of cases by the remote physicians. The remote physician cited obstruction of view as the main reason for the discrepancy. 94% of remote physicians and 74% of local physicians felt comfortable communicating via the telepresence system. For 90% of cases, both the remote and local physicians strongly agreed that a telepresence system for consultations in the OR is more effective than a telephone conversation.ConclusionsA telepresence system was tested on a variety of surgical cases and demonstrated that it can be an appropriate solution for use in the operating room. Future research should determine its impact on processes of care and surgical outcomes.
Highlights
The benefits of telepresence in trauma and acute surgical care exist, yet its use in a live, operating room (OR) setting with real surgical cases remains limited
From a remote location in the hospital - an office on the second floor- the remote physician connected to the robot to see the activities in the operating room and communicate with local clinicians
Remote physicians reported a high level of satisfaction with the use of the telepresence robot (Figure 3)
Summary
The benefits of telepresence in trauma and acute surgical care exist, yet its use in a live, operating room (OR) setting with real surgical cases remains limited. Telemedicine extends the reach of trauma and surgical care specialists in real-time and regardless of distance, yet its widespread adoption remains elusive. Healthcare and market forces are driving the demand for innovative solutions to address the discrepancies in access to quality care and patient outcomes. Due to technological advances and declines in cost, telemedicine for trauma and surgical care is becoming increasingly a viable option to address these current challenges and demands. Access to remote specialists may help in patient transfer decision-making, helping distant hospitals treat patients locally when possible by bringing the specialist to the patient. This potentially can improve patient outcomes and safety; while reducing the need for costly, unnecessary transfers
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