Summary
Background
Telemedicine is a rapidly expanding technology involving the exchange of medical information
to assist diagnosis and treatment at a distance. Within the field of plastic surgery,
where visual examination contributes heavily to patient management decision-making,
telemedicine has great potential. However, privacy and medico-legal issues must be
considered when using electronic communication to assist our clinical practice.
Methods
A comprehensive literature review of manuscripts published on telemedicine was performed.
Articles were selected for relevance to plastic and reconstructive surgery and reviewed
for applications, benefits and complications of telemedicine. In addition, the manuscripts
were reviewed for conforming to current legal guidelines for the electronic transfer
of patient information.
Results
Twenty-nine articles met the inclusion criteria (11 trauma and burns, 4 hand, 5 wound-care,
5 maxillofacial, 1 digital replantation, 2 free-flap monitoring, and 1 technical application).
Twenty-eight (96%) manuscripts reported a benefit of telemedicine (commonly including
increased access to expertise and costs saved through reduction of unnecessary transfers).
However only five (17%) reported a statistical benefit compared to a standard treatment
cohort (face-to-face interactions). Fifteen (51%) reported on adverse effects, which
included misdiagnosis, time consumption, training, technical and cost issues. Only
four manuscripts (14%) discussed conforming to legal guidelines within their institution.
Conclusions
Telemedicine can improve access to the specialty of plastic surgery by facilitating
the provision of expertise at remote sites. Its application can be used in many situations
and between a variety of healthcare professionals. However, there is little critical
analysis on the benefits and risks of telemedicine. In addition, its legal implications
need to be carefully considered if it is to be safely integrated into our daily practice.
Keywords
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Article info
Publication history
Published online: December 19, 2011
Accepted:
November 25,
2011
Received:
June 11,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
