Virtual intensivist and neurology services in hospitals without access to an on-call specialist are already in use. “One would expect that this would be expanded to non-surgical specialties and simple surgical concerns as well,” Dr. Keefe said.
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July 2017In addition, “tele-doc companies” for general practice patients who can have evaluations over the phone often obviate the need for these patients to visit a medical clinic for routine medical issues. The “tele-doc” can even call in prescriptions for the patient.
The future of telemedicine in otolaryngology certainly looks bright.
Karen Appold is a freelance medical writer based in New Jersey.
Innovations in Otolaryngology Telemedicine
Several vendors now manufacture digital otoscopes and rhinoscopes that can be connected to a telehealth platform to collect and send or store images, said Linda Branagan, PhD, director of the Telehealth Resource Center at the University of California, San Francisco. A few of these devices can attach to an iPhone. Tele-audiology applications allow hearing tests and hearing aid programming to be done at a distance. In fact, the U.S. Department of Veterans Affairs has a well-established program for this.
Dr. Moberly’s group is focusing on developing software, called Auto-Scope, that will provide automatic diagnostic support for clinicians evaluating ear pathologies. “The goal is to address the societal problem of overdiagnosis and overtreatment of acute otitis media, which is associated with increasing antibiotic resistance, antibiotic-related adverse events, and overtreatment with surgical tympanostomy tube placement,” he added.
The software will use a large database of images and videos that have been collected to provide the clinician with the most likely diagnosis for a new image collected, along with a high level of confidence for that diagnosis and three images from the database that are similar to the image a provider collects.
Thus far, prototype software has been developed that can determine whether a tympanic membrane is normal or abnormal 85% of the time. “Diagnosing ear diseases based on a brief glimpse of the eardrum, or even when using still digital images, is difficult and associated with poor diagnostic accuracy,” Dr. Moberly said. A recent study by his group identified an accuracy rate of only about 75%, even for expert otologists reviewing digital otoscopic images (J Telemed Telecare. Published online ahead of print January 1, 2017). “This suggests the continued need for devices to assist in improving diagnostic accuracy.”