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The purpose of this study is to determine whether telemedicine consultations (lead by standard scheme)allows to increase quality of anatomical and functional outcomes and improve clinical work-flow at patients with acute bone and joint trauma, hip pathology and congenital orthopedics abnormalities.
Levels of bad outcomes, untimely death and disability due to acute trauma, specific orthopedic pathology (congenital, coxarthrosis) and non-efficient organisation of clinical work-flow are still very high (especially in rural areas). Standard telemedicine work stations (with special protocols and manuals for original approach to telemedicine activity organisation and management) will be placed into small municipal and rural hospitals. Telemedicine links will be established between 3rd level Trauma&Ortho center and remote sites. Synchronous and asynchronous teleconsultations will be perform for help in evidence-based timely clinical decisions, continual support of clinical wor-flow and treatment process.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Telemed | Experimental | Group of trauma&orthopedic patients - for determination of clinical strategy and treatment plan telemedicine will be used |
|
| InternalControl | Active Comparator | Group of trauma&orthopedic patients from 3rd level trauma center - for determination of clinical strategy and treatment plan usual clinical approaches will be used |
|
| ExternalControl | Active Comparator | Group of trauma&orthopedic patients from 1-2rd level trauma centers (in rural and small municipal hospitals) - for determination of clinical strategy and treatment plan personal arriving of the expert by the car (so-called Urgent Expert Care) will be used |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telemedicine consultation | Procedure | Standard synchronous or asynchronous telemedicine consultations according recommendations and best practice models of ISfTeH |
|
| Measure | Description | Time Frame |
|---|---|---|
| Scales for outcomes in trauma and orthopedic (Harris Hip Score, national protocol for trauma outcomes). Sets of criteria: ARR, RRR, ABІ, RBI, RR, odds ratio and NNT | one year |
| Measure | Description | Time Frame |
|---|---|---|
| "Relevance of Telemedicine Consultation" Questionnaire | one year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anton V Vladzymyrskyy, M.D. | R&D Institute of Traumatology and Orthopedics | Principal Investigator |
| Volodymyr G Klymovytskyy, Professor | R&D Institute of Traumatology and Orthopedics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Volnovakha Central Area Hospital | Volnovakha | Donetsk Oblast | 85700 | Ukraine | ||
| Gorlovka Municipal Hospital N2 |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16168165 | Background | Vladzymyrskyy AV. Four years' experience of teleconsultations in daily clinical practice. J Telemed Telecare. 2005;11(6):294-7. doi: 10.1258/1357633054893337. | |
| 15286891 | Background | Vladzymyrskyy AV. Our experience with telemedicine in traumatology and orthopedics. Ulus Travma Acil Cerrahi Derg. 2004 Jul;10(3):189-91. |
| Label | URL |
|---|---|
| Best Practice Models in Telemedicine for Trauma (recognized by ISFTEH) | View source |
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| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
| D007592 | Joint Diseases |
| D050723 | Fractures, Bone |
| D015207 | Osteoarthritis, Hip |
| D000013 | Congenital Abnormalities |
| ID | Term |
|---|---|
| D009140 | Musculoskeletal Diseases |
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D012216 | Rheumatic Diseases |
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|
| Treatment plan | Procedure | Treatment plan include diagnostic tests (physical examination, laboratory tests, xray, CT, MRI), medications and surgical treatment (debridements, osteosynthesis, arthroplasty, ORIF etc) |
|
|
| Gorlovka |
| Donetskya Oblast |
| 84600 |
| Ukraine |
| Central Clinical Municipal Hospital N6 | Donetsk | 83000 | Ukraine |
| Donetsk R&D Institute of Traumatology and Orthopedics | Donetsk | 83048 | Ukraine |
| Clinics of Maxillo-Fascial Surgery of DNMU | Donetsk | 83114 | Ukraine |
| Med-e-Tel Digital Library: 2005-2007 presentations and papers about telemedicine activity of investigators | View source |
| D009358 |
| Congenital, Hereditary, and Neonatal Diseases and Abnormalities |