Telementoring for Emergency Ultrasonography Performed by Emergency Physicians With Low Experience.

Telementoring for Emergency Ultrasonography Performed by Emergency Physicians

1. Purpose

   • This study aims to evaluate the feasibility of iPhone based telementoring for the ultrasonography.

2. Methods

   • Study Design: Prospective observational study
   • Study Setting: Urban academic ED of tertiary care teaching hospital
   • Study period: July, 2014 ~ December, 2014 (six months)
   • Study participants: Of the patients who need to undergo ultrasonography in the ED, those who are agreed to participate in this study are enrolled.

3. We hypothesize that the iPhone based real time tele-diagnosis by remote expert would not be different from the diagnosis via his/her direct ultrasound examination.

• Teleultrasound system

  1. We already developed the telesystem for viewing the ultrasound examinations performed in the emergency department (ED) by using the iPhone display simultaneously at the out of ED.
  2. Remote mentors can view the patient and examiner's hand holding the ultrasound probe while simultaneously viewing the ultrasound image in the same field of ultrasound display
  3. The examiner and the mentor can communicate with each other.

• Procedures:

  1. The residents perform the ultrasonography and the out of ED expert observe the practice by using the iPhone.
  2. While viewing the practice, the mentor can guide the examiner (resident) to manipulate the probe to get the best ultrasound image.
  3. After finishing the practice, the mentor measures the speed of used mobile network using the application of 'BENCHBEE' and records the predesigned registry.
  4. The registry includes the patients' information, the time and date of examination, the type of mobile network (3G, LTE, WiFi and etc.) and the speed of mobile network, used tele-displayer (iPhone, iPad, iPad mini), used probe, performed body organ (cardiac, lung, Hepatobiliary, vascular, genital organ, appendix and intestine including suspected intussusception), the examiner's level of training and the ultrasound experience of the examiner and the mentor.
  5. The mentor records the patient's diagnosis and the problems during this procedure.
  6. The mentor goes to the patient, perform the ultrasonography directly and confirm the patients' diagnosis.
  7. We will investigate the diagnostic accuracy for iPhone-based tele-ultrasonography comparing these diagnoses.

Inclusion Criteria:

• the patients who undergo the emergency physician-performed ultrasonography

Exclusion Criteria:

• the failure of examination due to such as patients' severe obesity, a large amount of gas and etc.
• the patients who refuse to participate in this study.
• the patients who need emergency ultrasonography.