Abstract
Clinical genetics services in Iowa are delivered to 16 clinic sites with over 87 clinics/year by the Regional Genetics Consultation Services (RGCS)/ Univ. of Iowa, Dept. of Peds Univ of Iowa has an extensive telecommunications network, which connects 11 hospitals in Iowa using the interactive video system, TeleDoc with a digital exam camera, otoscope and electronic stethoscope. We recently completed a 15-month pilot project, which integrated the resources of Univ of Iowa's telemedicine program with the RGCS to evaluate the use of telemedicine for delivery of clinical genetics services.
We evaluated the effectiveness of telemedicine for follow-up genetics visits by examining the following parameters: 1) patient satisfaction and compliance; 2) physician satisfaction and productivity, 3) utility (advantages and disadvantages) in different types of genetics consultations, 4) ease of use; 5) cost-effectiveness, and 6) access. These parameters were compared with the regular RGCS clinics. Each patient and his/her family, referring physician, consulting physician, and the genetic nurse counselor completed surveys regarding demographics, access, cost & satisfaction. Forty-seven patients were seen in 12 clinics. Attendance rate was 87% compared to 90% in RGCS clinics. The patient group included 24 males and 23 females. Ages ranged from 7 months to 37 years. Of the 47 patients, 36 (76%) had pre-established diagnoses, 11(23 1%) did not. Diagnoses included a variety of genetic conditions such as, chromosomal, single gene disorders, FAS, and MCA syndromes Assessment of the suitability and clarity of telemedicine to visualize the many varied clinical exam findings was completed. The survey results revealed scores ranging from 3 62 to 3.92 on a 1-5 scale with 5 being excellent. Responses from patient satisfaction surveys showed that most families (44/47) were very satisfied with the health care they received and quality of telemedicine interaction We also evaluated costs: one six-hour clinic was slightly less ($450) than the regular RGCS clinic (-$500), and was similar to other telemedicine clinics held at UIHC (avg cost $487), excluding physician professional fees. Potential advantages of telemedicine included similar clinical productivity for number of patients seen per time slot, but elimination of travel time to and from the clinic site, and ability of physician to complete work/answer calls Potential disadvantages included occasional interruptions in transmission, inability to palpate or completely assess neurological exam, and time to adjust camera position We will review further survey results and demonstrate the quality of the transmission
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Kepplernoreuil, K., Welch, J., Sebille, S. et al. Evaluation of telemedicine use for clinical genetics services in Iowa. Genet Med 2, 79 (2000). https://doi.org/10.1097/00125817-200001000-00101
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DOI: https://doi.org/10.1097/00125817-200001000-00101