A New Community-to-Hospital Specialist Otology Pathway Using Telemedicine: A Pilot Study of 50 Patients

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-06-20 DOI:10.1111/coa.14192

Ankit Patel, Cillian Forde, Suneal Doal, Jay Patel, Dawn Clare, Michael Burslem, Joseph G. Manjaly, Nishchay Mehta

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引用次数: 0

Abstract

Introduction

Pathway innovation using smartphone otoscopy and tablet-based audiometry technologies to deliver ear and hearing services via trained audiologists may improve efficiency of the service. An ENT-integrated-community-ear service (ENTICES—combining community audiology management, remote ENT review and novel technologies) was piloted. We aimed to assess the efficiency and safety of ENTICES.

Method

ENTICES was a community-based and audiologist-led pathway. Patients with otological symptoms were self-referred to this service. Smartphone otoscopy and tablet-based audiograms were performed. Two otologists reviewed all decisions made in the community by audiologists based on video-otoscopy, hearing tests and chart reviews. Data on the first 50 consecutive new patients attending either consultant-led hospital otology clinics (HOC), audiologist-led hospital advanced audiology diagnostics (AAD) or ENTICES clinics were collected between 1 August 2021 and 31 December 2021. Data were collected through chart reviews and questionnaires to compare the three pathways with respect to efficiency, patient satisfaction, technology utility and safety.

Results

No audiology-led ENTICES decisions were amended by hospital otologists following remote review. Remote review of video-otoscopy with history was sufficient for a diagnosis in 80% of cases. Adding hearing tests and standardised history increased the diagnostic yield to 98%. Patient satisfaction scores showed 100% service recommendation. The cost per patient, per visit, was £83.36, £99.07 and £69.72 for AAD, HOC or ENTICES, respectively.

Conclusion

ENTICES provides a safe ear and hearing service that patients rated highly. Thirty-two per cent of hospital otology patients were eligible for this service. For those patients, ENTICES is 20% more cost-effective and can reduce the number of clinic visits by up to 60% compared with HOC.

查看原文本刊更多论文

使用远程医疗的新型社区到医院耳科专科路径：针对 50 名患者的试点研究。

导言：利用智能手机耳镜和平板电脑测听技术，通过训练有素的听力学家提供耳科和听力服务的途径创新可提高服务效率。耳鼻喉科综合社区耳科服务（ENTICES--将社区听力管理、远程耳鼻喉科检查和新技术结合在一起）进行了试点。我们旨在评估 ENTICES 的效率和安全性：ENTICES是一个以社区为基础、听力学家为主导的途径。有耳科症状的患者可自行转诊至此项服务。患者可通过智能手机进行耳镜检查和平板电脑测听。两名耳科医生对听力学家在社区根据视频耳镜检查、听力测试和病历审查做出的所有决定进行审查。在 2021 年 8 月 1 日至 2021 年 12 月 31 日期间，收集了前 50 名连续就诊的新患者的数据，这些患者分别就诊于顾问主导的医院耳科诊所 (HOC)、听力学家主导的医院高级听力诊断 (AAD) 或耳鼻喉科诊所。通过病历审查和问卷调查收集数据，对三种途径的效率、患者满意度、技术实用性和安全性进行比较：结果：医院耳科专家在远程审查后未对听力学主导的 ENTICES 决定进行修改。在80%的病例中，远程视频耳镜检查和病史分析足以做出诊断。增加听力测试和标准化病史后，诊断率提高到98%。患者满意度评分显示，100% 的患者推荐这项服务。AAD、HOC 或 ENTICES 每名患者每次就诊的成本分别为 83.36 英镑、99.07 英镑和 69.72 英镑：结论：ENTICES 提供安全的耳科和听力服务，得到了患者的高度评价。32%的医院耳科患者有资格享受这项服务。对这些患者而言，与HOC相比，ENTICES的成本效益高出20%，并可减少多达60%的就诊次数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.