Tele-Mentored Handheld Ultrasound System for General Practitioners: A Prospective, Descriptive Study in Remote and Rural Communities

Author:

Zhou Yu-Jing1,Guo Le-Hang23,Bo Xiao-Wan23,Sun Li-Ping23,Zhang Yi-Feng23,Chai Hui-Hui23,Ye Rui-Zhong4,Peng Cheng-Zhong23,Qin Chuan15,Xu Hui-Xiong6

Affiliation:

1. Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China

2. Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China

3. Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China

4. Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou 310014, China

5. Department of Ultrasound, Karamay Central Hospital, Karamay 834000, China

6. Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Abstract

Background: Rural general practitioners (GPs) have insufficient diagnostic information to deal with complex clinical scenarios due to the inequality in medical imaging resources in rural and remote communities. The objective of this study is to explore the value of a tele-mentored handheld ultrasound (tele-HHUS) system, allowing GPs to provide ultrasound (US) services in rural and remote communities. Methods: Overall, 708 patients underwent tele-HHUS examination between March and October 2021 and March and April 2022 across thirteen primary hospitals and two tertiary-care general hospitals. All US examinations were guided and supervised remotely in real time by US experts more than 300 km away using the tele-HHUS system. The following details were recorded: location of tele-HHUS scanning, primary complaints, clinical diagnosis, and US findings. The recommendations (referral or follow-up) based on clinical experience alone were compared with those based on clinical experience with tele-HHUS information. Results: Tele-HHUS examinations were performed both in hospital settings (90.6%, 642/708) and out of hospital settings (9.4%, 66/708). Leaving aside routine physical examinations, flank pain (14.2%, 91/642) was the most common complaint in inpatients, while chest distress (12.1%, 8/66) and flank discomfort (12.1%, 8/66) were the most common complaints in out-of-hospital settings. Additionally, the referral rate increased from 5.9% to 8.3% (kappa = 0.202; p = 0.000). Conclusions: The tele-HHUS system can help rural GPs perform HHUS successfully in remote and rural communities. This novel mobile telemedicine model is valuable in resource-limited areas.

Funder

the Science and Technology Assistance Subject for Xinjiang

Publisher

MDPI AG

Subject

Clinical Biochemistry

Reference29 articles.

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5. Prospective Evaluation of Point-of-Care Ultrasound at a Remote, Multi-Day Music Festival;Prager;Prehospital Disaster Med.,2018

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