Tele-counselling service for Neurosurgery
This service is available for: Syddanmark, Timisoara, Veneto
Objectives
The objectives of the service are:
- reducing mortality and morbidity resulting from cranio-encephalic trauma and spine injuries by reducing transfer times and by improving the appropriateness of patient transfers to a neurosurgery centre;
- avoiding transfers due purely to the need of a neurosurgical consultation and also preventing ?undertriage? ? for patients requiring surgical intervention or sophisticated monitoring;
- improving the ability to rapidly diagnose serious injury for patients non transferred to a neurosurgery centre;
- rationalising the use of human and technological resources;
- establishing uniform levels of trauma care throughout the a region, through the use of standardised protocols;
- guaranteeing equality of treatment to all citizens victim of a trauma, irrespective of where it occurs within the regional boundaries
- releasing financial resources.
Upon positive assessment of the initial use of the tele-counselling service for skull-encephalic traumas and spine injuries, which will be given priority because of their life threatening character, and because of the expertise available in the centres which participated to the Market Validation phase, the extension of the tele-counselling service to other trauma pathologies ( e.g. serious pelvic traumas, cardiac or large vessel injuries, or internal organ injuries) will be considered.
Description
According to the current workflow, the patient with severe wounds is admitted to the peripheral emergency room and a CT examination is carried out. Whenever a doubt arises, the patient is physically transferred to the nearest Neurosurgery Centre where additional examinations are performed and therapeutic decisions taken.
Through the adoption of telemedicine, the emergency room specialist can ask a tertiary hospital neurosurgeon for an opinion. This is done through a digitally signed electronic request which contains all the clinical information and images required. Once the information is received, the Neurosurgery Centre sends back a digitally signed opinion. It is also possible to escalate the request for opinion even further by involving another specialist in the circuit. This can be a neurosurgeon on duty in another tertiary hospital or the Head of the Neurosurgery Department who, through a remote connection, can view the report and the images even from home.
In this way telemedicine can create a real counselling network involving the various Neurosurgery Centres, peripheral hospitals and emergency rooms in a region. The availability of more than one Neurosurgery Centre in the network also allows to route the request for counselling to the most appropriate structure (i.e. not all the Neurosurgery Centres necessarily have the same range of skills) and, in case the patient needs to be transferred to one of the Neurosurgery Centres, the network makes possible to identify the most suitable structure (e.g. by checking the availability of beds in the Intensive Care Unit, surgeon team on duty, etc.). Thanks to the telematic network, the number of unnecessary transfers can be drastically reduced and it will be possible to rationalise the intervention of the different Neurosurgery Centres thus enhancing their individual performance and the overall performance of the healthcare system.
