Using handheld pocket computers in a wireless telemedicine system

Abstract

Objectives: To see if senior emergency nurse practitioners can provide support to inexperienced ones in a Minor Injuries Unit by using a wireless LAN system of telemedicine transmitting images to a PDA when they were on duty. In addition, whether such a system could be sufficiently accurate to make clinical diagnoses with a high level of diagnostic confidence. This would permit an overall lower grade of nurse to be employed to manage most of the cases as they arrive with a proportionate lowering of costs. Methods: The wireless LAN equipment could roam in the Minor Injuries Unit and the experienced emergency Nurse practitioners could be at home, shopping or even at a considerable distance from the centre. Thirty pictorial images of patients who had been sent to the Review Clinic were transmitted to a PDA various distances of one to sixteen miles from the centre. Two senior emergency nurse practitioners viewed the images and opined on the diagnosis, their degree of confidence in the diagnosis and their opinion of the quality of the image. Results: the images of patients were sharp, clear, and of diagnostic quality. The image quality was only uncertain, as was the level of confidence of the diagnosis if the patient was very dark skinned. Conclusions: The wireless LAN system works with a remote PDA in this clinical situation. However there are question marks over the availability of enough experienced emergency nurse practitioners to staff a service that provides senior cover for longer parts of the day and at weekends.