Journal of Telemedicine and Telecare > Volume 15, Number 3 > Pp. 118-121

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PAPERS

Head and neck cancer assessment by flexible endoscopy and telemedicine

Cathy Dorrian ^* , Jim Ferguson ^*, Kim Ah-See , Catriona Barr , Kushik Lalla , Marjon van der Pol , Lynda McKenzie  and Richard Wootton ^*

^* Scottish Centre for Telehealth, Aberdeen; ENT Department, Aberdeen Royal Infirmary, Aberdeen; Gilbert Bain Hospital, Shetland; Health Economics Research Unit, University of Aberdeen, UK

Correspondence: Ms Cathy Dorrian, Scottish Centre for Telehealth, Foresterhill Lea, Aberdeen AB25 2ZY, UK (Fax: +44 1224 559 119; Email: cathy.dorrian{at}nhs.net)

We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total of 42 patients were seen in Aberdeen via videoconferencing for a head and neck cancer assessment. Feasibility was confirmed after the first 20 patients, following positive feedback from all concerned and the absence of any significant clinical or technical problems. A total of 42 journeys was avoided, each journey saving 123 kg CO₂ per person. A preliminary cost analysis showed that the threshold at which tele-ENT became cheaper than travel was a workload of 35 patients/year. The actual workload during the pilot study was 29 patients/year. A national telemedicine service for the initial assessment of potential malignancy has the potential to reduce unnecessary transfers to specialist centres, with accompanying reductions in carbon emissions.

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