Title page for ETD etd-02192009-144458


Type of Document Dissertation
Author Sutherland, James Eric
Author's Email Address sutherland.je@gmail.com
URN etd-02192009-144458
Title Telesonography Adoption and Use to Improve the Standard of Patient Care Within a Dominican Community
Degree PhD
Department Education
Advisory Committee
Advisor Name Title
Sutphin, H. Dean Committee Chair
Burton, John K. Committee Member
Rawlins, Fred Committee Member
Redican, Kerry J. Committee Member
Keywords
  • Veron
  • Dominican Republic
  • telemedicine
  • teleradiology
  • teleultrasound
  • telesonography
  • teleconsultation
  • store and forward
  • portable ultrasound
  • standard of care
Date of Defense 2009-01-30
Availability unrestricted
Abstract
Teleradiology has far-reaching implications for the health of remote and underserved populations. With coordination of radiographic evaluation and diagnosis from a distance, teleradiology has the potential to raise the standard of patient care throughout the world. Perhaps the safest and most cost-effective mode of teleradiology today is telesonography. The current research determined that telesonography improves the standard of care at a rural, government-run primary clinic within the Dominican Republic. The work reported herein is intended to compare the use of telesonography to the current standard of sonographic examination which is referral to government hospital 60km from the clinic. the following research questions were addressed: When compared to the standard of care, (1) To what extent does the use of asynchronous telesonography increase the percentage of received sonographic reports based on the total number of ultrasound referrals (sonographic reports / total number of referrals)? (2) To what extent does the use of asynchronous telesonography increase the rate of successful follow-up visits based on the total number of ultrasound referrals? (3) To what extent does the elapsed time between ultrasound referral and sonographic report delivery decrease with the use of asynchronous telesonography? (4) To what extent does the elapsed time between ultrasound referral and patient follow-up decrease with the use of asynchronous telesonography? Research methodology included randomly assigning 100 patients with clinical indications for sonographic examination into experimental and control groups during a 9-week implementation period. Findings from this study indicate that the implemented telesonography system, along with patient awareness of such a system, while not having an appreciable effect on the time to patient follow-up, provided a 4-fold increase in the proportion of patient follow-ups and a 6-fold increase in the proportion of returned radiological reports, and delivered those reports to the referring physician 6-times faster than in the control group. This study demonstrates the feasibility of utilizing a store-and forward telesonography system within this setting. Additional research focusing on the impact of telesonography on patient outcomes within this setting is recommended.
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