Royal Free Hospital, UK
Sonya Gardiner completed her Medical Degree at Jesus College Cambridge University in 2010 and became a Member of the Royal College of Surgeons of England in 2012. She has undertaken research both as part of her Neuroscience degree at Cambridge University and at Memorial Sloan-Kettering Cancer Center. She is currently carrying out her surgical training at the Royal Free Hospital, London and is applying for higher specialty training in plastic and reconstructive surgery. Along with her strong publication record, she has held positions as a Cambridge University Supervisor for Medical Undergraduates and an Anatomy Demonstrator at Imperial College London.
Background: Telemedicine is a rapidly expanding technology involving the exchange of medical information to assist diagnosis and treatment at a distance. It is particularly valuable when the specialty has a strong visual component. The concept of teleradiology is well recognised and in other specialties such as plastic surgery, where visual examination contributes heavily to diagnosis and patient management, telemedicine holds great potential. Methods: A comprehensive literature review of manuscripts published on telemedicine was performed. Articles were selected for relevance to plastic and reconstructive surgery and reviewed for their applications, benefits and complications. In addition, the manuscripts were assessed for conforming to current legal guidelines for the electronic transfer of patient information. Results: Twenty-nine articles met the inclusion criteria. Twenty-eight (96%) manuscripts reported a benefit of telemedicine. Fifteen (51%) reported on adverse effects, which included misdiagnosis, time consumption, training, technical and cost issues. Only four manuscripts (14%) discussed conforming to legal guidelines within their institution. Conclusions: Telemedicine can improve access to specialties such as plastic surgery by facilitating the provision of expertise at remote sites. Within radiology, where reliable image interpretation can be carried out off-site, it would be expected that telemedicine could be used to a greater extent than other fields and with fewer adverse effects. However, more critical analysis on the benefits and risks of telemedicine is needed. In addition, its privacy and medico-legal implications need to be carefully considered if it is to be safely integrated into our daily practice.