Telemedicine Strategies Advancing

The world is leading toward more and more connectedness and the potential to extend the footprint of very knowledgeable people is great as tele systems gather strength. The use of commercially available I Phones and FaceTime for Medical consultation was first reported for Airway Management by Dr John Sakles and Dr Jarrod Mosier from the University of Arizona . (Telebation : Next-Generation telemedicine in remote airway management using current wireless technologies. Telemed J E health 2013,Feb 19,(2): 95-8.)

This new study from Japan extends this theme

A pilot study of tele-anaesthesia by virtual private network between an island hospital and a mainland hospital in Japan

1. Tetsuya Miyashita, Yusuke Mizuno,Yo Sugawara, Yusuka Nagamine, Yukihide Koyama
2. Tomoyuki Miyazaki, Kazuhiro Uchimoto, Yasuhiro Iketani, Kentaro Tojo, Takahisa Goto.

1. Department of Anesthesiology, Yokohama City University Hospital, Japan

1. Dr Tetsuya Miyashita, Department of Anesthesiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama City, Kanagawa 236-0004, Japan. Email: yushukyo@gmail.com

We studied the use of tele-anaesthesia between Sado General Hospital (SGH) located on Sado Island and Yokohama City University Hospital (YCUH) located in mainland Japan. The two sites were connected via a virtual private network (VPN). We investigated the relationship between the bandwidth of the VPN and both the frame rate and the delay time of the tele-anaesthesia monitoring system. The tool used for communication between the two hospitals was free videoconferencing software (FaceTime), which can be used over Wi-Fi connections. We also investigated the accuracy of the commands given during teleanaesthesia: any commands from the anaesthetist at the YCUH that were not carried out for any reason, were recorded in the anaesthetic records at the SGH. The original frame rate and data rate at the SGH were 5 fps and approximately 18 Mbit/s, respectively. The frame rate at the transmission speeds of 1, 5 and 20 Mbit/s was 0.6, 1.6 and 5.0 fps, respectively. The corresponding delay time was 12.2, 4.9 and 0.7 s. Twenty-five adult patients were enrolled in the study and tele-anaesthesia was performed. The total duration of anaesthesia was 37 hours. All 888 anaesthetic commands were completed. There were 7 FaceTime disconnections, which lasted for 10 min altogether. Because no commands needed to be given during the FaceTime disconnection, the telephone was not used. The anaesthesia assistance system might form part of the solution to medical resource shortages.

• Accepted September 26, 2014.