Introduction

Recently, telemedical services are increasingly used. It remains unclear, if outpatients in general surgery can be treated via telemedicine (e.g. telework). We aimed to evaluate, if diagnosis and therapies of outpatients in general surgery can be found using a mobile healthcare communication app instead of personal contact.

Material and Methods

In a prospective, double blind, anonymized clinical study we included consecutive outpatients at a general surgery department at a university hospital. For the telemedical “treatment” the on-site doctors uploaded variables (e.g. anamnesis, radiograph, etc.) for each patient. The telemedical doctor received the information only via app and did not see the patient physically. Both, the doctor on-site and the virtual telemedical-doctor then uploaded the diagnosis and their suggested therapy – blinded to each other. The outpatient received the on-site treatment only. The virtual treatment was solely for scientific purposes and had no therapeutic impact.

Results

225 consecutive surgical outpatients (53 % female and 47 % male) were included. Mean age was 61 years. In 84 % of cases the telemedical diagnosis matched the on-site diagnosis. The telemedical treatment was not inferior as compared to the on-site treatment in 94 % of all cases and the same therapy was proposed in 76 %. In 6% of all cases the telemedical therapeutic regimen could possibly harm or lead to an over- or under treatment of the patient.

Conclusion

Telemedical consultation seems to work in the field of general surgery. Telemedicine in general surgery potentially could decrease waiting time for an appointment and patient frequency. However, the potential harm of a wrong therapy remains due to the lack of a clinical observation.

中文翻译：

---

一家外科大学诊所的远程医疗与现场治疗：连续225例患者的研究

介绍

最近，越来越多地使用远程医疗服务。尚不清楚是否可以通过远程医疗（例如，远程工作）对普通外科手术的门诊病人进行治疗。我们旨在评估，是否可以使用移动医疗通讯应用程序而非个人联系方式来找到普通外科门诊病人的诊断和治疗方法。

材料与方法

在一项前瞻性，双盲，匿名临床研究中，我们纳入了大学医院普通外科门诊中的连续门诊患者。对于远程医疗“治疗”，现场医生上载了每个患者的变量（例如，回忆，射线照相等）。远程医疗医生仅通过应用程序接收到该信息，并且没有看到患者的身体。然后，现场医生和虚拟远程医疗医生都上传了诊断信息和建议的治疗方法-彼此不知情。门诊患者仅接受现场治疗。虚拟治疗仅出于科学目的，没有治疗效果。

结果

包括225名连续的外科门诊病人（53％的女性和47％的男性）。平均年龄为61岁。在84％的病例中，远程医疗诊断与现场诊断相符。在所有病例中，远程医疗治疗均不比现场治疗低劣，占所有病例的94％，并且提出了76％的患者采用相同的治疗方法。在所有情况下，有6％的远程医疗治疗方案可能伤害或导致患者过度或治疗不足。

结论

远程医疗咨询似乎在普通外科领域起作用。普通外科手术中的远程医疗可能会减少预约的等待时间和患者的频率。但是，由于缺乏临床观察，错误治疗的潜在危害仍然存在。