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      Telemedicine consultations in oral and maxillofacial surgery.

      Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
      Adult, Ambulatory Surgical Procedures, Anesthesia, General, Cost-Benefit Analysis, Female, Gingivectomy, Health Care Reform, Humans, Intubation, Intratracheal, Jaw, surgery, Male, Molar, Third, Periodontium, Prisoners, Remote Consultation, Reproducibility of Results, Retrospective Studies, Time Factors, Tooth, Tooth Extraction, Tooth, Impacted

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          Abstract

          The purpose of this study was to evaluate the efficiency of telemedicine consultation for preoperative assessment of patients. A retrospective study of 43 patients was done to evaluate the efficiency of telemedicine consultation in adequately assessing patients for dentoalveolar surgery with general anesthesia and nasotracheal intubation. Efficiency was defined as the ability to conduct surgery with general anesthesia at the immediately following clinic appointment without the need for further preoperative testing, evaluation, or consultation. Thirty-five of these patients were subsequently treated. Ninety-five percent (33) of patients were able to undergo surgery with general anesthesia at the immediate appointment, and 100% of patients were assessed correctly, using telemedicine consultation. Two of the patients were assessed as American Society of Anesthesiologists Class III during telemedicine consultation and required further evaluation before surgery could be scheduled. No surgical procedure was canceled, and there were no anesthetic complications attributable to inadequate preoperative assessment of patients during telemedicine consultation. This study confirms that telemedicine consultations are as reliable as those conducted by traditional methods. Because of the reorganization of health care and the ways it is financed, it may be more economical to move data from place to place than to move doctors from place to place. Telecommunication is an efficient and cost-effective mechanism to provide preoperative evaluation in situations in which patient transport is difficult or costly.

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