Use of telemedicine technology to conduct clinical medicine and health promotion classes at a remote location

A real-time telemedicine pilot project is ongoing between Naval Hospital Camp Pendleton, and 52 Area Naval Branch Medical Clinic, located 17 miles away at the Infantry Training School (ITS) on base. The population includes all Active Duty Marines stationed at ITS and presenting to the medical clinic for evaluation. The system utilizes a Pictel System 4000 videoconferencing unit and Codec digitizer, with 28 inch color monitor at both ends. A real time image is projected at 384 Kbps. (384,000 bits per second), the slowest speed at which clinical health care interaction is ethical and effective. Overheads were projected on a Cannon RE-650 Video Visualizer. To date 52 Active Duty Marines were evaluated by nine specialists for a total of 63 diagnoses. Patients, referring providers and specialists completed a satisfaction questionnaire. The majority of both patients and providers rated the quality of moving images, volume and ease of use of the control panel as good or excellent. Two specialties (dermatology and radiology) rated the quality for diagnosis as poor. The majority of consulted physicians were satisfied with their telediagnosis and patient disposition. A majority of consulted physicians noted the telemedicine system had either no effect on, or slightly shortened the length of the obstetrics patient encounter. Active Duty members seen via telemedicine however, returned to their unit an average of six hours earlier than those seen at the hospital through the traditional referral system