V12-09: Telecystoscopy: Use of Remote Video Technology for Bedside Flexible Cystoscopy
The healthcare environment continues to evolve. As medicine becomes increasingly compartmentalized there is increased demand for access to specialists. Telemedicine is loosely defined as the use of telecommunication and information technology to provide clinical health care from a distance. The increased demand for specialized care will necessitate advances in telemedicine specific to each subspecialty allowing for increased access to high quality care. Cystoscopy is one of the most common procedures in the Urologic practice with multiple indications. Urology's continued advancement into the field of telemedicine would be greatly propelled by the development of a system for remote cystoscopy without sacrificing quality of care provided to our patients. We present a method for remote cystoscopy to be performed by any healthcare provider under the direct supervision of a Urologist in real time.
In the William Beaumont Hospital Urology Staff clinic four cystoscopies were performed using the Quintree software that allows for the 'expert' Urologist to be available remotely.
Four cystoscopic evaluations were performed during the proof of concept period. We found excellent results in terms of the use of telecommunication software, allowing providers the ability to perform basic cystoscopic procedures under the real-time supervision of an attending Urologist. Throughout each procedure the attending Urologist was able to communicate with the provider, as well as patients. During one procedure the 'expert' was able to direct the attention of the provider to an area of abnormal appearing mucosa concerning for malignancy. No adverse events occurred during any of the procedures.
This proof of concept project successfully identified a technique for performance remotely of cystoscopic procedures. Though not formally measured, initial review by patient, provider, and expert demonstrated positive results with successful completion of the procedures and no detrimental effects on efficacy, comfort of both the patient and provider, or communication. Further formal investigation of this technique is necessary to demonstrate patient and provider satisfaction as well as to determine effects on outcomes in terms of diagnostic capabilities compared to standard procedures. While the software provides an excellent platform for our initial investigation, further tailoring to allow for ease of use in a more mobile platform would aid in furthering the use of telecystoscopy to more locations and departments.