Objective/Hypothesis 

As we evolve into the managed care era, telemedicine technologies can help to provide efficiencies for the entire health care system.

Our practice is centered around a residency training program in a federal facility.

Our goal was to lay the groundwork for an entire service being on-line.

Study Design 

Prospective.

Methods 

The stepwise process is as follows :

• needs assessment to examine what part of the practice would lend itself to telemedicine deployment ;

• usability studies to select the best equipment ;

• study in-house to normalize the technology to the current standard of care comparing control subjects with experimental subjects ;

• and deploying remote units to study remote referral.

Results 

Videootoscopy captures the image of an eardrum that can be sent from a remote site in a store-forward mode.

After normalizing the standard of care, the potential for diagnosing and treating certain ear conditions such as hearing loss is readily apparent.

An audiogram, pertinent laboratory data, and history and physical performed by the referring primary care provider would allow the patient to be seen and triaged virtually.

Time savings for the patient and the otolaryngologist would be gained.

Initial data indicate a greater than 90% correlation with handheld otoscopy and binocular microscopy.

In speech sciences, a need existed to evaluate and treat patients from remote sites where speech therapists are unavailable. (...)