ENT Tele-endoscopy - for Head & Neck Cancer Assessment

The Scottish Centre for Telehealth (SCT) is currently supporting all NHS Boards across Scotland to pilot the use of Telehealth where it is appropriate to redesign and improve patient access to health care no matter where they live.

Telemedicine has been used successfully in a number of clinical areas such as dermatology, cardiology and neurology. This is when telecommunication technology is used to transfer images via videoconferencing to specialists. It can help reduce the need for patients to travel to major cities and hospitals to receive their care and treatment.

Nationally numerous specialist services are currently under pressure, ENT being one example where endoscopy is now a key diagnostic tool. ENT Consultants also report increasing patient referrals for assessment from primary care. In addition to this there was increased pressure to meet the National Waiting Time target of 18-weeks by December 2007 with a focus on the rapid assessment of patients referred with possible ENT tumours NHS HDL(2007) 09

The redesign project for ENT tele-endoscopy was jointly sponsored by the Improvement & Support Team, SEHD Directorate of Delivery to develop the use of technology to provide clinical advice, consultation and improve the delivery of healthcare services. Therefore lessons from this work that have validity to the rest of NHSScotland will be key and can be rapidly spread through the IST network of improvement programmes as appropriate.

The first two tele-endoscopy clinics went live from Aberdeen to Shetland on the 25th of July and 29th of August 2007. Patients on Shetland reported that they were delighted with the new local service and many of them have stated that it is much better than having to travel to Aberdeen for their appointment.

The study was evaluated and demonstrated that ENT Tele-endoscopy improved patient access to a key diagnostic test. It appears to be safe and has high levels of diagnostic accuracy and patient satisfaction. The model is also more cost effective than seeing patients face-to-face in Aberdeen and it reduces the carbon footprint of the NHS.

Due to the success of the pilot, the model has been accepted and is now part of routine service delivery with clinics running every 2 months from Aberdeen to Shetland.

This work has now been published in the Journal of Telemedicine and Telecare. The full reference is:

Cathy Dorrian, Jim Ferguson, Kim Ah-See, Catriona Barr, Kushik Lalla, Marjon van der Pol, Lynda McKenzie and Richard Wootton, Head and neck cancer assessment by flexible endoscopy and telemedicine. J Telemed Telecare 2009;15(3); p118-121 doi:10.1258/jtt.2009.003004