Open Access Original article

How to set up a low cost tele-ultrasound capable videoconferencing system with wide applicability

Innes Crawford1, Paul B McBeth2, Mark Mitchelson34, James Ferguson34, Corina Tiruta6 and Andrew W Kirkpatrick256*

Author Affiliations

1 University of Aberdeen, Aberdeen, Scotland, AB24-3, U, United Kingdom

2 Department of Surgery, Foothills Medical Centre, Calgary, Alberta, AB-T2N-2T9, Canada

3 Department of Emergency Medicine, Aberdeen Royal Infirmary, Urquhart Road City Centre, Aberdeen, AB24 5AU, Scotland, UK

4 Scottish Centre for Telehealth, Riverside Drive, Aberdeen, Scotland, AB11 7LH, UK

5 Critical Care Medicine, Foothills Medical Centre, Calgary, Alberta, AB-T2N-2T9, Canada

6 Regional Trauma Services, Foothills Medical Centre, Calgary, Alberta, AB-T2N-2T9, Canada

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Critical Ultrasound Journal 2012, 4:13  doi:10.1186/2036-7902-4-13

Published: 29 May 2012

Abstract

Background

Worldwide ultrasound equipment accessibility is at an all-time high, as technology improves and costs decrease. Ensuring that patients benefit from more accurate resuscitation and diagnoses from a user-dependent technology, such as ultrasound, requires accurate examination, typically entailing significant training. Remote tele-mentored ultrasound (RTUS) examination is, however, a technique pioneered in space medicine that has increased applicability on earth. We, thus, sought to create and demonstrate a cost-minimal approach and system with potentially global applicability.

Methods

The cost-minimal RTUS system was constructed by utilizing a standard off-the-shelf laptop computer that connected to the internet through an internal wireless receiver and/or was tethered through a smartphone. A number of portable hand-held ultrasound devices were digitally streamed into the laptop utilizing a video converter. Both the ultrasound video and the output of a head-mounted video camera were transmitted over freely available Voice Over Internet Protocol (VOIP) software to remote experts who could receive and communicate using any mobile device (computer, tablet, or smartphone) that could access secure VOIP transmissions from the internet.

Results

The RTUS system allowed real-time mentored tele-ultrasound to be conducted from a variety of settings that were inside buildings, outside on mountainsides, and even within aircraft in flight all unified by the simple capability of receiving and transmitting VOIP transmissions. . Numerous types of ultrasound examinations were conducted such as abdominal and thoracic examinations with a variety of users mentored who had previous skills ranging from none to expert. Internet connectivity was rarely a limiting factor, with competing logistical and scheduling demands of the participants predominating.

Conclusions

RTUS examinations can educate and guide point of care clinical providers to enhance their use of ultrasound. The scope of the examinations conducted is limited only by the time available and the criticality of the subject being examined. As internet connectivity will only improve worldwide, future developments need to focus on the human factors to optimize tele-sonographic interactions.

Keywords:
Tele-ultrasound; Injury; Pre-hospital; Trauma systems