Authors:

Abstract

Introduction: The orthopaedic unit at the Teaching Hospital, Ragama is the referral centre for three large hospitals, having the only orthopaedic surgeon in the entire Gampaha district (with a population in excess of two million). Each day, patients are transferred for orthopaedic opinion and for further management at inconvenience to the patient and cost to the hospital. An electronic mail link between two units is easily set up at minimal cost as a route for telemedicine.

Method: A surgical unit at district general hospital Gampaha served as a referring unit. A template was used. History, management, digital photographs of radiographs, and of the wound where relevant were electronically mailed with Short Message Service notification. Trauma patients requiring orthopaedic opinion were included in the process except those whom the surgeon decided needed immediate transfer (to Ragama for orthopaedics or to Colombo for neurosurgery)

Results: Eighty four patients were referred in 43 batches. The initial management at Gampaha was considered satisfactory in 40 (48%). Minor corrections were advised in 14 (17%). Eleven, (13%)were to be reviewed in the clinic at Ragama. Only 4 (5%) required immediate transfer. Maximum delay in obtaining an opinion was 12 hours (overnight). Overall, 62 (74%) patients were saved a four hour round trip.Anestimated thirty four ambulance journeys including 3 to 4 staff members per journey were saved.

Conclusion: Electronic referral in orthopaedics is feasible. Inconvenience to patients is reduced while the hospital will save time and money.

Key words: Electronic referral; Tele-medicine; Orthopaedic trauma.

DOI: http://dx.doi.org/10.4038/sljs.v29i1.3576

Sri Lanka Journal of Surgery 2011: 29(1) 15-18

Keywords: Electronic referral,  Tele-medicine,  Orthopaedic trauma.