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  • Teleconsultation by Nurses for neurosurgical patients. A paradigm shift in cost-effective patient care for developing countries

    Final Number:

    Deepak Agrawal MBBS MS MCh

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: Neurosurgical patients have to travel long distances for follow up visits as local doctors unable to attend to simple queries of these patients.On the other hand, Mobile penetration in India exceeds 90% with almost every family having access to mobile phone. Objective:To evaluate a pilot system of teleconsultation using nurses and a call-centre to handle neurosurgical patient's queries.

    Methods: Prospective study was conducted in Trauma centre, AIIMS over 6 month’s period (March- August 2011). A new Cadre of Nurses created called Nurse Informatics specialists (NIS) who were posted in ED round the clock & whose job responsibilities include receiving patient queries (through call centre), coordinating with doctors In ED & resolving the queries. The workflow consists of the following steps: Patient phones call centre (+9111-40401010). Agent answers. In case of medical queries transfers the call to NIS. NIS understands query, opens patients electronic chart and goes through the patient condition, discusses query with concerned resident neurosurgeon. The NIS then calls the patient and gives answer to query. A ‘teleconsult’ note is also typed into the Electronic medical record detailing the query & response. In case query cannot be handled at nurse level, patient asked to come in the ED.

    Results: Total incoming calls received in our call center were 12648. Of these 64 call were diverted to NIS.Of these, 55(86%) cases were rectified & Solved by the nurse at their level itself & 9(14%) cases were further discussed with concerned doctors.40(63%)were medication queries,6(9%) queries related to symptoms/ signs,10 (16%)queries related to clinic appointments & 8(13%) were miscellaneous queries.

    Conclusions: Our study shows that almost 90% of all neurosurgical patients queries can be handled at the nurse level itself & nurses can play a extremely important role in in providing follow up care remotely to these patients cost-effectively-especially in developing countries

    Patient Care: This research shows that neurosurgical care delivery can be significantly enhanced extremely cost-effectively using nurses.

    Learning Objectives: To see if cost-effective neurosurgical care can be provided remotely using nurses and a call centre


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