Store and Forward
Store-and-forward telemedicine involves collecting clinical information and sending it electronically to another site for evaluation by a specialist at their convenience. Transmitted information typically includes demographic data, medical history, documents such as laboratory reports, and image, video and/or sound files.
The health professional may use a desktop computer or a mobile device, such as a smartphone. Information is transmitted by electronic mail, uploaded to a secure website, or uses a private network.
Store-and-forward consultations are convenient compared to video-conference consultations. They improve access to specialist care and reduce costs to the health system and patients.
- The patient, the GP and the specialist do not have to be available at the same time—improving efficiency
- They do not need to travel—participants can be located anywhere
- Waiting times are reduced—specialist reports are often received within a few hours of the request
- Second opinions can be obtained rapidly from the most suitable expert
- Language and cultural barriers are removed
- Outpatient appointments are freed up for patients that need them
- Unnecessary prescriptions and surgical procedures are minimised
A disadvantage is that the specialist does not examine the patient directly. It may be necessary to arrange a face-to-face or video consultation at a later date.
Store-and-forward telemedicine activities in New Zealand include:
- X-rays taken at a remote location or after hours reviewed by a specialist radiologist or physician (teleradiology)
- Images of a wound taken by a junior doctor in the emergency department and sent to his consultant to obtain advice on acute management
- Digital images of a patient's skin condition sent by a GP to a dermatologist for diagnosis and treatment advice (teledermatology)
- Nurse-led skin lesion and mole mapping clinics providing high quality images to skin cancer specialists (teledermatoscopy)
- Images of diabetic retinopathy taken by a technician and reviewed by an ophthalmologist (retinal screening)
- Pathology images used for a multidisciplinary meeting (telepathology)
- Patient portals allowing communication between patient and their GP