Head and neck cancer assessment by flexible endoscopy and telemedicine

J Telemed Telecare. 2009;15(3):118-21. doi: 10.1258/jtt.2009.003004.


We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total of 42 patients were seen in Aberdeen via videoconferencing for a head and neck cancer assessment. Feasibility was confirmed after the first 20 patients, following positive feedback from all concerned and the absence of any significant clinical or technical problems. A total of 42 journeys was avoided, each journey saving 123 kg CO(2) per person. A preliminary cost analysis showed that the threshold at which tele-ENT became cheaper than travel was a workload of 35 patients/year. The actual workload during the pilot study was 29 patients/year. A national telemedicine service for the initial assessment of potential malignancy has the potential to reduce unnecessary transfers to specialist centres, with accompanying reductions in carbon emissions.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Feasibility Studies
  • Female
  • Greenhouse Effect
  • Head and Neck Neoplasms / diagnosis*
  • Head and Neck Neoplasms / economics
  • Health Services Accessibility / economics*
  • Humans
  • Laryngoscopes
  • Laryngoscopy / economics*
  • Male
  • National Health Programs / economics
  • Pilot Projects
  • Referral and Consultation / economics*
  • Rural Health Services
  • Scotland
  • Telemedicine / economics*
  • Travel / economics