The “Patient Trajectory”: A Modeling Tool for Planning and Evaluating Rural Telemedicine Systems

  • Maxine L. Rockoff
  • Arthur M. Bennett
Part of the Nato Conference Series book series (NATOCS, volume 6)


This paper presents an analytical tool developed and applied to plan for, the use of telecommunications technology to link a non-physician health care provider in a rural satellite clinic to a central source of medical expertise. An implicit underlying hypothesis was that high technology plus lower skills (non-physicians) would be “equivalent” in some to-be-defined sense to low technology plus higher skills (physicians). The measurement tool developed to compare the performance of such different manpower/technology combinations is based on the concept of a “patient trajectory,” the sequenced set of interactions that take place between a patient and the health care system from the time the patient perceives a need for medical care for some problem until that problem is resolved. For a fixed non-physician man- power level (defined by medical protocols, three Independent physicians estimated the ability of different telecommunications technologists to avert patient travel at decision points within the protocols that called for physician consultation or referral. These judgments) were used as inputs to a computer simulation to assess prospectively the overall effects on reducing patient travel that might be expected from each of several telecommunications technologies, The major result obtained was that telephone-compatible, narrowband technologies (such as slow-scan television) could avert nearly two-thirds of the travel that could be averted with broadband technologies


Health Care System Problem Type Decision Point Otitis Externa Telecommunication Technology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Maxine L. Rockoff
    • 1
  • Arthur M. Bennett
    • 2
  1. 1.National Center for Health Services ResearchHyattsvilleUSA
  2. 2.The METREK Division of the MITRE CorporationMcLeanUSA

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