Cloud technology and capsule endoscopy: A single-center users' experience of remote online video analysis and reporting.

Background and study aims Telemedicine has progressed significantly in recent years, with newer, more integrated information technology systems improving healthcare delivery. The development of the world's first cloud-based capsule platform could allow safe and timely virtual analysis of videos from a network of linked hospital centers. We aimed to assess the efficacy of Medtronic's PillCam Remote Reader System. Methods PillCam remote reader technical data were collected from the capsule endoscopy (CE) database over 8 months. User-reported performance was collect using an online survey. Outcomes included overall procedure success, video-upload/report-download rates and speeds, encryption/decryption rates, and user/reader satisfaction. Results Data from 377 studies encompassing seven different readers was collected (318 small bowel capsules, 59 colon capsules). Overall procedure success was 100% (all videos reported). Two upload delays occurred (< 24 hours). There were no encryption/decryption errors. Seven of seven respondents felt it easy to access and use vs one of seve for the old system. Six of seven respondents felt department efficiency increased. Benefits included off-site reading and multisite-conferences. Issues included offsite difficulty accessing other hospital systems. Conclusions PillCam remote reader is a reliable, secure, and effective capsule analysis platform and should be incorporated into any CE service development plan.

Colon capsule endoscopy is a viable alternative to colonoscopy for the investigation of intermediate- and low-risk patients with gastrointestinal symptoms: results of a pilot study.

Background and study aims Colon capsule endoscopy (CCE) is a recommended viable alternative to colonoscopy for colonic visualisation in a variety of clinical settings with proven efficacy in polyp detection, surveillance, screening and Inflammatory Bowel Disease (IBD) assessment. CCE efficacy in an unselected average risk symptomatic cohort has yet to be established. The aim of this study was to determine the feasibility of CCE imaging assessment in average risk symptomatic patients as an alternative to colonoscopy with and without additional biomarker assessment. Patients and methods This was a prospective, single-center comparison study of colonoscopy, CCE and biomarker assessment. Results Of 77 invited subjects, 66 underwent both a CCE and colonoscopy. A fecal immunochemical test (FIT) and fecal calprotectin (FC) were available in 56 and 59 subjects. In all 64 % (n = 42) had any positive finding with 16 (24 %) found to have significant disease (high-risk adenomas, IBD) on colonoscopy. The CCE completion rate was 76 %, five (8 %) had an inadequate preparation, the CCE polyp detection rate was high at 35 %. The sensitivity, specificity, positive and negative predictive values of CCE for significant disease were 81 %, 98 %, 93 % and 94 % respectively. In addition, three (5 %) significant small bowel diagnoses were made on CCE. FC and FIT were frequently elevated in patients with both colitis (5/7, 71 %) and high-risk adenomas (4/7 57 %). While both had a low positive predictive value for clinically significant disease, FIT 32 % and FC 26 %. Conclusions CCE is a safe and effective alternative to colonoscopy in symptomatic average risk patients with or without the addition of biomarker screening.