WorldWideScience

Sample records for emergency telemedicine system

  1. Employment of telemedicine in emergency medicine. Clinical requirement analysis, system development and first test results

    National Research Council Canada - National Science Library

    Czaplik, M; Bergrath, S; Rossaint, R; Thelen, S; Brodziak, T; Valentin, B; Hirsch, F; Beckers, S K; Brokmann, J C

    2014-01-01

    .... However several studies have shown a deficiency in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS that may provide expertise and improve quality of medical treatment on the scene...

  2. Emerging Technologies for Telemedicine

    Energy Technology Data Exchange (ETDEWEB)

    Minh, Cao Duc [National Agency for Science and Technology Information, Hanoi (Viet Nam); Shimizu, Shuji; Antoku, Yasuaki; Torata, Nobuhiro; Kudo, Kuriko; Okamura, Koji; Nakashima, Naoki; Tanaka, Masao [Kyushu University Hospital, Fukuoka (Japan)

    2012-02-15

    This paper focuses on new technologies that are practically useful for telemedicine. Three representative systems are introduced: a Digital Video Transport System (DVTS), an H.323 compatible videoconferencing system, and Vidyo. Based on some of our experiences, we highlight the advantages and disadvantages of each technology, and point out technologies that are especially targeted at doctors and technicians, so that those interested in using similar technologies can make appropriate choices and achieve their own goals depending on their specific conditions.

  3. A Wireless Emergency Telemedicine System for Patients Monitoring and Diagnosis

    Directory of Open Access Journals (Sweden)

    M. Abo-Zahhad

    2014-01-01

    Full Text Available Recently, remote healthcare systems have received increasing attention in the last decade, explaining why intelligent systems with physiology signal monitoring for e-health care are an emerging area of development. Therefore, this study adopts a system which includes continuous collection and evaluation of multiple vital signs, long-term healthcare, and a cellular connection to a medical center in emergency case and it transfers all acquired raw data by the internet in normal case. The proposed system can continuously acquire four different physiological signs, for example, ECG, SpO2, temperature, and blood pressure and further relayed them to an intelligent data analysis scheme to diagnose abnormal pulses for exploring potential chronic diseases. The proposed system also has a friendly web-based interface for medical staff to observe immediate pulse signals for remote treatment. Once abnormal event happened or the request to real-time display vital signs is confirmed, all physiological signs will be immediately transmitted to remote medical server through both cellular networks and internet. Also data can be transmitted to a family member’s mobile phone or doctor’s phone through GPRS. A prototype of such system has been successfully developed and implemented, which will offer high standard of healthcare with a major reduction in cost for our society.

  4. A wireless emergency telemedicine system for patients monitoring and diagnosis.

    Science.gov (United States)

    Abo-Zahhad, M; Ahmed, Sabah M; Elnahas, O

    2014-01-01

    Recently, remote healthcare systems have received increasing attention in the last decade, explaining why intelligent systems with physiology signal monitoring for e-health care are an emerging area of development. Therefore, this study adopts a system which includes continuous collection and evaluation of multiple vital signs, long-term healthcare, and a cellular connection to a medical center in emergency case and it transfers all acquired raw data by the internet in normal case. The proposed system can continuously acquire four different physiological signs, for example, ECG, SpO2, temperature, and blood pressure and further relayed them to an intelligent data analysis scheme to diagnose abnormal pulses for exploring potential chronic diseases. The proposed system also has a friendly web-based interface for medical staff to observe immediate pulse signals for remote treatment. Once abnormal event happened or the request to real-time display vital signs is confirmed, all physiological signs will be immediately transmitted to remote medical server through both cellular networks and internet. Also data can be transmitted to a family member's mobile phone or doctor's phone through GPRS. A prototype of such system has been successfully developed and implemented, which will offer high standard of healthcare with a major reduction in cost for our society.

  5. Multipurpose Health Care Telemedicine System

    Science.gov (United States)

    2001-10-25

    telemonitoring . In emergency cases where immediate medical treatment is the issue, recent studies conclude that early and specialized pre-hospital patient ...Lama, J Vila: “Intelligent Telemonitoring of Critical Care Patients ”, IEEE EMB Mag, Vol 18, No 4, pp 80-88, Jul/Aug 1999. [7] Strode S, Gustke S...Abstract- In this study we present a multipurpose health care telemedicine system, which can be used for emergency or patient monitoring cases

  6. Telemedicine for Trauma, Emergencies, and Disaster Management

    CERN Document Server

    Latifi, Rifat

    2010-01-01

    Telemedicine has evolved to become an important field of medicine and healthcare, involving everything from simple patient care to actual performance of operations at a distance. This groundbreaking volume addresses the complex technical and clinical development in the management of trauma, disaster, and emergency situations using telemedicine. The book explains how telemedicine and related technologies can be used to effectively handle a wide range of scenarios, from a situation as small as a car crash, to major disasters such as an earthquake. Professionals find critical discussions on the p

  7. Systematic review of telemedicine applications in emergency rooms.

    Science.gov (United States)

    Ward, Marcia M; Jaana, Mirou; Natafgi, Nabil

    2015-09-01

    Despite the frequency of use of telemedicine in emergency care, limited evidence exists on its impacts at the patient, provider, organization, and system level. Hospital-based applications of telemedicine present a potentially important solution, particularly for small and rural hospitals where access to local specialists is rarely available. We conducted a systematic review of telemedicine applications for hospital-based emergency care, which aims to synthesize the existing evidence on the impact of tele-emergency applications that could inform future efforts and research in this area. A search of four databases (PubMed, CINAHL, EMBASE, Cochrane) using a combination of telemedicine and emergency room (ER) keywords for publications yielded 340 citations. Four coders independently determined eligibility based on initial criteria and then extracted information on the 38 resulting articles based on four main categories: study setting, type of technology, research methods, and results. Of the 38 articles, 11 studies focused on telemedicine for diffuse patient populations that typically present in ERs, 8 studies considered telemedicine in the context of minor treatment clinics for patients presenting with minor injuries or illnesses, and 19 studies focused on the use of telemedicine to connect providers in ERs to medical specialists for consultations on patients with specific conditions. Overwhelmingly, tele-emergency studies reported positive findings especially in terms of technical quality and user satisfaction. There were also positive findings reported for clinical processes and outcomes, throughput, and disposition, but the rigor of studies using these measures was limited. Studies of economic outcomes are particularly sparse. Despite limitations in their research methodology, the studies on tele-emergency indicate an application with promise to meet the needs of small and rural hospitals to address infrequent but emergency situations requiring specialist care

  8. Decision support telemedicine systems: A conceptual model and reusable templates

    NARCIS (Netherlands)

    Nannings, Barry; Abu-Hanna, A.

    2006-01-01

    Decision support telemedicine systems (DSTSs) are systems combining elements from telemedicine and clinical decision support systems. Although emerging more, these types of systems have not been given much attention in the literature. Our objective is to define the term DSTS, to propose a general

  9. Telemedicine in the intensive care unit: its role in emergencies and disaster management.

    Science.gov (United States)

    Rolston, Daniel M; Meltzer, Joseph S

    2015-04-01

    Disasters and emergencies lead to an overburdened health care system after the event, so additional telemedicine support can improve patient outcomes. If telemedicine is going to become an integral part of disaster response, there needs to be improved preparation for the use of telemedicine technologies. Telemedicine can improve patient triage, monitoring, access to specialists, health care provider burnout, and disaster recovery. However, the evidence for telemedicine and tele-intensive care in the disaster setting is limited, and it should be further studied to identify situations in which it is the most clinically effective and cost-effective. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Telemedicine systems and telecommunications.

    Science.gov (United States)

    Harnett, Brett

    2006-01-01

    Successful telemedicine requires appropriate equipment and some kind of telecommunications medium. However, successful telemedicine requires more than just technology. The three essential components are the personnel, the technology and a liberal measure of perseverance. Before the technology can be selected, it is necessary to consider the nature of the information to be transmitted between the sites and the time frame over which it must be sent to achieve the desired clinical goals, because this will determine the choice of equipment and the telecommunications network. Factors to be considered include the types of information to be transmitted, the quantity of information to be transferred, and security and privacy (e.g. in Europe and the USA there has been recent legislation about data security). The choice of transmission method for any telemedicine application is, in practice, a compromise between what one would like and what one can afford. In practice, various trade-offs have to be made, which include cost, availability of the service (i.e. the coverage), bandwidth, reliability and quality of service. Equipment and the telecommunications medium are a necessary, but not sufficient, pre-requisite for a successful telemedicine programme. The right people are also required and they must be properly trained.

  11. Wireless and mobile systems in telemedicine

    Directory of Open Access Journals (Sweden)

    Reza Safdari

    2012-12-01

    Full Text Available Background: It is necessary to deploy mobile and wireless systems in healthcare, because they have many benefits for healthcare systems. The objectives of this article were introducing various systems, applications, and standards of the wireless and mobile telemedicine. Material and Methods: This review study was conducted in 2010. To conduct the study, published articles in the years 2005 to 2012, in English with an emphasis on wireless and mobile technologies in health were studied. Search was done with key words include telemedicine, wireless health systems, health and telecommunications technology in databases including Pubmed, Science Direct, Google Scholar, Web of Sciences, Proquest. The collected data were analyzed. Results: Telemedicine system in the ambulance, telemedicine systems in space, telecardiology systems, EEG system, ultrasound system are some types of wireless and mobile systems in telemedicine. PDA-based mobile and wireless telemedicine application, based PDA drug application, and patient tracking application are some of wireless and mobile applications of telemedicine. The most important standards of wireless and mobile telemedicine are HL7, DICOM, SNOMed, and ICD-9-CM. Conclusion: There are many challenges in the wireless and mobile systems in telemedicine, despite the many benefits. Slow speed in sending pictures and video, lack of attention to the privacy in the design of these systems, environmental variables and the number of users during the day are some of these challenges. It is recommended to consider these challenges during the planning and designing of wireless and mobile systems in telemedicine.

  12. Telemedicine

    Science.gov (United States)

    ... Pregnancy Healthy Food Shopping Healthy Drinks for Kids Telemedicine KidsHealth > For Parents > Telemedicine Print A A A ... the way health care is done. What Is Telemedicine? In simple terms, telemedicine allows health care providers ...

  13. Design of multimedia telemedicine system for inter-hospital consultation.

    Science.gov (United States)

    Yoo, Sun K; Kim, Kwang M; Jung, Suck M; Lee, K J; Kim, Nam H

    2004-01-01

    The telemedicine systems for the decision of patient transfer, and the direction of patient treatment through remote consultation are necessarily required for better patient care in emergency situation. In this paper, the prototype emergency telemedicine system has been designed and implemented. The unified integration of multimedia components, including full-quality video, vital sign signals, radiological images and video conferencing in a single computer, provides an efficient means to investigate the accurate status of emergency patient at the remote location. The software implementation of needed functionality without any externally attached hardware CODEC units enables the compact design with low cost, and ease of operation at the emergency room. Experimental tests at the local networks analyze the technical aspects of implemented systems, and optimize the parameters subjectively to run telemedicine systems with affordable error. Inter-hospital experiments demonstrate the possibility to be effectively used at emergency situation.

  14. Operation Joint Endeavor in Bosnia: telemedicine systems and case reports.

    Science.gov (United States)

    Calcagni, D E; Clyburn, C A; Tomkins, G; Gilbert, G R; Cramer, T J; Lea, R K; Ehnes, S G; Zajtchuk, R

    1996-01-01

    For the last several years the U.S. Department of Defense (DoD) has operated a telemedicine test bed at the U.S. Army Medical Research and Material Command's Medical Advanced Technology Management Office. The goal of this test bed is to reengineer the military health service system from the most forward deployed forces to tertiary care teaching medical centers within the United States by exploiting emerging telemedicine technologies. The test bed has conducted numerous proof-of-concept telemedicine demonstrations as part of military exercises and in support of real-world troop deployments. The most ambitious of those demonstrations is Primetime III, an ongoing effort to provide telemedicine and other advanced technology support to medical units supporting Operation Joint Endeavor in Bosnia. Several of the first instances of the clinical use of the Primetime III systems are presented as case reports in this paper. These reports demonstrate capabilities and limitations of telemedicine. The Primetime III system demonstrates the technical ability to provide current telecommunications capabilities to medical units stationed in the remote, austere, difficult-to-serve environment of Bosnia. Telemedicine capabilities cannot be used without adequate training, operations, and sustainment support. Video consultations have eliminated the need for some evacuations. The system has successfully augmented the clinical capability of physicians assigned to these medical units. Fullest clinical utilization of telemedicine technologies requires adjustment of conventional clinical practice patterns.

  15. Design and development of a multimedia database for emergency telemedicine.

    Science.gov (United States)

    Pavlopoulos, S; Berler, A; Kyriacou, E; Koutsouris, D

    1998-09-01

    Recent studies conclude that early and specialised pre-hospital patient management contributes to emergency cases survival. Recent developments in telecommunication and medical informatics by means of telemedicine can be extremely useful to accomplish such tasks in a cost-effective manner. Along that direction, we have designed a portable device for emergency telemedicine. This device is able to telematically "bring" the expert doctor at the emergency site, have him perform an accurate diagnosis, and subsequently direct the Emergency Medical Technicians on how to treat the patient until he arrives to the hospital. The need for storing and archiving all data being interchanged during the telemedicine sessions is very crucial for clinical, legal and administrative purposes. For this, we have developed a multimedia database able to store and manage the data collected by the AMBULANCE system. The database was equipped with a user-friendly graphical interface to enable use from computer naive users. Furthermore, the database has the possibility to display, in an standard way, ECG's, X-ray, CT and MRI images. The application is password protected with a three-level hierarchy access for users with different privileges. The scope of this application is to enhance the capabilities of the doctor on duty for a more precise and prompt diagnosis. The application has the ability to store audio files related to each emergency case and still images of the scene. Finally, this database can become a useful multimedia tool which will work together with the AMBULANCE portable device, the HIS and the PACS of the hospital. The system has been validated in selected non-critical cases and proved to be functional and successful in enhancing the ability of the doctor's on duty for prompt and accurate diagnosis and specialised pre-hospital treatment.

  16. Secure Wireless Military Healthcare Telemedicine Enterprise System

    National Research Council Canada - National Science Library

    Lucas, Kenneth

    2003-01-01

    ...(exp TM) software and Division Tools with cross platform telemedicine systems, inclusive of computer based systems, handheld wireless PDA devices, and miniature computers, to existing DoD legacy...

  17. Secure Wireless Military Healthcare Telemedicine Enterprise System

    National Research Council Canada - National Science Library

    Lucas, Kenneth

    2002-01-01

    ...) software and Dvision Tools with cross platform telemedicine systems, inclusive of computer based systems, handheld wireless PDA devices, and miniature computers, to existing DoD legacy and developing...

  18. Telemedicine consultations and medication errors in rural emergency departments.

    Science.gov (United States)

    Dharmar, Madan; Kuppermann, Nathan; Romano, Patrick S; Yang, Nikki H; Nesbitt, Thomas S; Phan, Jennifer; Nguyen, Cynthia; Parsapour, Kourosh; Marcin, James P

    2013-12-01

    To compare the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). We conducted retrospective chart reviews on seriously ill and injured children presenting to 8 rural EDs with access to pediatric critical care physicians from an academic children's hospital. Physician-related ED medication errors were independently identified by 2 pediatric pharmacists by using a previously published instrument. The unit of analysis was medication administered. The association of telemedicine consultations with ED medication errors was modeled by using hierarchical logistic regression adjusting for covariates (age, risk of admission, year of consultation, and hospital) and clustering at the patient level. Among the 234 patients in the study, 73 received telemedicine consultations, 85 received telephone consultations, and 76 received no specialist consultations. Medications for patients who received telemedicine consultations had significantly fewer physician-related errors than medications for patients who received telephone consultations or no consultations (3.4% vs. 10.8% and 12.5%, respectively; P telemedicine consultations had a lower odds of physician-related errors than medications for patients who received telephone consultations (odds ratio: 0.19, P telemedicine consultations were associated with a significantly reduced risk of physician-related ED medication errors among seriously ill and injured children in rural EDs.

  19. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    Much information is shared, interpreted and recreated between caller, emergency dispatch personnel and ambulance crew during an emergency call. This paper studies the use of reflection in the ambulance control center based on the information an ambulance crew produces during patient treatment in ...... to understand and use the feedback delivered through the system. The paper argues for broadening the scope of telemedicine use outside the boundaries of communication between ambulance and emergency department....

  20. Telemedicine and its transformation of emergency care: a case study of one of the largest US integrated healthcare delivery systems.

    Science.gov (United States)

    Sharma, Rahul; Fleischut, Peter; Barchi, Daniel

    2017-12-01

    Innovative methods for delivering healthcare via the use of technology are rapidly growing. Despite the passage of the Affordable Care Act, emergency department visits have continued to rise nationally. Healthcare systems must devise solutions to face these increasing volumes and also deliver high quality care. In response to the changing healthcare landscape, New York Presbyterian Hospital has implemented a comprehensive enterprise wide digital health portfolio which includes the first mobile stroke treatment unit on the east coast and the first emergency department-based digital emergency care program in New York City.

  1. Telemedicine-Assisted Intubation in Rural Emergency Departments: A National Emergency Airway Registry Study.

    Science.gov (United States)

    Van Oeveren, Lucas; Donner, Julie; Fantegrossi, Andrea; Mohr, Nicholas M; Brown, Calvin A

    2017-04-01

    Intubation in rural emergency departments (EDs) is a high-risk procedure, often with little or no specialty support. Rural EDs are utilizing real-time telemedicine links, connecting providers to an ED physician who may provide clinical guidance. We endeavored to describe telemedicine-assisted intubation in rural EDs that are served by an ED telemedicine network. Prospective data were collected on all patients who had an intubation attempt while on the video telemedicine link from May 1, 2014 to April 30, 2015. We report demographic information, indication, methods, number of attempts, operator characteristics, telemedicine involvement/intervention, adverse events, and clinical outcome by using descriptive statistics. Included were 206 intubations. The most common indication for intubation was respiratory failure. First-pass success rate (postactivation) was 71%, and 96% were eventually intubated. Most attempts (66%) used rapid-sequence intubation. Fifty-four percent of first attempts used video laryngoscopy (VL). Telemedicine providers intervened in 24%, 43%, and 55% of first-third attempts, respectively. First-pass success with VL and direct laryngoscopy was equivalent (70% vs. 71%, p = 0.802). Adverse events were reported in 49 cases (24%), which were most frequently hypoxemia. The impact of telemedicine during emergency intubation is not defined. We showed a 71% first-pass rate post-telemedicine linkage (70% of cases had a previous attempt). Our ultimate success rate was 96%, similar to that in large-center studies. Telemedicine support may contribute to success. Telemedicine-supported endotracheal intubation performed in rural hospitals is feasible, with good success rates. Future research is required to better define the impact of telemedicine providers on emergency airway management.

  2. Usability Problems in a Home Telemedicine System

    DEFF Research Database (Denmark)

    Bruun, Anders; Stage, Jan

    2010-01-01

    a high level of usability in order to enable their users to employ the required functionality, especially if the target user group is elderly people. This paper reports from a usability evaluation of a home telemedicine system. Five elderly persons carried out specified tasks with the system, and based......Home telemedicine systems have the potential to reduce health care costs and improve the quality of life for many patients, including those suffering from chronic illness. This requires that the systems have functionality that fulfils relevant needs. Yet it also requires that the systems have...... on that we identified usability problems with the system. The problems are presented, analysed in relation to 12 different usability themes and related to results from other evaluations of similar systems....

  3. Semantically based clinical TCM telemedicine systems

    CERN Document Server

    Wong, Allan K Y; Lin, Wilfred W K; Dillon, Tharam S; Chang, Elizabeth J

    2015-01-01

    Recent years have seen the development of two significant trends namely: the adoption of some Traditional Chinese Medicine Practices into mainstream Allopathic Western Medicine and the advent of the internet and broad band networks leading to an increased interest in the use of Telemedicine to deliver medical services. In this book, we see the convergence of these two trends leading to a semantically-based TCM Telemedicine system that utilizes an ontology to provide sharable knowledge in the TCM realm to achieve this. The underpinning research required the development of a three-layer architecture and an Ontology of the TCM knowledge. As TCM knowledge like all medical knowledge is not frozen in time it was important to develop an approach that would allow evolution of the Ontology when new evidence became available. In order for the system to be practically grounded it was important to work with an industry partner PuraPharm Group/HerbMiners Informatics Limited. This partnership was initiated through Professo...

  4. Integrating Data Mining Techniques into Telemedicine Systems

    Directory of Open Access Journals (Sweden)

    Mihaela GHEORGHE

    2014-01-01

    Full Text Available The medical system is facing a wide range of challenges nowadays due to changes that are taking place in the global healthcare systems. These challenges are represented mostly by economic constraints (spiraling costs, financial issues, but also, by the increased emphasis on accountability and transparency, changes that were made in the education field, the fact that the biomedical research keeps growing in what concerns the complexities of the specific studies etc. Also the new partnerships that were made in medical care systems and the great advances in IT industry suggest that a predominant paradigm shift is occurring. This needs a focus on interaction, collaboration and increased sharing of information and knowledge, all of these may is in turn be leading healthcare organizations to embrace the techniques of data mining in order to create and sustain optimal healthcare outcomes. Data mining is a domain of great importance nowadays as it provides advanced data analysis techniques for extracting the knowledge from the huge volumes of data collected and stored by every system of a daily basis. In the healthcare organizations data mining can provide valuable information for patient's diagnosis and treatment planning, customer relationship management, organization resources management or fraud detection. In this article we focus on describing the importance of data mining techniques and systems for healthcare organizations with a focus on developing and implementing telemedicine solution in order to improve the healthcare services provided to the patients. We provide architecture for integrating data mining techniques into telemedicine systems and also offer an overview on understanding and improving the implemented solution by using Business Process Management methods.

  5. Barriers and facilitators to pediatric emergency telemedicine in the United States.

    Science.gov (United States)

    Uscher-Pines, Lori; Kahn, Jeremy M

    2014-11-01

    Pediatric emergency telemedicine has the potential to improve the quality of pediatric emergency care in underserved areas, reducing socioeconomic disparities in access to care. Yet, telemedicine in the pediatric emergency setting remains underutilized. We aimed to assess the current state of pediatric emergency telemedicine and identify unique success factors and barriers to widespread use. We conducted a telephone survey of current, former, and planned pediatric emergency telemedicine programs in the United States. We surveyed 25 respondents at 20 unique sites, including 12 current, 5 planned, and 3 closed programs. Existing programs were located primarily in academic medical centers and served an average of 12.5 spoke sites (range, 1-30). Respondents identified five major barriers, including difficulties in cross-hospital credentialing, integration into established workflows, usability of technology, lack of physician buy-in, and misaligned incentives between patients and providers. Uneven reimbursement was also cited as a barrier, although this was not seen as major because most programs were able to operate independent of reimbursement, and many were not actively seeking reimbursement even when allowed. Critical success factors included selecting spoke hospitals based on receptivity rather than perceived need and cultivating clinical champions at local sites. Although pediatric emergency telemedicine confronts many of the same challenges of other telemedicine applications, reimbursement is relatively less significant, and workflow disruption are relatively more significant in this setting. Although certain challenges such as credentialing can be addressed with available policy options, others such as the culture of transfer at rural emergency departments require innovative approaches.

  6. Cognitive human factors for telemedicine systems.

    Science.gov (United States)

    Piazza, Matteo; Giorgino, Toni; Azzini, Ivano; Stefanelli, Mario; Luo, Roger

    2004-01-01

    The recent integration of telephony systems with information and communication technology (ICT) enables the development of innovative tools for telemedicine. The dissemination and widespread acceptance of telephone-based care monitoring systems challenge the researcher to deal with the cognitive factors involved in the patient-physician interaction, and the way they should be to shape up the technological solutions. This paper proposes a model that describes the impact of socio-cognitive factors in the complex process of health care management. The model has been used to design and develop a telephone system for the management of hypertensive patient within the EU funded Homey project. The knowledge existed in a widely accepted guideline for the care of hypertension has been represented and augmented through the proposed cognitive model. The final product is an intelligent system able to manage an adaptive dialogue. It monitors patients' adherence and increases their involvement by promoting self-care through frequent virtual visits, which is complementary to the traditional face-to-face encounters with their primary care physicians.

  7. Usability in telemedicine systems-A literature survey.

    Science.gov (United States)

    Klaassen, B; van Beijnum, B J F; Hermens, H J

    2016-09-01

    The rapid development of sensors and communication technologies enable the growth of new innovative services in healthcare, such as Telemedicine. An essential ingredient in the development of a telemedicine system and its final acceptance by end users are usability studies. The principles of usability engineering, evaluations and telemedicine are well established, and it may contribute to the adoption and eventually deployment of such systems and services. An in-depth usability analysis, including performance and attitude measures, requires knowledge about available usability techniques, and is depending on the amount of resources. Therefore it is worth investigating how usability methods are applied in developing telemedicine systems. Our hypothesis is: with increasing research and development of telemedicine systems, we expect that various usability methods are more equally employed for different end-user groups and applications. A literature survey was conducted to find telemedicine systems that have been evaluated for usability or ease of use. The elements of the PICO framework were used as a basis for the selection criteria in the literature search. The search was not limited by year. Two independent reviewers screened all search results first by title, and then by abstract for inclusion. Articles were included up to May 2015. In total, 127 publications were included in this survey. The number of publications on telemedicine systems significantly increased after 2008. Older adults and end-users with cardiovascular conditions were among largest target end-user groups. Remote monitoring systems were found the most, in 90 publications. Questionnaires are the most common means for evaluating telemedicine systems, and were found in 88 publications. Questionnaires are used frequently in studies focusing on cardiovascular diseases, Parkinson's disease and older adult conditions. Interviews are found the most in publications related to stroke. In total 71% of the

  8. Emerging roles for telemedicine and smart technologies in dementia care

    Directory of Open Access Journals (Sweden)

    Bossen AL

    2015-03-01

    Full Text Available Ann L Bossen,1 Heejung Kim,2,3 Kristine N Williams,1 Andreanna E Steinhoff,2 Molly Strieker1 1University of Iowa College of Nursing, Iowa City, IA, USA; 2University of Kansas School of Nursing, Kansas City, KS, USA; 3Yonsei University College of Nursing, Seoul, Republic of Korea Abstract: Demographic aging of the world population contributes to an increase in the number of persons diagnosed with dementia (PWD, with corresponding increases in health care expenditures. In addition, fewer family members are available to care for these individuals. Most care for PWD occurs in the home, and family members caring for PWD frequently suffer negative outcomes related to the stress and burden of observing their loved one's progressive memory and functional decline. Decreases in cognition and self-care also necessitate that the caregiver takes on new roles and responsibilities in care provision. Smart technologies are being developed to support family caregivers of PWD in a variety of ways, including provision of information and support resources online, wayfinding technology to support independent mobility of the PWD, monitoring systems to alert caregivers to changes in the PWD and their environment, navigation devices to track PWD experiencing wandering, and telemedicine and e-health services linking caregivers and PWD with health care providers. This paper will review current uses of these advancing technologies to support care of PWD. Challenges unique to widespread acceptance of technology will be addressed and future directions explored. Keywords: technology, dementia care, caregiver support 

  9. Quality-of-Data Management for Telemedicine Systems

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Hermens, Hermanus J.

    This paper describes techniques to manage the quality-of-data (QoD), particularly in telemedicine systems. Hence, clinical data users, such as clinical decision support systems that support ‘real-time’ guidance of ambulatory patients, can process the data together with QoD in order to make the

  10. A Comparative Study of Compression Methods and the Development of CODEC Program of Biological Signal for Emergency Telemedicine Service

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, T.S.; Kim, J.S. [Changwon National University, Changwon (Korea); Lim, Y.H. [Visionite Co., Ltd., Seoul (Korea); Yoo, S.K. [Yonsei University, Seoul (Korea)

    2003-05-01

    In an emergency telemedicine system such as the High-quality Multimedia based Real-time Emergency Telemedicine(HMRET) service, it is very important to examine the status of the patient continuously using the multimedia data including the biological signals(ECG, BP, Respiration, S{sub p}O{sub 2}) of the patient. In order to transmit these data real time through the communication means which have the limited transmission capacity, it is also necessary to compress the biological data besides other multimedia data. For this purpose, we investigate and compare the ECG compression techniques in the time domain and in the wavelet transform domain, and present an effective lossless compression method of the biological signals using JPEG Huffman table for an emergency telemedicine system. And, for the HMRET service, we developed the lossless compression and reconstruction program of the biological signals in MSVC++ 6.0 using DPCM method and JPEG Huffman table, and tested in an internet environment. (author). 15 refs., 17 figs., 7 tabs.

  11. Dual-Use Telemedicine Support System for Pathology.

    Science.gov (United States)

    1998-12-01

    51 CDRH Center for Devices and Radiological Health 52 CEA Carcino-Embroyonic Antigen 53 CEN European Standards Group 54 CEN/TC 251 Working on spec...Telemedicine and Hospital Information Related Systems Acronyms; 12/10/98 197 MDL MD Lookup 198 MDR MD Retrieval 199 MEDIX MEDical Data InterX (X stands for

  12. The MADE reference information model for interoperable pervasive telemedicine systems

    NARCIS (Netherlands)

    Fung, L.S.N.; Jones, Valerie M.; Hermens, Hermanus J.

    2017-01-01

    Objectives: The main objective is to develop and validate a reference information model (RIM) to support semantic interoperability of pervasive telemedicine systems. The RIM is one component within a larger, computer-interpretable "MADE language" developed by the authors in the context of the

  13. An intelligent telemedicine system for detection of diabetic foot complications

    NARCIS (Netherlands)

    Liu, C.

    2014-01-01

    Early identification and timely treatment of diabetic foot complications are essential in preventing their devastating consequences such as lower-extremity amputation and mortality. Frequent and automatic risk assessment by an intelligent telemedicine system may be feasible and cost-effective. As

  14. Web-based home telemedicine system for orthopedics

    Science.gov (United States)

    Lau, Christopher; Churchill, Sean; Kim, Janice; Matsen, Frederick A., III; Kim, Yongmin

    2001-05-01

    Traditionally, telemedicine systems have been designed to improve access to care by allowing physicians to consult a specialist about a case without sending the patient to another location, which may be difficult or time-consuming to reach. The cost of the equipment and network bandwidth needed for this consultation has restricted telemedicine use to contact between physicians instead of between patients and physicians. Recently, however, the wide availability of Internet connectivity and client and server software for e- mail, world wide web, and conferencing has made low-cost telemedicine applications feasible. In this work, we present a web-based system for asynchronous multimedia messaging between shoulder replacement surgery patients at home and their surgeons. A web browser plug-in was developed to simplify the process of capturing video and transferring it to a web site. The video capture plug-in can be used as a template to construct a plug-in that captures and transfers any type of data to a web server. For example, readings from home biosensor instruments (e.g., blood glucose meters and spirometers) that can be connected to a computing platform can be transferred to a home telemedicine web site. Both patients and doctors can access this web site to monitor progress longitudinally. The system has been tested with 3 subjects for the past 7 weeks, and we plan to continue testing in the foreseeable future.

  15. Global telemedicine using INMARSAT satellite system

    Science.gov (United States)

    Mukhedkar, Dinkar; Laxminarayan, Swamy; Lambert Torres, Germano

    1990-06-01

    Departement of Electrical Engineering Escola Federal de Engenharia de Itajuba Itajuba Minas Gerais Brazil This paper describes a " medical satellite network" for long distance diagnosis. The network proposed will be composed by mobile medical laboratories two transmission stations and a satellite system. This network will allow to link two hospitals for emergency expert medical consultations. INMARSAT satellite system is investigated and a tradeoff is made between a land based I ink and a satellitecommunication link. 1.

  16. Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies.

    Science.gov (United States)

    Narasimha, Shraddhaa; Madathil, Kapil Chalil; Agnisarman, Sruthy; Rogers, Hunter; Welch, Brandon; Ashok, Aparna; Nair, Aswathi; McElligott, James

    2017-06-01

    One area where telemedicine may prove to be highly effective is in providing medical care to the geriatric population, an age group predicted to account for 20% of the population in the near future. However, even though telemedicine has certain advantages, the usability of these systems with this population merits investigation. This article reviews the literature published from 2000 to 2016 with the goal of analyzing the characteristics of usability-related studies conducted using geriatric participants and the subsequent usability challenges identified. Articles were found using Web of Knowledge and PubMed citation indexing portals using the keywords (1) Telemedicine* AND Geriatrics* (2) Telemedicine* AND Usability* (3) Telemedicine* AND Usability* AND Older Adults*. A total of 297 articles were obtained from the initial search. After further detailed screening, 16 articles were selected for review based on the inclusion criteria. Of these, 60% of the studies focused on the overall usability of telemedicine systems; 6.25% focused on the usability of a telepresence robot; 12.5% compared a face-to-face medical consultation with the use of telemedicine systems, and 25% focused on the study of other aspects of telemedicine in addition to its usability. Findings reported in the studies included high patient satisfaction with telemedicine in 31.25%, whereas another 31.25% indicated a high acceptance of this method of medical consultation. Care coordination in 6.25% of the studies; confidence in telemedicine in 6.25%; trust, privacy, and reliability in 6.25%; and increased convenience when compared to personal visits in 18.75% were also reported. This review suggests limited research providing scientifically valid and reproducible usability evaluation at various stages of telemedicine system development. Telemedicine system designers need to consider the age-related issues in cognition, perception, and behavior of geriatric patients while designing telemedicine

  17. Quality-of-data broker for quality-of-data-aware telemedicine systems

    OpenAIRE

    Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Widya, I.A.; Hermens, Hermanus J.

    2016-01-01

    Purpose: Telemedicine systems must provide clinical data of sufficient quality (according to medical standards) to support safe treatment guidance of outpatients. Quality of clinical data (QoD) typically varies due to unstable performance of ICT-components of these telemedicine systems. Therefore, telemedicine systems that support treatment guidance of outpatients should be QoD-aware and must be able to appropriately adapt treatment guidance to QoD variations. Only in this way, the effectiven...

  18. Changes in User Perceptions of a Telemedicine System Over Time: From Initial Implementation to Everyday Use.

    Science.gov (United States)

    Lemon, Christopher; Liu, Na; Lane, Stuart; Sud, Archana; Branley, James; Khadra, Mohamed; Kim, Jinman

    2017-12-20

    Benefits associated with telemedicine are contingent upon positive user perceptions. Despite this, research on user perceptions of telemedicine remains limited. Usability approaches offer a robust way to assess user perceptions, but have rarely been applied in telemedicine. In this study, a usability approach was employed to examine how user perceptions toward a telemedicine system changed over the course of everyday use. A telemedicine system was introduced to a hospital in the home service. Ten mobile nurses completed the System Usability Scale (SUS) after initial use, then again after 18 months of everyday use. Results were compared. Analysis included Bangor et al.'s (2009) adjective rating scale. The initial SUS mean was 83 (standard deviation [SD] = 7.98), indicating "excellent" usability. After 18 months, the SUS mean was 64.38, indicating "OK" usability (SD = 14.25, p benefits and longevity of telemedicine systems, responding to intermittent user appraisal is desirable.

  19. Geospatial Information System Analysis of Healthcare Need and Telemedicine Delivery in California.

    Science.gov (United States)

    Kaufman, Taylor; Geraghty, Estella M; Dullet, Navjit; King, Jesse; Kissee, Jamie; Marcin, James P

    2017-05-01

    Geospatial Information Systems (GIS) superimpose data on geographical maps to provide visual representations of data by region. Few studies have used GIS data to investigate if telemedicine services are preferentially provided to communities of greatest need. This study compared the healthcare needs of communities with and without telemedicine services from a university-based telemedicine program. Originating sites for all telemedicine consultations between July 1996 and December 2013 were geocoded using ArcGIS software. ZIP Code Tabulation Areas (ZCTAs) were extracted from the 2010 U.S. Census Bureau's Topologically Integrated Geographic Encoding and Referencing file and assigned a community needs index (CNI) score to reflect the ZCTA community's healthcare needs based on evidence-based barriers to healthcare access. CNI scores were compared across communities with and without active telemedicine services. One hundred ninety-four originating telemedicine clinic sites in California were evaluated. The mean CNI score for ZCTAs with at least one telemedicine clinic was significantly higher (3.32 ± 0.84) than those without a telemedicine site (2.95 ± 0.99) and higher than the mean ZCTAs for all of California (2.99 ± 1.01). Of the 194 telemedicine clinics, 71.4% were located in communities with above average need and 33.2% were located in communities with very high needs. Originating sites receiving telemedicine services from a university-based telemedicine program were located in regions with significantly higher community healthcare needs. Leveraging a geospatial information system to understand community healthcare needs provides an opportunity for payers, hospitals, and patients to be strategic in the allocation of telemedicine services.

  20. Quality-of-data broker for quality-of-data-aware telemedicine systems

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Widya, I.A.; Hermens, Hermanus J.

    2016-01-01

    Purpose: Telemedicine systems must provide clinical data of sufficient quality (according to medical standards) to support safe treatment guidance of outpatients. Quality of clinical data (QoD) typically varies due to unstable performance of ICT-components of these telemedicine systems. Therefore,

  1. The MADE Reference Information Model for Interoperable Pervasive Telemedicine Systems.

    Science.gov (United States)

    Fung, Nick L S; Jones, Valerie M; Hermens, Hermie J

    2017-03-23

    The main objective is to develop and validate a reference information model (RIM) to support semantic interoperability of pervasive telemedicine systems. The RIM is one component within a larger, computer-interpretable "MADE language" developed by the authors in the context of the MobiGuide project. To validate our RIM, we applied it to a clinical guideline for patients with gestational diabetes mellitus (GDM). The RIM is derived from a generic data flow model of disease management which comprises a network of four types of concurrent processes: Monitoring (M), Analysis (A), Decision (D) and Effectuation (E). This resulting MADE RIM, which was specified using the formal Vienna Development Method (VDM), includes six main, high-level data types representing measurements, observations, abstractions, action plans, action instructions and control instructions. The authors applied the MADE RIM to the complete GDM guideline and derived from it a domain information model (DIM) comprising 61 archetypes, specifically 1 measurement, 8 observation, 10 abstraction, 18 action plan, 3 action instruction and 21 control instruction archetypes. It was observed that there are six generic patterns for transforming different guideline elements into MADE archetypes, although a direct mapping does not exist in some cases. Most notable examples are notifications to the patient and/or clinician as well as decision conditions which pertain to specific stages in the therapy. The results provide evidence that the MADE RIM is suitable for modelling clinical data in the design of pervasive telemedicine systems. Together with the other components of the MADE language, the MADE RIM supports development of pervasive telemedicine systems that are interoperable and independent of particular clinical applications.

  2. Lessons learned from the usability assessment of home-based telemedicine systems.

    Science.gov (United States)

    Agnisarman, Sruthy Orozhiyathumana; Chalil Madathil, Kapil; Smith, Kevin; Ashok, Aparna; Welch, Brandon; McElligott, James T

    2017-01-01

    At-home telemedicine visits are quickly becoming an acceptable alternative for in-person patient visits. However, little work has been done to understand the usability of these home-based telemedicine solutions. It is critical for user acceptance and real-world applicability to evaluate available telemedicine solutions within the context-specific needs of the users of this technology. To address this need, this study evaluated the usability of four home-based telemedicine software platforms: Doxy.me, Vidyo, VSee, and Polycom. Using a within-subjects experimental design, twenty participants were asked to complete a telemedicine session involving several tasks using the four platforms. Upon completion of these tasks for each platform, participants completed the IBM computer system usability questionnaire (CSUQ) and the NASA Task Load Index test. Upon completing the tasks on all four platforms, the participants completed a final post-test subjective questionnaire ranking the platforms based on their preference. Of the twenty participants, 19 completed the study. Statistically significant differences among the telemedicine software platforms were found for task completion time, total workload, mental demand, effort, frustration, preference ranking and computer system usability scores. Usability problems with installation and account creation led to high mental demand and task completion time, suggesting the participants preferred a system without such requirements. Majority of the usability issues were identified at the telemedicine initiation phase. The findings from this study can be used by software developers to develop user-friendly telemedicine systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnographic study.

    Science.gov (United States)

    Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

    2017-12-28

    Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision

  4. ISSUES OF UNIFIED TELEMEDICINE COUNSELLING

    Directory of Open Access Journals (Sweden)

    J. G. Astashevich

    2013-01-01

    Full Text Available The questions of the construction and operation of the unified telemedicine electronic consulting system are considered, as well as relevant directions of telemedicine consultations development.

  5. Quality of clinical data aware telemedicine systems

    NARCIS (Netherlands)

    Larburu Rubio, Nekane

    2016-01-01

    Healthcare services have been evolving continuously owing to new demands caused by demographic and lifestyle changes. The advancements in information and communication technology (ICT) have propelled the development of new healthcare systems that can fulfil these demands. One of the key developments

  6. Global Grid Telemedicine System: Expert Consult Manager

    Science.gov (United States)

    2000-10-01

    REPB REPAIR-BLOOD-VESSEL-OTHER-THAN-FOR- FISTULA -WTH-OR-WITHOUT-PATCH-ANGIOPLASTY 0 2 D% REPA REPAIR- ARTERIOVENOUS - FISTULA 2 5 40% PERI PERICAROIUM...that the conceptual model of 5.1.1 together with the domain knowledge of 5.1.3 represented as in 5.1.2 is capable of functioning as an effective and...critical for system acceptance and functionality . The primary risk of our strategy is that what we learn from a narrow application domain may not

  7. Telemedicine in veterinary practice

    Directory of Open Access Journals (Sweden)

    M. Mars

    2006-06-01

    Full Text Available Veterinary surgeons have a long tradition of consulting one another about problem cases and many have unwittingly practised telemedicine when discussing cases by telephone or by sending laboratory reports by telefax. Specific veterinary telemedicine applications have been in use since the early 1980s, but little research has been undertaken in this field. The Pubmed and CAB International databases were searched for the following Boolean logic-linked keywords; veterinary AND telemedicine, veterinary AND telecare, animal AND telemedicine, animal AND telecare and veterinary AND e-mail and an additional search was made of the worldwide web, using Google Scholar. This returned 25 papers which were reviewed. Of these only 2 report research. Sixteen papers had no references and 1 author was associated with 13 papers. Several themes emerge in the papers reviewed. These include remarks about the use of telemedicine, the benefits that can and are derived from the use of telemedicine, areas of practice in which telemedicine is being used, ethical and legal issues around the practice of telemedicine, image standards required for telemedicine, the equipment that is required for the practice of telemedicine, advice on ways in which digital images can be obtained and educational aspects of telemedicine. These are discussed. Veterinary practice has lagged behind its human counterpart in producing research on the validity and efficacy of telemedicine. This is an important field which requires further research.

  8. Designing Home-Based Telemedicine Systems for the Geriatric Population: An Empirical Study.

    Science.gov (United States)

    Narasimha, Shraddhaa; Agnisarman, Sruthy; Chalil Madathil, Kapil; Gramopadhye, Anand; McElligott, James T

    2017-07-31

    Background and Introduction: Telemedicine, the process of providing healthcare remotely using communication devices, has the potential to be useful for the geriatric population when specifically designed for this age group. This study explored the design of four video telemedicine systems currently available and outlined issues with these systems that impact usability among the geriatric population. Based on the results, design suggestions were developed to improve telemedicine systems for this population. Using a between-subjects experimental design, the study considered four telemedicine systems used in Medical University of South Carolina. The study was conducted at a local retirement home. The participant pool consisted of 40 adults, 60 years or older. The dependent measures used were the mean times for telemedicine session initiation and video session, mean number of errors, post-test satisfaction ratings, the NASA-Task Load Index (NASA-TLX) workload measures, and the IBM-Computer Systems Usability Questionnaire measures. Statistical significance was found among the telemedicine systems' initiation times. The analysis of the qualitative data revealed several issues, including lengthy e-mail content, icon placement, and chat box design, which affect the usability of these systems for the geriatric population. Human factor-based design modifications, including short, precise e-mail content, appropriately placed icons, and the inclusion of instructions, are recommended to address the issues found in the qualitative study.

  9. Telemedicine system interoperability architecture: concept description and architecture overview.

    Energy Technology Data Exchange (ETDEWEB)

    Craft, Richard Layne, II

    2004-05-01

    In order for telemedicine to realize the vision of anywhere, anytime access to care, it must address the question of how to create a fully interoperable infrastructure. This paper describes the reasons for pursuing interoperability, outlines operational requirements that any interoperability approach needs to consider, proposes an abstract architecture for meeting these needs, identifies candidate technologies that might be used for rendering this architecture, and suggests a path forward that the telemedicine community might follow.

  10. Asynchronous web-based patient-centered home telemedicine system.

    Science.gov (United States)

    Lau, Christopher; Churchill, R Sean; Kim, Janice; Matsen, Frederick A; Kim, Yongmin

    2002-12-01

    A web-based system for asynchronous multimedia messaging between shoulder replacement surgery patients at home and their surgeons was developed and tested. A web browser plug-in simplifies the process of capturing video and transferring it to a web site for novice computer users. The design of the video capture plug-in can be reused to acquire and securely transfer any type of data over the web. For example, readings from home biosensor instruments (e.g., glucometers and spirometers) that can be connected to a personal computer can be transferred to a home telemedicine web site. Both patients and doctors can access this web site to monitor health status longitudinally. Six patients, whose familiarity with computers ranged from no experience to expert users, used the system. All of the subjects were able to use the system to check treatment reminders and to send at least one message with video to their surgeons. The surgeons monitored the system regularly and always responded to messages within 24 h during the six-month trial period.

  11. A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study.

    Science.gov (United States)

    Nicolaidou, Iolie; Antoniades, Athos; Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S

    2015-06-17

    Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students' preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: "What are professionals' perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?" The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with the game. Overall, the results were

  12. A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study

    Science.gov (United States)

    Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S

    2015-01-01

    Background Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students’ preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. Objective The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: “What are professionals’ perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?” Methods The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with

  13. Telemedicine as an innovative model for rebuilding medical systems in developing countries through multipartnership collaboration: the case of Albania.

    Science.gov (United States)

    Latifi, Rifat; Dasho, Erion; Shatri, Zhaneta; Tilley, Elizabeth; Osmani, Kalterina L; Doarn, Charles R; Dogjani, Agron; Olldashi, Fatos; Koçiraj, Agim; Merrell, Ronald C

    2015-06-01

    The U.S. Government and other developed nations provide billions of dollars annually in relief assistance to countries around the world. The long-term benefits of this aid, however, are often difficult to elucidate. The aim of this article is to present a model of a multipartnership collaboration among U.S. governmental, nongovernmental organizations, and academia to rebuild medical systems using telemedicine as a sustainable model of foreign aid. The International Virtual e-Hospital implemented the "initiate-build-operate-transfer" strategy to establish an effective telemedicine system in Albania that includes the National Telemedicine Center and 12 regional telemedicine centers. This nationwide telemedicine network has active clinical programs, virtual educational programs, and an electronic library that has substantially improved the access to care while advancing medical education. We propose that telemedicine is an optimal, sustainable, low-cost model for rebuilding medical systems of developing countries when implemented through a multipartnership approach.

  14. Reliability associated with the Roter Interaction Analysis System (RIAS) adapted for the telemedicine context.

    Science.gov (United States)

    Nelson, Eve-Lynn; Miller, Edward Alan; Larson, Kiley A

    2010-01-01

    This study's purpose was to adapt the Roter Interaction Analysis System (RIAS) for telemedicine clinics and to investigate the adapted measure's reliability. The study also sought to better understand the volume of technology-related utterance in established telemedicine clinics and the feasibility of using the measure within the telemedicine setting. This initial evaluation is a first step before broadly using the adapted measure across technologies and raters. An expert panel adapted the RIAS for the telemedicine context. This involved accounting for all consultation participants (patient, provider, presenter, family) and adding technology-specific subcategories. Ten new and 36 follow-up telemedicine encounters were videotaped and double coded using the adapted RIAS. These consisted primarily of follow-up visits (78.0%) involving patients, providers, presenters, and other parties. Reliability was calculated for those categories with 15 or more utterances. Traditional RIAS categories related to socioemotional and task-focused clusters had fair to excellent levels of reliability in the telemedicine setting. Although there were too few utterances to calculate the reliability of the specific technology-related subcategories, the summary technology-related category proved reliable for patients, providers, and presenters. Overall patterns seen in traditional patient-provider interactions were observed, with the number of provider utterances far exceeding patient, presenter, and family utterances, and few technology-specific utterances. The traditional RIAS is reliable when applied across multiple participants in the telemedicine context. Reliability of technology-related subcategories could not be evaluated; however, the aggregate technology-related cluster was found to be reliable and may be especially relevant in understanding communication patterns with patients new to the telemedicine setting. Use of the RIAS instrument is encouraged to facilitate comparison

  15. Diabetes Care and Treatment Project: A Diabetes Institute of Walter Reed Health Care System and Joslin Telemedicine Initiative

    Science.gov (United States)

    2008-09-01

    the potential to bring the highest quality care to all patients with diabetes. The JVN Telehealth program is a web-based interactive telemedicine ... telehealth network demonstration project. Telemedicine Journal and e-Health 2003, 9: 13-23. 48.Feil EG, Glasgow RE, Boles S, McKay HG. Who...Diabetes Institute of Walter Reed Health Care System and Joslin Telemedicine Initiative PRINCIPAL INVESTIGATOR: Robert A

  16. Diabetes Care and Treatment Project: A Diabetes Institute of the Walter Reed Health Care System and Joslin Telemedicine Initiative

    Science.gov (United States)

    2009-04-09

    highest quality care to all patients with diabetes. The JVN Telehealth program is a web-based interactive telemedicine application that can...Outcomes of an integrated telehealth network demonstration project. Telemedicine Journal and e-Health 2003, 9: 13-23. 48.Feil EG, Glasgow RE...the Walter Reed Health Care System and Joslin Telemedicine Initiative PRINCIPAL INVESTIGATOR: Robert A. Vigersky, COL MC CONTRACTING ORGANIZATION

  17. A Decision Support System For Equipment Allocation In A Telemedicine Referral Network

    Directory of Open Access Journals (Sweden)

    Treurnicht, Maria J.

    2014-05-01

    Full Text Available Telemedicine applications have had much success in strengthening health systems worldwide. Unfortunately, many systems are implemented without decisions based on proper needs assessments. In South Africa, this technology push approach has led to a large amount of equipment standing dormant. It is proposed that the potential of telemedicine be measured prior to implementation, thus pulling the technology towards a clinical need. A decision support system is developed that uses health informatics and computational intelligence to determine the need for telemedicine and to allocate equipment in a network of facilities to achieve the best cost benefit. The system facilitates the collection and storage of electronic health record (EHR data in a data warehouse. A linear programming model is used with a genetic algorithm. The system was developed and tested for the South African public health sector, using data from 27 hospitals in the Western Cape Province. Results have shown that if telemedicine workstations with specific peripheral equipment, as determined by the algorithm, were implemented in the given period, an estimated R8.7 million in referral costs could have been saved for the 27 hospitals. Thus the case study provided evidence for the benefits of implementation in the chosen network of hospitals. This new application of health informatics could provide telemedicine management with a useful tool for making implementation decisions based on evidence. Future work would include the development of similar systems for other markets.

  18. Realization of personal telemedicine in the interface point of emergency services and preventive care

    Science.gov (United States)

    Golovner, Michal

    2002-08-01

    SHL was founded in 1987, based in Tel Aviv Israel. SHL is a leading provider of personal telemedicine systems and services. SHL operates a medical call center in Israel that offers remote monitoring services to approx.65000 subscribers. Currently SHL is implementing successful Israeli business model in international markets and has established a number of strategic relationships with leading consumer and healthcare companies in Europe, including Philips Electronics and Nestor Healthcare. As of June 2002, Raytel Medical, a US based company, became a wholly- owned subsidiary of SHL. Core products are FDA approved, carry the CE mark and have a long established reputation in the medical community and a successful track record. SHL offers subscribers and their physicians, Internet access to selected medical data. SHL is publicly traded on the SWX market, Switzerland).

  19. A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study

    OpenAIRE

    Nicolaidou, Iolie; Antoniades, Athos; Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S

    2015-01-01

    Background Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students? preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in me...

  20. Toward a More Usable Home-Based Video Telemedicine System: A Heuristic Evaluation of the Clinician User Interfaces of Home-Based Video Telemedicine Systems.

    Science.gov (United States)

    Agnisarman, Sruthy; Narasimha, Shraddhaa; Chalil Madathil, Kapil; Welch, Brandon; Brinda, Fnu; Ashok, Aparna; McElligott, James

    2017-04-24

    Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms-Doxy.me, Polycom, Vidyo, and VSee-to assess possible problems and limitations that could affect the usability of the system from the clinician's perspective. It was found that 5 experts individually evaluated all four systems using Nielsen's list of heuristics, classifying the issues based on a severity rating scale. A total of 46 unique problems were identified by the experts. The heuristics most frequently violated were visibility of system status and Error prevention amounting to 24% (11/46 issues) each. Esthetic and minimalist design was second contributing to 13% (6/46 issues) of the total errors. Heuristic evaluation coupled with a severity rating scale was found to be an effective method for identifying problems with the systems. Prioritization of these problems based on the rating provides a good starting point for resolving the issues affecting these platforms. There is a need for better transparency and a more streamlined approach for how physicians use telemedicine systems. Visibility of the system status and speaking the users' language are keys for achieving this.

  1. A decision support system for telemedicine through the mobile telecommunications platform.

    Science.gov (United States)

    Eren, Ali; Subasi, Abdulhamit; Coskun, Osman

    2008-02-01

    In this paper we have discussed the application of artificial intelligence in telemedicine using mobile device. The main goal of our research is to develop methods and systems to collect, analyze, distribute and use medical diagnostics information from multiple knowledge sources and areas of expertise. Physicians may collect and analyze information obtained from experts worldwide with the help of a medical decision support system. In this information retrieval system, modern communication tools such as computers and mobile phones can be used efficiently. In this work we propose a medical decision support system using the general packet radio service (GPRS). GPRS, a data extension of the mobile telephony standard Global system for mobile communications (GSM) is emerging as the first true packet-switched architecture to allow mobile subscribers to benefit from high-speed transmission rates and run JAVA based applications from their mobile terminals. An academic prototype of a medical decision support system using mobile device was implemented. The results reveal that the system could find acceptance from the medical community and it could be an effective means of providing quality health care in developing countries.

  2. Telemedicine system using computed tomography van of high-speed telecommunication vehicle.

    Science.gov (United States)

    Takizawa, M; Sone, S; Hanamura, K; Asakura, K

    2001-03-01

    The current medical system provides medical services to patients who visit hospitals. However, medical services can be provided at or close to the home of the patient using fully equipped mobile telemedicine systems. Such a system can identify the disease at an early stage, improve quality of life and prognosis through early diagnosis and treatment, and reduce the costs of medical service. Furthermore, the unit can provide mass screenings of the population, as well as full medical service to remote areas. The Telecommunications Advanced Organization of Japan, Matsumoto, Japan, and Shinshu University Hospital, Matsumoto, Japan, established a research center for a unique telemedicine project using a mobile system. The mobile unit consists of a van that houses a spiral computed-tomography (CT) machine and various telecommunications equipment. The unit allows medical examination, CT scanning, and on-line two-way transfer of image data/teleconferencing to a medical center for consultation with various specialists. We have used the system thus far for the early detection of lung cancer through mass screenings over a four-year period in 29 administrative districts. Mass screenings of 19117 residents resulted in the identification of 75 cases of early lung cancer who were later treated by partial pneumonectomy at Shinshu University Hospital and affiliated hospitals. We have also used the system to provide medical services to rural areas, as telemedicine support at remote areas, wintertime telemedicine support to an international sports competition, and various medical services to a home-care facility.

  3. Telemedicine for Developing Countries

    Science.gov (United States)

    Combi, Carlo; Pozzani, Gabriele

    2016-01-01

    Summary Background Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries. PMID:27803948

  4. Commercial applications of telemedicine

    Science.gov (United States)

    Natiello, Thomas A.

    1991-01-01

    Telemedicine Systems Corporation was established in 1976 and is a private commercial supplier of telemedicine systems. These systems are various combinations of communications and diagnostic technology, designed to allow the delivery of health care services to remote facilities. The technology and the health care services are paid for by the remote facilities, such as prisons.

  5. The Development of Virtual Reality Telemedicine System for Treatment of Acrophobia

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, J.H.; Beack, S.H.; Paek, S.E.; Hong, S.C. [Myongji University, Yongin (Korea)

    2003-04-01

    Acrophobia is an abnormal fear of heights. Medications or cognitive-behavior methods have been mainly used as a treatment. Lately the virtual reality technology has been applied to that kind of anxiety disorders. A virtual environment provides patient with stimuli which arouses phobia, and exposing to that environment makes him having ability to over come the fear. Recently, the patient can take diagnose from a medical doctor in distance with the telemedicine system. The hospital and doctors can get the medical data, audio, video, signals in the actual examination room or operating room via a live interactive system. Audio visual and multimedia conference service, online questionary, ECG signal transfer system, update system are needed in this system. Virtual reality simulation system that composed with a position sensor, head mount display, and audio system, is also included in this telemedicine system. In this study, we tried this system to the acrophobia patient in distance. (author). 16 refs., 7 figs.

  6. Utilizing patient geographic information system data to plan telemedicine service locations.

    Science.gov (United States)

    Soares, Neelkamal; Dewalle, Joseph; Marsh, Ben

    2017-09-01

    To understand potential utilization of clinical services at a rural integrated health care system by generating optimal groups of telemedicine locations from electronic health record (EHR) data using geographic information systems (GISs). This retrospective study extracted nonidentifiable grouped data of patients over a 2-year period from the EHR, including geomasked locations. Spatially optimal groupings were created using available telemedicine sites by calculating patients' average travel distance (ATD) to the closest clinic site. A total of 4027 visits by 2049 unique patients were analyzed. The best travel distances for site groupings of 3, 4, 5, or 6 site locations were ranked based on increasing ATD. Each one-site increase in the number of available telemedicine sites decreased minimum ATD by about 8%. For a given group size, the best groupings were very similar in minimum travel distance. There were significant differences in predicted patient load imbalance between otherwise similar groupings. A majority of the best site groupings used the same small number of sites, and urban sites were heavily used. With EHR geospatial data at an individual patient level, we can model potential telemedicine sites for specialty access in a rural geographic area. Relatively few sites could serve most of the population. Direct access to patient GIS data from an EHR provides direct knowledge of the client base compared to methods that allocate aggregated data. Geospatial data and methods can assist health care location planning, generating data about load, load balance, and spatial accessibility.

  7. Hospital Views of Factors Affecting Telemedicine Use.

    Science.gov (United States)

    Merchant, Kimberly A S; Ward, Marcia M; Mueller, Keith J

    2015-04-01

    Telemedicine (also known as telehealth) is a means to increase access to care, one of the foundations of the Triple Aim. However, the expansion of telemedicine services in the United States has been relatively slow. We previously examined the extent of uptake of hospital based telemedicine using the 2013 HIMSS (Healthcare Information and Management Systems Society) Analytics national database of 4,727 non-specialty hospitals. Our analysis indicated that the largest percentage of operational telemedicine implementations (15.7 percent) was in radiology departments, with a substantial number in emergency/trauma care (7.5 percent) and cardiology/stroke/heart attack programs (6.8 percent). However, existing databases are limited because they do not identify whether a respondent hospital is a "hub" (providing telemedicine services) or a "spoke" (receiving telemedicine services). Therefore, we used data from interviews with hospital representatives to deepen the research and understanding of telemedicine use and the factors affecting that use. Interviews were conducted with key informants at 18 hub hospitals and 18 spoke hospitals to explore their perceptions of barriers and motivators to telemedicine adoption and expansion. Key Findings. (1) Respondents from both hub and spoke hospitals reported that telemedicine helps them meet their mission, enhances access, keeps lower-acuity patients closer to home, and helps head off competition. (2) Respondents from both hub and spoke hospitals reported licensing and credentialing to be significant barriers to telemedicine expansion. Thus, half of hubs provide services only within their state. (3) A variety of one-time funding sources have been used to initiate and grow telemedicine services among hubs and spokes. However, reimbursement issues have impeded the development of workable business models for sustainability. Hub hospitals shoulder the responsibility for identifying sustainable business models. (4) Although respondents

  8. International Telemedicine/Disaster Medicine Conference: Papers and Presentations

    Science.gov (United States)

    1991-01-01

    The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

  9. Telemedicine: a new dimension in the practice of medicine.

    Science.gov (United States)

    Zajtchuk, R; Gilbert, G R

    1999-06-01

    Telemedicine has drawn increasing attention as one of the emerging service delivery vehicles running on the information highway. Until recently, the adoption of telemedicine has been discouraged by the cost of telecommunications and equipment and by the lack of infrastructure, standards, and evidence of cost-effectiveness and cultural acceptance. Although there have been attempts to reduce costs by making use of computer communication networks, they were technically limited by slow network speed and the lack of real-time audio/video compression technology. Ongoing technologic advances in telecommunications, imaging, multimedia computers, and information systems are making interactive telemedicine increasingly possible as high-speed video, voice, and data services are brought to large segments of the general population. The current synergy between health reform initiatives, which are redefining how health care services are accessed and delivered, and advances in technologies that support telemedicine has resulted in a proliferation of telemedicine projects. However, there is still no proof that telemedicine is necessarily cost-effective for a broad set of applications. Each prospective application requires its own business case analysis. Within the current environment, the development of a telemedicine strategy should be based on a sound knowledge of the current and future potential of telemedicine to improve health care access and quality while containing and possibly reducing health care costs.

  10. A methodology for the development of software agent based interoperable telemedicine systems: a tele-electrocardiography perspective.

    Science.gov (United States)

    Ganguly, P; Ray, P

    2000-01-01

    Telemedicine involves the integration of information, human-machine, and healthcare technologies. Because different modalities of patient care require applications running on heterogeneous computing environment, software interoperability is a major issue in telemedicine. Software agent technology provides a range of promising techniques to solve this problem. This article discusses the development of a methodology for the design of interoperable telemedicine systems (illustrated with a tele-electrocardiography application). Software interoperability between different applications can be modeled at different levels of abstraction such as physical interoperability, data-type interoperability, specification-level interoperability, and semantic interoperability. Software agents address the issue of software interoperability at semantic level. A popular object-oriented software development methodology - unified modeling language (UML) - has been used for this development. This research has demonstrated the feasibility of the development of agent-based interoperable telemedicine systems. More research is needed before widespread deployment of such systems can take place.

  11. Mapping telemedicine efforts

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2015-01-01

    are being utilized? What medical disciplines are being addressed using telemedicine systems? Methods: All data was surveyed from the "Telemedicinsk Landkort", a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. Results......Objectives: The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies......: The results of this study suggest that a growing number of telemedicine initiatives are currently in operation across Denmark but that considerable variations existed in terms of regional efforts as the number of operational telemedicine projects varied from region to region. Conclusions: The results...

  12. A telemedicine system for wireless home healthcare based on Bluetooth and the Internet.

    Science.gov (United States)

    Zhao, Xiaoming; Fei, Ding-Yu; Doarn, Charles R; Harnett, Brett; Merrell, Ronald

    2004-01-01

    The VitalPoll Telemedicine System (VTS) was designed and developed for wireless home healthcare. The aims of this study were: to design the architecture and communication methods for a telemedicine system; to implement a physiologic routing hub to collect data from different medical devices and sensors; and to evaluate the feasibility of this system for applications in wireless home healthcare. The VTS was built using Bluetooth wireless and Internet technologies with client/server architecture. Several medical devices, which acquire vital signs, such as real-time electrocardiogram signals, heart rate, body temperature, and activity (physical motion), were integrated into the VTS. Medical information and data were transmitted over short-range interface (USB, RS232), wireless communication, and the Internet. The medical results were stored in a database and presented using a web browser. The patient's vital signals can be collected, transmitted, and displayed in real time by the VTS. The experiments verified no data loss during Bluetooth and Internet communication. Bluetooth and the Internet provide enough bandwidth channels to tranmit these vital signs. The experimental results show that VTS may be suitable for a practical telemedicine system in home healthcare.

  13. High-Intensity Telemedicine Decreases Emergency Department Use for Ambulatory Care Sensitive Conditions by Older Adult Senior Living Community Residents.

    Science.gov (United States)

    Shah, Manish N; Wasserman, Erin B; Gillespie, Suzanne M; Wood, Nancy E; Wang, Hongyue; Noyes, Katia; Nelson, Dallas; Dozier, Ann; McConnochie, Kenneth M

    2015-12-01

    Emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs) are common among older adults. The high-intensity telemedicine model of care has been proposed as an innovative approach to expand access to acute illness care, thereby preventing ED visits. The aim of this study was to assess the effect of a high-intensity telemedicine program for senior living community (SLC) residents on the rate of ED use for ACSCs. We performed a prospective cohort study at a primary care geriatrics practice that provides care to 22 SLCs. Six SLCs selected as intervention facilities, with the remaining SLCs serving as controls. Consenting practice patients at intervention facilities could have patient-to-provider, real-time, or store-and-forward high-intensity telemedicine services to diagnose and treat illnesses. The primary outcome was the rate of ED visits for which the primary diagnosis was an "ambulatory-care-sensitive" condition by the Institute of Medicine, which we compared between control and intervention participants. During the study period, control participants had 310 ED visits for ACSCs, for a rate of 0.195 visits/person-year. Intervention participants visited the ED for ACSCs 85 times, for a rate of 0.138 visits/person-year [unadjusted rate ratio (RR): 0.71, 95% confidence interval (CI): 0.53-0.94]. Among intervention participants, ED use for ACSCs decreased at an annual rate of 34% (RR: 0.661, 95% CI: 0.444-0.982), whereas, in the control group there was no statistically significant change in ED use over time (RR: 1.01, 95% CI: 0.90-1.14). Providing acute illness care by high-intensity telemedicine to older adults residing in SLCs significantly decreases the rate of ED use for ACSCs over 1 year, compared with no change in the rate of ED use for ACSCs among the control group. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  14. User satisfaction with asynchronous telemedicine: a study of users of Santa Catarina's system of telemedicine and telehealth.

    Science.gov (United States)

    von Wangenheim, Aldo; de Souza Nobre, Luiz Felipe; Tognoli, Heitor; Nassar, Silvia Modesto; Ho, Kendall

    2012-06-01

    User satisfaction analyses in synchronous telemedicine and teleconsultation environments have been widely performed and generally show satisfied users. In the field of asynchronous telemedicine, however, satisfaction studies were performed only in one single location or with a restricted set of users. With the aim of offering an exemplar evaluation of the impact of the statewide use of a large-scale asynchronous telemedicine network on the satisfaction of the involved users, this study presents the results obtained from a survey of the perceived quality of the service by both patients and healthcare staff. For this purpose, a survey with satisfaction questionnaires was performed with 564 patients from seven upstate municipalities and 56 healthcare professionals from 46 municipalities, using a methodology from the process improvement field. The collected data were quantified and underwent statistical analysis, which showed a clear perception of the improvement in the quality of service by both patients and healthcare professionals. The present findings also showed that both patients and healthcare professionals felt that introducing these new technologies was a positive step, even in upstate areas and when they involved great changes in the usual processes of primary care.

  15. The business case for telemedicine.

    Science.gov (United States)

    Henny, Chris; Hartington, Katharine; Scott, Stuart; Tveiten, Agnar; Canals, Luisa

    2013-01-01

    Following the coming into force of the International Labour Organisation Maritime Labour Convention (ILO/MLC) and International Maritime Organisation Standards for Training, Certification and Watchkeeping, Manila 2010 (IMO/STCW) amendments, the objective of this article is to provide the shipping community with an initial assessment of the economic reasons and business case, in support of both publicly financed and private telemedicine being implemented on board commercial vessels. It provides the global scale of the requirement, the number of Telemedicine Assistance Services (TMAS) calls handled by participating TMAS, the average direct and indirect costs incurred by both TMAS and ship operators, responding to medical emergencies, and also provides a calculation of the market size of about 760 million Euro/year. It estimates a return on investment per ship, of implementing telemedicine on board to meet the MLC and STCW requirements at less than 1 year. 1. There are both financial and soft benefits, such as crew retention and being perceived as a quality employer offering a telemedicine service on board. 2. It is quite possible to obtain a 20% savings to the industry of perhaps 152 million Euro/year from the deployment of telemedicine on board. 3. The deployment of a telemedical service on ships is an opportunity to encourage further cooperation between TMAS and also with the private TMAS sector. 4. There is clearly a great need, on a global basis, for more cooperation, particularly in standardisation of pre-boarding medical files available, the equipmentrequired on board at a minimum, and level of service quality provided. 5. A collection of a common TMAS annual set of normalised statistics from the stakeholders in the maritime industry is needed. Should someone not be tasked with collecting this? 6. Open registries and countries where the private sector only providestele medicine, should be encouraged to work with the global public TMAS system and contribute to

  16. Implementation phase of a multicentre prehospital telemedicine system to support paramedics: feasibility and possible limitations.

    Science.gov (United States)

    Bergrath, Sebastian; Czaplik, Michael; Rossaint, Rolf; Hirsch, Frederik; Beckers, Stefan Kurt; Valentin, Bernd; Wielpütz, Daniel; Schneiders, Marie-Thérèse; Brokmann, Jörg Christian

    2013-07-11

    Legal regulations often limit the medical care that paramedics can provide. Telemedical solutions could overcome these limitations by remotely providing expert support. Therefore, a mobile telemedicine system to support paramedics was developed. During the implementation phase of this system in four German emergency medical services (EMS), the feasibility and possible limitations of this system were evaluated. After obtaining ethical approval and providing a structured training program for all medical professionals, the system was implemented on three paramedic-staffed ambulances on August 1st, 2012. Two more ambulances were included subsequently during this month. The paramedics could initiate a consultation with EMS physicians at a teleconsultation centre. Telemedical functionalities included audio communication, real-time vital data transmission, 12-lead electrocardiogram, picture transmission on demand, and video streaming from a camera embedded into the ceiling of each ambulance. After each consultation, telephone-based debriefings were conducted. Data were retrieved from the documentation protocols of the teleconsultation centre and the EMS. During a one month period, teleconsultations were conducted during 35 (11.8%) of 296 emergency missions with a mean duration of 24.9 min (SD 12.5). Trauma, acute coronary syndromes, and circulatory emergencies represented 20 (57%) of the consultation cases. Diagnostic support was provided in 34 (97%) cases, and the administration of 50 individual medications, including opioids, was delegated by the teleconsultation centre to the paramedics in 21 (60%) missions (range: 1-7 per mission). No medical complications or negative interpersonal effects were reported. All applications functioned as expected except in one case in which the connection failed due to the lack of a viable mobile network. The feasibility of the telemedical approach was demonstrated. Teleconsultation enabled early initiation of treatments by paramedics

  17. [Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts].

    Science.gov (United States)

    Roig, Francesc; Saigí, Francesc

    2011-01-01

    Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. KAMEDIN: a telemedicine system for computer supported cooperative work and remote image analysis in radiology.

    Science.gov (United States)

    Handels, H; Busch, C; Encarnação, J; Hahn, C; Kühn, V; Miehe, J; Pöppl, S I; Rinast, E; Rossmanith, C; Seibert, F; Will, A

    1997-03-01

    The software system KAMEDIN (Kooperatives Arbeiten und MEdizinische Diagnostik auf Innovativen Netzen) is a multimedia telemedicine system for exchange, cooperative diagnostics, and remote analysis of digital medical image data. It provides components for visualisation, processing, and synchronised audio-visual discussion of medical images. Techniques of computer supported cooperative work (CSCW) synchronise user interactions during a teleconference. Visibility of both local and remote cursor on the conference workstations facilitates telepointing and reinforces the conference partner's telepresence. Audio communication during teleconferences is supported by an integrated audio component. Furthermore, brain tissue segmentation with artificial neural networks can be performed on an external supercomputer as a remote image analysis procedure. KAMEDIN is designed as a low cost CSCW tool for ISDN based telecommunication. However it can be used on any TCP/IP supporting network. In a field test, KAMEDIN was installed in 15 clinics and medical departments to validate the systems' usability. The telemedicine system KAMEDIN has been developed, tested, and evaluated within a research project sponsored by German Telekom.

  19. Low Band Telemedicine Decision Support System for Disaster Situations

    National Research Council Canada - National Science Library

    Hastings, Patricia

    2000-01-01

    Project accomplishments as of the date of the report: The first part of the project involves development of software in preparation for field testing of the trauma web-based decision support system. Dr...

  20. An image processing and management system for radiology with telemedicine services

    Energy Technology Data Exchange (ETDEWEB)

    Pavlopoulos, S.; Koutsouris, D. [Biomedical Engineering Laboratory, Department of Electrical and Computer Engineering, National Technical University of Athens (NTUA), 9 Iroon Polytechniou Str., H/Y Building, Zografou Campus, Athens (Greece)

    1999-03-11

    The morphology of Greece has a significant effect on the structure and operational characteristics of the Greek health care system. The remote location of many rural health care centers and the concentration of major hospitals in the few big cities have an effect on both the quality and availability of health care that is provided. We are developing a strategic plan that would allow hospitals and health care centers across Greece to exchange medical data in digital form and have access to telemedicine and teleconsulting facilities. Two pilot networks have been implemented. The first network is designed to allow for telemedicine and teleconsulting services in the island of Evia. The second pilot network is an Image Management and Communications Systems (IMAC) and was implemented in the Onassio Hospital in Athens. Results of the pilot demonstrators were evaluated and have been very promising for a scaled-up implementation of this pilot project. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  1. Geographic Information Systems Mapping of Diabetic Retinopathy in an Ocular Telemedicine Network.

    Science.gov (United States)

    Jani, Pooja D; Forbes, Lauren; McDaniel, Philip; Viera, Anthony; Garg, Seema

    2017-07-01

    Minimal information exists on the use of geographic information systems mapping for visualizing access barriers to eye care for patients with diabetes. To use geographic information systems mapping techniques to visualize (1) the locations of patients participating in the North Carolina Diabetic Retinopathy Telemedicine Network, (2) the locations of primary care clinicians and ophthalmologists across the state, and (3) the travel times associated with traveling to the 5 primary care clinics in our study. Cross-sectional study conducted from January 6, 2014, to November 1, 2015, at 5 Area Health Education Center primary care clinics that serve rural and underserved populations in North Carolina. In total, 1787 patients with diabetes received retinal screening photographs with remote expert interpretation to determine the presence and severity of diabetic retinopathy. Participants included patients 18 years or older with type 1 or type 2 diabetes who presented to these 5 clinics for their routine diabetes care. Development of qualitative maps illustrating the density of patients with diabetes and their distribution around the 5 North Carolina Diabetic Retinopathy Telemedicine Network sites by zip code and the density of ophthalmologists and primary care clinicians by zip code relative to US Census Urban Areas. A travel time map was also created using road network analysis to determine all areas that can be reached by car in a user-specified amount of time. Mean (SD) age of patients was 55.4 (12.7) years. Women made up 62.7% of the study population. The study included more African American patients (55.4%) compared with white (35.5%) and Hispanic (5.8%) patients. The mean (SD) hemoglobin A1c level was 7.8% (2.4%) (to convert to proportion of total hemoglobin, multiply by 0.01), and the mean (SD) duration of diabetes was 9.2 (8.2) years. Whereas the clinics located in Greensboro, Asheville, and Fayetteville screened patients from more immediate surrounding areas, the

  2. caREMOTE: the design of a cancer reporting and monitoring telemedicine system for domestic care.

    Science.gov (United States)

    Cheng, Chihwen; Stokes, Todd H; Wang, May D

    2011-01-01

    After receiving cancer treatment, patients often experience a decline of HRQoL (health-related quality of life). Physicians typically evaluate HRQoL during periodic clinical visits. However, out-patient reporting of vital signals between two visits could be used to interpret the decline of HRQoL. Considering that the vast majority of patients recovering from cancer are not in hospitals, it is often impractical for the care providers to collect these data. In this paper, we design and prototype caREMOTE, a cancer reporting and monitoring telemedicine system, which can be used in domestic cancer care. By extending a standard clinical trial informatics model, we build a prototype on cloud computing services that can be accessed by a mobile application. We aim to maximize the potential of caREMOTE to help medical practitioners efficiently monitor discharged patients' HRQoL and vital signals, and facilitate data reusability and system interoperability in future collaborative cancer research.

  3. Testing a top-down strategy for establishing a sustainable telemedicine program in a developing country: the Arizona telemedicine program-US Army-Republic of Panama Initiative.

    Science.gov (United States)

    Vega, Silvio; Marciscano, Ivette; Holcomb, Michael; Erps, Kristine A; Major, Janet; Lopez, Ana Maria; Barker, Gail P; Weinstein, Ronald S

    2013-10-01

    Many developing countries have shown interest in embracing telemedicine and incorporating it into their healthcare systems. In 2000, the U.S. Army Yuma Proving Ground (YPG) initiated a program to assist the Republic of Panama in establishing a demonstration Panamanian rural telemedicine program. YPG engaged the Arizona Telemedicine Program (ATP) to participate in the development and implementation of the program. The ATP recommended adoption of a "top-down" strategy for creating the program. Early buy-in of the Panamanian Ministry of Health and academic leaders was regarded as critical to the achievement of long-term success. High-level meetings with the Minister of Health and the Rectors (i.e., Presidents) of the national universities gained early program support. A telemedicine demonstration project was established on a mountainous Indian reservation 230 miles west of Panama City. Today, three rural telemedicine clinics are linked to a regional Ministry of Health hospital for teleconsultations. Real-time bidirectional videoconferencing utilizes videophones connected over Internet protocol networks at a data rate of 768 kilobits per second to the San Felix Hospital. Telepediatrics, tele-obstetrics, telepulmonology, teledermatology, and tele-emergency medicine services became available. Telemedicine services were provided to the three sites for a total of 1,013 cases, with numbers of cases increasing each year. These three demonstration sites remained in operation after discontinuation of the U.S. involvement in September 2009 and serve as a model program for other telemedicine initiatives in Panama. Access to the assets of a partner-nation was invaluable in the establishment of the first model telemedicine demonstration program in Panama. After 3 years, the Panamanian Telemedicine and Telehealth Program (PTTP) became self-sufficient. The successful achievement of sustainability of the PTTP after disengagement by the United States fits the Latifi-Weinstein model

  4. Realtime telemedicine.

    Science.gov (United States)

    Wootton, Richard

    2006-01-01

    Telemedicine conducted via prerecorded interaction is more convenient than that using realtime interaction. On the other hand, a realtime consultation allows an immediate result to be obtained and there is likely to be a strong educational component for the remote practitioner. The use of the telephone is under-rated in telemedicine. Telephones have been used in outpatient follow-up, mental health, help lines and support groups. Telephones (fixed and mobile) have also been used for data transfer (e.g. for transmission of electrocardiograms). Realtime transfer of still images has been used in telepathology for many years, and more recently for rapid assessment of injuries. Realtime transfer of video images has been widely explored, perhaps most successfully in telepsychiatry. Some realtime telemedicine applications have been taken up with enthusiasm, even if formal evidence of cost-effectiveness may be lacking. Teleradiology and telepsychiatry are two examples where widespread adoption is beginning to occur. Other forms of realtime telemedicine represent 'niche' applications. That is, they appear to be both successful and sustainable in the centres where they were pioneered, but have not been adopted elsewhere. Teledialysis and teleoncology are examples of this type. The patchy diffusion of telemedicine is something that is not yet well understood.

  5. Telemedicine in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Ambrosino, Nicolino; Vagheggini, Guido; Mazzoleni, Stefano; Vitacca, Michele

    2016-12-01

    Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation. The costs of care assistance in chronic disease patients are dramatically increasing.Telemedicine may be a very useful application of information and communication technologies in high-quality healthcare services.Many remote health monitoring systems are available, ensuring safety, feasibility, effectiveness, sustainability and flexibility to face different patients' needs.The legal problems associated with telemedicine are still controversial.National and European Union governments should develop guidelines and ethical, legal, regulatory, technical, administrative standards for remote medicine.The economic advantages, if any, of this new approach must be compared to a "gold standard" of homecare that is very variable among different European countries and within each European country.The efficacy of respiratory disease telemedicine projects is promising (i.e. to tailor therapeutic intervention; to avoid useless hospital and emergency department admissions, and reduce general practitioner and specialist visits; and to involve the patients and their families).Different programmes based on specific and local situations, and on specific diseases and levels of severity with a high level of flexibility should be utilised.A European Respiratory Society Task Force produced a statement on commonly accepted clinical criteria for indications, follow-up, equipment

  6. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

    Science.gov (United States)

    de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

    2015-02-01

    A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

  7. Dynamic biosignal management and transmission during telemedicine incidents handled by Mobile Units over diverse network types.

    Science.gov (United States)

    Mandellos, George J; Koutelakis, George V; Panagiotakopoulos, Theodor C; Koukias, Andreas M; Koukias, Mixalis N; Lymberopoulos, Dimitrios K

    2008-01-01

    Early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. This paper focuses on the design and implementation of a telemedicine system that supports diverse types of endpoints including moving transports (MT) (ambulances, ships, planes, etc.), handheld devices and fixed units, using diverse communication networks. Target of the above telemedicine system is the pre-hospital patient treatment. While vital sign transmission is prior to other services provided by the telemedicine system (videoconference, remote management, voice calls etc.), a predefined algorithm controls provision and quality of the other services. A distributed database system controlled by a central server, aims to manage patient attributes, exams and incidents handled by different Telemedicine Coordination Centers (TCC).

  8. Telemedicine in Oncology.

    Science.gov (United States)

    Doyle-Lindrud, Susan

    2016-02-01

    For patients who have difficulty traveling to a clinic or doctor's office because of living in a remote location or lack of transportation, increasing opportunities exist to access health care remotely. Telemedicine is a growing field that has potential benefits for patients, providers, and the healthcare system.
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  9. A real-time, mobile phone-based telemedicine system to support young adults with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Andrew Farmer

    2005-11-01

    Full Text Available Telemedicine systems have been proposed as a means of supporting people with diabetes in the self-management of their condition. Requirements for monitoring parameters of care, including glycaemic control, extent of analysis and interpretation of data, patient_clinician contacts, and involvement of a multidisciplinary care team with effective communication, can be addressed by telemedicine systems. We describe the development and implementation of an innovative real-time telemedicine system based around transmission and feedback of data to and from a mobile phone. Proprietary Java-based programs were used to link a blood glucose meter to a mobile phone. In addition to immediate transmission of blood glucose data, information about insulin dose, eating patterns and physical exercise were collected. Immediate feedback to the phone included a colour histogram to draw attention to levels of control over glycaemia over the previous two weeks. Clinicians supporting patients had access to summary screens identifying users not testing, and those with levels of blood glucose outside pre-defined limits. More detailed graphical displays of data were used to provide data about control of insulin dose and the degree to which it was modified in response to diet and exercise. The system has been evaluated in a clinical trial conducted in secondary care and is now being adapted for use in a trial in primary care, which is designed to assess its effectiveness in providing integrated management for the patient, general practitioner and pharmacist.

  10. Cost-effectiveness of Access to Critical Cerebral Emergency Support Services (ACCESS): a neuro-emergent telemedicine consultation program.

    Science.gov (United States)

    Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard

    2018-01-19

    Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).

  11. Telemedicine: A brief analysis

    Directory of Open Access Journals (Sweden)

    Rajani Gupta

    2014-12-01

    Full Text Available This paper reveals the present status of wireless telemedicine system for m-health application. Wireless telemedicine network equipped with mobile, computer and telecommunication technologies which provide medical data, information and services from distant locations. Telemedicine opens a world of healthcare delivery by building clinical bridges between patients and available healthcare by integrating Information and Communication Technology, Biomedical Engineering, Medical Science, etc. using minimum costs, effective development and utilization of ancillary infrastructure and services. We have studied 130 research papers on telemedicine and its aspects, this paper is an extraction which emphasized on wireless technologies like GSM, General Packet Radio Services, EDGE, 3G, 4G, 5G, Cognitive Radio Network, World Wide interoperability of Microwave Access, Wireless Local Area Network, Wireless Body Area Network, Very Small Aperture Terminal, Satellite communication and WPAN (Bluetooth used for m-health application. It also gives the details of storage, security, protocols, optimum bandwidth and fair scheduling schemes used for transmission of medical signals, images and videos.

  12. Teleradiology usage and user satisfaction with the telemedicine system operated by Médecins Sans Frontières

    Directory of Open Access Journals (Sweden)

    Jarred eHalton

    2014-10-01

    Full Text Available Médecins Sans Frontières (MSF began a pilot trial of store-and-forward telemedicine in 2010, initially operating separate networks in English, French and Spanish; these were merged into a single, multilingual platform in 2013. We reviewed the pattern of teleradiology usage on the MSF telemedicine platform in the four-year period from April 2010. In total, 564 teleradiology cases were submitted from 22 different countries. A total of 1114 files were uploaded with the 564 cases, the majority being of type JPEG (n=1081, 97%. The median file size was 938 kB (interquartile range, IQR 163 to 1659. A panel of 14 radiologists was available to report cases, but most (90% were reported by only four radiologists. The median radiologist response time was 6.1 hours (IQR 3.0 to 20. A user satisfaction survey was sent to 29 users in the last six months of the study. There was a 28% response rate. Most respondents found the radiologist's advice helpful and all of them stated that the advice assisted in clarification of a diagnosis. Although some MSF sites made substantial use of the system for teleradiology, there is considerable potential for expansion. More promotion of telemedicine may be needed at different levels of the organisation to increase engagement of staff.

  13. Telemedicine spirometry training and quality assurance program in primary care centers of a public health system.

    Science.gov (United States)

    Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B

    2014-04-01

    Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (pspirometry tests were assessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pspirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.

  14. Characterizing the Danish telemedicine ecosystem

    DEFF Research Database (Denmark)

    Manikas, Konstantinos; Hansen, Klaus Marius

    2013-01-01

    The use of telemedicine is arguably beneficial even in densely populated areas in reducing cost and increasing efficiency of healthcare. However, the implementation of telemedicine solutions in the healthcare system of Denmark has been perceived as being faced with implementation...... and interoperability issues, silo solutions, and lack of guidelines and standards. In this paper, we characterise the ecosystem evolved around the telemedicine services in Denmark and study the actors involved in this ecosystem. We establish a method for this study, where we define two actor roles and ways...... of characterizing actor contributions, and apply the method to the largest healthcare region of Denmark. Our findings reveal an ecosystem that is relatively closed to new actors, where the actors tend to be related to single telemedicine applications, the applications have low connectivity, and the most influential...

  15. Telemedicine in oncology: European perspective.

    Science.gov (United States)

    Mohr, Markus

    2008-01-01

    Telemedicine in oncology or teleoncology integrates many so far well-known telemedicine elements such as teleconsultation, telesupport, telesurgery and telerobotics, teleeducation, and many others and is integral part of many disciplines such as internal medicine, surgery, dermatology, but also dentistry and psychooncology/psychiatry. Changes in ICT, new developments in oncology, the need to think and work interdisciplinarily, geographic and economic challenges as well as the transgression of sectoral boundaries as elements of modern teleoncology. Whereas the northern parts of Europe show a well-developed telemedicine infrastructure with a growing tendency to incorporate teleoncology for documentation, data analysis and quality assurance, in more southern countries this process is still underway and often marked by project status. Modern technology using xDSL and other terrestrial network lines but also satellite connectivity is at hand to cover a wide variety of telemedicine applications and services from which teleoncology benefits. More and more specifically designed software applications can be used to assess the medical workflow of an oncological patient and determine a life-long oncological electronic patient record. The trend, however, goes to the systemic integration of single applications and services into clinical information systems with a telemedicine approach. Although past evaluations of telemedicine applications and services have shown very positive results, only the right financial funding determines their survival and wide-spread usability in daily routine medical use. Formerly identifiable barriers for this use nowadays can be overcome more easily.

  16. Wireless telemedicine systems for diagnosing sleep disorders with Zigbee star network topology

    Science.gov (United States)

    Oh, Sechang; Kwon, Hyeokjun; Varadan, Vijay K.

    2012-10-01

    Good sleep is critical for one's overall physical and mental health but more than 50 million Americans have experienced or are suffering from sleep disorders. Nevertheless, 85% of them remain undiagnosed or untreated. They can lead to chronic diseases. Sleep disorders are diagnosed through polysomnography, also known as sleep study, performed in a sleep laboratory overnight. This perturbs his/her daily sleep routine, and consequently, an accurate diagnosis cannot be made. Many companies have been developing home sleep test systems to reduce the cost of sleep studies and provide a more convenience solution to patients. The category of the system varies as type II, type III and type IV according to the type of sleep study. Current systems cannot be easily extended from one type to include a higher type. A patient who has a type III system to diagnose sleep apnea should additionally purchase a type II system which has functions that overlap with a type III system, to evaluate sleep stages. In this paper, we propose a wireless telemedicine system for easy extension of channels using the start network topology of the Zigbee protocol. The HST system consists of two wireless HST devices with a Zigbee module, a wireless HST receiver with both a Zigbee and a Wi-Fi module, and a sever which monitors/saves the physiological signals. One transmitter provides 5 channels for 2x EOG, 2x EEG and EMG to evaluate sleep stages. The other transmitter provides 5 additional channels for ECG, nasal air flow, body position, abdominal/chest efforts and oxygen saturation to diagnose sleep apnea. These two transmitters, acting as routers, and the receiver as a coordinator form a Zigbee star network. The data from each transmitter in the receiver are retransmitted to the monitoring unit through Wi-Fi. By building a star network with Zigbee, channels can be easily extended so that low level systems can be upgraded to higher level systems by simply adding the necessary channels. In addition

  17. Telemedicine in Urology: State of the Art.

    Science.gov (United States)

    Ellimoottil, Chandy; Skolarus, Ted; Gettman, Matthew; Boxer, Richard; Kutikov, Alexander; Lee, Benjamin R; Shelton, Jeremy; Morgan, Todd

    2016-08-01

    Whereas telemedicine is recognized as one of the fastest-growing components of the healthcare system, the status of telemedicine use in urology is largely unknown. In this narrative review, we detail studies that investigate the use of televisits and teleconsultations for urologic conditions. Moreover, we discuss current regulatory and reimbursement policies. Finally, we discuss the significant barriers to widespread dissemination and implementation of telemedicine and reasons why the field of urology may be positioned to become a leader in the provision of telemedicine services. Published by Elsevier Inc.

  18. Emergency Lightning System

    Science.gov (United States)

    1980-01-01

    Super Vacuum Manufacturing Company's Stem-Lite Emergency Lighting System is widely used by fire, police, ambulance and other emergency service departments. The lights -- four floodlights which provide 2,000 watts of daytime equivalent visibility and a high-intensity flashing beacon can be elevated 10 feet above the roof of an emergency vehicle by means of an extendible mast. The higher elevation expands the effective radius of the floodlights and increases the beacon's visibility to several miles affording extra warning time to approaching traffic. When not in use, the light can be retracted into the compact rooftop housing. Stem-Lite also includes a generator which can serve to power such emergency equipment as pumps and drills, and a dashboard-mounted control panel for switching the lights and extending or retracting the mast.

  19. QoE for telemedicine: challenges and trends

    Science.gov (United States)

    Cavaro-Ménard, Christine; Lu, Zhang Ge; Le Callet, Patrick

    2013-09-01

    Telemedicine that involves sharing of digital data (i.e. physiological signals, 2D/3D images and videos) should meet the same standards of traditional healthcare in terms of usability, accessibility, efficiency, effectiveness and quality of clinical processes. All these requirements can be seen as elementary components that participate to the quality of experience (QoE) in an ad hoc medical application scenario. Although, the quality of service (QoS) in telemedicine has been quite investigated, QoE is still lacking clear definition in this context. This later should not be assimilated to QoS as it refers clearly to the experience by the user while QoS focuses mostly on the system. QoE has a potential relevancy to optimize and understand the technical transmission chain from the final task point viewpoint which one of the most important factor for adoption of telemedicine. Towards this goal, QoE studies should be conducted with an appropriate methodology incorporating user involvement and digital data and their relation with QoS. As one of the first effort in this field, this paper proposes a survey of some key issues and solutions associated to QoE in telemedicine. We first present the services offered by telemedicine and underline the significance of QoE for tele-diagnosis and tele-surgery. Next, we identify and analyze the influencing factors such as application area, application purpose (emergency care, acquisition assistance, second opinion, education...), content type (data specificities depending on acquisition modality), context of use (offline/real time, interactivity...), and user's state (stress, expertise...), that have to be considered for a relevant QoE assessment in telemedicine.

  20. Psychiatrist's adherence: a new factor in relapse prevention of schizophrenia. A randomized controlled study on relapse control through telemedicine system.

    Science.gov (United States)

    Spaniel, F; Novak, T; Bankovska Motlova, L; Capkova, J; Slovakova, A; Trancik, P; Matejka, M; Höschl, C

    2015-12-01

    Exposure to psychotic states has detrimental effects on the long-term outcome of schizophrenia and brain integrity. Therefore, improving relapse prevention is a key component of long-term management of schizophrenia. Previous studies using continuous monitoring of an individual's early signs of relapse and adopting preventative pharmacological interventions, when early signs are detected, showed promising clinical results in terms of relapse risk reduction. This 18-month multi-centre parallel randomized controlled, open label, trial with telemedicine relapse prevention programme ITAREPS failed to show superiority of maintenance plus prodrome-based targeted medication strategy over treatment as usual. The study, marked by low investigator's adherence, confirmed that absence of pharmacological intervention at early stage of prodrome, critically influenced the risk of relapse. This and previous randomized controlled trials with telemedicine programme ITAREPS suggested that substantial improvement in relapse prevention in schizophrenia is likely to be unattainable under current clinical settings. Future preventive strategies in schizophrenia would require rapid pharmacological intervention upon occurrence of subclinical prodromal symptoms that are undetectable under conventional outpatient practice. Studies with ITAREPS suggested that integration of telemedicine relapse prevention systems and visiting nurse service might together represent practical solution capable to address those requirements. The Information Technology Aided Relapse Prevention Programme in Schizophrenia (ITAREPS) presents a telemedicine solution for weekly monitoring and management of schizophrenia. This study aims to evaluate the effectiveness of the programme in reducing the number of hospitalizations during the 18-month multi-centre parallel randomized controlled, open label, trial. Outpatients with schizophrenia or schizoaffective disorder were randomized to the active (n = 74) or control group

  1. Augmented Reality as a Telemedicine Platform for Remote Procedural Training.

    Science.gov (United States)

    Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

    2017-10-10

    Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor's hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers' perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

  2. Augmented Reality as a Telemedicine Platform for Remote Procedural Training

    Directory of Open Access Journals (Sweden)

    Shiyao Wang

    2017-10-01

    Full Text Available Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER through mixed reality capture (MRC and serves as a novel telemedicine platform with remote pointing capabilities. The mentor’s hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers’ perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

  3. Cockpit emergency safety system

    Science.gov (United States)

    Keller, Leo

    2000-06-01

    A comprehensive safety concept is proposed for aircraft's experiencing an incident to the development of fire and smoke in the cockpit. Fire or excessive heat development caused by malfunctioning electrical appliance may produce toxic smoke, may reduce the clear vision to the instrument panel and may cause health-critical respiration conditions. Immediate reaction of the crew, safe respiration conditions and a clear undisturbed view to critical flight information data can be assumed to be the prerequisites for a safe emergency landing. The personal safety equipment of the aircraft has to be effective in supporting the crew to divert the aircraft to an alternate airport in the shortest possible amount of time. Many other elements in the cause-and-effect context of the emergence of fire, such as fire prevention, fire detection, the fire extinguishing concept, systematic redundancy, the wiring concept, the design of the power supplying system and concise emergency checklist procedures are briefly reviewed, because only a comprehensive and complete approach will avoid fatal accidents of complex aircraft in the future.

  4. Evaluation of a telemedicine system for heart failure patients: feasibility, acceptance rate, satisfaction and changes in patient behavior: results from the CARME (CAtalan Remote Management Evaluation) study.

    Science.gov (United States)

    Domingo, Mar; Lupón, Josep; González, Beatriz; Crespo, Eva; López, Raúl; Ramos, Anna; Urrutia, Agustàn; Pera, Guillem; Verdú, José Ma; Bayes-Genis, Antoni

    2012-12-01

    Telemedicine can be useful for managing heart failure (HF), but patient acceptance of telemedicine and its impact on patient behavior are unclear. To assess a telemedicine program in a HF Unit. This sub-analysis of the CARME study assessed the use of an interactive telemedicine platform. This prospective intervention study had a before/after design with HF patients randomized 1:1 into two groups: (A) Motiva system (educational videos, motivational messages, and questionnaires); and (B) Motiva system + telemonitoring of blood pressure, heart rate and weight. Of 211 patients screened, 44 were excluded, 62 did not consent to participate and 8 withdrew consent prior to installation of the system. The final study population included 97 patients. During 1 year of follow-up, 22 patients voluntarily discontinued use of the system, 5 died (three after early discontinuation) and 5 withdrew consent before the last evaluation. A total of 15,017 questionnaires were sent to patients, with a median response rate of 88%. Satisfaction with the system and tools was high (median score 8.4/10), especially with the self-monitoring chart, scale and sphygmomanometer. Positive changes were observed in patient behavior, especially for blood pressure and weight control (p < 0.001). After the study, 65% of the patients wished to continue with telemonitoring, particularly those in group B (p = 0.004). Less than half of our patients participated in the telemedicine study. However, those who completed the study had confidence in the system, a high degree of satisfaction with the tools and positive behavioral changes.

  5. American Telemedicine Association: Federal Telemedicine Policy Summit

    Directory of Open Access Journals (Sweden)

    Benjamin Forstag

    2013-06-01

    Full Text Available ATA Federal Telemedicine Policy Summit, Washington DC - Hyatt Regency on Capitol Hill June 27, 2013 at 1:00 pm and June 28, 2013 at 12:00 pm The ATA Federal Telemedicine Policy Summit is an opportunity to hear and interact with leaders from Congress, key federal agencies and influential policy thinkers about the latest developments affecting telemedicine. The Summit will include participation of key stakeholders including healthcare providers, business interests, medical societies, consumer groups and more. Join the conversation and hear the latest, inside information about the swift changes underway in healthcare delivery, public policy and the opportunities these provide for those involved in telemedicine. The Summit has an exciting line-up of speakers, representing the nation’s top policy leaders in healthcare. For information: http://www.americantelemed.org/ata-federal-telemedicine-policy-summit/summit-overview

  6. Emergent behaviors of classifier systems

    Energy Technology Data Exchange (ETDEWEB)

    Forrest, S.; Miller, J.H.

    1989-01-01

    This paper discusses some examples of emergent behavior in classifier systems, describes some recently developed methods for studying them based on dynamical systems theory, and presents some initial results produced by the methodology. The goal of this work is to find techniques for noticing when interesting emergent behaviors of classifier systems emerge, to study how such behaviors might emerge over time, and make suggestions for designing classifier systems that exhibit preferred behaviors. 20 refs., 1 fig.

  7. The EU-project United4Health: User-centred design of an information system for a Norwegian telemedicine service.

    Science.gov (United States)

    Smaradottir, Berglind; Gerdes, Martin; Martinez, Santiago; Fensli, Rune

    2016-10-01

    Organizational changes of health care services in Norway brought to light a need for new clinical pathways. This study presents the design and evaluation of an information system for a new telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge. A user-centred design approach was employed composed of a workshop with end-users, two user tests and a field trial. For data collection, qualitative methods such as observations, semi-structured interviews and a questionnaire were used. User workshop's outcome informed the implementation of the system initial prototype, evaluated by end-users in a usability laboratory. Several usability and functionality issues were identified and solved, such as the interface between the initial colour scheme and the triage colours. Iterative refinements were made and a second user evaluation showed that the main issues were solved. The responses to a questionnaire presented a high score of user satisfaction. In the final phase, a field trial showed satisfactory use of the system. This study showed how the target end-users groups were actively involved in identifying the needs, suggestions and preferences. These aspects were addressed in the development of an information system through a user-centred design process. The process efficiently enabled users to give feedback about design and functionality. Continuous refinement of the system was the key to full development and suitability for the telemedicine service. This research was a result of the international cooperation between partners within the project United4Health, a part of the Seventh Framework Programme for Research of the European Union. © The Author(s) 2015.

  8. Secure Wireless Military Healthcare Telemedicine Enterprise

    National Research Council Canada - National Science Library

    Lucas, Kenneth W

    2005-01-01

    The primary objective of this research effort is to integrate ViTel Net's MedVizerTM software and Division Tools with cross platform telemedicine systems, inclusive of computer based systems, handheld...

  9. Telemedicine in Greenland

    DEFF Research Database (Denmark)

    Nielsen, Lasse Overballe; Krebs, Hans Jørgen; Albert, Nancy M.

    2017-01-01

    BACKGROUND: Telemedicine may have the possibility to provide better access to healthcare delivery for the citizens. Telemedicine in arctic remote areas must be tailored according to the needs of the local population. Therefore, we need more knowledge about their needs and their view of telemedicine....... OBJECTIVE: The aim of this study has been to explore how citizens living in the Greenlandic settlements experience the possibilities and challenges of telemedicine when receiving healthcare delivery in everyday life. MATERIALS AND METHODS: Case study design was chosen as the overall research design......: Data collected on citizens' views about the possibilities of using telemedicine in Greenland revealed the following findings: Greenlandic citizens are positive toward telemedicine, and telemedicine can help facilitate improved access to healthcare for residents in these Greenlandic settlements...

  10. Mapping telemedicine efforts: surveying regional initiatives in Denmark.

    Science.gov (United States)

    Kierkegaard, Patrick

    2015-05-01

    The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies are being utilized? What medical disciplines are being supported using telemedicine systems? All data were surveyed from the Telemedicinsk Landkort, a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. The results of this study suggest that a growing numbers of telemedicine initiatives are currently in operation across Denmark but that considerable variations exist in terms of regional efforts as the number of operational telemedicine projects varied from region to region. The results of this study provide a timely picture of the factors that are shaping the telemedicine landscape of Denmark and suggest potential strategies to help policymakers increase and improve national telemedicine deployment.

  11. Cost-benefit analysis on the use of telemedicine program of Kosova for continuous medical education: a sustainable and efficient model to rebuild medical systems in developing countries.

    Science.gov (United States)

    Latifi, Kalterina; Lecaj, Ismet; Bekteshi, Flamur; Dasho, Erion; Doarn, Charles R; Merrell, Ronald C; Latifi, Rifat

    2011-12-01

    The Ministry of Health of Kosova has recently announced the Telemedicine Program of Kosova (TMPK) as the official institution responsible for managing and coordinating the nation's Long-Distance Continuous Medical Education (CME) program. There are a lack of studies on cost-benefit analysis (CBA) and other economic evaluations of telemedicine programs (TMP), in particular the financial value of CME offered through such a service. In addition, there is lack of prospective studies on Monitoring & Evaluation (M&E) of TMP. The goal of this study was to conduct a retrospective CBA of prospective data collected at TMPK over a 5-year period (2005-2010) in order to determine the cost benefit as opposed to the alternative method of delivery of this model for developing countries whose healthcare systems are in disarray. We reviewed data on the number of participants in virtual lectures both at the Telemedicine Center of Kosova (TCK) as well as the number of participants at six Regional Telemedicine Centers throughout Kosova, the number of lectures broadcasted, the clinical cases reviewed and transmitted for international consultation, and other quantitative data. Only in 2009, approximately 2,000 CME certificates were awarded to physicians and nurses of Kosova, 18 international teleconsultations were conducted, 138 videoconferences, lectures, and seminars were held, and there were over 9,000 visitors at the TCK e-library. Data analysis shows that the TMPK has been an efficient mechanism for CME and sustainable model for rebuilding the medical system. TMPK has been successful in offering physicians, nurses, and other medical professions access to electronic information. TMP is an efficient mechanism to ensure CME and rebuilding medical systems in developing countries. There is a need for prospective CBA of any TMP and the establishment of M&E programs in any future telemedicine initiatives in developing countries.

  12. Patient perspectives of telemedicine quality

    Directory of Open Access Journals (Sweden)

    LeRouge CM

    2014-12-01

    Full Text Available Cynthia M LeRouge,1 Monica J Garfield,2 Alan R Hevner3 1Saint Louis University, St Louis, MO, 2Bentley University, Waltham, MA, 3University of South Florida, Tampa, FL, USA Background: The purpose of this study was to explore the quality attributes required for effective telemedicine encounters from the perspective of the patient.Methods: We used a multi-method (direct observation, focus groups, survey field study to collect data from patients who had experienced telemedicine encounters. Multi-perspectives (researcher and provider were used to interpret a rich set of data from both a research and practice perspective.Results: The result of this field study is a taxonomy of quality attributes for telemedicine service encounters that prioritizes the attributes from the patient perspective. We identify opportunities to control the level of quality for each attribute (ie, who is responsible for control of each attribute and when control can be exerted in relation to the encounter process. This analysis reveals that many quality attributes are in the hands of various stakeholders, and all attributes can be addressed proactively to some degree before the encounter begins.Conclusion: Identification of the quality attributes important to a telemedicine encounter from a patient perspective enables one to better design telemedicine encounters. This preliminary work not only identifies such attributes, but also ascertains who is best able to address quality issues prior to an encounter. For practitioners, explicit representation of the quality attributes of technology-based systems and processes and insight on controlling key attributes are essential to implementation, utilization, management, and common understanding. Keywords: patient perspective, technology service encounters, health care operations, telemedicine, quality, field study, mixed methodology

  13. Design and implementation of a telemedicine system using Bluetooth protocol and GSM/GPRS network, for real time remote patient monitoring.

    Science.gov (United States)

    Jasemian, Yousef; Nielsen, Lars Arendt

    2005-01-01

    This paper introduces the design and implementation of a generic wireless and Real-time Multi-purpose Health Care Telemedicine system applying Bluetooth protocol, Global System for Mobile Communications (GSM) and General Packet Radio Service (GPRS). The paper explores the factors that should be considered when evaluating different technologies for application in telemedicine system. The design and implementation of an embedded wireless communication platform utilising Bluetooth protocol is described, and the implementation problems and limitations are investigated. The system is tested and its telecommunication general aspects are verified. The results showed that the system has (97.9 +/- 1.3)% Up-time, 2.5 x 10(-5) Bit Error Rate, 1% Dropped Call Rate, 97.4% Call Success Rate, 5 second transmission delay in average, (3.42 +/- 0.11) kbps throughput, and the system may have application in electrocardiography.

  14. NASA's telemedicine testbeds: Commercial benefit

    Science.gov (United States)

    Doarn, Charles R.; Whitten, Raymond

    1998-01-01

    The National Aeronautics and Space Administration (NASA) has been developing and applying telemedicine to support space flight since the Agency's beginning. Telemetry of physiological parameters from spacecraft to ground controllers is critical to assess the health status of humans in extreme and remote environments. Requisite systems to support medical care and maintain readiness will evolve as mission duration and complexity increase. Developing appropriate protocols and procedures to support multinational, multicultural missions is a key objective of this activity. NASA has created an Agency-wide strategic plan that focuses on the development and integration of technology into the health care delivery systems for space flight to meet these challenges. In order to evaluate technology and systems that can enhance inflight medical care and medical education, NASA has established and conducted several testbeds. Additionally, in June of 1997, NASA established a Commercial Space Center (CSC) for Medical Informatics and Technology Applications at Yale University School of Medicine. These testbeds and the CSC foster the leveraging of technology and resources between government, academia and industry to enhance health care. This commercial endeavor will influence both the delivery of health care in space and on the ground. To date, NASA's activities in telemedicine have provided new ideas in the application of telecommunications and information systems to health care. NASA's Spacebridge to Russia, an Internet-based telemedicine testbed, is one example of how telemedicine and medical education can be conducted using the Internet and its associated tools. Other NASA activities, including the development of a portable telemedicine workstation, which has been demonstrated on the Crow Indian Reservation and in the Texas Prison System, show promise in serving as significant adjuncts to the delivery of health care. As NASA continues to meet the challenges of space flight, the

  15. Emergency Notification System

    Data.gov (United States)

    US Agency for International Development — The USAID ENS provides quick and effective notification messages during any emergency affecting the Ronald Reagan Building, SA-44, Potomac Yards and USAID Washington...

  16. Telemedicine in wound care.

    Science.gov (United States)

    Chanussot-Deprez, Caroline; Contreras-Ruiz, José

    2008-12-01

    Telemedical wound care is one of the applications of teledermatology. We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 x 10 cm) and one on his right leg (9 x 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via email to a wound care specialist in Mexico City. The photographs allowed the expert to diagnose and evaluate the chronic wounds periodically. In the present cases, telemedicine allowed us to have a rapid evaluation, diagnosis and treatment. The images were of enough quality to be useful and small enough to be sent via regular email to the remote physician who immediately gave his feedback. The expert was confident to give therapeutic recommendations in this way, and we considered this method to be very cost-effective, saving the patient and the health care system, especially in transportation.

  17. A Web-based Architecture Enabling Multichannel Telemedicine Applications

    Directory of Open Access Journals (Sweden)

    Fabrizio Lamberti

    2003-02-01

    Full Text Available Telemedicine scenarios include today in-hospital care management, remote teleconsulting, collaborative diagnosis and emergency situations handling. Different types of information need to be accessed by means of etherogeneous client devices in different communication environments in order to enable high quality continuous sanitary assistance delivery wherever and whenever needed. In this paper, a Web-based telemedicine architecture based on Java, XML and XSL technologies is presented. By providing dynamic content delivery services and Java based client applications for medical data consultation and modification, the system enables effective access to an Electronic Patient Record based standard database by means of any device equipped with a Web browser, such as traditional Personal Computers and workstation as well as modern Personal Digital Assistants. The effectiveness of the proposed architecture has been evaluated in different scenarios, experiencing fixed and mobile clinical data transmissions over Local Area Networks, wireless LANs and wide coverage telecommunication network including GSM and GPRS.

  18. Mobile Cloud Computing for Telemedicine Solutions

    Directory of Open Access Journals (Sweden)

    Mihaela GHEORGHE

    2014-01-01

    Full Text Available Mobile Cloud Computing is a significant technology which combines emerging domains such as mobile computing and cloud computing which has conducted to the development of one of the most IT industry challenging and innovative trend. This is still at the early stage of devel-opment but its main characteristics, advantages and range of services which are provided by an internet-based cluster system have a strong impact on the process of developing telemedi-cine solutions for overcoming the wide challenges the medical system is confronting with. Mo-bile Cloud integrates cloud computing into the mobile environment and has the advantage of overcoming obstacles related to performance (e.g. battery life, storage, and bandwidth, envi-ronment (e.g. heterogeneity, scalability, availability and security (e.g. reliability and privacy which are commonly present at mobile computing level. In this paper, I will present a compre-hensive overview on mobile cloud computing including definitions, services and the use of this technology for developing telemedicine application.

  19. The Responsibility of Telemedicine Focused Organizations in regards to creating Compliant end Users Products and Services

    Directory of Open Access Journals (Sweden)

    Adrian Dumitru Tanţău

    2014-02-01

    Full Text Available The main purpose of the present study is to provide a highly comprehensive methodological solution for carrying out products/services which fully comply with customers (i.e. end users functional and performance requirements in Telemedicine field, and furthermore to satisfy multitude end users simultaneously. By bringing into the light Systems Engineering (SE as a multidisciplinary theory used preponderantly in the aero-space segment for realization of complex projects, the paper illustrates the way it can be fulfilled the Functional and Performance Requirements of the end users from Romanian (non emergency medicine services in order to develop an innovative telemedicine product. The case study is based on two sets of qualitative researches as interviews in order to validate the telemedicine triggering idea among users, and to classify them, and secondly, as ample observations in order to gain insights on the users' scenarios and further to elaborate user requirements. Both sets of researches undertaken from users' specific environments were backed up with secondary information gained through document analysis. Relevant for this telemedicine research, it is the fact that the results of this survey have been already successfully used as a baseline to prototype the telemedicine product for Romanian market, in a European Space Agency (ESA Project.

  20. [Telemedicine and telematics in medical education].

    Science.gov (United States)

    Banjanović, B; Masić, I

    1999-01-01

    Health telematics is a composite term for health-related activities, services and systems carried out over a distance by means of information and communications technologies, for the purposes of global health promotion, disease control and health care, as well as education, management, and research for health. The concept of health telematics encompasses the following functional areas: --tele-education;--telemedicine;--telematics for health research;--telematics for health services management. Communications technologies are rapidly revolutionizing health care. For example, electronic communications support diagnosis and treatment of disease. TeleMedicine is an umbrella term for growing disciplines such as TeleRadiology. TelePathology. TeleCardiology, TelePsychiatry and TeleEducation. TeleMedicine is a component of TeleHealth, which includes the use of telecommunications technology and services for the surveillance and control of diseases and education. In this article authors describes the role of telemedicine and telematics in medical education and medical praxis.

  1. A Review of Telemedicine Services in Finland

    DEFF Research Database (Denmark)

    Khatri, Vikramajeet; Peterson, Carrie Beth; Kyriazakos, Sofoklis

    2011-01-01

    Patient Records (EPR), with e-referral and e-discharge letters, have prevented patients from unnecessary repeated laboratory examinations and treatments. The e-Archive (Finland’s national EPR) is in the planning stage, making EPR on national level, to promote ease of access to patient records......Telemedicine is gaining popularity due to the provision of ubiquitous health care services that is a fundamental need for every socialized society. In this paper, telemedicine services in Finland are discussed, as well as how they came into existence, how they are funded, evaluated, and what...... are their impacts on health care systems and society. Telemedicine services like teleradiology, telelaboratory, telepsychiatry and remote consultations, are being offered in all hospital districts. Primary health care centers in Finland are lacking telemedicine services, and are planning to have them. Electronic...

  2. Telemedicine for Developing Countries. A Survey and Some Design Issues.

    Science.gov (United States)

    Combi, Carlo; Pozzani, Gabriele; Pozzi, Giuseppe

    2016-11-02

    Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries.

  3. International telemedicine consultations for neurodevelopmental disabilities.

    Science.gov (United States)

    Pearl, Phillip L; Sable, Craig; Evans, Sarah; Knight, Joseph; Cunningham, Parker; Lotrecchiano, Gaetano R; Gropman, Andrea; Stuart, Sheela; Glass, Penny; Conway, Anne; Ramadan, Issam; Paiva, Tania; Batshaw, Mark L; Packer, Roger J

    2014-06-01

    A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE. Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session. Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions. Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental

  4. [Telemedicine, cementing the nursing team].

    Science.gov (United States)

    Canipel, Lydie

    2016-11-01

    Communication technologies have an impact on our healthcare system. We care for human beings in an environment which is now digital and which influences their experience, their treatment and their perception of their disease. Telemedicine will become a key tool for all caregivers. It has no bearing on nurses' skills, but changes the way care is organised, for the benefit of patients as well as healthcare professionals. Copyright © 2016. Published by Elsevier Masson SAS.

  5. Quality of data computational models and telemedicine treatment effects

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.

    2014-01-01

    Clinical decision-support functions of telemedicine systems use patient's monitored clinical data to support treatment of outpatients. However, the quality of monitored clinical data may vary due to performance variations of technological resources inside a deployed telemedicine system. This paper

  6. Proposal on the Establishment of Telemedicine Guidelines for Korea.

    Science.gov (United States)

    Jung, Eun-Young; Kang, Hyung Wook; Park, In-Hwa; Park, Dong Kyun

    2015-10-01

    An official guideline must be prepared for legalizing the doctor-patient telemedicine system based on the evaluations of the ongoing telemedicine demonstration project performed by the Korean government. In this study, critical items of the Korean telemedicine guideline are suggested based on the guidelines of developed countries. To investigate the telemedicine guidelines of developed countries, a keyword of 'telemedicine guidelines' was used for Google search to find out US, Australian, and Japanese guidelines. The common items included in two or more of the followings were screened: US Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions, the Australian New South Wales (NSW) Agency for Clinical Innovation Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW, and the Japanese Guidelines for the practice of home telemedicine. A total of 22 common items of the following four domains, which could be used for the Korean guideline were screened: the common features in overall considerations (6 items), the common features in clinical considerations (6 items), the common features in technical considerations (5 items), and the common features in privacy considerations (5 items). These 22 items were suggested as the critical items of the Korean telemedicine guideline. The screened 22 items of the telemedicine guideline must be further organized for details. Additional studies and professional opinions on the telemedicine cases and on the guidelines of developed countries are required to establish the Korean guideline in the near future.

  7. Telemedicin 1

    DEFF Research Database (Denmark)

    Sørensen, John Aasted; Munck-Fairwood, Roger; Holst-Christensen, Bo

    2011-01-01

    Efter at have gennemført kurset, vil den studerende være i stand til at udføre følgende: - Redegøre for principper ved etablering af et telemedicinsk system, der sammenknytter en patient i privat hjem med en telemedicinsk hospitalsafdeling. Der tages udgangspunkt i de medicinske, organisatoriske,...

  8. Characterizing emergency departments to improve understanding of emergency care systems.

    Science.gov (United States)

    Steptoe, Anne P; Corel, Blanka; Sullivan, Ashley F; Camargo, Carlos A

    2011-07-14

    International emergency medicine aims to understand different systems of emergency care across the globe. To date, however, international emergency medicine lacks common descriptors that can encompass the wide variety of emergency care systems in different countries. The frequent use of general, system-wide indicators (e.g. the status of emergency medicine as a medical specialty or the presence of emergency medicine training programs) does not account for the diverse methods that contribute to the delivery of emergency care both within and between countries. Such indicators suggest that a uniform approach to the development and structure of emergency care is both feasible and desirable. One solution to this complex problem is to shift the focus of international studies away from system-wide characteristics of emergency care. We propose such an alternative methodology, in which studies would examine emergency department-specific characteristics to inventory the various methods by which emergency care is delivered. Such characteristics include: emergency department location, layout, time period open to patients, and patient type served. There are many more ways to describe emergency departments, but these characteristics are particularly suited to describe with common terms a wide range of sites. When combined, these four characteristics give a concise but detailed picture of how emergency care is delivered at a specific emergency department. This approach embraces the diversity of emergency care as well as the variety of individual emergency departments that deliver it, while still allowing for the aggregation of broad similarities that might help characterize a system of emergency care.

  9. A new multidisciplinary home care telemedicine system to monitor stable chronic human immunodeficiency virus-infected patients: a randomized study.

    Directory of Open Access Journals (Sweden)

    Agathe León

    2011-01-01

    Full Text Available Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals.We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I or through standard care at the day hospital (Arm II. After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out.Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I and 41 through standard care (Arm II. Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21 and compliance levels >90% (p = 0.58] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care.Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management

  10. Transforming Gastroenterology Care With Telemedicine.

    Science.gov (United States)

    Siegel, Corey A

    2017-04-01

    Health care is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective, and, importantly, high-quality methods to care for patients. We teach medical students that optimal patient care requires face-to-face interaction to collect information on the patient's history and perform the physical examination. However, management of many patients-especially those with chronic diseases-does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push toward efficiency and value but also requires the belief that excellent patient care is not always provided in person. Telemedicine can include a variety of aspects of patient care adapted to be performed remotely, such as telemonitoring, tele-education, teleconsultation, and telecare. All of these have been evaluated in gastroenterology practice and have demonstrated feasibility and patient preference but have produced mixed results regarding patient outcomes. By combining telemedicine tools and new care models, we can redesign chronic disease management to include fewer in-person visits when patients are well yet increase access for patients who need to be seen. This change could lead to higher-value care by improving the experience of care, decreasing costs, and improving the health of the population. Barriers include reimbursement, licensing, and fear of litigation. However, if we hope to meet the needs of patients within our changing health care system, telemedicine should be incorporated into our strategy. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. Telemedicine: experience at SGPGIMS, Lucknow.

    Science.gov (United States)

    Kapoor, L; Mishra, S K; Singh, Kartar

    2005-01-01

    Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) located in Lucknow, capital of Uttar Pradesh, a state in Northern India, is a tertiary level referral academic medical center involved in teaching and training of super specialist medical professionals with 22 academic departments. It is the first tertiary care hospital in public healthcare sector in India to adopt Information Technology (IT) for healthcare delivery. The Hospital Information System (HIS) was implemented in 1998 to record, store, process and retrieve health data of all the patients. This software was developed in-house in collaboration with Center for Development of Advanced Computing (C- DAC), Pune. Later in the year 1999, telemedicine activities were initiated in the form of testing the concept and technology. The first research grant was availed of in the year 2001, which helped in creating an infrastructure for telemedicine. Regular tele-healthcare and tele-educational services were introduced for the postgraduate students of medical colleges of Orissa. These services have now been extended to educate the doctors of other medical colleges and community centers in other states. Besides, the Institute is associated with organizational activities and in policy initiatives of the government. All the activities are in project mode and are being financially supported by government agencies such as Indian Space Research Organisation (ISRO) and Department of Information Technology. Looking at the need of skilled manpower in the field of telemedicine and e-health, a school of telemedicine is coming up in the campus, which will also provide core infrastructure for research and development.

  12. Telemedicine: Experience at SGPGIMS, Lucknow

    Directory of Open Access Journals (Sweden)

    Kapoor L

    2005-01-01

    Full Text Available Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS located in Lucknow, capital of Uttar Pradesh, a state in Northern India, is a tertiary level referral academic medical center involved in teaching and training of super specialist medical professionals with 22 academic departments. It is the first tertiary care hospital in public healthcare sector in India to adopt Information Technology (IT for healthcare delivery. The Hospital Information System (HIS was implemented in 1998 to record, store, process and retrieve health data of all the patients. This software was developed in-house in collaboration with Center for Development of Advanced Computing (C- DAC, Pune. Later in the year 1999, telemedicine activities were initiated in the form of testing the concept and technology. The first research grant was availed of in the year 2001, which helped in creating an infrastructure for telemedicine. Regular tele-healthcare and tele-educational services were introduced for the postgraduate students of medical colleges of Orissa. These services have now been extended to educate the doctors of other medical colleges and community centers in other states. Besides, the Institute is associated with organizational activities and in policy initiatives of the government. All the activities are in project mode and are being financially supported by government agencies such as Indian Space Research Organisation (ISRO and Department of Information Technology. Looking at the need of skilled manpower in the field of telemedicine and e-health, a school of telemedicine is coming up in the campus, which will also provide core infrastructure for research and development.

  13. An Analysis of Telemedicine in Taiwan: A Business Model Perspective

    Directory of Open Access Journals (Sweden)

    Tung-Cheng Lin

    2011-12-01

    Conclusions: The framework we proposed serves as a useful tool to obtain more insights into the future development of telemedicine. The cost of operating a telemedicine service system is currently not low. The practitioner could reduce the cost through modifying value proposition, service process or allying with more experienced partner.

  14. Usability in telemedicine systems—a literature survey

    NARCIS (Netherlands)

    Klaassen, Bart; van Beijnum, Bernhard J.F.; Hermens, Hermanus J.

    Introduction: The rapid development of sensors and communication technologies enable the growth of new innovative services in healthcare, such as Telemedicine. An essential ingredient in the development of a telemedicine system and its final acceptance by end users are usability studies. The

  15. Telemedicine and European law.

    Science.gov (United States)

    Callens, Stefaan

    2003-01-01

    A Directive of the European Union was first published in 2000, which dealt with telemedicine as part of its provisions. This E-Commerce Directive, as it became known, was subjected to further study which revealed some problems relative to the practice of telemedicine. Among the subjects discussed in this paper are those of privacy, data protection, free movement of services, the impact of electronic communication and ethical issues.

  16. Practising oncology via telemedicine.

    Science.gov (United States)

    Doolittle, G C; Allen, A

    1997-01-01

    Although there are increasing numbers of telemedicine programmes in the USA, few have offered teleoncology services, so that the role of telemedicine in the practice of clinical oncology has yet to be fully defined. Telemedicine has been used successfully for direct patient care in Kansas. It is also a method of providing supportive care for the cancer patient, including assessments of pain and nutrition. In addition, televised tumour conferences and nursing education courses can help smaller communities develop a level of expertise that allows patients to be treated locally. Telemedicine may well be used in future for access to national and international cancer experts, and for participation in new cancer treatment protocols through cooperative group trials. When practising oncology via telemedicine, there are unique problems, including issues regarding technology (interactive video and radiograph review) and practice (patient/oncologist preferences and doctor-patient communication). Very little has been published in the area of tele-oncology so far, and studies concerning its efficacy, cost-effectiveness and the best organizational structure are still in progress. However, telemedicine appears to be a useful technique in the practice of oncology.

  17. Patient Attitudes Toward Telemedicine for Diabetic Retinopathy.

    Science.gov (United States)

    Valikodath, Nita G; Leveque, Thellea K; Wang, Sophia Y; Lee, Paul P; Newman-Casey, Paula Anne; Hansen, Sean O; Woodward, Maria A

    2017-03-01

    Diabetic retinopathy (DR) is the leading cause of new-onset blindness in adults. Telemedicine is a validated, cost-effective method to improve monitoring. However, little is known of patients' attitudes toward telemedicine for DR. Our study explores factors that influence patients' attitudes toward participating in telemedicine. Ninety seven participants in a university and the Veterans Administration setting completed a survey. Only people with diabetes mellitus (DM) were included. The main outcome was willingness to participate in telemedicine. The other outcomes were perceived convenience and impact on the patient-physician relationship. Participants reported demographic information, comorbidities, and access to healthcare. Analysis was performed with t-tests and multivariable logistic regression. Demographic factors were not associated with the outcomes (all p > 0.05). Patients had decreased odds of willingness if they valued the patient-physician relationship (adjusted odds ratio [OR] = 0.08, confidence interval [CI] = 0.02-0.35, p = 0.001) or had a longer duration of diabetes (adjusted OR = 0.93, CI = 0.88-0.99, p = 0.02). Patients had increased odds of willingness if they perceived increased convenience (adjusted OR = 8.10, CI = 1.77-36.97, p = 0.01) or had more systemic comorbidities (adjusted OR = 1.85, CI = 1.10-3.11, p = 0.02). It is critical to understand the attitudes of people with DM where telemedicine shows promise for disease management and end-organ damage prevention. Patients' attitudes are influenced by their health and perceptions, but not by their demographics. Receptive patients focus on convenience, whereas unreceptive patients strongly value their patient-physician relationships or have long-standing DM. Telemedicine monitoring should be designed for people who are in need and receptive to telemedicine.

  18. Urban Telemedicine Enables Equity in Access to Acute Illness Care.

    Science.gov (United States)

    Ronis, Sarah D; McConnochie, Kenneth M; Wang, Hongyue; Wood, Nancy E

    2017-02-01

    Children with care for acute illness available through the Health-e-Access telemedicine model at childcare and schools were previously found to have 22% less emergency department (ED) use than counterparts without this service, but they also had 24% greater acute care use overall. We assessed the hypothesis that increased utilization reflected improved access among impoverished inner-city children to a level experienced by more affluent suburban children. This observational study compared utilization among children without and with telemedicine access, beginning in 1993, ending in 2007, and based on 84,287 child-months of billing claims-based observation. Health-e-Access Telemedicine was initiated in stepwise manner over 187 study-months among 74 access sites (childcare, schools, community centers), beginning in month 105. Children dwelled in inner city, rest-of-city Rochester, NY, or in surrounding suburbs. Rate of total acute care visits (office, ED, telemedicine) was measured as visits per 100 child-years. Observed utilization rates were adjusted in multivariate analysis for age, sex, insurance type, and season of year. When both suburban and inner-city children lacked telemedicine access, overall acute illness visits were 75% greater among suburban than inner-city children (suburban:inner-city rate ratio 1.75, p telemedicine became available to inner-city children, their overall acute visits approximated those of suburban children (suburban:inner-city rate ratio 0.80, p = 0.07), whereas acute visits among suburban children remained at least (worst-case comparison) 56% greater than inner-city children without telemedicine (rate ratio 1.56, p telemedicine to that of suburban children at baseline. Without telemedicine, however, inner-city use remained substantially less than for suburban counterparts. Health-e-Access Telemedicine redressed socioeconomic disparities in acute care access in the Rochester area, thus contributing to a more equitable community.

  19. Telemedicine and remote management of patients with heart failure.

    Science.gov (United States)

    Anker, Stefan D; Koehler, Friedrich; Abraham, William T

    2011-08-20

    Advances in telecommunication technologies have created new opportunities to provide telemedical care as an adjunct to medical management of patients with heart failure. Meta-analyses suggest that telemedicine can reduce morbidity and mortality in such patients; however, two prospective clinical trials not included in the analyses do not support these findings. Therefore, the effectiveness of telemedicine in heart failure is not established. Telemedicine approaches range from computer-based support systems to programmes led by nurses and physicians. Standardisation and appropriate classification of telemedical systems are needed to enable accurate interpretation of clinical trials. Here we propose a classification of four generations of telemedicine in heart failure. Not all approaches are the same and not every patient with heart failure will need telemedicine. Crisis prevention and treatment, and stabilisation and self-empowerment of patients are focuses of telemedicine in heart failure. The profile of patients who can potentially benefit from telemedicine is unknown and should be investigated in adequately powered randomised clinical trials. We are optimistic that telemedicine is an efficient approach and will become an important feature of management in heart failure. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Wilderness Emergency Medical Services Systems.

    Science.gov (United States)

    Millin, Michael G; Hawkins, Seth C

    2017-05-01

    Wilderness emergency medical services (WEMS) are designed to provide high quality health care in wilderness environments. A WEMS program should have oversight by a qualified physician responsible for protocol development, education, and quality improvement. The director is also ideally fully trained as a member of that wilderness rescue program, supporting the team with real-time patient care. WEMS providers function with scopes of practice approved by the local medical director and regulatory authority. With a focus on providing quality patient care, it is time for the evolution of WEMS as an integrated element of a local emergency response system. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Metrics for assessing the reliability of a telemedicine remote monitoring system.

    Science.gov (United States)

    Charness, Neil; Fox, Mark; Papadopoulos, Amy; Crump, Cindy

    2013-06-01

    The goal of this study was to assess using new metrics the reliability of a real-time health monitoring system in homes of older adults. The "MobileCare Monitor" system was installed into the homes of nine older adults >75 years of age for a 2-week period. The system consisted of a wireless wristwatch-based monitoring system containing sensors for location, temperature, and impacts and a "panic" button that was connected through a mesh network to third-party wireless devices (blood pressure cuff, pulse oximeter, weight scale, and a survey-administering device). To assess system reliability, daily phone calls instructed participants to conduct system tests and reminded them to fill out surveys and daily diaries. Phone reports and participant diary entries were checked against data received at a secure server. Reliability metrics assessed overall system reliability, data concurrence, study effectiveness, and system usability. Except for the pulse oximeter, system reliability metrics varied between 73% and 92%. Data concurrence for proximal and distal readings exceeded 88%. System usability following the pulse oximeter firmware update varied between 82% and 97%. An estimate of watch-wearing adherence within the home was quite high, about 80%, although given the inability to assess watch-wearing when a participant left the house, adherence likely exceeded the 10 h/day requested time. In total, 3,436 of 3,906 potential measurements were obtained, indicating a study effectiveness of 88%. The system was quite effective in providing accurate remote health data. The different system reliability measures identify important error sources in remote monitoring systems.

  2. Convergence of Health Level Seven Version 2 Messages to Semantic Web Technologies for Software-Intensive Systems in Telemedicine Trauma Care.

    Science.gov (United States)

    Menezes, Pedro Monteiro; Cook, Timothy Wayne; Cavalini, Luciana Tricai

    2016-01-01

    To present the technical background and the development of a procedure that enriches the semantics of Health Level Seven version 2 (HL7v2) messages for software-intensive systems in telemedicine trauma care. This study followed a multilevel model-driven approach for the development of semantically interoperable health information systems. The Pre-Hospital Trauma Life Support (PHTLS) ABCDE protocol was adopted as the use case. A prototype application embedded the semantics into an HL7v2 message as an eXtensible Markup Language (XML) file, which was validated against an XML schema that defines constraints on a common reference model. This message was exchanged with a second prototype application, developed on the Mirth middleware, which was also used to parse and validate both the original and the hybrid messages. Both versions of the data instance (one pure XML, one embedded in the HL7v2 message) were equally validated and the RDF-based semantics recovered by the receiving side of the prototype from the shared XML schema. This study demonstrated the semantic enrichment of HL7v2 messages for intensive-software telemedicine systems for trauma care, by validating components of extracts generated in various computing environments. The adoption of the method proposed in this study ensures the compliance of the HL7v2 standard in Semantic Web technologies.

  3. Impact of an intensive care unit telemedicine program on patient outcomes in an integrated health care system.

    Science.gov (United States)

    Nassar, Boulos S; Vaughan-Sarrazin, Mary S; Jiang, Lan; Reisinger, Heather S; Bonello, Robert; Cram, Peter

    2014-07-01

    Intensive care unit (ICU) telemedicine (TM) programs have been promoted as improving access to intensive care specialists and ultimately improving patient outcomes, but data on effectiveness are limited and conflicting. To examine the impact of ICU TM on mortality rates and length of stay (LOS) in an integrated health care system. Observational pre-post study of patients treated in 8 "intervention" ICUs (7 hospitals within the US Department of Veterans Affairs health care system) during 2011-2012 that implemented TM monitoring during the post-TM period as well as patients treated in concurrent control ICUs that did not implement an ICU TM program. Implementation of ICU TM monitoring. Unadjusted and risk-adjusted ICU, in-hospital, and 30-day mortality rates and ICU and hospital LOS for patients who did or did not receive treatment in ICUs equipped with TM monitoring. Our study included 3355 patients treated in our intervention ICUs (1708 in the pre-TM period and 1647 in the post-TM period) and 3584 treated in the control ICUs during the same period. Patient demographics and comorbid illnesses were similar in the intervention and control ICUs during the pre-TM and post-TM periods; however, predicted ICU mortality rates were modestly lower for admissions to the intervention ICUs compared with control ICUs in both the pre-TM (3.0% vs 3.6%; P = .02) and post-TM (2.8% vs 3.5%; P day mortality rates or LOS in unadjusted or adjusted analyses. For example, unadjusted ICU mortality in the pre-TM vs post-TM periods were 2.9% vs 2.8% (P = .89) for the intervention ICUs and 4.0% vs 3.4% (P = .31) for the control ICUs. Unadjusted 30-day mortality during the pre-TM vs post-TM periods were 7.7% vs 7.8% (P = .91) for the intervention ICUs and 12.0% vs 10.2% (P = .08) for the control ICUs. Evaluation of interaction terms comparing the magnitude of mortality rate change during the pre-TM and post-TM periods in the intervention and control ICUs failed to

  4. Diagnostic performance and system delay using telemedicine for prehospital diagnosis in triaging and teatment of STEMI

    DEFF Research Database (Denmark)

    Rasmussen, Martin Bøhme; Frost, Lars; Stengaard, Carsten

    2014-01-01

    living diagnosis and triage of patients directly to the catheter laboratory is feasible and allows 89% of patients living up to 95 km from the invasive centre to be treated......Objective: European ST-segment elevation myocardial infarction (STEMI) guidelines recommend prehospital diagnosis to facilitate early reperfusion in patients with STEMI, and they provide recommendations regarding optimal system delay (time from first medical contact (FMC) to the primary...... percutaneous coronary intervention (PPCI)). There are limited data on achievable system delays in an optimal STEMI system of care using prehospital diagnosis to triage patients with STEMI directly to percutaneous coronary intervention (PCI) centres. We examined the proportion of tentative prehospital STEMI...

  5. Design of a PC-based multimedia telemedicine system for brain function teleconsultation.

    Science.gov (United States)

    Yoo, S K; Kim, S H; Kim, N H; Kang, Y T; Kim, K M; Bae, S H; Vannier, M W

    2001-05-01

    During time-critical brain surgery, the detection of developing cerebral ischemia is particularly important because early therapeutic intervention may reduce the mortality of the patient. The purpose of this system is to provide an efficient means of remote teleconsultation for the early detection of ischemia, particularly when subspecialists are unavailable. The hardware and software design architecture for the multimedia brain function teleconsultation system including the dedicated brain function monitoring system is described. In order to comprehensively support remote teleconsultation, multi-media resources needed for ischemia interpretation were included: EEG signals, CSA, CD-CSA, radiological images, surgical microscope video images and video conferencing. PC-based system integration with standard interfaces and the operability over the Ethernet meet the cost-effectiveness while the modular software was customized with a diverse range of data manipulations and control functions necessary for shared workspace and standard interfaces.

  6. An ontology for telemedicine systems resiliency to technological context variations in pervasive healthcare

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Widya, I.A.; Hermens, Hermanus J.

    2015-01-01

    Clinical data are crucial for any medical case to study and understand a patient's condition and to give the patient the best possible treatment. Pervasive healthcare systems apply information and communication technology to enable the usage of ubiquitous clinical data by authorized medical persons.

  7. Scaling up Telemedicine

    DEFF Research Database (Denmark)

    Christensen, Jannie Kristine Bang; Nielsen, Jeppe Agger; Gustafsson, Jeppe

    through negotiating, mobilizing coalitions, and legitimacy building. To illustrate and further develop this conceptualization, we build on insights from a longitudinal case study (2008-2014) and provide a rich empirical account of how a Danish telemedicine pilot was transformed into a large......-scale telemedicine project through simultaneous translation and theorization efforts in a cross-sectorial, politicized social context. Although we focus on upscaling as a bottom up process (from pilot to large scale), we argue that translation and theorization, and associated political behavior occurs in a broader...

  8. Telemedicine for wound management

    Directory of Open Access Journals (Sweden)

    Ravi K Chittoria

    2012-01-01

    Full Text Available The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer and real-time transmission (synchronous transfer, e.g. video conference, are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

  9. Virtual reality in telemedicine.

    Science.gov (United States)

    Riva, G; Gamberini, L

    2000-01-01

    Virtual reality (VR) can be considered as the leading edge of a general evolution of present communication interfaces involving the television, computer, and telephone. The main characteristic of this evolution is the full immersion of the human sensorimotor channels into a vivid and global communication experience. Because telemedicine principally focuses on transmitting medical information, VR has the potential to enhance this function. Particularly, VR can be used in telemedicine as an advanced communication interface, which enables a more intuitive mode of interacting with information, and as a flexible environment that enhances the feeling of physical presence during the interaction. In this article, the state of the art in VR-based telemedicine applications is described. This technology is now used in remote or augmented surgery as well as surgical training, which are critically dependent on eye-hand coordination. Recently, however, different researchers have tried to use virtual environments in medical visualization and for assessment and rehabilitation in neuropsychology. This article also discusses technological, ergonomical, and human factor issues, and specific guidelines are presented for expanding the use of VR in telemedicine.

  10. Data protection in telemedicine

    Directory of Open Access Journals (Sweden)

    Gusarova A.

    2012-10-01

    Full Text Available Telemedicine – is the use of information and communication technologies in the situation when health care professional and the patient are not in the same location. That means that health care services are provided from the distance. The telemedicine services include transmission of information about patients’ health through text, sound, images and other data forms for the prevention, diagnosis treatment and follow-up of the patient. The use of telemedicine services contributes to health improvement and its application should be considered favourably. However, it is necessary to be aware that the use of different telemedicine solutions includes processing of patient’s data. Thus, this issue should be considered from the perspective of data protection. Despite the fact that the use of telemedicine services will positively makes changes in relationship between health care professional and patient that should not negatively affect persons’ rights to data protection. The person who receives health care services is entitled to expect that health care service will be provided with the respect to human rights.

  11. Arogyasree: An Enhanced Grid-Based Approach to Mobile Telemedicine

    Directory of Open Access Journals (Sweden)

    Sriram Kailasam

    2010-01-01

    Full Text Available A typical telemedicine system involves a small set of hospitals providing remote healthcare services to a small section of the society using dedicated nodal centers. However, in developing nations like India where majority live in rural areas that lack specialist care, we envision the need for much larger Internet-based telemedicine systems that would enable a large pool of doctors and hospitals to collectively provide healthcare services to entire populations. We propose a scalable, Internet-based P2P architecture for telemedicine integrating multiple hospitals, mobile medical specialists, and rural mobile units. This system, based on the store and forward model, features a distributed context-aware scheduler for providing timely and location-aware telemedicine services. Other features like zone-based overlay structure and persistent object space abstraction make the system efficient and easy to use. Lastly, the system uses the existing internet infrastructure and supports mobility at doctor and patient ends.

  12. Improved virologic suppression with HIV subspecialty care in a large prison system using telemedicine: an observational study with historical controls.

    Science.gov (United States)

    Young, Jeremy D; Patel, Mahesh; Badowski, Melissa; Mackesy-Amiti, Mary Ellen; Vaughn, Pyrai; Shicker, Louis; Puisis, Michael; Ouellet, Lawrence J

    2014-07-01

    Correctional populations have an elevated human immunodeficiency virus (HIV) prevalence, yet many individuals lack access to subspecialty care. Our study showed that HIV-infected inmates had significantly greater virologic suppression and higher CD4 T-lymphocyte counts when managed by a multidisciplinary team of subspecialists conducting clinics via telemedicine. In other studies, these outcomes have been associated with reductions on HIV-related morbidity and mortality, as well as HIV transmission. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Telepointer technology in telemedicine: a review.

    Science.gov (United States)

    Abdul Karim, Rohana; Zakaria, Nor Farizan; Zulkifley, Mohd Asyraf; Mustafa, Mohd Marzuki; Sagap, Ismail; Md Latar, Nani Harlina

    2013-03-09

    Telepointer is a powerful tool in the telemedicine system that enhances the effectiveness of long-distance communication. Telepointer has been tested in telemedicine, and has potential to a big influence in improving quality of health care, especially in the rural area. A telepointer system works by sending additional information in the form of gesture that can convey more accurate instruction or information. It leads to more effective communication, precise diagnosis, and better decision by means of discussion and consultation between the expert and the junior clinicians. However, there is no review paper yet on the state of the art of the telepointer in telemedicine. This paper is intended to give the readers an overview of recent advancement of telepointer technology as a support tool in telemedicine. There are four most popular modes of telepointer system, namely cursor, hand, laser and sketching pointer. The result shows that telepointer technology has a huge potential for wider acceptance in real life applications, there are needs for more improvement in the real time positioning accuracy. More results from actual test (real patient) need to be reported. We believe that by addressing these two issues, telepointer technology will be embraced widely by researchers and practitioners.

  14. Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.

    Science.gov (United States)

    McIntosh, Scott; Cirillo, Dominic; Wood, Nancy; Dozier, Ann M; Alarie, Carol; McConnochie, Kenneth M

    2014-12-01

    Telemedicine has enhanced care for children with illness in Rochester, NY, since May 2001, enabling 13,568 acute illness visits through December 2013. Prior findings included high parent satisfaction with childcare- and school-based telemedicine ("school telemedicine") and potential to replace 85% of office visits for illness. Urban neighborhood telemedicine ("neighborhood telemedicine") was designed to offer convenient care for illness episodes that school telemedicine often cannot serve because illness arises when children are at home or symptoms preclude attendance. This study was designed to characterize health problems prompting neighborhood telemedicine use and to assess parent perceptions of its value. A parent satisfaction instrument was developed with input from parents and providers. Neighborhood telemedicine was initiated in January 2009 and totaled 1,362 visits through November 2013. During a 29-month survey period through January 2012, 3,871 acute illness telemedicine visits were completed, 908 (23.5%) of them via neighborhood telemedicine. Instruments were completed for 392 (43.2%) of the 908 visits. Neighborhood telemedicine comprised 27% of all telemedicine visits during the year of peak neighborhood activity. Almost all survey respondents were satisfied or highly satisfied with neighborhood visits (97.6%) and endorsed greater convenience than alternatives (94.5%). Family preferences and the high value placed on neighborhood telemedicine suggest such service is important, especially in health systems driven by patient values. Service provided by neighborhood telemedicine holds potential to meet a large demand for care of acute childhood illness. Financing reform to support patient-centered care (e.g., bundled payments) should encompass sustainable business models for this service.

  15. Plan System and Emergency Disposal of Videoconference System

    Science.gov (United States)

    Li, Yongjie; Shao, Qi; Hao, Yang

    2017-12-01

    The conception and compose of emergency plan system is introduced and the emergency disposal principle, measure and procedure of videoconference system is detailed stated. It will benefit the construction of emergency response plan system

  16. Information Systems Coordinate Emergency Management

    Science.gov (United States)

    2012-01-01

    -changing planet. This information can be captured, analyzed, and visualized by geographic information systems (GIS) to produce maps, charts, and other tools that can reveal information essential to a wide variety of applications including emergency management. Knowing precise, real-time information about the size, location, environmental conditions, and resulting damage of an event like a flood or wildfire as well as the location and numbers of emergency responders and other resources contributes directly to the effectiveness of disaster mitigation. The need for such information is also evident when responding to homeland security threats, such as a terrorist attack. Recognizing the value of its geospatial information resources for this and other purposes, in 1998 Stennis and the state of Mississippi partnered to form what became the Enterprise for Innovative Geospatial Solutions (EIGS) industry cluster, supporting the growth of remote sensing and GIS-based research and business. As part of EIGS, several companies partnered with NASA through dual use and Small Business Innovation Research (SBIR) contracts. Among those was NVision.

  17. Transfer and adoption of advanced information technology solutions in resource-poor environments: the case of telemedicine systems adoption in Ethiopia.

    Science.gov (United States)

    Kifle, Mengistu; Payton, Fay Cobb; Mbarika, Victor; Meso, Peter

    2010-04-01

    The study of the adoption of information technology (IT) by individuals has taken two approaches, one emphasizing rationalistic goal-oriented behavior and the other focusing on poignant forces that influence an individual's reaction to a new IT. These approaches are not necessarily mutually exclusive. Individuals' acceptance and subsequent usage of a new IT is predicated on both. Additionally, the tendency in past studies has been to examine either the rational or the poignant factors in the context of a "resource-rich" environment-one in which there is an abundance of IT, adequate infrastructure, and a high level of acculturation to technology solutions. Consequently, there is a clear need for the examination of these factors in resource-poor environments, where assumptions on technology abundance and technology culturation do not hold. We empirically test a model that explains the intention of physicians in a resource-poor environment (epitomized by rural Ethiopia) to adopt telemedicine systems. This model integrates the rational factors driving goal-oriented behavior with the poignant/emotive factors that are an innate part of each adopter's reaction to the new technology. We use the model to expose salient contextual factors that explain the acceptance behavior of individuals toward complex information and communications technology (ICT) solutions and implications of these on the management of technology transfer initiatives in a resource-poor environment. The model is parsimonious, yet explains 28% of the variance in the intention to adopt telemedicine systems and 58% in perceived ease of use. The theoretical and practical implications of this model are discussed. Namely, Sub-Saharan African, in general, and Ethiopian culture, in particular, plays an integral role in the adoption of ICT solutions. Organizational positions and roles among physicians, clinical professionals, and superiors stand to impact the adoption of telemedicine and other healthcare

  18. Open-source telemedicine platform for wireless medical video communication.

    Science.gov (United States)

    Panayides, A; Eleftheriou, I; Pantziaris, M

    2013-01-01

    An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings.

  19. Open-Source Telemedicine Platform for Wireless Medical Video Communication

    Directory of Open Access Journals (Sweden)

    A. Panayides

    2013-01-01

    Full Text Available An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN and 3.5G high-speed packet access (HSPA wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings.

  20. Telemedicine Information Analysis Center (TIAC)

    National Research Council Canada - National Science Library

    Zajtchuk, Russ

    2003-01-01

    ...) to telemedicine to identify key words, creating a bibliographic database using these key words, providing analyses by subject matter experts for clinical and technical queries, preparing reports...

  1. An interactive diary for diet management (DAI): a new telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce.

    Science.gov (United States)

    Rossi, Maria Chiara; Perozzi, Cinzia; Consorti, Carla; Almonti, Teresa; Foglini, Paolo; Giostra, Nena; Nanni, Paola; Talevi, Susanna; Bartolomei, Dante; Vespasiani, Giacomo

    2010-08-01

    The aim of this multicenter, longitudinal, single-arm, pre-post comparison was to test a telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce. DAI (MeTeDa srl, San Benedetto del Tronto, Italy) is a software for mobile phones to support patients following a specific dietetic program. It facilitates the communication between the patient and dietician via short text messages. Overall, three specialized dieticians enrolled 140 consecutive patients with body mass index (BMI) >or=25 kg/m(2) who voluntered to follow a specific diet program to be managed with DAI. At baseline and after 20 weeks, data on body weight, waist circumference, BMI, fasting blood glucose, lipid profile, food habits, and physical activity were collected and compared by the Wilcoxon test or the McNemar test. Overall, 115 individuals (82.1%) completed the follow-up. The mean (95% confidence interval) reduction in body weight was -2.5 (-3.2; -1.8) kg, whereas the reduction in waist circumference was -3.7 (-4.6; -2.9) cm, and that in BMI was 1.0 (-0.7; -1.2) kg/m(2). The software was useful as an educational tool: participants achieving the Mediterranean diet targets increased from 14.4% to 69.8% after 20 weeks. On average, each patient recognized and chose fresh local vegetables eight times per week during the follow-up. Participants regularly communicated with dieticians through short text messages. This study allowed the documentation of the efficacy of a new telemedicine system in supporting people who need to lose body weight. The tool was also suitable for a more articulated initiative of "nutritional education" aiming to promote the healthy properties of the Mediterranean diet and the consumption of local produce.

  2. High quality image oriented telemedicine with multimedia technology.

    Science.gov (United States)

    Takeda, H; Minato, K; Takahasi, T

    1999-07-01

    Researchers at Osaka and Kyoto University hospital performed three experiments, beginning in 1995, which looked at high quality-oriented telemedicine. This paper describes the system design for the three projects. Experiment 1 applied high-definition TV images and B-ISDN for distance learning and medical information exchange. Experiment 2 developed a super high-definition medical image filing system and the images were transmitted via B-ISDN for teleconferences and experiment 3 utilized digital, high-definition, TV images and communication satellites for teleconferences. Multimedia and communication technologies were considered to be fundamental components of telemedicine. The three projects were evaluated initially for quality of images, operability and utility. The experimental design and its implementation showed that it was possible to provide high quality image-oriented telemedicine in the health care environment. Obstacles to establishing practical telemedicine are also discussed.

  3. Telemedicine for neonatal resuscitation.

    Science.gov (United States)

    Scheans, Patricia

    2014-01-01

    Maintaining high levels of readiness for neonatal resuscitation in low-risk maternity settings is challenging. The neonatal resuscitation program (NRP) algorithm is a community standard in the United States; yet training is biannual, and exposure to enough critical events to be proficient at timely implementation of the algorithm and the advanced procedures is rare. Evidence supports hands-free leadership to help prevent task saturation and communication to promote patient safety. Telemedicine for neonatal resuscitation involves the addition of remote, expert NRP leadership (a NICU-based neonatal nurse practitioner) via camera link to augment effectiveness of the low-risk birth center team. Unanticipated outcomes to report include faster times to transfer initiation and neuroprotective cooling. The positive impact of remote NRP leadership could lead to use of telemedicine to support teams at birthing centers throughout the United States as well as around the world.

  4. Telemedicine in neurosciences.

    Science.gov (United States)

    Ganapathy, K; Ravindra, Aditi

    2008-01-01

    It is well known that in most countries, there is a perennial shortage of specialists in neurosciences. Even the few available neurologists and neurosurgeons are clustered in the metros and urban areas. Those living in suburban and rural areas have limited or no access to neurological care. At the same time there has been an unprecedented growth in ICT (Information and Communication Technology). In this article, the authors review the increasing use of telemedicine in neurosciences.

  5. Risk of Telemedicine Infeasibility: An Evidential Reasoning Approach

    Directory of Open Access Journals (Sweden)

    Sofienne Mansouri

    2017-10-01

    Full Text Available The viability of a telemedicine system is the strength of its business continuity. Business continuity can only stand if the telemedicine system remains continuously feasible. This article studies telemedicine risk in terms of its feasibility on all its five components: economical, technical, social, operational, and legal/ethical. Any deficiencies in one or more of the feasibility components will affect the system business continuity risk and can lead to infeasibility and possible dissolution. The telemedicine computing environment is full of uncertainties and ambiguities and it just involves too much background knowledge that Bayesian theory cannot accommodate. Decision theory however offers a basic evidence-based multi-criteria decision mechanism that can tackle those decision problems treating both quantitative and qualitative criteria under various uncertainties including ignorance and randomness. We propose an evidential reasoning model to assess a telemedicine business continuity risk based on infeasibility. This business continuity risk is modelled using Dempster and Shafer Theory as the plausibility of infeasibility of the telemedicine system. A numerical example is provided to demonstrate the working of the proposed risk assessment model.

  6. [Aspects of data protection in telemedicine].

    Science.gov (United States)

    Vetter, R

    2001-10-01

    Telemedical applications like the electronic patient file, the electronic physician's letter and the electronic consultation ("Telekonsil"), the electronic prescription, the electronic patient's card (the "patient smart card") facilitate and improve the processing of sensitive medical data as well as the possibilities for using medical resources in an unusual degree and can thereby substantially contribute to the well-being of the patient. However, improving the quality of medical supply must not lead to a degradation of the patients' rights, in particular their right of self-determination. The introduction and the use of telemedical applications do not change the legal basic conditions for medical data processing. Therefore, a patient-friendly telemedicine must include data protection as well. Data protective telemedicine requires medical secrecy ensuring the patients' rights of information and transparency, correction of false and the up-to-date deletion of information that is no longer necessary, as well as secure data processing. All electronic processing of patients' data must meet the requirements of data security, i.e. the confidentiality, the integrity, the availability of the data at any time and the verifiability of the data processing have to be guaranteed. For this, electronic signatures and encodings have to be used, medical information systems have to be protected effectively against any risks resulting from open networks, particularly the Internet, and data processing has to be monitored. Electronic patient files may be open only to the treating physician and the medical assistants up to the necessary extent, ensuring the possibility of an emergency access. Any access beyond that does require the special consent of the patient. The medical secrecy has to be ensured. The electronic prescription with a documentation of the patient's medication requires the consent of the patient and must protect the rights of the physicians. In particular it has to

  7. Telemedicine and robotics: paving the way to the globalization of surgery.

    Science.gov (United States)

    Senapati, S; Advincula, A P

    2005-12-01

    The concept of delivering health services at a distance, or telemedicine is becoming an emerging tool for the field of surgery. For the surgical services, telepresence surgery through robotics is gradually being incorporated into health care practices. This article will provide a brief overview of the principles surrounding telemedicine and telepresence surgery as they specifically relate to robotics. Where limitations have been reached in laparoscopy, robotics has allowed further steps forward. The development of robotics in medicine has been a progression from passive to immersive technology. In gynecology, the utilization of robotics has evolved from the use of Aesop, a robotic arm for camera manipulation, to full robotic systems such as Zeus, and the daVinci surgical system. These systems have not only been used directly for a variety of procedures but have also become a useful tool for conferencing and the mentoring of surgeons from afar. As this mode of technology becomes assimilated into the culture of surgery and medicine globally, caution must be taken to carefully navigate the economic, legal and ethical implications of telemedicine. Despite the challenges faced, telepresence surgery holds promise for more widespread applications.

  8. Challenges of communication system during emergency disaster ...

    African Journals Online (AJOL)

    the policy makers, responsible personnel as well as researchers on the vulnerability of the communication systems during disaster and the future direction of effective communication system in Malaysia. Keywords: disaster; communication system;GIRN; effective communication system; emergency medicine.

  9. Telemedicine in support of peacekeeping operations overseas: an audit.

    Science.gov (United States)

    Navein, J; Hagmann, J; Ellis, J

    1997-01-01

    Since 1993, the Department of Defense has augmented the medical support for Army units on peacekeeping operations in Macedonia through the medium of telemedicine. This project, known as Operation Primetime 1, was the first satellite-based telemedicine system deployed in support of remote primary-care physician in the U.S. military. Its declared aims are: (1) to improve the standard of care; (2) to reduce evacuations; (3) to support junior physicians in the field; and (4) to improve the military effectiveness of the deployed units. This paper audits the success in attaining those goals for the period January 1994 to April 1995. A log was collated from the referring units and questionnaires completed by both referring and consulting physicians. The referring physicians were interviewed on their return from Macedonia, and a more detailed study was undertaken of cases in which a change in outcome was noted. Follow-up interview of consultants was not possible. A total of 53 consults were undertaken on 47 patients. The use of telemedicine affected the decision to evacuate 13 times (13/47), with a net reduction of 9 evacuations. Management of individual cases was changed in 30 of the 47 cases in which telemedicine was used. Physician confidence and military effectiveness were also improved. The level of utilization of the system was largely dependent on a training and sustainment program. Units and General Medical Officers who were trained in the clinical use of telemedicine and the technical sustainment of the equipment used the system; those who were not, did not. Most patients (45/47) were treated satisfactorily with a single consult. Telemedicine under these circumstances seems to be cost effective. The deployed sites chose the referral centers that provided the best service. Telemedicine is a valuable tool capable of augmenting medical support to deployed military units. A successful deployed telemedicine project requires an integrated support package that includes

  10. Telemedicine and telepharmacy: current status and future implications.

    Science.gov (United States)

    Angaran, D M

    1999-07-15

    Uses of telemedicine are described and potential roles for pharmacists are discussed. Telemedicine has been defined as "the use of electronic information and communications technologies to provide and support health care when distance separates the participants." Technologies included in telemedicine are videoconferencing, telephones, computers, the Internet, fax, radio, and television. Telepharmacy has the same basic definition but refers to pharmaceutical care provision. Although the videotelemedicine market is expected to grow considerably, lack of reimbursement and high costs are continuing obstacles. Pharmacy is using video-conferencing for education, training, and management purposes. The telephone has changed from a dial-and-talk instrument to a multimedia access tool. Medical devices are being attached to telephone lines to provide remote monitoring and therapy, and call centers are providing medication counseling, prior authorization, refill authorization, and formulary compliance monitoring. Although the Internet has quickly become a star performer, utilization by health care lags behind that of other industries. The Internet-fueled empowerment of consumers and their expectations for speed, access, and convenience are creating more unmet expectations of the traditional health care system. Pharmacy has both organizational and individual practitioner Web sites, but it is online drugstores that are attracting most attention. Potential benefits of telemedicine include improved access to care, greater efficiency in diagnosis and treatment, higher productivity, and market positioning for the coming century. Telemedicine will tax the economic, regulatory, legal, ethical, and clinical care expertise of the entire health care system. Studies of the effectiveness, cost, and societal implications of telemedicine are needed, along with practice models and standards, training programs, and solutions to regulatory, licensing, and legal questions. Securing reimbursement

  11. Internet technologies and requirements for telemedicine

    Science.gov (United States)

    Lamaster, H.; Meylor, J.; Meylor, F.

    1997-01-01

    Internet technologies are briefly introduced and those applicable for telemedicine are reviewed. Multicast internet technologies are described. The National Aeronautics and Space Administration (NASA) 'Telemedicine Space-bridge to Russia' project is described and used to derive requirements for internet telemedicine. Telemedicine privacy and Quality of Service (QoS) requirements are described.

  12. Monitoring Telemedicine Implementation in Denmark.

    Science.gov (United States)

    Nøhr, Christian; Villumsen, Sidsel; Bernth Ahrenkiel, Stephanie; Hulbæk, Lars

    2015-01-01

    According to the literature, Denmark has a leading position in the dissemination and use of health informatics. However, there is a lack of systematically collected and documented experience of telemedicine solutions in Denmark. This evidence is being established with a new project, which maps out all telemedicine initiatives in Denmark. Data on all the initiatives is collected in a single database and some of the data is analyzed in this paper. It is shown that there are a very large number of telemedicine initiatives in Denmark and that the elements from the national strategy for telemedicine are clearly visible in the telemedicine map. The very large number of projects could, however, also indicate a lack of national coordination of initiatives and a need for evaluation activities to systematically collect and communicate the learning outcomes from all the new projects.

  13. Integrating telemedicine and telehealth: putting it all together.

    Science.gov (United States)

    Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

    2008-01-01

    Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care

  14. Clinical- and Cost-effectiveness of Telemedicine in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis

    OpenAIRE

    Zhai, Yun-kai; Zhu, Wei-jun; Cai, Yan-ling; Sun, Dong-xu; Zhao, Jie

    2014-01-01

    Abstract Emerging telemedicine programs offer potential low-cost solutions to the management of chronic disease. We sought to evaluate the clinical effectiveness and cost effectiveness of telemedicine approaches on glycemic control in patients with type 2 diabetes mellitus. Using terms related to type 2 diabetes and telemedicine, MEDLINE, Cochrane, EMBASE, and CINAHL Plus were searched to identify relevant studies published through February 28, 2014. Data from identified clinical trials were ...

  15. Evaluating the impact of a mobile oral telemedicine system on medical management and clinical outcomes of patients with complicated oral lesions in Botswana.

    Science.gov (United States)

    Tesfalul, Martha; Littman-Quinn, Ryan; Antwi, Cynthia; Ndlovu, Siphiwo; Motsepe, Didintle; Phuthego, Motsholathebe; Tau, Boitumelo; Mohutsiwa-Dibe, Neo; Kovarik, Carrie

    2013-01-01

    Mobile telemedicine, which involves the use of cellular phone telecommunications to facilitate exchange of information between parties in different locations to assist in the management of patients, has become increasingly popular, particularly in resource-limited settings. In Botswana, small studies of mobile telemedicine programs suggest access to these services positively affect patients, but these programs' impact is difficult to capture given limitations of baseline and comparative data. Our observational study uses each patient receiving mobile oral telemedicine services in Botswana as his/her own control to assess the impact of these services on his/her diagnosis and management plan. At month 5 of 12 total, preliminary analysis of eligible cases (n = 27) reveals management plan discordance between clinicians submitting cases and the specialist was 68.0% (17/25), suggesting that telemedicine can result in significant changes in management of patients.

  16. Emergency Preparedness and Response Systems

    National Research Council Canada - National Science Library

    Alvarez, Maria D

    2006-01-01

    .... Natural and man-made disasters, such as earthquakes, floods, plane crashes, high-rise building collapses, or major nuclear facility malfunctions, pose an ever-present danger challenge to public emergency services...

  17. Telemedicine in Alentejo

    Science.gov (United States)

    Bayer, Steffen; Gonçalves, Luís; Barlow, James

    2014-01-01

    Abstract Alentejo covers a third of Portugal, yet it is home to only 5% of the population. Residents of the region are poorer, older, and less educated than the rest of the country. There is a shortage of physicians in several specialties. The low population density, a concentration of specialized services, and a poor public transportation network all create barriers to access. Telemedicine was introduced in 1998 to help address these challenges. In this article, we provide an overview of the program and its current status, focusing on infrastructure, services, and activity volume. We also discuss the impact the program has had from the perspectives of patients and healthcare professionals. From 1998 to 2011, there were 132,546 episodes of service using telemedicine, including real-time teleconsultations, teleradiology, teleultrasound, and telepathology. At present, the network includes 20 primary care units and five hospitals, covering almost 30,000 km2 and 500,000 people. Units have high-resolution videoconferencing equipment, access to patients' clinical records, an image archive, and peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are available in 15 medical specialties and areas, ranging from neurology to pediatric surgery. In 2008, regional health authorities started a tele-education program, and by the end of 2011, 876 healthcare professionals, across 52 locations, had participated in remote learning sessions. More than a decade since telemedicine was introduced in Alentejo, it is now an integral part of everyday service provision. A comprehensive assessment of the costs and consequences of the program is currently underway. PMID:24180419

  18. American Telemedicine Association: First China (Tianjin International Telemedicine Technology Exhibition

    Directory of Open Access Journals (Sweden)

    Jordana Bernard

    2014-09-01

    Full Text Available With the support of Tianjin Municipal People’s Government and the People’s Government of Binhai New Area, the “First China (Tianjin International Telemedicine Technology Exhibition” hosted by the American Telemedicine Association (ATA, will be held October 28- 30, 2014 at the Tianjin Binhai International Convention and Exhibition Center. The three day event will feature keynote sessions, concurrent discussion forums, exhibits (e.g., telemedicine, information technology, mHealth, a venture summit, meet-and-greet sessions for international and domestic companies for potential business collaboration, and policy discussions on China healthcare. For registration information: http://www.atacn.org/en/

  19. Clinical outcomes resulting from telemedicine interventions: a systematic review

    Directory of Open Access Journals (Sweden)

    Kraemer Dale

    2001-11-01

    Full Text Available Abstract Background The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. Methods Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis. All included articles were abstracted and graded for quality and direction of the evidence. Results A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. Conclusions Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.

  20. US-USSR telemedicine consultation spacebridge to Armenia and Ufa

    Science.gov (United States)

    1991-01-01

    The Final Report on the U.S.-U.S.S.R. Telemedicine Consultation Spacebride to Armenia and Ufa is presented. The goal of this activity was to provide expert medical consultation to the Armenian medical personnel in the areas of plastic and reconstructive surgery, physical and psychological rehabilitation, public health, and epidemiology following the devastating earthquake in Dec. 1988. The U.S. and U.S.S.R. implementation teams developed new standards for medical information transmittal as well as protocols and schedules on how to conduct medical consultations. The consultations were provided to the Republic Diagnostic Center in Yerevan, U.S.S.R. by four U.S. medical centers: University of Utah/LDS Hospital, University of Texas, Maryland Institute for Emergency Medical Service Systems, and Uniformed Services University of the Health Sciences.

  1. Barriers and challenges in adopting Saudi telemedicine network: The perceptions of decision makers of healthcare facilities in Saudi Arabia.

    Science.gov (United States)

    Alaboudi, Abdulellah; Atkins, Anthony; Sharp, Bernadette; Balkhair, Ahmed; Alzahrani, Mohammed; Sunbul, Tamara

    Despite emerging evidence about the benefits of telemedicine, there are still many barriers and challenges to its adoption. Its adoption is often cited as a failed project because 75% of them are abandoned or 'failed outright' and this percentage increases to 90% in developing countries. The literature has clarified that there is neither one-size-fit-all framework nor best-practice solution for all ICT innovations or for all countries. Barriers and challenges in adopting and implementing one ICT innovation in a given country/organisation may not be similar - not for the same ICT innovation in another country/organisation nor for another ICT innovation in the same country/organisation. To the best of our knowledge, no comprehensive scientific study has investigated these challenges and barriers in all Healthcare Facilities (HCFs) across the Kingdom of Saudi Arabia (KSA). This research, which is undertaken based on the Saudi Telemedicine Network roadmap and in collaboration with the Saudi Ministry of Health (MOH), is aimed at identifying the principle predictive challenges and barriers in the context of the KSA, and understanding the perspective of the decision makers of each HCF type, sector, and location. Three theories are used to underpin this research: the Unified Theory of Acceptance and Use of Technology (UTAUT), the Technology-Organisation-Environment (TOE) theoretical framework, and the Evaluating Telemedicine Systems Success Model (ETSSM). This study applies a three-sequential-phase approach by using three mixed methods (i.e., literature review, interviews, and questionnaires) in order to utilise the source triangulation and the data comparison analysis technique. The findings of this study show that the top three influential barriers to adopt and implement telemedicine by the HCF decision makers are: (i) the availability of adequate sustainable financial support to implement, operate, and maintain the telemedicine system, (ii) ensuring conformity of

  2. Preparing Student Nurses for the Future of Wound Management: Telemedicine in a Simulated Learning Enviroment

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2015-01-01

    was to integrate the concept of telemedicine for wound care into a simulation-based class for undergraduate student nurses and to evaluate their experiences with this integrated learning method. Methods: Five medium-fidelity mannequins were used in a simulated learning environment consisting of a simulated....... Findings: Students found the concept of telemedicine relevant and enjoyable, and the challenges and benefits of telemedicine clearly emerged in the simulated learning environment. Conclusions: Based on student evaluations and the need to prepare students for “real-life” telemedicine for wound management......, the simulated learning environment seems to be a constructive didactic method. The simulated learning environment should also be tested with postgraduate nurses with less experience in telemedicine....

  3. Towards technical interoperability in telemedicine.

    Energy Technology Data Exchange (ETDEWEB)

    Craft, Richard Layne, II

    2004-05-01

    For telemedicine to realize the vision of anywhere, anytime access to care, the question of how to create a fully interoperable technical infrastructure must be addressed. After briefly discussing how 'technical interoperability' compares with other types of interoperability being addressed in the telemedicine community today, this paper describes reasons for pursuing technical interoperability, presents a proposed framework for realizing technical interoperability, identifies key issues that will need to be addressed if technical interoperability is to be achieved, and suggests a course of action that the telemedicine community might follow to accomplish this goal.

  4. Telemedicine: challenges to dissemination in Brazil

    Directory of Open Access Journals (Sweden)

    Jose Manuel Santos de Varge Maldonado

    Full Text Available Abstract: Telemedicine has been seen as an important tool for facing the challenges of universal health systems. The goal of this article is to discuss the main challenges to its full dissemination in Brazil. Being a somewhat new area, there are not many scientific papers that systematize it. This article is an exploratory paper, as it aims to provide an overall perspective on the subject. From an economic point of view, telemedicine is a strategic area due to its an intrinsic potential of being a source for generating innovation, for requiring and incorporating technological breakthroughs from other areas, and for its interdisciplinary nature and dynamic inter-relations that drive different industries. From the social perspective, it has the potential to make access to health services democratic, by connecting remote regions with health services located in hospitals and centers of reference for prevention, diagnosis and treatment.

  5. Telemedicine and Palliative Care: an Increasing Role in Supportive Oncology.

    Science.gov (United States)

    Worster, Brooke; Swartz, Kristine

    2017-06-01

    With the emergence of telemedicine as a routine form of care in various venues, the opportunities to use technology to care for the most vulnerable, most ill cancer patients are extremely appealing. Increasingly, evidence supports early integration of palliative care with standard oncologic care, supported by recent NCCN guidelines to increase and improve access to palliative care. This review looks at the use of telemedicine to expand access to palliative care as well as provide better care for patients and families where travel is difficult, if not impossible. When telemedicine has been used, often in Europe, for palliative care, the results show improvements in symptom management, comfort with care as well as patient and family satisfaction. One barrier to use of telemedicine is the concerns with technology and technology-related complications in population that is often elderly, frail and not always comfortable with non-face-to-face physician care. There remain significant opportunities to explore this intersection of supportive care and telemedicine.

  6. Telemedicine facilitates CHF home health care for those with systolic dysfunction.

    Science.gov (United States)

    Seibert, Pennie S; Whitmore, Tiffany A; Patterson, Carin; Parker, Patrick D; Otto, Caitlin; Basom, Jean; Whitener, Nichole; Zimmerman, Christian G

    2008-01-01

    An estimated 5 million Americans have congestive heart failure (CHF) and one in five over the age of 40 will develop CHF. There are numerous examples of CHF patients living beyond the years normally expected for people with the disease, usually attributed to taking an active role in disease management. A relatively new alternative for CHF outpatient care is telemedicine and e-health. We investigated the effects of a 6-week in-home telemedicine education and monitoring program for those with systolic dysfunction on the utilization of health care resources. We also measured the effects of the unit 4.5 months after its removal (a total of 6 months post introduction of the unit into the home). Concurrently, we assessed participants' perceptions of the value of having a telemedicine unit. Participants in the telemedicine group reported weighing more times a week with less variability than did the control group. Telemedicine led to a reduction in physician and emergency department visits and those in the experimental group reported the unit facilitating self-care, though this was not significantly different from the control group (possibly due to small sample size). These findings suggest a possibility for improvement in control of CHF when telemedicine is implemented. Our review of the literature also supports the role of telemedicine in facilitating home health care and self-management for CHF patients. There are many challenges still to be addressed before this potential can be reached and further research is needed to identify opportunities in telemedicine.

  7. The effect of telemedicine on outcome and quality of life in pregnant women with diabetes.

    Science.gov (United States)

    Dalfrà, Maria Grazia; Nicolucci, Antonio; Lapolla, Annunziata

    2009-01-01

    We evaluated the effect of a telemedicine system on maternal and fetal outcome in women with diabetes. A total of 276 pregnant women were enrolled in the study. Women were sequentially assigned to a telemedicine or a control group. There were 88 women with gestational diabetes in the telemedicine group and 115 in the control group; there were 17 women with type 1 diabetes in the telemedicine group and 15 in the control group. Women in telemedicine groups were asked to submit their blood glucose data every week, and had a medical examination at the diabetes clinic once a month. Women in the control groups had a medical examination every two weeks. Subjective outcomes were investigated using the following questionnaires: CES-D for depression, SF-36 for health-related quality of life (QoL), Stress and Distress for the impact of diabetes. Clinical variables and pregnancy outcomes were no different between the two telemedicine groups, whereas women with gestational diabetes in the telemedicine group had a better metabolic control in the 3rd trimester and a lower rate of caesarean sections and macrosomia. As for QoL, women in the telemedicine groups showed lower levels of frustration and concerns about their diabetes, and a better acceptance of their diabetic condition. A questionnaire on the use of the telemedicine system showed a high degree of acceptance (85%). Both telemedicine groups had fewer check-ups at the diabetes clinics. The use of a telemedicine system for glucose monitoring improved pregnancy outcome in women with gestational diabetes and improved QoL in all diabetic pregnancies.

  8. Patient perspectives of telemedicine quality

    OpenAIRE

    LeRouge, Cynthia M; Garfield, Monica J; Hevner, Alan R

    2014-01-01

    Cynthia M LeRouge,1 Monica J Garfield,2 Alan R Hevner3 1Saint Louis University, St Louis, MO, 2Bentley University, Waltham, MA, 3University of South Florida, Tampa, FL, USA Background: The purpose of this study was to explore the quality attributes required for effective telemedicine encounters from the perspective of the patient.Methods: We used a multi-method (direct observation, focus groups, survey) field study to collect data from patients who had experienced telemedicine encounters. ...

  9. M-Health: Emerging Mobile Health Systems

    Science.gov (United States)

    Istepanian, Robert; Laxminarayan, Swamy; Pattichis, Constantinos S.

    M-health can be defined as the "emerging mobile communications and network technologies for healthcare systems.' This book paves the path toward understanding the future of m-health technologies and services and also introducing the impact of mobility on existing e-health and commercial telemedical systems. M-Health: Emerging Mobile Health Systems presents a new and forward-looking source of information that explores the present and future trends in the applications of current and emerging wireless communication and network technologies for different healthcare scenaria.

  10. Emergency vehicle traffic signal preemption system

    Science.gov (United States)

    Bachelder, Aaron D. (Inventor); Foster, Conrad F. (Inventor)

    2011-01-01

    An emergency vehicle traffic light preemption system for preemption of traffic lights at an intersection to allow safe passage of emergency vehicles. The system includes a real-time status monitor of an intersection which is relayed to a control module for transmission to emergency vehicles as well as to a central dispatch office. The system also provides for audio warnings at an intersection to protect pedestrians who may not be in a position to see visual warnings or for various reasons cannot hear the approach of emergency vehicles. A transponder mounted on an emergency vehicle provides autonomous control so the vehicle operator can attend to getting to an emergency and not be concerned with the operation of the system. Activation of a priority-code (i.e. Code-3) situation provides communications with each intersection being approached by an emergency vehicle and indicates whether the intersection is preempted or if there is any conflict with other approaching emergency vehicles. On-board diagnostics handle various information including heading, speed, and acceleration sent to a control module which is transmitted to an intersection and which also simultaneously receives information regarding the status of an intersection. Real-time communications and operations software allow central and remote monitoring, logging, and command of intersections and vehicles.

  11. Synchronization and emergence in complex systems

    Indian Academy of Sciences (India)

    We show how novel behaviour can emerge in complex systems at the global level through synchronization of the activities of their constituent units. Two mechanisms are suggested for the emergence, namely non-diffusive coupling and time delays. In this way ... Max Planck Institute for Mathematics in the Sciences, Inselstr.

  12. A System Dynamic Model of Leader Emergence

    Science.gov (United States)

    2008-03-01

    Judge, 2004; Judge, Bono, Ilies, & Gerhardt, 2002; Eagly, Johanneses-Schmidt, & Van Engen , 2003; Taggar, Hackett, & Saha, 1999; Stogdill, 1948...System dynamics emerged from the study of electrical control systems, and when generalized found many useful applications in natural systems outside...of the electrical world (Forrester, 1992). Whereas correlations describe cause and effect relationships in a linear equation, system dynamics

  13. Economic analysis of telemedicine and the teledermatology paradigm.

    Science.gov (United States)

    Whited, John D

    2010-03-01

    Abstract Economic considerations are an important component in the planning and execution of a telemedicine program. The goal of this review is to familiarize readers with economic concepts relevant to the analysis of telemedicine programs. Economic perspectives, cost attribution, types of economic analysis, and commonly encountered problems will be discussed as they pertain to telemedicine. Societal perspectives, healthcare system perspectives, patient perspectives, fixed versus variable costs, labor costs, and distinctions between cost-effectiveness analyses and other types of economic analysis also will be examined. Examples from the teledermatology literature will be used as a paradigm to illustrate how these concepts are integrated into existing analyses of teledermatology systems. Teledermatology shows promise as a cost-saving healthcare delivery system with outcomes comparable to or better than those of conventional care processes. The literature also points out the importance of economic perspectives in the findings and interpretation of an analysis.

  14. Emergency information systems for cars

    Science.gov (United States)

    Thirunavukkarasu, M.; Vani Manasa, N.; Kumar, K. Rajesh; Sundar, S.

    2017-11-01

    The main objective of this work is to create a Health Care monitoring and Guidance system for persons who are travelling in outdoor environments like cars. GSM (Global System for Mobile Communications) and GPS (Global Positioning System) technologies are separately and combined today in many applications in our day to day life. The GSM module will send a message along with the GPS location to the end user through text, and a call is initiated to the user for further instructions. The Global Positioning System (GPS) will give the location of the interested vehicle. This system helps the doctor or anyone to monitor the accident who is outdoor and has less help. This will help the hospital to monitor the accident as well as guide the injured through difficult situations. Using a buzzer, the persons nearby will come to know that the person is in danger or in poor health conditions. This project provides a good two-way communication with the injured and the hospital to assist them to give first aid before an ambulance arrives. So, this paper devices a novel technique to assist the people who just met with accident through GPS and GSM.

  15. Emergent "Quantum" Theory in Complex Adaptive Systems.

    Science.gov (United States)

    Minic, Djordje; Pajevic, Sinisa

    2016-04-30

    Motivated by the question of stability, in this letter we argue that an effective quantum-like theory can emerge in complex adaptive systems. In the concrete example of stochastic Lotka-Volterra dynamics, the relevant effective "Planck constant" associated with such emergent "quantum" theory has the dimensions of the square of the unit of time. Such an emergent quantum-like theory has inherently non-classical stability as well as coherent properties that are not, in principle, endangered by thermal fluctuations and therefore might be of crucial importance in complex adaptive systems.

  16. Pediatric Critical Care Telemedicine Program: A Single Institution Review.

    Science.gov (United States)

    Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

    2016-01-01

    Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

  17. Mobile health systems and emergence

    NARCIS (Netherlands)

    Jones, Valerie M.; Graziosi, Barbara

    2015-01-01

    Changes in the age distribution of the population and increased prevalence of chronic illnesses, together with a shortage of health professionals and other resources, will increasingly challenge the ability of national healthcare systems to meet rising demand for services. Large-scale use of eHealth

  18. Trends in telemedicine use in addiction treatment

    OpenAIRE

    Molfenter, Todd; Boyle, Mike; Holloway, Don; Zwick, Janet

    2015-01-01

    Introduction Telemedicine use in addiction treatment and recovery services is limited. Yet, because it removes barriers of time and distance, telemedicine offers great potential for enhancing treatment and recovery for people with substance use disorders (SUDs). Telemedicine also offers clinicians ways to increase contact with SUD patients during and after treatment. Case description A project conducted from February 2013 to June 2014 investigated the adoption of telemedicine services among p...

  19. Non-telephone healthcare: the role of 4G and emerging mobile systems for future m-health systems.

    Science.gov (United States)

    Istepanian, R; Philip, N; Wang, X H; Laxminarayan, S

    2004-01-01

    The next generation of "m-health technologies" is a new and evolving topic in the areas of telemedical and telecare systems. These technologies involve the exploitation of mobile telecommunication and multimedia technologies to provide better access to healthcare personnel on the move, by removing the key disadvantage of trailing wires in current systems. These technologies provide equal access to medical information and expert care by overcoming the boundaries of separation that exist today between different users of such medical information. A great benefit to all users will be a more efficient use of resources and far greater location independence. In this paper we will address some notes and future trends in these emerging areas and their applications for m-health systems. Especially we will discuss the role of 4G and emerging mobile systems for future m-health systems. The new technologies can make the remote medical monitoring, consulting, and health care more flexible and convenient. But, there are challenges for successful wireless telemedicine, which are addressed in this paper.

  20. Towards reinforcing telemedicine adoption amongst clinicians in Nigeria.

    Science.gov (United States)

    Adenuga, Kayode I; Iahad, Noorminshah A; Miskon, Suraya

    2017-08-01

    Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has received little academic attention is the provision of suitable encouragement for clinicians to adopt telemedicine, in the form of rewards, motivation or incentives. A further consideration for telemedicine usage in developing countries, especially sub-Saharan Africa and Nigeria in particular, are to the severe shortage of available practising clinicians. The researchers therefore explore the need to positively reinforce the adoption of telemedicine amongst clinicians in Nigeria, and also offer a rationale for this using the UTAUT model. Data were collected using a structured paper-based questionnaire, with 252 physicians and nurses from six government hospitals in Ondo state, Nigeria. The study applied SmartPLS 2.0 for analysis to determine the relationship between six variables. Demographic moderating variables, age, gender and profession, were included. The results indicate that performance expectancy (pperformance expectancy, effort expectancy, facilitating condition and reinforcement determinants are influential factors in the use of telemedicine services for remote-patient clinical diagnosis and management by the Nigerian clinicians. Copyright © 2017. Published by Elsevier B.V.

  1. Evolution of telemedicine in the space program and earth applications

    Science.gov (United States)

    Nicogossian, A. E.; Pober, D. F.; Roy, S. A.

    2001-01-01

    Remote monitoring of crew, spacecraft, and environmental health has always been an integral part of the National Aeronautics and Space Administration's (NASA's) operations. Crew safety and mission success face a number of challenges in outerspace, including physiological adaptations to microgravity, radiation exposure, extreme temperatures and vacuum, and psychosocial reactions to space flight. The NASA effort to monitor and maintain crew health, system performance, and environmental integrity in space flight is a sophisticated and coordinated program of telemedicine combining cutting-edge engineering with medical expertise. As missions have increased in complexity, NASA telemedicine capabilities have grown apace, underlying its role in the field. At the same time, the terrestrial validation of telemedicine technologies to bring healthcare to remote locations provides feedback, improvement, and enhancement of the space program. As NASA progresses in its space exploration program, astronauts will join missions lasting months, even years, that take them millions of miles from home. These long-duration missions necessitate further technological breakthroughs in tele-operations and autonomous technology. Earth-based monitoring will no longer be real-time, requiring telemedicine capabilities to advance with future explorers as they travel deeper into space. The International Space Station will serve as a testbed for the telemedicine technologies to enable future missions as well as improve the quality of healthcare delivery on Earth.

  2. Is a black market in telemedicine on the horizon?

    Science.gov (United States)

    McLean, Thomas R; McLean, Patrick B

    2007-12-01

    Regulation of a global market by regional licensure systems and trade barriers has significant drawbacks. Literature review of telemedicine, law and economics. Today's patients are willing to use out-of-pocket dollars to purchase medical care from: (a) foreign physicians in the medical tourism market; and (b) nurse-practitioners in pharmacy clinics. As telemedicine comes of age, patients are likely to purchase more health care from foreign telemedical 'pharmacy' clinics to avoid the costs, and the hassle, of travel. Many of these foreign medicine providers are likely to be unlicensed. This is problematic because experience with Mydoc.com and Usanetrx.com demonstrates that today's patients are relatively unconcerned with the licensure status of telemedicine providers. Accordingly, the elements of a black market in telemedicine may be on the horizon. Strengthening medical licensure laws is unlikely to keep foreign providers out the US health care market forever. Alternatively, one method to minimize the size of a black market in telemedical services would be to allow the market to regulate itself through the creation of a commodities-type exchange. Now is the time to open a global dialogue on how to regulate telemedicine. (c) 2008 John Wiley & Sons, Ltd.

  3. Hemodialysis patient management by telemedicine: design and implementation.

    Science.gov (United States)

    Winchester, J F; Tohme, W G; Schulman, K A; Collmann, J; Johnson, A; Meissner, M C; Rathore, S; Khanafer, N; Eisenberg, J M; Mun, S K

    1997-01-01

    The authors describe the design and implementation of a personal computer based telemedicine system for managing patients by telemedicine. With three identical systems connected by high speed T1 lines, the physician (or allied healthcare giver) can interact, by videoconferencing, and by using multimedia files, with patients at two remote hemodialysis sites. The physician is able to visualize specifically the patient's fistula/graft, and auscultate fistula, heart and lung sounds, and incorporate still pictures or audio sounds in the patient's multimedia database folder, which also contains an electronic and paperless medical record. In addition there is the capability of downloading into this database all the machine parameters during dialysis.

  4. Telemedicine in Parkinson's disease: A patient perspective at a tertiary care centre.

    Science.gov (United States)

    Qiang, Judy K; Marras, Connie

    2015-05-01

    To overcome travel distance and lack of local expertise, telemedicine programs have been implemented and are still pilot programs in many jurisdictions. Patient perspectives remain poorly understood. In the largest study to date, we examined user satisfaction and predictors of patient choice to use telemedicine among Parkinson's Disease (PD) patients in the context of a well-developed telemedicine system. These data can help to optimize healthcare delivery by telemedicine. A patient satisfaction questionnaire was administered to current or previous users via telephone. Patients' cost savings were determined. The proportion of non-users interested in using telemedicine was quantified. Demographic and clinical characteristics of those who expressed interest in the program vs. those who did not were compared. A total of 34 users and 103 non-users were recruited. Users reported an average cost reduction of $200 and 209 minutes of reduction in commute time (p telemedicine, inexperience of some telehealth nurses was a major source of patient dissatisfaction. Patients preferred a combination of telehealth and in-person visits. A majority of non-users (55/103, 53%) declared interest in telemedicine, but it had not been offered to them. A lower Hoehn and Yahr stage and a longer commute time were associated with patient interest in telemedicine. Training of nurses is an important determinant of patient satisfaction. Clinicians should consider offering telehealth to all patients for whom it is medically appropriate, especially those who experience long travel times. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. The SUMMA Project: a feasibility study on telemedicine in selected Italian areas.

    Science.gov (United States)

    Scalvini, Simonetta; Tridico, Caterina; Glisenti, Fulvio; Giordano, Amerigo; Pirini, Silvia; Peduzzi, Paolo; Auxilia, Francesco

    2009-04-01

    Telemedicine is achieving relevant clinical importance in rural areas in the management of patients. The Second opinion Unificata per Medici di Medicina generAle (SUMMA) Project was designed to evaluate the feasibility of a joint telemedicine service application across general practitioners and clinical specialists in Italy. The secondary objective of the study included the comparison of telemedicine with the routine general practitioners' approach and a cost-effectiveness evaluation. One hundred and thirty-five general practitioners from Lombardy, Molise, and Valle d'Aosta were enrolled. An ad hoc questionnaire was used to evaluate the feasibility, approval, efficacy, and satisfaction of telemedicine among the general practitioners. Ninety-three general practitioners used the telemedicine consultation (responders) for a total of 1,396 calls (1,264 for cardiology, 65 for dermatology, 32 for diabetology, 22 for rheumatology, and 13 for pneumology). In cardiology, telemedicine was used to address all problems without further action in 733 cases (61%). Ninety-eight percent of responders indicate satisfaction with telemedicine. The cost of telemedicine in our study was estimated to be 25.36 Euros/contact. In conclusion, the SUMMA Project demonstrated for the first time clinically the effectiveness of second-opinion consultation by general practitioners and therefore fulfilling the actual needs in areas usually managed by the National Health System.

  6. Standardized emergency management system and response to a smallpox emergency.

    Science.gov (United States)

    Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

    2003-01-01

    The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring

  7. American College of Allergy, Asthma & Immunology Position Paper on the Use of Telemedicine for Allergists.

    Science.gov (United States)

    Elliott, Tania; Shih, Jennifer; Dinakar, Chitra; Portnoy, Jay; Fineman, Stanley

    2017-12-01

    The integration of telecommunications and information systems in health care first began 4 decades ago with 500 patient consultations performed via interactive television. The use of telemedicine services and technology to deliver health care at a distance is increasing exponentially. Concomitant with this rapid expansion is the exciting ability to provide enhancements in quality and safety of care. Telemedicine enables increased access to care, improvement in health outcomes, reduction in medical costs, better resource use, expanded educational opportunities, and enhanced collaboration between patients and physicians. These potential benefits should be weighed against the risks and challenges of using telemedicine. The American College of Allergy, Asthma, and Immunology advocates for incorporation of meaningful and sustained use of telemedicine in allergy and immunology practice. This article serves to offer policy and position statements of the use of telemedicine pertinent to the allergy and immunology subspecialty. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Rural telemedicine project in northern New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Zink, S.; Hahn, H.; Rudnick, J.; Snell, J.; Forslund, D. [Los Alamos National Lab., NM (United States); Martinez, P. [Northern New Mexico Community Coll., Espanola, NM (United States)

    1998-12-31

    A virtual electronic medical record system is being deployed over the Internet with security in northern New Mexico using TeleMed, a multimedia medical records management system that uses CORBA-based client-server technology and distributed database architecture. The goal of the NNM Rural Telemedicine Project is to implement TeleMed into fifteen rural clinics and two hospitals within a 25,000 square mile area of northern New Mexico. Evaluation of the project consists of three components: job task analysis, audit of immunized children, and time motion studies. Preliminary results of the evaluation components are presented.

  9. An Emergence Principle for Complex Systems

    Science.gov (United States)

    Cotsaftis, Michel

    From elementary system graph representation, systems are shown to belong to only three states: simple, complicated, and complex. First two have been studied over past centuries. Last one originates in existence of threshold above which components interaction overtakes outside interaction, leading to system self-organization which filters outer action, making it more robust with emergence of new behaviour not predictable from components study. The threshold value, expressed in terms of coupling system parameters, is verified to recovers limits found in a broad range of domains in Physics and Mathematics, giving explicit criterion for emergence in complex system. Application to man-made systems concentrates on the balance between relative system isolation when becoming complex and delegation of more “intelligence” in adequate frame between new augmented system state and supervising operator. Entering complexity state opens the possibility for the function to feedback onto the structure, ie to mimic technically the early invention of Nature.

  10. Telemedicine in the treatment of patients with inflammatory bowel disease.

    Science.gov (United States)

    Aguas, Mariam; Del Hoyo, Javier; Faubel, Raquel; Valdivieso, Bernardo; Nos, Pilar

    2017-11-01

    Inflammatory bowel disease (IBD) is a chronic and relapsing disorder with significant medical, social and financial impacts. IBD patients require continuous follow-up, and healthcare resource use in this context increases over time. In the last decade, telemedicine has influenced the treatment of chronic diseases like IBD via the application of information and communication technologies to provide healthcare services remotely. Telemedicine and its various applications (telemanagement, teleconsulting and tele-education) enable closer follow-up and provide education resources that promote patient empowerment, encouraging treatment optimisation over the entire course of the disease. We describe the impact of using telemedicine on IBD health outcomes and discuss the limitations of implementing these systems in the real-life management of IBD patients. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  11. Impact of the "Diabetes Interactive Diary" telemedicine system on metabolic control, risk of hypoglycemia, and quality of life: a randomized clinical trial in type 1 diabetes.

    Science.gov (United States)

    Rossi, Maria Chiara; Nicolucci, Antonio; Lucisano, Giuseppe; Pellegrini, Fabio; Di Bartolo, Paolo; Miselli, Valerio; Anichini, Roberto; Vespasiani, Giacomo

    2013-08-01

    Telemedicine systems based on mobile phones represent new promising educational tools. The "Diabetes Interactive Diary" (DID) is a carbohydrate/bolus calculator promoting the patient-physician communication via short message service. This study aimed to compare the efficacy of the DID versus usual care on metabolic control, hypoglycemia, and quality of life. Patients with type 1 diabetes on a basal:bolus regimen with insulin glargine and insulin glulisine, not previously educated on carbohydrate (CHO) counting, were randomized to DID (Group A; n=63) or traditional education (Group B; n=64). Generalized hierarchical linear regression models for repeated measures were applied to compare changes between groups. Incidence of hypoglycemia was compared using Poisson regression models. Of 127 patients (age, 36.9±10.5 years; diabetes duration, 16.3±9.3 years), 15 (11.8%) dropped out. After 6 months, hemoglobin A1c (HbA1c) levels decreased by -0.49±0.11 in Group A and -0.48±0.11 in Group B (P=0.73). Group A showed a 86% lower risk of grade 2 hypoglycemia than Group B. Compared with usual care, DID improved the "perceived frequency of hyperglycemic episodes" scale of the Diabetes Treatment Satisfaction Questionnaire and the "social relations" and the "fear of hypoglycemia" dimensions of the Diabetes Specific Quality of Life Scale. Results obtained with DID markedly differ among patients and centers. DID is no more effective than traditional CHO counting education in reducing HbA1c levels. DID reduces the risk of moderate/severe hypoglycemia and improves quality of life. A better understanding of patients' and healthcare professionals' attitudes associated with an effective care supported by technology is essential to avoid waste of resources.

  12. The business of telemedicine: strategy primer.

    Science.gov (United States)

    LeRouge, Cynthia; Tulu, Bengisu; Forducey, Pamela

    2010-10-01

    There is some tacit understanding that telemedicine can provide cost efficiency along with increased access and equality of care for the geographically disadvantaged. However, concrete strategic guidance for healthcare organizations to attain these benefits is fragmented and limited in existing literature. Telemedicine programs need to move from a grant-funded to a profit-centered status to sustain their existence. This article extends work presented at a recent American Telemedicine Association Business and Finance Special Interest Group course to provide a conceptual framework for strategic planning and for effectively implementing telemedicine programs. An expert panel of telemedicine coordinators provides insight and recommendations.

  13. Emergent hybrid synchronization in coupled chaotic systems.

    Science.gov (United States)

    Padmanaban, E; Boccaletti, Stefano; Dana, S K

    2015-02-01

    We evidence an interesting kind of hybrid synchronization in coupled chaotic systems where complete synchronization is restricted to only a subset of variables of two systems while other subset of variables may be in a phase synchronized state or desynchronized. Such hybrid synchronization is a generic emergent feature of coupled systems when a controller based coupling, designed by the Lyapunov function stability, is first engineered to induce complete synchronization in the identical case, and then a large parameter mismatch is introduced. We distinguish between two different hybrid synchronization regimes that emerge with parameter perturbation. The first, called hard hybrid synchronization, occurs when the coupled systems display global phase synchronization, while the second, called soft hybrid synchronization, corresponds to a situation where, instead, the global synchronization feature no longer exists. We verify the existence of both classes of hybrid synchronization in numerical examples of the Rössler system, a Lorenz-like system, and also in electronic experiment.

  14. Framework to investigate emergence in system engineering

    CSIR Research Space (South Africa)

    Oosthuizen, R

    2011-09-01

    Full Text Available patterns, cities, World Wide Web, Internet, Artificial Intelligence and language. d. Technological Systems. Autopilot systems, robotics, integration and interoperability. Fromm [7] defines emergence as the distinction between the properties... and unpredicted behavior, the aim is to minimize undesirable consequences through cross discipline engineering. Unfortunately, SE became bogged down is a myriad of rigid standards and processes as a replacement for Systems Thinking. This necessitates a fresh...

  15. Emergency Broadcast System Based On GIS

    Science.gov (United States)

    Junfeng, Kang; Baoyu, Wang; Xueying, Jiang; Xiaosheng, Liu

    2017-02-01

    Nowadays, disaster occurs more and more frequently, which brings huge losses to the society. Presented a GIS based emergency broadcast system (GIS-EBS), to provide rapid, accurate information to the public, can reduce the people’s losses maximum. Different from the traditional radio data system (RDS), by adding broadcasting terminal control instruction on the FM signal, GIS-EBS extended the RDS protocol, which can control each radio terminal’s state. And through the extended RDS protocol, GIS-EBS can broadcast and release the emergency information to the right place and the people most in need in the shortest time.

  16. Telemedicine in Space Flight - Summary of a NASA Workshop

    Science.gov (United States)

    Barsten, K. N.; Watkins, S. D.; Otto, C.; Baumann, D. K.

    2011-01-01

    The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

  17. New Nuclear Emergency Prognosis system in Korea

    Science.gov (United States)

    Lee, Hyun-Ha; Jeong, Seung-Young; Park, Sang-Hyun; Lee, Kwan-Hee

    2016-04-01

    This paper reviews the status of assessment and prognosis system for nuclear emergency response in Korea, especially atmospheric dispersion model. The Korea Institute of Nuclear Safety (KINS) performs the regulation and radiological emergency preparedness of the nuclear facilities and radiation utilizations. Also, KINS has set up the "Radiological Emergency Technical Advisory Plan" and the associated procedures such as an emergency response manual in consideration of the IAEA Safety Standards GS-R-2, GS-G-2.0, and GS-G-2.1. The Radiological Emergency Technical Advisory Center (RETAC) organized in an emergency situation provides the technical advice on radiological emergency response. The "Atomic Computerized Technical Advisory System for nuclear emergency" (AtomCARE) has been developed to implement assessment and prognosis by RETAC. KINS developed Accident Dose Assessment and Monitoring (ADAMO) system in 2015 to reflect the lessons learned from Fukushima accident. It incorporates (1) the dose assessment on the entire Korean peninsula, Asia region, and global region, (2) multi-units accident assessment (3) applying new methodology of dose rate assessment and the source term estimation with inverse modeling, (4) dose assessment and monitoring with the environmental measurements result. The ADAMO is the renovated version of current FADAS of AtomCARE. The ADAMO increases the accuracy of the radioactive material dispersion with applying the LDAPS(Local Data Assimilation Prediction System, Spatial resolution: 1.5 km) and RDAPS(Regional Data Assimilation Prediction System, Spatial resolution: 12km) of weather prediction data, and performing the data assimilation of automatic weather system (AWS) data from Korea Meteorological Administration (KMA) and data from the weather observation tower at NPP site. The prediction model of the radiological material dispersion is based on the set of the Lagrangian Particle model and Lagrangian Puff model. The dose estimation methodology

  18. Evaluation of telemedicine in the management of dentogenous infections

    Directory of Open Access Journals (Sweden)

    Miladinović Milan

    2013-01-01

    Full Text Available Introduction/Aim. The first written evidence of telemedicine dates back to the times of Sava Nemanjić (the end of 12th and the beginning of 13th century. Nowadays, the use of telemedicine in Serbia gains momentum, and the cause of this lies in the creation of a central telemedicine system XPA3 Online and the establishment of the Center for Telemedicine at the Faculty of Medicine, University of Priština/Kosovska Mitrovica, Kosovska Mitrovica, Serbia. Dentogenous infections are among the most urgent conditions in dentistry, which may have even a fatal outcome. The aim of this study was to assess the possibility of using telemedicine methods in the pathology of dentogenous infections. Methods. This experimental randomized study incl uded 414 patients with suspected dentogenous infection. The patients were enrolled at 7 sites, with systematic photograph-taking, collection, and digitalization of the available anamnestic and laboratory data, tests, and x-rays. Together with clinical findings, the data were uploaded on the XPA3 Online central telemedicine system; after that, 10 teleconsultants reviewed the material, set the diagnosis, and gave their opinion about the treatment. The agreement was determined using the Cohen’s kappa (k coefficient, as well as diagnostic sensitivity (SE, specificity (SP, and efficacy (EFF. Statistical significance and comparisons were done using the z-test, and testing nonparametric properties using the McNemar’s χ2-test for the significance threshold of p = 0.05. Results. The results describing agreement of telemedicine diagnosis of the areas primarily involved with infection compared to clinical inspection, indicate an almost complete diagnostic agreement (k = 0.971. Diagnostic agreement as to the type of infection was also almost complete (k = 0.951, and a similar value was obtained also for the treatment agreement (k > =0.892. Conclusion. The method of telemedicine provides us with a tool to make a correct

  19. Emergency Communications: The Emergency Alert System (EAS) and All-Hazard Warnings

    Science.gov (United States)

    2005-09-02

    Communications: The Emergency Alert System (EAS) and All- Hazard Warnings Updated September 2, 2005 Linda K. Moore Analyst in Telecommunications Policy...3. DATES COVERED - 4. TITLE AND SUBTITLE Emergency Communications: The Emergency Alert System (EAS) and All- Hazard Warnings 5a. CONTRACT... Emergency Alert System (EAS) and All- Hazard Warnings Summary The Emergency Alert System (EAS) is one of several federally managed warning systems. The

  20. From System Complexity to Emergent Properties

    CERN Document Server

    Aziz-Alaoui, M. A

    2009-01-01

    Emergence and complexity refer to the appearance of higher-level properties and behaviours of a system that obviously comes from the collective dynamics of that system's components. These properties are not directly deductable from the lower-level motion of that system. Emergent properties are properties of the "whole'' that are not possessed by any of the individual parts making up that whole. Such phenomena exist in various domains and can be described, using complexity concepts and thematic knowledges. This book highlights complexity modelling through dynamical or behavioral systems. The pluridisciplinary purposes, developped along the chapters, are enable to design links between a wide-range of fundamental and applicative Sciences. Developing such links - instead of focusing on specific and narrow researches - is characteristic of the Science of Complexity that we try to promote by this contribution.

  1. Asynchronous telemedicine applications in rehabilitation of acquired speech-language disorders in neurologic patients

    Directory of Open Access Journals (Sweden)

    Beijer L

    2015-02-01

    Full Text Available Lilian Beijer,1 Toni Rietveld2 1Sint Maartenskliniek, 2Centre of Language Studies, Radboud University of Nijmegen, Nijmegen, The Netherlands Abstract: In this time of an aging population in the Western world and a concomitant need for cost reduction, there is an obvious need for innovative health care delivery. One of the consequences is that a growing number of telemedicine applications are emerging in different health care domains. Also in the area of speech-language (SL disorders, particularly neurogenic disorders, telemedicine is rapidly gaining interest. In this paper, we place applications for neurogenic SL disorders in a telemedicine taxonomy in order to establish common features along the dimensions of functionality, application, and technology, and their components. Thus, we aim at identifying common features in a wide variety of telemedicine applications and to establish common interests of stakeholders in health care for classified groups of telemedicine applications. This may facilitate decision-making with regard to expansion of innovative products, and give directions to measures needed for upscaling and structural embedding of feasible and effective SL telemedicine applications in health care. Common interests of stakeholders in health care, established using telemedicine taxonomy, is a key factor in decision-making with regard to which telemedicine applications should be given priority for genuine utilization. Priorities of health care institutions, patients, and reimbursement companies are also leading for researchers aiming at solid scientific evidence for the beneficial effects of target applications. That is, although research results tend to indicate the potential of telemedicine in the area of SL pathology, the alleged benefits of most applications have not been confirmed according to the accepted standards for clinical outcome testing as yet. Methodologic obstacles and the lack of adequate speech materials and suitable

  2. Unité de Coordination Clinique des Services Préhospitaliers d'Urgence: A clinical telemedicine platform that improves prehospital and community health care for rural citizens.

    Science.gov (United States)

    Bussières, Sylvain; Tanguay, Alain; Hébert, Denise; Fleet, Richard

    2017-01-01

    Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care. To this end, Basic Life Support paramedics and nurses were taught interventions outside of their field of expertise. Prehospital electrocardiograms were used to remotely diagnose ST segment elevation myocardial infarction and to monitor patients who were en route by ambulance to the nearest catheterization facility or emergency department. Basic Life Support paramedics received extended medical authorization that allowed them to provide opioid analgesia via telemedicine physician orders. Nurses from community health centres without physician coverage were able to request medical assistance via a video telemedicine system. The second objective is to optimize medical resources. To this end, remote death certifications were implemented to avoid unnecessary transport of deceased persons to hospitals. This paper presents the telemedicine program and some results.

  3. Telemedicine and rural health care applications

    Directory of Open Access Journals (Sweden)

    Smith Anthony

    2005-01-01

    Full Text Available Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication.

  4. A Distributed Intelligent System for Emergency Convoy

    Directory of Open Access Journals (Sweden)

    Mohammed Benalla

    2016-09-01

    Full Text Available The general problem that guides this research is the ability to design a distributed intelligent system for guiding the emergency convoys; a solution that will be based on a group of agents and on the analysis of traffic in order to generate collective functional response. It fits into the broader issue of Distributed Artificial System (DAI, which is to operate a cooperatively computer agent into multi-agents system (MAS. This article describes conceptually two fundamental questions of emergency convoys. The first question is dedicated to find a response to the traffic situation (i.e. fluid way, while the second is devoted to the convoy orientation; while putting the point on the distributed and cooperative resolution for the general problem.

  5. Recent trends in intelligent and emerging systems

    CERN Document Server

    Sarma, Manash; Sarma, Mousmita

    2015-01-01

    It is a compilation of research works related to intelligent and emerging system design using a range of tools including soft-computation. The book includes reviews, actual designs, research works, discussion and experimental results related to works in the areas of communication, computation, vision sciences, bio-inspired system design, social dynamic, related process design, etc. The audience of this book is expected to be researchers who deal with intelligent and emerging system design through mathematical and computational modeling and experimental designs. Specifically, audiences that are broadly involved in the domains of electronics and communication, electrical engineering, mathematics, computer science, other applied informatics domains and related areas will find the book interesting. The works included in the book broadly covers all areas of Electronics and Communication Engineering and Technology, Soft-computational Applications, Human Computer Interactive Designs and Social and Economic Dynamics....

  6. Health systems organization for emergency care.

    Science.gov (United States)

    Pedroto, Isabel; Amaro, Pedro; Romãozinho, José Manuel

    2013-10-01

    The increasing number of acute and severe digestive diseases presenting to hospital emergency departments, mainly related with an ageing population, demands an appropriate answer from health systems organization, taking into account the escalating pressure on cost reduction. However, patients expect and deserve a response that is appropriate, effective, efficient and safe. The huge variety of variables which can influence the evolution of such cases warranting intensive monitoring, and the coordination and optimization of a range of human and technical resources involved in the care of these high-risk patients, requires their admission in hospital units with conveniently equipped facilities, as is done for heart attack and stroke patients. Little information of gastroenterology emergencies as a function of structure, processes and outcome is available at the organizational level. Surveys that have been conducted in different countries just assess local treatment outcome and question the organizational structure and existing resources but its impact on the outcome is not clear. Most studies address the problem of upper gastrointestinal bleeding and the out-of-hours endoscopy services in the hospital setting. The demands placed on emergency (part of the overall continuum of care) are obvious, as are the needs for the efficient use of resources and processes to improve the quality of care, meaning data must cover the full care cycle. Gastrointestinal emergencies, namely gastrointestinal bleeding, must be incorporated into the overall emergency response as is done for heart attack and stroke. This chapter aims to provide a review of current literature/evidence on organizational health system models towards a better management of gastroenterology emergencies and proposes a research agenda. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Engaging Elderly People in Telemedicine Through Gamification.

    Science.gov (United States)

    de Vette, Frederiek; Tabak, Monique; Dekker-van Weering, Marit; Vollenbroek-Hutten, Miriam

    2015-12-18

    Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great connectivity between these taxonomies

  8. The use of telemedicine in the care of the pediatric trauma patient.

    Science.gov (United States)

    Kim, Paul T; Falcone, Richard A

    2017-02-01

    Telemedicine is increasingly becoming an important part of the health care system as it has the potential to help deliver quality medical care to underserved areas. When implemented correctly, it can be a cost-effective way of expanding access to excellent medical care. However, because it is a relatively new and quickly changing field, there are multiple issues and challenges that need to be addressed. This article reviews the current literature on various modalities of telemedicine, evidence for teletrauma, and challenges and barriers related to telemedicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. A Novel Hierarchical Semi-centralized Telemedicine Network Architecture Proposition for Bangladesh

    DEFF Research Database (Denmark)

    Choudhury, Samiul; Peterson, Carrie Beth; Kyriazakos, Sofoklis

    2011-01-01

    One of the major functions of telemedicine is the prompt delivery of modern healthcare to the remotest areas with reduced cost and efficient use of communication resources. The establishment of a well organized telemedicine system is therefore exigent for the developing countries like Bangladesh...... where there are extreme paucities of efficient healthcare professionals and equipments, specifically in the rural areas. In this paper a novel, hierarchical and semi-centralized telemedicine network architecture has been proposed holisti-cally focusing on the rural underdeveloped areas of Bangladesh...

  10. Telemedicine Provides Noninferior Research Informed Consent for Remote Study Enrollment: A Randomized Controlled Trial.

    Science.gov (United States)

    Bobb, Morgan R; Van Heukelom, Paul G; Faine, Brett A; Ahmed, Azeemuddin; Messerly, Jeffrey T; Bell, Gregory; Harland, Karisa K; Simon, Christian; Mohr, Nicholas M

    2016-07-01

    Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study was to determine whether patient comprehension of telemedicine-enabled research informed consent is noninferior to standard face-to-face (F2F) research informed consent. A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic emergency department (ED) to test whether telemedicine-enabled research informed consent provided noninferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of 0.12% oral chlorhexidine gluconate in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard F2F consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc.) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified quality of informed consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. A total of 131 patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to F2F consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p = 0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Telemedicine is noninferior to F2F consent for delivering research informed consent, with no detected

  11. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Cuadros JA

    2015-06-01

    Full Text Available Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS programs have been developed to identify patients with sight-threatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future. Keywords: telemedicine, diabetes, retinopathy, retinal imaging

  12. A review of telemedicine business models.

    Science.gov (United States)

    Chen, Shengnan; Cheng, Alice; Mehta, Khanjan

    2013-04-01

    Telemedicine has become an increasingly popular option for long-distance/virtual medical care and education, but many telemedicine ventures fail to grow beyond the initial pilot stage. Studying the business models of successful telemedicine ventures can help develop business strategies for upcoming ventures. This article describes business models of eight telemedicine ventures from different regions of the world using Osterwalder's "Business Model Canvas." The ventures are chosen on the basis of their apparent success and their diverse value chains. The business models are compared to draw inferences and lessons regarding their business strategy and contextual factors that influenced it. Key differences between telemedicine business practices in developing and developed countries are also discussed. The purpose of this article is to inform and inspire the business strategy of the next generation of telemedicine ventures to be economically sustainable and to successfully address local healthcare challenges.

  13. High-Surety Telemedicine in a Distributed, 'Plug-andPlan' Environment

    Energy Technology Data Exchange (ETDEWEB)

    Craft, Richard L.; Funkhouser, Donald R.; Gallagher, Linda K.; Garcia, Rudy J.; Parks, Raymond C.; Warren, Steve

    1999-05-17

    Commercial telemedicine systems are increasingly functional, incorporating video-conferencing capabilities, diagnostic peripherals, medication reminders, and patient education services. However, these systems (1) rarely utilize information architectures which allow them to be easily integrated with existing health information networks and (2) do not always protect patient confidentiality with adequate security mechanisms. Using object-oriented methods and software wrappers, we illustrate the transformation of an existing stand-alone telemedicine system into `plug-and-play' components that function in a distributed medical information environment. We show, through the use of open standards and published component interfaces, that commercial telemedicine offerings which were once incompatible with electronic patient record systems can now share relevant data with clinical information repositories while at the same time hiding the proprietary implementations of the respective systems. Additionally, we illustrate how leading-edge technology can secure this distributed telemedicine environment, maintaining patient confidentiality and the integrity of the associated electronic medical data. Information surety technology also encourages the development of telemedicine systems that have both read and write access to electronic medical records containing patient-identifiable information. The win-win approach to telemedicine information system development preserves investments in legacy software and hardware while promoting security and interoperability in a distributed environment.

  14. A model for assessment of telemedicine applications

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Ekeland, Anne Granstrøm; Jensen, Lise Kvistgaard

    2012-01-01

    Telemedicine applications could potentially solve many of the challenges faced by the healthcare sectors in Europe. However, a framework for assessment of these technologies is need by decision makers to assist them in choosing the most efficient and cost-effective technologies. Therefore in 2009...... the European Commission initiated the development of a framework for assessing telemedicine applications, based on the users' need for information for decision making. This article presents the Model for ASsessment of Telemedicine applications (MAST) developed in this study....

  15. Trends in telemedicine use in addiction treatment.

    Science.gov (United States)

    Molfenter, Todd; Boyle, Mike; Holloway, Don; Zwick, Janet

    2015-05-28

    Telemedicine use in addiction treatment and recovery services is limited. Yet, because it removes barriers of time and distance, telemedicine offers great potential for enhancing treatment and recovery for people with substance use disorders (SUDs). Telemedicine also offers clinicians ways to increase contact with SUD patients during and after treatment. A project conducted from February 2013 to June 2014 investigated the adoption of telemedicine services among purchasers of addiction treatment in five states and one county. The project assessed purchasers' interest in and perceived facilitators and barriers to implementing one or more of the following telemedicine modalities: telephone-based care, web-based screening, web-based treatment, videoconferencing, smartphone mobile applications (apps), and virtual worlds. Purchasers expressed the most interest in implementing videoconferencing and smartphone mobile devices. The anticipated facilitators for implementing a telemedicine app included funding available to pay for the telemedicine service, local examples of success, influential champions at the payer and treatment agencies, and meeting a pressing need. The greatest barriers identified were: costs associated with implementation, lack of reimbursement for telemedicine services, providers' unfamiliarity with technology, lack of implementation models, and confidentiality regulations. This paper discusses why the project participants selected or rejected different telemedicine modalities and the policy implications that purchasers and regulators of addiction treatment services should consider for expanding their use of telemedicine. This analysis provides initial observations into how telemedicine is being implemented in addiction services in five states and one county. The project demonstrated that despite the considerable interest in telemedicine, implementation challenges exist. Future studies should broaden the sample analyzed and track technology

  16. Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network

    OpenAIRE

    O'Gorman, Laurel D.; Hogenbirk, John C; Warry, Wayne

    2016-01-01

    Abstract Introduction: Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000?km2. The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. Materials and Methods: We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. ...

  17. Telemedicine in the Management of Type 1 Diabetes.

    Science.gov (United States)

    Xu, Timothy; Pujara, Shreya; Sutton, Sarah; Rhee, Mary

    2018-01-25

    Veterans with type 1 diabetes who live in rural Alabama and Georgia face barriers to receiving specialty diabetes care because of a lack of endocrinologists in the Central Alabama Veterans Health Care System. Telemedicine is a promising solution to help increase access to needed health care. We evaluated telemedicine's effectiveness in delivering endocrinology care from Atlanta-based endocrinologists. We conducted a retrospective chart review of patients who were enrolled in the Atlanta VAMC Endocrinology Telehealth Clinic from June 2014 to October 2016. Outcomes of interest were hemoglobin A1c levels, changes in glycemic control, time savings for patients, cost savings for the US Veterans Health Administration, appointment adherence rates, and patient satisfaction with telehealth. Thirty-two patients with type 1 diabetes received telehealth care and in general received the recommended processes of diabetes care. Patients trended toward a decrease in mean hemoglobin A1c and glucose variability and a nonsignificant increase in hypoglycemic episodes. Patients saved 78 minutes of travel time (one way), and the VA saved $72.94 in travel reimbursements per patient visit. Patients adhered to 88% of scheduled telehealth appointments on average, and 100% of surveyed patients stated they would recommend telehealth to other veterans. Specialty diabetes care delivered via telemedicine was safe and was associated with time savings, cost savings, high appointment adherence rates, and high patient satisfaction. Our findings support growing evidence that telemedicine is an effective alternative method of health care delivery.

  18. Telemedicine Provides Non-Inferior Research Informed Consent for Remote Study Enrollment: A Randomized Controlled Trial

    Science.gov (United States)

    Bobb, Morgan R.; Van Heukelom, Paul G.; Faine, Brett A.; Ahmed, Azeemuddin; Messerly, Jeffrey T.; Bell, Gregory; Harland, Karisa K.; Simon, Christian; Mohr, Nicholas M.

    2016-01-01

    Objective Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study is to determine whether patient comprehension of telemedicine-enabled research informed consent is non-inferior to standard face-to-face research informed consent. Methods A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic Emergency Department (ED) to test whether telemedicine-enabled research informed consent provided non-inferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of oral chlorhexidine gluconate 0.12% in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard face-to-face consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc., Hackensack, NJ) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified Quality of Informed Consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. Results One-hundred thirty-one patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to face-to-face consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p=0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Conclusion Telemedicine is non-inferior to face

  19. Bedside ROP screening and telemedicine interpretation integrated to a neonatal transport system: Economic aspects and return on investment analysis.

    Science.gov (United States)

    Kovács, Gábor; Somogyvári, Zsolt; Maka, Erika; Nagyjánosi, László

    Peter Cerny Ambulance Service - Premature Eye Rescue Program (PCA-PERP) uses digital retinal imaging (DRI) with remote interpretation in bedside ROP screening, which has advantages over binocular indirect ophthalmoscopy (BIO) in screening of premature newborns. We aimed to demonstrate that PCA-PERP provides good value for the money and to model the cost ramifications of a similar newly launched system. As DRI was demonstrated to have high diagnostic performance, only the costs of bedside DRI-based screening were compared to those of traditional transport and BIO-based screening (cost-minimization analysis). The total costs of investment and maintenance were analyzed with micro-costing method. A ten-year analysis time-horizon and service provider's perspective were applied. From the launch of PCA-PERP up to the end of 2014, 3722 bedside examinations were performed in the PCA covered central region of Hungary. From 2009 to 2014, PCA-PERP saved 92,248km and 3633 staff working hours, with an annual nominal cost-savings ranging from 17,435 to 35,140 Euro. The net present value was 127,847 Euro at the end of 2014, with a payback period of 4.1years and an internal rate of return of 20.8%. Our model presented the NPVs of different scenarios with different initial investments, annual number of transports and average transport distances. PCA-PERP as bedside screening with remote interpretation, when compared to a transport-based screening with BIO, produced better cost-savings from the perspective of the service provider and provided a return on initial investment within five years after the project initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Intelligent computing systems emerging application areas

    CERN Document Server

    Virvou, Maria; Jain, Lakhmi

    2016-01-01

    This book at hand explores emerging scientific and technological areas in which Intelligent Computing Systems provide efficient solutions and, thus, may play a role in the years to come. It demonstrates how Intelligent Computing Systems make use of computational methodologies that mimic nature-inspired processes to address real world problems of high complexity for which exact mathematical solutions, based on physical and statistical modelling, are intractable. Common intelligent computational methodologies are presented including artificial neural networks, evolutionary computation, genetic algorithms, artificial immune systems, fuzzy logic, swarm intelligence, artificial life, virtual worlds and hybrid methodologies based on combinations of the previous. The book will be useful to researchers, practitioners and graduate students dealing with mathematically-intractable problems. It is intended for both the expert/researcher in the field of Intelligent Computing Systems, as well as for the general reader in t...

  1. Use of change management theories in gaining acceptance of telemedicine technology.

    Science.gov (United States)

    Rufo, Rebecca Zapatochny

    2012-01-01

    The success of telemedicine applications within health care begins with the process of implementing planned change. The attitudes of staff and their willingness to embrace new technology can be positively influenced in order to gain acceptance of new ways to perform tasks. Telemedicine applications have been designed to improve operational efficiency and obtain improved outcomes, but system designers and procurers are dependent upon the organization's leadership to effect attitudinal and behavioral changes that are essential for acceptance and usage of new technology.

  2. The Model for Assessment of Telemedicine (MAST)

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Clemensen, Jane; Caffery, Liam J

    2017-01-01

    The evaluation of telemedicine can be achieved using different evaluation models or theoretical frameworks. This paper presents a scoping review of published studies which have applied the Model for Assessment of Telemedicine (MAST). MAST includes pre-implementation assessment (e.g. by use...

  3. Communication network for telemedicine | Debretsion | Zede Journal

    African Journals Online (AJOL)

    Telemedicine is the most promising one for improving the access to specialized health services to all remote, rural areas in all developing countries. Exploiting the technological advancements in the field of electronics, signal processing and software a communication network for telemedicine is proposedfor the existing ...

  4. Engaging elderly people in telemedicine through gamification

    NARCIS (Netherlands)

    de Vette, Anna Frederiek Alberdien; Tabak, Monique; van Weering, Marit; Vollenbroek-Hutten, Miriam Marie Rosé

    2015-01-01

    BACKGROUND: Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the

  5. Telemedicine: Definition, Benefits and Limitation | Okoromah ...

    African Journals Online (AJOL)

    A practical, cheap, “store and forward, electronic mail-based communication may be used to send patients data with image file attachments for expert consultation any where in the world. Issues of major concern in telemedicine are related to security and confidentially of patient data. The cost of establishing telemedicine in ...

  6. Modeling Emergency Warning Systems for Disaster Reduction

    Science.gov (United States)

    Sorensen, J. H.

    2015-12-01

    Emergency warning systems are the last line of defense for reducing losses from natural hazards. Well-designed systems enable populations-at-risk in impending disasters to take appropriate protective actions. There have been a limited number of research efforts designed to quantify the performance of various types of warning systems and these have been primarily technology-specific. This paper describes the result of research on developing models of warning systems based of the 3 stages of warning: deciding to issue a warning, disseminating the warning to the population-at-risk and initiating a protective action. The warning issuance stage is the time between emergency warning officials being notified of the existence of a threat and reaching a decision to activate the warning system. The warning dissemination stage is the time between that decision and individuals receiving the first warning. The protective action stage is the time between receiving the warning and initiating a protective action. A fourth stage consisting of implementing the protective action is not discussed in this paper. The basic method used in developing models of each stage of the warning process was to first review previous modeling research. Second, assemble historic data on the timing of the warning process. This included point data as well as cumulative distributions. Third, develop a modeling approach to specify a diffusion equation. Fourth, compare the empirical data to the results of the simulation. The attached figure depicts a comparision between simulated warning diffusion and empirical data For each stage, best and worst case curves are develop. Several moderate or average curves are also developed. Factors associated with identifying which curves would be appropriate for a large range of potential event scenarios are identified and discussed. Potential application to lose of life modeling and hazard mitigation strategies are also discussed.

  7. Current situation and future opportunity of telemedicine in Bangladesh

    OpenAIRE

    KALAM, Abul

    2011-01-01

    Developing countries are leisurely adopter of new technologies, particularly with regards to the health services of these countries. This study explores the current health information infrastructure and future prospects of information and communication technology in health system of Bangladesh using an interpretative case study approach and proposes apply Telemedicine system to ensure health for all. This study almost certainly the first of its variety in Bangladesh; there have been some...

  8. Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

    Directory of Open Access Journals (Sweden)

    Bart M. Demaerschalk

    2010-01-01

    Full Text Available Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2±9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0±9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.

  9. TELEMEDICINE — PROSPECTS AND DIFFICULTIES BEFORE A NEW DEVELOPMENT STAGE

    Directory of Open Access Journals (Sweden)

    A. A. Baranov

    2013-01-01

    Full Text Available The article is devoted to telemedicine — an applied sphere of medical science linked with development and practical application of rendering distant medical care and specialized information, sharing methods on the basis of modern information and telecommunication technologies. This landmark sphere of medical care organization and rendering has already become an inalienable part of modern public health. The aim of telemedicine is to provide quality medical care to anyone regardless of their location and social status. Telemonitoring as a future technology is already finding wide use in spheres where constant domiciliary medical care is required. It is used in neonatology to observe infants with low and extremely low body weight during the antenatal period, in cardiology — to control the condition of a patient with an implantable device (pacemaker or cardioverter defibrillator; this method is also widely used in other spheres ofmedicine. It is possible to organize advisory assistance to medical care rendering through employing highly qualified specialists of largescalemedical centers in case of emergency. Extra possibilities of applying new medical approaches, which considerably expand the range of patients under outpatient observation and reduce the number of patients’ visits to clinics, appeared owing to the application of information technologies in public health. The article gives a detailed account of various aspects of telemedicine.

  10. Telemedicine Futures Symposium

    Science.gov (United States)

    2004-10-01

    Navigation System Levine’ 3 Gesture Pendant Computer Vision Starner 29 System for Home Automation Control and Medical Monitoring 4 Digital Family Portraits...al., "The Gesture Pendant: A Self-Illuminating, Wearable, Infrared, Computer Vision System for Home Automation Control and Medical Monitoring," Proc

  11. Do you see what I see? Insights from using google glass for disaster telemedicine triage.

    Science.gov (United States)

    Cicero, Mark X; Walsh, Barbara; Solad, Yauheni; Whitfill, Travis; Paesano, Geno; Kim, Kristin; Baum, Carl R; Cone, David C

    2015-02-01

    Disasters are high-stakes, low-frequency events. Telemedicine may offer a useful adjunct for paramedics performing disaster triage. The objective of this study was to determine the feasibility of telemedicine in disaster triage, and to determine whether telemedicine has an effect on the accuracy of triage or the time needed to perform triage. This is a feasibility study in which an intervention team of two paramedics used the mobile device Google Glass (Google Inc; Mountain View, California USA) to communicate with an off-site physician disaster expert. The paramedic team triaged simulated disaster victims at the triennial drill of a commercial airport. The simulated victims had preassigned expected triage levels. The physician had an audio-video interface with the paramedic team and was able to observe the victims remotely. A control team of two paramedics performed disaster triage in the usual fashion. Both teams used the SMART Triage System (TSG Associates LLP; Halifax, England), which assigns patients into Red, Yellow, Green, and Black triage categories. The paramedics were video recorded, and their time required to triage was logged. It was determined whether the intervention team and the control team varied regarding accuracy of triage. Finally, the amount of time the intervention team needed to triage patients when telemedicine was used was compared to when that team did not use telemedicine. The two teams triaged the same 20 patients. There was no significant difference between the two groups in overall triage accuracy (85.7% for the intervention group vs 75.9% for the control group; P = .39). Two patients were triaged with telemedicine. For the intervention group, there was a significant difference in time to triage patients with telemedicine versus those without telemedicine (35.5 seconds; 95% CI, 72.5-143.5 vs 18.5 seconds; 95% CI, 13.4-23.6; P = .041). There was no increase in triage accuracy when paramedics evaluating disaster victims used telemedicine

  12. 46 CFR 169.829 - Emergency lighting and power systems.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency lighting and power systems. 169.829 Section... SCHOOL VESSELS Operations Tests, Drills, and Inspections § 169.829 Emergency lighting and power systems. (a) Where fitted, the master shall have the emergency lighting and power systems operated and...

  13. 78 FR 36278 - Fuel Oil Systems for Emergency Power Supplies

    Science.gov (United States)

    2013-06-17

    ... COMMISSION Fuel Oil Systems for Emergency Power Supplies AGENCY: Nuclear Regulatory Commission. ACTION... Regulatory Guide (RG) 1.137, ``Fuel Oil Systems for Emergency Power Supplies.'' Revision 2 of RG 1.137 endorses ANSI/ANS- 59.51-1997, ``Fuel Oil Systems for Safety-Related Emergency Diesel Generators...

  14. 77 FR 39745 - Fuel Oil Systems for Emergency Power Supplies

    Science.gov (United States)

    2012-07-05

    ...] [FR Doc No: 2012-16426] NUCLEAR REGULATORY COMMISSION [NRC-2012-0159] Fuel Oil Systems for Emergency... comment draft regulatory guide (DG), DG-1282, ``Fuel Oil Systems for Emergency Power Supplies.'' This... Commission's requirements regarding fuel oil systems for safety-related emergency diesel generators and oil...

  15. Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram

    Science.gov (United States)

    2015-01-01

    Objectives Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. Methods This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. Results It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. Conclusions To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions. PMID:26618028

  16. Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram.

    Science.gov (United States)

    Chang, Hyejung

    2015-10-01

    Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.

  17. Telemedicine support to patients with chronic diseases for better long-term control at home

    Directory of Open Access Journals (Sweden)

    Drago Rudel

    2017-02-01

    Full Text Available Authors in many scientific publications suggest that the telemonitoring of health parameters is a useful tool for supporting patients with long-term conditions staying at home and their self-management of the disease. Those patients are likely to benefit from timely and adequate response to deteriorated conditions detected by the telemedicine system. Almost all of the studies state that telemedicine provided as telemonitoring can be an effective add-on tool in the hands of patients and medical experts for the self-management of patients with, for example, heart failure or diabetes. In this paper the principles of patient telemonitoring are presented as applied within a telemedicine service provided by the Centre for Telehealth (CEZAR at the General Hospital Slovenj Gradec (Slovenia. The centre supports patients with diabetes mellitus type 2 and/or with chronic congestive heart failure. The service was set-up in 2014 as part of a European project called UNITED4HEALTH. Since then over 550 patients from the Carinthia and Saleška regions (Slovenia have been receiving telemedicine support for more than two years. The clinical outcomes of the telemedicine service published elsewhere prove that the selected telemedicine service model is adequate and the implemented technological solution is acceptable for all service users: the patients and the clinicians.

  18. Delivering kidney cancer care in rural Central and Southern Illinois: a telemedicine approach.

    Science.gov (United States)

    Alanee, S; Dynda, D; LeVault, K; Mueller, G; Sadowski, D; Wilber, A; Jenkins, W D; Dynda, M

    2014-11-01

    There is a growing body of experience and research suggesting that telemedicine (video conferencing, smart phones and online patient portals) could be the solution to addressing gaps in the provision of specialised healthcare in rural areas. The proposed role of telemedicine in providing needed services in hard to reach areas is not new. The United States Telecommunication Act of 1996 provided the initial traction for telemedicine by removing important economic and legal obstacles regarding the use of technology in healthcare delivery. This initial ruling has been supplemented by the availability of federal funding to support efforts aimed at developing telemedicine in underserved areas. In this paper, we explore one aspect of disease disparity pertinent to rural Illinois (kidney cancer incidence and mortality) and describe how we are planning to use an existing telemedicine program at Southern Illinois University School of Medicine (SIUSOM) to improve kidney cancer (Kca) care in rural Illinois. This represents an example of the possible role of telemedicine in addressing healthcare disparities in rural areas/communities and provides a description of general challenges and barriers to the implementation and maintenance of such systems. © 2014 John Wiley & Sons Ltd.

  19. 77 FR 153 - Passenger Train Emergency Systems II

    Science.gov (United States)

    2012-01-03

    ... Passenger Train Emergency Systems (PTES) addressing: emergency communication, emergency egress, and rescue... windows used by emergency responders. See 73 FR 6370. During the development of the PESS rule and the PTES... issued the PTES rule. As noted above, the final rule was published on February 1, 2008, and it addressed...

  20. [Development and application of emergency medical information management system].

    Science.gov (United States)

    Wang, Fang; Zhu, Baofeng; Chen, Jianrong; Wang, Jian; Gu, Chaoli; Liu, Buyun

    2011-03-01

    To meet the needs of clinical practice of rescuing critical illness and develop the information management system of the emergency medicine. Microsoft Visual FoxPro, which is one of Microsoft's visual programming tool, is used to develop computer-aided system included the information management system of the emergency medicine. The system mainly consists of the module of statistic analysis, the module of quality control of emergency rescue, the module of flow path of emergency rescue, the module of nursing care in emergency rescue, and the module of rescue training. It can realize the system management of emergency medicine and,process and analyze the emergency statistical data. This system is practical. It can optimize emergency clinical pathway, and meet the needs of clinical rescue.

  1. The simulation model of teleradiology in telemedicine project.

    Science.gov (United States)

    Goodini, Azadeh; Torabi, Mashallah; Goodarzi, Maryam; Safdari, Reza; Darayi, Mohamad; Tavassoli, Mahdieh; Shabani, MohammadMehdi

    2015-01-01

    Telemedicine projects are aimed at offering medical services to people who do not have access to direct diagnosis and treatment services. As a powerful tool for analyzing the performance of complex systems and taking probable events into consideration, systemic simulation can facilitate the analysis of implementation processes of telemedicine projects in real-life-like situations. The aim of the present study was to propose a model for planning resource capacities and allocating human and operational resources to promote the efficiency of telemedicine project by investigating the process of teleradiology. In this article, after verification of the conceptual model by the experts of this field, the computerized simulation model is developed using simulation software Arena. After specifying the required data, different improvement scenarios are run using the computerized model by feeding the data into the software and validation and verification of the model. Fixing input data of the system such as the number of patients, their waiting time, and process time of each function, for example, magnetic resonance imaging or scan, has been compared with the current radiology process. Implementing the teleradiology model resulted in reduction of time of patients in the system (current: 1.84 ± 0.00, tele: 0.81 ± 0.00). Furthermore, through this process, they can allocate the lower resources to perform better functions of staff. The use of computerized simulation is essential for designing processes, optimal allocation of resources, planning, and making appropriate decisions for providing timely services to patients.

  2. Developing a Newborn Resuscitation Telemedicine Program: A Comparison of Two Technologies.

    Science.gov (United States)

    Beck, Jenna A; Jensen, Julie A; Putzier, Rochelle F; Stubert, Lisa A; Stuart, Kathleen D; Mohammed, Hussain; Kreofsky, Beth L; Boles, Kelly W; Colby, Christopher E; Fang, Jennifer L

    2017-12-12

    Early work has demonstrated the feasibility and acceptance of newborn resuscitation telemedicine programs (NRTPs). The technology requirements for providing this type of emergency telemedicine service are unclear. We hypothesized that during NRTP consults, a wired telemedicine cart would provide a more reliable and higher-quality user experience than a consumer-grade wireless tablet. In this retrospective observational study, six spoke sites used consumer-grade wireless tablets during preintervention and wired coder/decoder (CODEC)-based telemedicine carts during postintervention. Both technologies used the same videoconferencing software. After the telemedicine consult, providers completed surveys assessing connection reliability, user satisfaction, and audio and video quality using a 1-5 Likert scale. Preintervention, users completed 99 consults and 95 surveys. Postintervention, users completed 73 consults and 192 surveys. Successful connection on first attempt was significantly improved with the wired cart compared with the wireless tablet (82.7% vs. 69.5%, p = 0.01), and the percentage of consults complicated by an unplanned disconnection was reduced (6.4% vs. 14.7%, p = 0.02). User satisfaction and video and audio quality ratings were significantly higher for the wired cart. The wired telemedicine cart increased connection reliability, which is important given the critical nature and long duration of NRTP consults. Audio-video quality was also improved, allowing for better visualization of the neonate and communication with the care team. Consumer-grade wireless tablets did not meet the program's technical requirements. Wired telemedicine carts improved reliability, user satisfaction, and audio-video quality. Wired carts may not fully meet NRTP requirements because of cart size and limited mobility.

  3. Stroke care in Galicia: telemedicine in the early, multidisciplinary treatment of all acute stroke cases.

    Science.gov (United States)

    Rodríguez-Castro, Emilio; Vázquez-Lima, Manuel José; Rodríguez-Yáñez, Manuel; Verde, Luis; Castillo, José

    2018-02-01

    Stroke is the main cause of morbidity and mortality in Spain and in Galicia in particular. Tissue viability after stroke depends on the time taken to restore circulation. The widely dispersed and aging population of this region challenges efforts to provide equal care for patients with time-sensitive emergencies such as stroke. Two regional hospitals (Hospital do Salnés and Hospital do Barbanza) and the reference Hospital Clínico de Santiago launched a telestroke pilot program in 2011 in which patients whose treatment was guided at a distance were discharged with lower levels of stroke severity and mortality. That outcome was probably attributable to more rapid diagnosis. Given those preliminary results and the characteristics of the population, the centrally coordinated Galician Stroke Care Plan was launched in 2016 to provide a telemedicine service that connects all hospitals in the health system of Galicia. This paper summarizes the experience of developing and implementing the program.

  4. A Tactical Emergency Response Management System (Terms ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... of mobile technology to enhance communication between emergency response personnel. The test results obtained revealed that if fully implemented, this technology can improve the speed of intervention between the use cases ... the impact of an emergency on the public and the environment. Emergency ...

  5. System Study: Emergency Power System 1998-2014

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, John Alton [Idaho National Lab. (INL), Idaho Falls, ID (United States). Risk Assessment and Management Services Dept.

    2015-12-01

    This report presents an unreliability evaluation of the emergency power system (EPS) at 104 U.S. commercial nuclear power plants. Demand, run hours, and failure data from fiscal year 1998 through 2014 for selected components were obtained from the Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES). The unreliability results are trended for the most recent 10 year period while yearly estimates for system unreliability are provided for the entire active period. An extremely statistically significant increasing trend was observed for EPS system unreliability for an 8-hour mission. A statistically significant increasing trend was observed for EPS system start-only unreliability.

  6. Meaningful use: a national framework for integrated telemedicine.

    Science.gov (United States)

    Vo, Alexander; Shore, Jay; Waugh, Maryann; Doarn, Charles R; Richardson, Jeffrey; Hathaway, Owen; Bostick, Ed; Lippolis, Samantha; Thomas, Marshall

    2015-05-01

    The Centers for Medicare and Medicaid Services has incentivized electronic health records (EHRs) implementation through meaningful use (MU) to improve healthcare quality and efficacy. Telemedicine is a key tool that has shown its ability to facilitate MU through technological innovation with cost savings and has shown promise in the area of integrated behavioral healthcare. The purpose of this article is to propose a model of MU to frame the incentivized implementation of an integrated telemedicine (ITM)-specific model to effect system-level change. We reviewed the background, principles, and a justification for the ITM Model including cost issues, the development and structure of MU in the context of EHRs, the benefits of integrated behavioral healthcare and telemedicine, and the case for their combined implementation in the form of ITM. The model proposed, the ITM Incentive Program, parallels the current MU program and is composed of three stages. Stage 1 focuses on incentivizing current and new Medicaid providers to adapt, implement, and upgrade technology needed to conduct virtual meetings with patients and other healthcare professionals. Stage 2 is a tiered incentive system with process-focused and track metrics related to increasing the number of consultations with patients. In Stage 3, providers are encouraged to continue use of ITM by meeting thresholds for several objectives focused on clinical outcomes. Recommendations for implementing this model within a payment waiver system are discussed. The ITM Model offers a needed union of integrated care and telemedicine through the combination of technology, business, and clinical processes. The success of MU as a tiered incentive program for EHRs, as well as the precedent of using waiver opportunities for incentive funding repayments, sets forth a strategic framework to successful implementation of ITM to address cost issues and improve quality and access to care in the healthcare system.

  7. Healthcare innovation and performance factors for telemedicine acceptance in Malaysia

    OpenAIRE

    Wan Ahmad, WMNI; Van Coster, R; Wan Ahmad, M

    2017-01-01

    There are numerous issues and challenges faced by healthcare practitioners as principal end users to adopt healthcare innovation in their clinical works. The purpose of this paper is to identify the performance factors for telemedicine acceptance in Malaysia, based on the integration of technology acceptance and user satisfaction theories to adopt innovation technology. The conceptual model is developed based on factors mainly from Web-based Information System Success Model (WISSM) and The Un...

  8. Emergent supersymmetry in local equilibrium systems

    Science.gov (United States)

    Gao, Ping; Liu, Hong

    2018-01-01

    Many physical processes we observe in nature involve variations of macroscopic quantities over spatial and temporal scales much larger than microscopic molecular collision scales and can be considered as in local thermal equilibrium. In this paper we show that any classical statistical system in local thermal equilibrium has an emergent supersymmetry at low energies. We use the framework of non-equilibrium effective field theory for quantum many-body systems defined on a closed time path contour and consider its classical limit. Unitarity of time evolution requires introducing anti-commuting degrees of freedom and BRST symmetry which survive in the classical limit. The local equilibrium is realized through a Z 2 dynamical KMS symmetry. We show that supersymmetry is equivalent to the combination of BRST and a specific consequence of the dynamical KMS symmetry, to which we refer as the special dynamical KMS condition. In particular, we prove a theorem stating that a system satisfying the special dynamical KMS condition is always supersymmetrizable. We discuss a number of examples explicitly, including model A for dynamical critical phenomena, a hydrodynamic theory of nonlinear diffusion, and fluctuating hydrodynamics for relativistic charged fluids.

  9. Clinicians' Knowledge and Perception of Telemedicine Technology.

    Science.gov (United States)

    Ayatollahi, Haleh; Sarabi, Fatemeh Zahra Pourfard; Langarizadeh, Mostafa

    2015-01-01

    Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (α = 0.73). The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions.

  10. 78 FR 71785 - Passenger Train Emergency Systems II

    Science.gov (United States)

    2013-11-29

    ... published a final rule on Passenger Train Emergency Systems (PTES) on February 1, 2008. See 73 FR 6370. The... Working Group meetings, FRA initiated the Passenger Train Emergency Systems II (PTES II) rulemaking. In... regulations. For example, the 2008 PTES final rule established requirements that improve passenger emergency...

  11. Awareness Knowledge Attitude Skills of Telemedicine among Health Professional Faculty Working in Teaching Hospitals

    Science.gov (United States)

    Zayapragassarazan, Zayabalaradjane; Kumar, Santosh

    2016-01-01

    Introduction: Telemedicine is an emerging technology in health sector in India. The success of any new technology depends on many factors including the knowledge and understanding of the concept, skills acquired, attitude towards technology and working environment by the concerned professionals. Aim: The main objective of this study was to assess…

  12. Making grandma's data secure: a security architecture for home telemedicine.

    Science.gov (United States)

    Starren, J; Sengupta, S; Hripcsak, G; Ring, G; Klerer, R; Shea, S

    2001-01-01

    Home telemedicine presents special challenges for data security and privacy. Experience in the Informatics for Diabetes Education And Telemedicine (IDEATel) project has demonstrated that data security is not a one-size-fits-all problem. The IDEATel users include elderly patients in their homes, nurse case managers, physicians, and researchers. The project supports multiple computer systems that require a variety of user interactions, including: data entry, data review, patient education, videoconferencing, and electronic monitoring. To meet these various needs, a number of different of security solutions were utilized, including: UserID/Password, PKI certificates, time-based tokens, IP filtering, VPNs, symmetric and asymmetric encryption schemes, firewalls and dedicated connections. These were combined in different ways to meet the needs of each user groups.

  13. IEA Response System for Oil Supply Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-12-15

    Emergency response to oil supply disruptions has remained a core mission of the International Energy Agency since its founding in 1974. This information pamphlet explains the decisionmaking process leading to an IEA collective action, the measures available -- focusing on stockdraw -- and finally, the historical background of major oil supply disruptions and the IEA response to them. It also demonstrates the continuing need for emergency preparedness, including the growing importance of engaging key transition and emerging economies in dialogue about energy security.

  14. IEA Response System for Oil Supply Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-15

    Emergency response to oil supply disruptions has remained a core mission of the International Energy Agency since its founding in 1974. This information pamphlet explains the decisionmaking process leading to an IEA collective action, the measures available -- focusing on stockdraw -- and finally, the historical background of major oil supply disruptions and the IEA response to them. It also demonstrates the continuing need for emergency preparedness, including the growing importance of engaging key transition and emerging economies in dialogue about energy security.

  15. Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial

    DEFF Research Database (Denmark)

    Jacobsen, Anna Svarre; Laursen, Lars C; Østergaard, Birte

    2013-01-01

    Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable...... phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional...... hospital treatment measured according to first treatment failure, which is defined as readmission due to COPD within 30 days after discharge....

  16. A generic telemedicine infrastructure for monitoring an artificial pancreas trial.

    Science.gov (United States)

    Capozzi, Davide; Lanzola, Giordano

    2013-06-01

    Telemedicine systems are seen as a possible solution for the remote monitoring of physiological parameters and can be particularly useful for chronic patients treated at home. Implementing those systems however has always required spending a great effort on the underlying infrastructure instead of focusing on the application cores as perceived by their users. This paper proposes an abstract unifying infrastructure for telemedicine services which is loosely based on the multi-agent paradigm. It provides the capability of transferring to the clinic any remotely acquired information, and possibly sending back updates to the patient. The infrastructure is a layered one, with the bottom layer acting at the data level and implemented in terms of a software library targeting a wide set of hardware devices. On top of this infrastructure several services can be written shaping the functionality of the telemedicine application while at the highest level, adhering to a simple agent model, it is possible to reuse those functional components porting the application to different platforms. The infrastructure has been successfully used for implementing a telemonitoring service for a randomized controlled study aimed at testing the effectiveness of the artificial pancreas as a treatment within the AP@home project funded by the European Union. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Advanced telemedicine development

    Energy Technology Data Exchange (ETDEWEB)

    Forslund, D.W.; George, J.E.; Gavrilov, E.M.

    1998-12-31

    This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The objective of this project was to develop a Java-based, electronic, medical-record system that can handle multimedia data and work over a wide-area network based on open standards, and that can utilize an existing database back end. The physician is to be totally unaware that there is a database behind the scenes and is only aware that he/she can access and manage the relevant information to treat the patient.

  18. 76 FR 35810 - Review of the Emergency Alert System

    Science.gov (United States)

    2011-06-20

    ... Integrated Public Alert and Warning System for federal CAP-formatted messages; and (ii) state alert systems... Docket No. 04-296; FCC 11-82] Review of the Emergency Alert System AGENCY: Federal Communications... Commission (Commission) seeks comment on proposed changes to its rules governing the Emergency Alert System...

  19. Location Dependency and Antenna/Body/Sensor-Lead Interaction Effects in a Cell-Phone Based GSM 1800 Telemedicine Link

    National Research Council Canada - National Science Library

    Troulis, S

    2001-01-01

    The error-free requirement of today's cell-phone based telemedicine systems demands investigations into the potential causes of service degradation, Measuring the Received Signal Strength Indication (RSSI...

  20. Lights and siren: a review of emergency vehicle warning systems.

    Science.gov (United States)

    De Lorenzo, R A; Eilers, M A

    1991-12-01

    Emergency medical services providers routinely respond to emergencies using lights and siren. This practice is not without risk of collision. Audible and visual warning devices and vehicle markings are integral to efficient negotiation of traffic and reduction of collision risk. An understanding of warning system characteristics is necessary to implement appropriate guidelines for prehospital transportation systems. The pertinent literature on emergency vehicle warning systems is reviewed, with emphasis on potential health hazards associated with these techniques. Important findings inferred from the literature are 1) red flashing lights alone may not be as effective as other color combinations, 2) there are no data to support a seizure risk with strobe lights, 3) lime-yellow is probably superior to traditional emergency vehicle colors, 4) the siren is an extremely limited warning device, and 5) exposure to siren noise can cause hearing loss. Emergency physicians must ensure that emergency medical services transportation systems consider the pertinent literature on emergency vehicle warning systems.

  1. Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

    Science.gov (United States)

    O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

    2016-06-01

    Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

  2. Slow Scan Telemedicine

    Science.gov (United States)

    1984-01-01

    Originally developed under contract for NASA by Ball Bros. Research Corporation for acquiring visual information from lunar and planetary spacecraft, system uses standard closed circuit camera connected to a device called a scan converter, which slows the stream of images to match an audio circuit, such as a telephone line. Transmitted to its destination, the image is reconverted by another scan converter and displayed on a monitor. In addition to assist scans, technique allows transmission of x-rays, nuclear scans, ultrasonic imagery, thermograms, electrocardiograms or live views of patient. Also allows conferencing and consultation among medical centers, general practitioners, specialists and disease control centers. Commercialized by Colorado Video, Inc., major employment is in business and industry for teleconferencing, cable TV news, transmission of scientific/engineering data, security, information retrieval, insurance claim adjustment, instructional programs, and remote viewing of advertising layouts, real estate, construction sites or products.

  3. Augmentation of Acute Stroke Management via Telemedicine

    National Research Council Canada - National Science Library

    Choi, John

    2001-01-01

    .... 0 Necessary telemedicine study equipment was installed at the study sites. (PictureTel monitors and associated VTC equipment, flat-screen monitors, one PC, and VCR with digital video tape/VHS capabilities were installed...

  4. Nursing Roles within a Stroke Telemedicine Network

    Directory of Open Access Journals (Sweden)

    Terri-Ellen J. Kiernan

    2010-01-01

    Full Text Available Time sensitive acute stroke treatments and the growing shortage of vascular neurologists compound to create a gap in the delivery of care to meet the American Stroke Association guidelines in underserviced regions. Audio/video consultation (telemedicine, which has been evolving since the late 1990's, is a putative solution. While telemedicine can serve as a valuable facilitative tool, the telestroke consultation is only one piece of a complex collaboration between hub and spoke environments and clinical personnel. The growing use of telemedicine in stroke offers more opportunities for all nurses to participate in the continuum of cerebrovascular disease care. A review of this collaboration will include but will not be limited to: algorithms of the acute stroke evaluation, hub and spoke staff meetings, stroke education for spoke staff, and patient follow–up post acute treatment. Our team's telemedicine experience, utilizing research, education, and clinical practice, will be described.

  5. Benefit Analysis of Emergency Standby System Promoted to Cogeneration System

    Directory of Open Access Journals (Sweden)

    Shyi-Wen Wang

    2016-07-01

    Full Text Available Benefit analysis of emergency standby system combined with absorption chiller promoted to cogeneration system is introduced. Economic evaluations of such upgraded projects play a major part in the decisions made by investors. Time-of-use rate structure, fuel cost and system constraints are taken into account in the evaluation. Therefore, the problem is formulated as a mixed-integer programming problem. Using two-stage methodology and modified mixed-integer programming technique, a novel algorithm is developed and introduced here to solve the nonlinear optimization problem. The net present value (NPV method is used to evaluate the annual benefits and years of payback for the cogeneration system. The results indicate that upgrading standby generators to cogeneration systems is profitable and should be encouraged, especially for those utilities with insufficient spinning reserves, and moreover, for those having difficulty constructing new power plants.

  6. System Study: Emergency Power System 1998–2013

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, John Alton [Idaho National Lab. (INL), Idaho Falls, ID (United States). Risk Assessment and Management Services Dept.

    2015-02-01

    This report presents an unreliability evaluation of the emergency power system (EPS) at 104 U.S. commercial nuclear power plants. Demand, run hours, and failure data from fiscal year 1998 through 2013 for selected components were obtained from the Institute of Nuclear Power Operations (INPO) Consolidated Events Database (ICES). The unreliability results are trended for the most recent 10-year period, while yearly estimates for system unreliability are provided for the entire active period. No statistically significant trends were identified in the EPS results.

  7. System Study: Emergency Power System 1998–2012

    Energy Technology Data Exchange (ETDEWEB)

    T. E. Wierman

    2013-10-01

    This report presents an unreliability evaluation of the emergency power system (EPS) at 104 U.S. commercial nuclear power plants. Demand, run hours, and failure data from fiscal year 1998 through 2012 for selected components were obtained from the Equipment Performance and Information Exchange (EPIX). The unreliability results are trended for the most recent 10 year period while yearly estimates for system unreliability are provided for the entire active period. A statistically significant increasing trend was identified for unreliability (8 hour model) as a function of fiscal year. No statistically significant decreasing trend was identified in the EPS results.

  8. MEDLINE versus EMBASE and CINAHL for telemedicine searches.

    Science.gov (United States)

    Bahaadinbeigy, Kambiz; Yogesan, Kanagasingam; Wootton, Richard

    2010-10-01

    Researchers in the domain of telemedicine throughout the world tend to search multiple bibliographic databases to retrieve the highest possible number of publications when conducting review projects. Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) are three popular databases in the discipline of biomedicine that are used for conducting reviews. Access to the MEDLINE database is free and easy, whereas EMBASE and CINAHL are not free and sometimes not easy to access for researchers in small research centers. This project sought to compare MEDLINE with EMBASE and CINAHL to estimate what proportion of potentially relevant publications would be missed when only MEDLINE is used in a review project, in comparison to when EMBASE and CINAHL are also used. Twelve simple keywords relevant to 12 different telemedicine applications were searched using all three databases, and the results were compared. About 9%-18% of potentially relevant articles would have been missed if MEDLINE had been the only database used. It is preferable if all three or more databases are used when conducting a review in telemedicine. Researchers from developing countries or small research institutions could rely on only MEDLINE, but they would loose 9%-18% of the potentially relevant publications. Searching MEDLINE alone is not ideal, but in a resource-constrained situation, it is definitely better than nothing.

  9. A deep-learning-based emergency alert system

    Directory of Open Access Journals (Sweden)

    Byungseok Kang

    2016-06-01

    Full Text Available Emergency alert systems serve as a critical link in the chain of crisis communication, and they are essential to minimize loss during emergencies. Acts of terrorism and violence, chemical spills, amber alerts, nuclear facility problems, weather-related emergencies, flu pandemics, and other emergencies all require those responsible such as government officials, building managers, and university administrators to be able to quickly and reliably distribute emergency information to the public. This paper presents our design of a deep-learning-based emergency warning system. The proposed system is considered suitable for application in existing infrastructure such as closed-circuit television and other monitoring devices. The experimental results show that in most cases, our system immediately detects emergencies such as car accidents and natural disasters.

  10. Standards and Guidelines in Telemedicine and Telehealth

    Science.gov (United States)

    Krupinski, Elizabeth A.; Bernard, Jordana

    2014-01-01

    The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations, such as the American Telemedicine Association (ATA), have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices, as well as being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms not just in the traditional clinical environments, and practice guidelines will be a key factor in fostering this growth. Creation of guidelines is important to payers and regulators as well as increasingly they are adopting and integrating them into regulations and policies. This paper will review some of the recent ATA efforts in developing telemedicine practice guidelines, review the role of research in guidelines development, review data regarding their use, and discuss some of areas where guidelines are still needed. PMID:27429261

  11. Health capacity development through telemedicine in Africa.

    Science.gov (United States)

    Mars, M

    2010-01-01

    The aim of this paper is to identify and report the issues facing human capacity development through the use of telemedicine in Sub-Saharan Africa. Data were obtained through literature review and personal observation. Sub-Saharan Africa has a great burden of disease and an extreme shortage of health workers. Its countries are poor and the majority of its population rural. Telemedicine for clinical practice and education of health workers is seen as a possible means of addressing some of the health problems of Africa. A number of factors have been identified that impede the use of telemedicine in sub-Saharan Africa. These include, poverty, shortage of human resources, very limited existing infrastructure, lack of connectivity, high connectivity costs, lack of capacity development and policy issues. Examples of successful use of telemedicine and tele-educational programmes in Africa to develop capacity in health are given. Initiatives to develop capacity through tele-education appear to have been well received and are more successful than clinical telemedicine. There is need to raise awareness of telemedicine if it is to assist in developing ehealth capacity in Africa.

  12. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    , parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication...... with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. CONCLUSIONS: Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when......BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...

  13. The Manchester Triage System in paediatric emergency care

    NARCIS (Netherlands)

    M. van Veen (Mirjam)

    2010-01-01

    textabstractIn the first part of the thesis performance of the Manchester Triage System in paediatric emergency care was evaluated. In chapter 1 we reviewed the literature to evaluate realibility and validity of triage systems in paediatric emergency care. The Manchester Triage System was used to

  14. 77 FR 26701 - Review of the Emergency Alert System

    Science.gov (United States)

    2012-05-07

    ... Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0 (Oct. 13, 2009... COMMISSION 47 CFR Part 11 Review of the Emergency Alert System AGENCY: Federal Communications Commission... its rules governing the Emergency Alert System (EAS) rules so that EAS Participants may, but are not...

  15. 77 FR 16688 - Review of the Emergency Alert System

    Science.gov (United States)

    2012-03-22

    ... Integrated Public Alert and Warning System (IPAWS) technical standards and requirements for CAP and its... COMMISSION 47 CFR Part 11 Review of the Emergency Alert System AGENCY: Federal Communications Commission... its rules governing the Emergency Alert System (EAS) to codify the obligation to process alert...

  16. 77 FR 48177 - Fuel Oil Systems for Emergency Power Supplies

    Science.gov (United States)

    2012-08-13

    ... COMMISSION Fuel Oil Systems for Emergency Power Supplies AGENCY: Nuclear Regulatory Commission. ACTION: Draft... Regulatory Commission (NRC or the Commission) issued Draft Regulatory Guide, DG- 1282, ``Fuel Oil Systems for... ] requirements regarding fuel oil systems for safety-related emergency diesel generators and oil-fueled gas...

  17. Code orange: Towards transformational leadership of emergency management systems.

    Science.gov (United States)

    Caro, Denis H J

    2015-09-01

    The 21(st) century calls upon health leaders to recognize and respond to emerging threats and systemic emergency management challenges through transformative processes inherent in the LEADS in a caring environment framework. Using a grounded theory approach, this qualitative study explores key informant perspectives of leaders in emergency management across Canada on pressing needs for relevant systemic transformation. The emerging model points to eight specific attributes of transformational leadership central to emergency management and suggests that contextualization of health leadership is of particular import. © 2015 The Canadian College of Health Leaders.

  18. The Emergence of Modularity in Biological Systems

    Science.gov (United States)

    Lorenz, Dirk M.; Jeng, Alice; Deem, Michael W.

    2015-01-01

    In this review, we discuss modularity and hierarchy in biological systems. We review examples from protein structure, genetics, and biological networks of modular partitioning of the geometry of biological space. We review theories to explain modular organization of biology, with a focus on explaining how biology may spontaneously organize to a structured form. That is, we seek to explain how biology nucleated from among the many possibilities in chemistry. The emergence of modular organization of biological structure will be described as a symmetry-breaking phase transition, with modularity as the order parameter. Experimental support for this description will be reviewed. Examples will be presented from pathogen structure, metabolic networks, gene networks, and protein-protein interaction networks. Additional examples will be presented from ecological food networks, developmental pathways, physiology, and social networks. There once were two watchmakers, named Hora and Tempus, who manufactured very fine watches. Both of them were highly regarded, and the phones in their workshops rang frequently — new customers were constantly calling them. However, Hora prospered, while Tempus became poorer and poorer and finally lost his shop. What was the reason? The watches the men made consisted of about 1,000 parts each. Tempus had so constructed his that if he had one partly assembled and had to put it down — to answer the phone say— it immediately fell to pieces and had to be reassembled from the elements. The better the customers liked his watches, the more they phoned him, the more difficult it became for him to find enough uninterrupted time to finish a watch. The watches that Hora made were no less complex than those of Tempus. But he had designed them so that he could put together subassemblies of about ten elements each. Ten of these subassemblies, again, could be put together into a larger subassembly; and a system of ten of the latter sub

  19. The telemedicine spacebridge project: A joint US/Russian venture in long distance medicine via satellite

    Science.gov (United States)

    Zuzek, John E.; Cauley, Michael A.; Hollansworth, James E.

    1994-01-01

    The Telemedicine Spacebridge Demonstration Project is a joint U.S./Russian program whose purpose is to further the application of telemedicine both internationally, domestically, and in space. The system has been set up to use a Russian satellite over the Atlantic Ocean and a U.S. domestic satellite to allow physicians a two-way video and audio link between various sites of medical centers in the United States and the Central Hospital in Moscow, Russia. This paper contains a description of the project background, the Spacebridge system, the individual pieces of the system, and the operational experience gained thus far in the project.

  20. Towards a shared service centre for telemedicine: Telemedicine in Denmark, and a possible way forward.

    Science.gov (United States)

    Larsen, Simon Bo; Sørensen, Nanna Skovgaard; Petersen, Matilde Grøndahl; Kjeldsen, Gitte Friis

    2016-12-01

    Although evidence of the effectiveness of telemedicine is accumulating, knowledge of how to make best use of telemedicine is limited. This article presents results from a multi-stakeholder project that developed a new concept, a 'shared service centre' for telemedicine that is envisioned as working across different telemedical initiatives to support the implementation and wider adoption of telemedicine. One year of participatory design and analysis of the shared service centre concept involved stakeholders, such as clinicians, patients, technicians, policy makers, lawyers, economists and information technology architects. More than 100 people contributed to the findings. Most of the ideas generated for potential centre support for telemedicine could be categorised under four service categories. The need for such support services was verified in the cases investigated, and by agreement among stakeholders from regional health authorities, municipalities, and general practice. Therefore, it is probable that a shared service centre could help enable the wider deployment of telemedicine. In this article, we use 'telemedicine' as an umbrella term for all the 'tele-' labels that are sometimes used rather indiscriminately to denote the use of information and technology to support healthcare services, including 'telehealth', 'telemonitoring', 'telehomecare', 'e-health', and so on. As per our definition, telemedicine may be synchronous and/or asynchronous, and may apply to any information and technology-based means of connecting healthcare actors and the patient, such as video communication, e-mail, electronic monitoring equipment, and Internet portals. Furthermore, the term 'telemedical initiative' covers projects in which telemedicine is conducted by a temporary project organisation, as well as self-contained telemedicine services used in daily, clinical practice in existing organisations. © The Author(s) 2015.

  1. Telemedicine in healthcare. 1: Exploring its uses, benefits and disadvantages.

    Science.gov (United States)

    Sarhan, Firas

    This first in a two part series on telemedicine in healthcare outlines the background and context for using this technology. It discusses the levels of telemedicine and its possible applications in healthcare, and examines its advantages and disadvantages.

  2. A meta-analysis of telemedicine success in Africa.

    Science.gov (United States)

    Wamala, Dan S; Augustine, Kaddu

    2013-01-01

    highlights the under-representation of African researchers in the global whelm of information system research. Telemedicine in Africa though has not attracted enough political support is potentially a very useful conduit of health-care given the fact that the continent is resource limited and still enduring the effects of scarce human resource especially in health.

  3. A meta-analysis of telemedicine success in Africa

    Directory of Open Access Journals (Sweden)

    Dan S Wamala

    2013-01-01

    rates. This also highlights the under-representation of African researchers in the global whelm of information system research. Telemedicine in Africa though has not attracted enough political support is potentially a very useful conduit of health-care given the fact that the continent is resource limited and still enduring the effects of scarce human resource especially in health.

  4. Surgical emergencies of the respiratory system.

    Science.gov (United States)

    Ludwig, L L

    2000-05-01

    Management of the patient in respiratory distress requires an efficient and accurate diagnostic and therapeutic strategy. This article describes the approach to patients with respiratory compromise, including the indications and techniques for performing emergency surgical procedures. The clinical features of upper airway obstruction, thoracic wall trauma, and pleural space disease are discussed.

  5. Integration of Telemedicine in Graduate Medical Informatics Education

    OpenAIRE

    Demiris, George

    2003-01-01

    An essential part of health informatics is telemedicine, the use of advanced telecommunications technologies to bridge distance and support health care delivery and education. This report discusses the integration of telemedicine into a medical informatics curriculum and, specifically, a framework for a telemedicine course. Within this framework, the objectives and exit competencies are presented and course sections are described: definitions, introduction to technical aspects of telemedicine...

  6. Telemedicine in the Malaysian Multimedia Super Corridor: towards personalized lifetime health plans.

    Science.gov (United States)

    Abidi, S S; Yusoff, Z

    1999-01-01

    The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system--a distributed multimodule application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure--LifePlan--that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.

  7. A Proposed Information Architecture for Telehealth System Interoperability

    Energy Technology Data Exchange (ETDEWEB)

    Warren, S.; Craft, R.L.; Parks, R.C.; Gallagher, L.K.; Garcia, R.J.; Funkhouser, D.R.

    1999-04-07

    Telemedicine technology is rapidly evolving. Whereas early telemedicine consultations relied primarily on video conferencing, consultations today may utilize video conferencing, medical peripherals, store-and-forward capabilities, electronic patient record management software, and/or a host of other emerging technologies. These remote care systems rely increasingly on distributed, collaborative information technology during the care delivery process, in its many forms. While these leading-edge systems are bellwethers for highly advanced telemedicine, the remote care market today is still immature. Most telemedicine systems are custom-designed and do not interoperate with other commercial offerings. Users are limited to a set of functionality that a single vendor provides and must often pay high prices to obtain this functionality, since vendors in this marketplace must deliver entire systems in order to compete. Besides increasing corporate research and development costs, this inhibits the ability of the user to make intelligent purchasing decisions regarding best-of-breed technologies. We propose a secure, object-oriented information architecture for telemedicine systems that promotes plug-and-play interaction between system components through standardized interfaces, communication protocols, messaging formats, and data definitions. In this architecture, each component functions as a black box, and components plug together in a lego-like fashion to achieve the desired device or system functionality. The architecture will support various ongoing standards work in the medical device arena.

  8. Siren system installed to alert campus community to emergency events

    OpenAIRE

    Miller, Allan

    2006-01-01

    Virginia Tech is installing a system of warning sirens to alert the campus community to emergency events. The first test of the siren system is scheduled to occur on Wednesday, April 19, at 12:10 p.m.

  9. Reliability and Validity of Autism Assessments and Diagnosis Using Telemedicine?

    Science.gov (United States)

    2009-09-01

    school-based telehealth care in urban and rural elementary schools. Pediatrics, 112, 1088-1094. Appendices 1. Telemedicine Satisfaction Survey...TITLE: Reliability and Validity of Autism Assessments and Diagnosis Using Telemedicine ? PRINCIPAL INVESTIGATOR: R. Matthew Reese, PhD T...release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Telemedicine is increasingly utilized as a means to provide health care

  10. Emergent Properties in Natural and Artificial Dynamical Systems

    CERN Document Server

    Aziz-Alaoui, M.A

    2006-01-01

    An important part of the science of complexity is the study of emergent properties arising through dynamical processes in various types of natural and artificial systems. This is the aim of this book, which is the outcome of a discussion meeting within the first European conference on complex systems. It presents multidisciplinary approaches for getting representations of complex systems and using different methods to extract emergent structures. This carefully edited book studies emergent features such as self organization, synchronization, opening on stability and robustness properties. Invariant techniques are presented which can express global emergent properties in dynamical and in temporal evolution systems. This book demonstrates how artificial systems such as a distributed platform can be used for simulation used to search emergent placement during simulation execution.

  11. Federal Emergency Management Information System (FEMIS) System Administration Guide for FEMIS Version 1.5

    Energy Technology Data Exchange (ETDEWEB)

    Bower, John C.(BATTELLE (PACIFIC NW LAB)); Burnett, Robert A.(BATTELLE (PACIFIC NW LAB)); Carter, Richard J.(BATTELLE (PACIFIC NW LAB)); Downing, Timothy R.(BATTELLE (PACIFIC NW LAB)); Homer, Brian J.(BATTELLE (PACIFIC NW LAB)); Holter, Nancy A.(BATTELLE (PACIFIC NW LAB)); Johnson, Daniel M.(BATTELLE (PACIFIC NW LAB)); Johnson, Ranata L.(BATTELLE (PACIFIC NW LAB)); Johnson, Sharon M.(BATTELLE (PACIFIC NW LAB)); Loveall, Robert M.(BATTELLE (PACIFIC NW LAB)); Ramos Jr., Juan (BATTELLE (PACIFIC NW LAB)); Schulze, Stacy A.(BATTELLE (PACIFIC NW LAB)); Sivaraman, Chitra (BATTELLE (PACIFIC NW LAB)); Stephan, Alex J.(BATTELLE (PACIFIC NW LAB)); Stoops, Lamar R.(BATTELLE (PACIFIC NW LAB)); Wood, Blanche M.(BATTELLE (PACIFIC NW LAB))

    2001-12-01

    The Federal Emergency Management System (FEMIS) is an emergency management planning and response tool. The FEMIS System Administration Guide provides information on FEMIS System Administrator activities as well as the utilities that are included with FEMIS.

  12. Telemedicine in India: the Apollo story.

    Science.gov (United States)

    Ganapathy, Krishnan; Ravindra, Aditi

    2009-01-01

    The challenges faced and the methods implemented by the Apollo Hospitals Group in introducing telemedicine in the Indian setting are discussed in this article. Using Information and Communication Technology (ICT) to make available secondary and tertiary medical expertise to suburban and rural India was thought of as early as 1997. In March 2000, the world's first Very Small Aperture Terminal (VSAT)-enabled village hospital was commissioned. Today, with 115 centers including 9 overseas, the Apollo Telemedicine Networking Foundation (ATNF) is the oldest and largest multispecialty telemedicine network. More than 57,000 teleconsultations in various disciplines, ranging from sexual medicine to neurosurgery, have been provided. Patients have been evaluated from distances ranging from 120 to 4,500 miles. A majority (85%) of these teleconsults were reviews. The successful proof of concept validation studies, carried out from 2000 to 2001 by Apollo, were instrumental in the Indian Space Research Organization (ISRO) including telemedicine as a major thrust area. The pioneering role played by Apollo is also discussed in using VSAT-enabled Hospitals on Wheels. The paper reviews the significant role played by ATNF in the growth and development of telemedicine in South Asia. Academic activities are also highlighted. The pioneering efforts in the field of m-health, home telecare, the Pan African e-Network Project, starting the first formal educational course in telehealth and various other e-initiatives are elaborated.

  13. Community-based perceptions of emergency care in Zambian communities lacking formalised emergency medicine systems.

    Science.gov (United States)

    Broccoli, Morgan C; Cunningham, Charmaine; Twomey, Michele; Wallis, Lee A

    2016-12-01

    In Zambia, an increasing burden of acute illness and injury emphasised the necessity of strengthening the national emergency care system. The objective of this study was to identify critical interventions necessary to improve the Zambian emergency care system by determining the current pattern of emergency care delivery as experienced by members of the community, identifying the barriers faced when trying to access emergency care and gathering community-generated solutions to improve emergency care in their setting. We used a qualitative research methodology to conduct focus groups with community members and healthcare providers in three Zambian provinces. Twenty-one community focus groups with 183 total participants were conducted overall, split equally between the provinces. An additional six focus groups were conducted with Zambian healthcare providers. Data were coded, aggregated and analysed using the content analysis approach. Community members in Zambia experience a wide range of medical emergencies. There is substantial reliance on family members and neighbours for assistance, commonly with transportation. Community-identified and provider-identified barriers to emergency care included transportation, healthcare provider deficiencies, lack of community knowledge, the national referral system and police protocols. Creating community education initiatives, strengthening the formal prehospital emergency care system, implementing triage in healthcare facilities and training healthcare providers in emergency care were community-identified and provider-identified solutions for improving access to emergency care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. GPS and GPRS Based Telemonitoring System for Emergency Patient Transportation.

    Science.gov (United States)

    Satyanarayana, K; Sarma, A D; Sravan, J; Malini, M; Venkateswarlu, G

    2013-01-01

    Telemonitoring during the golden hour of patient transportation helps to improve medical care. Presently there are different physiological data acquisition and transmission systems using cellular network and radio communication links. Location monitoring systems and video transmission systems are also commercially available. The emergency patient transportation systems uniquely require transmission of data pertaining to the patient, vehicle, time of the call, physiological signals (like ECG, blood pressure, a body temperature, and blood oxygen saturation), location information, a snap shot of the patient, and voice. These requirements are presently met by using separate communication systems for voice, physiological data, and location that result in a lot of inconvenience to the technicians, maintenance related issues, in addition to being expensive. This paper presents design, development, and implementation of such a telemonitoring system for emergency patient transportation employing ARM 9 processor module. This system is found to be very useful for the emergency patient transportation being undertaken by organizations like the Emergency Management Research Institute (EMRI).

  15. Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

    Science.gov (United States)

    Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

    2017-04-01

    The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia

    Science.gov (United States)

    Shiferaw, Fassil; Zolfo, Maria

    2012-01-01

    Background Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes. Objective This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources. Design Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites. Results Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect ‘one size fits all’ technology and the use of combined interoperable applications, according to the local context, is highly recommended. Conclusions Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts. PMID:22479235

  17. Uncompressed video image transmission of laparoscopic or endoscopic surgery for telemedicine.

    Science.gov (United States)

    Huang, Ke-Jian; Qiu, Zheng-Jun; Fu, Chun-Yu; Shimizu, Shuji; Okamura, Koji

    2008-06-01

    Traditional narrowband telemedicine cannot provide quality dynamic images. We conducted videoconferences of laparoscopic and endoscopic operations via an uncompressed video transmission technique. A superfast broadband Internet link was set up between Shanghai in the People's Republic of China and Fukuoka in Japan. Uncompressed dynamic video images of laparoscopic and endoscopic operations were transmitted by a digital video transfer system (DVTS). Seven teleconferences were conducted between June 2005 and June 2007. Of the 7 teleconferences, 5 were live surgical demonstrations and 3 were recorded video teleconsultations. Smoothness of the motion picture, sharpness of images, and clarity of sound were benefited by this form of telemedicine based upon DVTS. Telemedicine based upon DVTS is a superior choice for laparoscopic and endoscopic skill training across the borders.

  18. Connected health: a review of technologies and strategies to improve patient care with telemedicine and telehealth.

    Science.gov (United States)

    Kvedar, Joseph; Coye, Molly Joel; Everett, Wendy

    2014-02-01

    With the advent of national health reform, millions more Americans are gaining access to a health care system that is struggling to provide high-quality care at reduced costs. The increasing adoption of electronic technologies is widely recognized as a key strategy for making health care more cost-effective. This article examines the concept of connected health as an overarching structure for telemedicine and telehealth, and it provides examples of its value to professionals as well as patients. Policy makers, academe, patient advocacy groups, and private-sector organizations need to create partnerships to rapidly test, evaluate, deploy, and pay for new care models that use telemedicine.

  19. Telemedicine - a scientometric and density equalizing analysis.

    Science.gov (United States)

    Groneberg, David A; Rahimian, Shaghayegh; Bundschuh, Matthias; Schwarzer, Mario; Gerber, Alexander; Kloft, Beatrix

    2015-01-01

    As a result of the various telemedicine projects in the past years a large number of studies were recently published in this field. However, a precise bibliometric analysis of telemedicine publications does not exist so far. The present study was conducted to establish a data base of the existing approaches. Density-equalizing algorithms were used and data was retrieved from the Thomson Reuters database Web of Science. During the period from 1900 to 2006 a number of 3290 filed items were connected to telemedicine, with the first being published in 1964. The studies originate from 101 countries, with the USA, Great Britain and Canada being the most productive suppliers participating in 56.08 % of all published items. Analyzing the average citation per item for countries with more than 10 publications, Ireland ranked first (10.19/item), New Zealand ranked second (9.5/item) followed by Finland (9.04/item). The citation rate can be assumed as an indicator for research quality. The ten most productive journals include three journals with the main focus telemedicine and another five with the main focus "Information/Informatics". In all subject categories examined for published items related to telemedicine, "Health Care Sciences & Services" ranked first by far. More than 36 % of all publications are assigned to this category, followed by "Medical Informatics" with 9.72 % and "Medicine, General & Internal" with 8.84 % of all publications. In summary it can be concluded that the data shows clearly a strong increase in research productivity. Using science citation analysis it can be assumed that there is a large rise in the interest in telemedicine studies.

  20. Establishing functional requirements for emergency management information systems

    Energy Technology Data Exchange (ETDEWEB)

    Reed, J.H.; Rogers, G.O.; Sorensen, J.H.

    1991-01-01

    The advancement of computer technologies has led to the development of a number of emergency management information systems (e.g., EIS, CAMEO, IEMIS). The design of these systems has tended to be technologically driven rather than oriented to meeting information management needs during an emergency. Of course, emergency management needs vary depending on the characteristics of the emergency. For example, in hurricanes, onset is typically slow enough to allow emergency managers to simulate evacuations dynamically while in chemical disasters onset may be sufficiently rapid to preclude such simulation(s). This paper describes a system design process in which the analysis of widely recognized emergency management functions was used to identify information requirements and the requisite software and hardware capabilities to deal with rapid onset, low probability, high consequence events. These requirements were then implemented as a prototype emergency management system using existing hardware and software to assure feasibility. Data, hardware, and software requirements were further developed, refined, and made more concrete through an iterative prototyping effort. This approach focuses attention directly on meeting emergency management information needs while avoiding unneeded technological innovations. 10 refs., 4 figs., 1 tab.

  1. 46 CFR 112.35-5 - Manually started emergency systems.

    Science.gov (United States)

    2010-10-01

    ... Diesel Engine or Gas Turbine Driven Generator as the Sole Emergency Power Source § 112.35-5 Manually... 46 Shipping 4 2010-10-01 2010-10-01 false Manually started emergency systems. 112.35-5 Section 112.35-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING...

  2. [Telemedicine and wireless devices in heart failure].

    Science.gov (United States)

    Billeci, Lucia; Guerriero, Lorenzo; L'Abbate, Antonio; Pioggia, Giovanni; Tartarisco, Gennaro; Trivella, Maria Giovanna

    2014-05-01

    Telemedicine has the potential to constitute the central element of the future primary care and become an effective means of prevention and early warning of acute exacerbation of chronic diseases. Up to now, the application of telemedicine has found a variety of difficulties, regarding the types and methods of acquisition and transmission of biological signals, the acceptance and cooperation of the patient, etc. The latest technological developments involve the combined use of wireless technologies and smartphones, for the collection and the transmission of data, and specific softwares for their automatic analysis. This paper examines some of the critical aspects in the application of new technologies for heart failure remote management.

  3. The public transportation system security and emergency preparedness planning guide

    Science.gov (United States)

    2003-01-01

    Recent events have focused renewed attention on the vulnerability of the nation's critical infrastructure to major events, including terrorism. The Public Transportation System Security and Emergency Preparedness Planning Guide has been prepared to s...

  4. Integrating emergency services in an urban health system.

    Science.gov (United States)

    Radloff, D; Blouin, A S; Larsen, L; Kripp, M E

    2000-03-01

    When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

  5. Transmission techniques for emergent multicast and broadcast systems

    CERN Document Server

    da Silva, Mario Marques; Dinis, Rui; Souto, Nuno; Silva, Joao Carlos

    2010-01-01

    Describing efficient transmission schemes for broadband wireless systems, Transmission Techniques for Emergent Multicast and Broadcast Systems examines advances in transmission techniques and receiver designs capable of supporting the emergent wireless needs for multimedia broadcast and multicast service (MBMS) requirements. It summarizes the research and development taking place in wireless communications for multimedia MBMS and addresses the means to improved spectral efficiency to allow for increased user bit rate, as well as increased capacity of the digital cellular radio network.The text

  6. Recommended modifications and applications of the Hospital Emergency Incident Command System for hospital emergency management.

    Science.gov (United States)

    Arnold, Jeffrey L; Dembry, Louise-Marie; Tsai, Ming-Che; Dainiak, Nicholas; Rodoplu, Ulkümen; Schonfeld, David J; Paturas, James; Cannon, Christopher; Selig, Scott

    2005-01-01

    The Hospital Emergency Incident Command System (HEICS), now in its third edition, has emerged as a popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the HEICS in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (SARS) outbreaks in eastern Asia and Toronto, Canada. Several modifications of the HEICS are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the HEICS to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in CBRN emergencies; (3) new unit leaders in the Operations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, and dependents in terrorism-related emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types of patients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems. New uses of the HEICS in hospital emergency management also are recommended, including: (1) the adoption of the HEICS as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the HEICS not only to healthcare facilities, but also to healthcare systems. Finally, three levels of healthcare worker competencies in the HEICS are suggested

  7. The conceptual MADE framework for pervasive and knowledge-based decision support in telemedicine

    NARCIS (Netherlands)

    Fung, L.S.N.; Jones, Valerie M.; Widya, I.A.; Broens, T.H.F.; Larburu Rubio, Nekane; Bults, Richard G.A.; Shalom, Erez; Hermens, Hermanus J.

    2016-01-01

    Telemedicine systems are inherently distributed, but, especially in the context of the Internet-of-Things, their complete physical configuration may only be determined after design time by considering, for example, the individual patient's needs. Therefore, to enable pervasive and knowledge-based

  8. Microneedles: an emerging transdermal drug delivery system.

    Science.gov (United States)

    Bariya, Shital H; Gohel, Mukesh C; Mehta, Tejal A; Sharma, Om Prakash

    2012-01-01

    One of the thrust areas in drug delivery research is transdermal drug delivery systems (TDDS) due to their characteristic advantages over oral and parenteral drug delivery systems. Researchers have focused their attention on the use of microneedles to overcome the barrier of the stratum corneum. Microneedles deliver the drug into the epidermis without disruption of nerve endings. Recent advances in the development of microneedles are discussed in this review for the benefit of young scientists and to promote research in the area. Microneedles are fabricated using a microelectromechanical system employing silicon, metals, polymers or polysaccharides. Solid coated microneedles can be used to pierce the superficial skin layer followed by delivery of the drug. Advances in microneedle research led to development of dissolvable/degradable and hollow microneedles to deliver drugs at a higher dose and to engineer drug release. Iontophoresis, sonophoresis and electrophoresis can be used to modify drug delivery when used in concern with hollow microneedles. Microneedles can be used to deliver macromolecules such as insulin, growth hormones, immunobiologicals, proteins and peptides. Microneedles containing 'cosmeceuticals' are currently available to treat acne, pigmentation, scars and wrinkles, as well as for skin tone improvement. Literature survey and patents filled revealed that microneedle-based drug delivery system can be explored as a potential tool for the delivery of a variety of macromolecules that are not effectively delivered by conventional transdermal techniques. © 2011 The Authors. JPP © 2011 Royal Pharmaceutical Society.

  9. Telemedicine for diabetes care: An Indian perspective - feasibility and efficacy

    Directory of Open Access Journals (Sweden)

    Jothydev Kesavadev

    2015-01-01

    Full Text Available Diabetes is a chronic and costly disease. In India, the usual practice among patients is to visit the doctor once in every 2–3 months to get advice on changes in the dosages of medications. The Diabetes Tele Management System (DTMS® is a telemedicine based follow-up program originally introduced at Jothydev's Diabetes Research Centre at Trivandrum South India in 1998. It is a chronic disease management system which enables patient to interact lively with a professionally trained multidisciplinary team comprising of diabetes educators, nurses, dieticians, pharmacists, psychologists, physicians, etc., in modifying the dosages of medications, diet, and physical activity either through telephone/email/secure website. The uniquely designed software and the trained multidisciplinary team overcomes the globally recognized major barriers to diabetes management namely fear of hypoglycemia, polypharmacy, discontinuation of stains, and antihypertensives or wrong injection techniques. DTMS is designed to provide individualized therapy advices on glycosylated hemoglobin, blood pressure, and low density lipoprotein customized to multiple patient characteristics which help attain goals of therapy. The system has been tested on various platforms over a decade and was shown to be a patient friendly approach with successful outcomes due to a live "round-the-clock" interactive communication in contrast to text or recorded messages. The major challenge to the widespread use of DTMS® is seeking a source of funding this unique telemedicine program.

  10. Modeling the emergence of lexicons in homesign systems.

    Science.gov (United States)

    Richie, Russell; Yang, Charles; Coppola, Marie

    2014-01-01

    It is largely 4ledged that natural languages emerge not just from human brains but also from rich communities of interacting human brains (Senghas, ). Yet the precise role of such communities and such interaction in the emergence of core properties of language has largely gone uninvestigated in naturally emerging systems, leaving the few existing computational investigations of this issue at an artificial setting. Here, we take a step toward investigating the precise role of community structure in the emergence of linguistic conventions with both naturalistic empirical data and computational modeling. We first show conventionalization of lexicons in two different classes of naturally emerging signed systems: (a) protolinguistic "homesigns" invented by linguistically isolated Deaf individuals, and (b) a natural sign language emerging in a recently formed rich Deaf community. We find that the latter conventionalized faster than the former. Second, we model conventionalization as a population of interacting individuals who adjust their probability of sign use in response to other individuals' actual sign use, following an independently motivated model of language learning (Yang, , ). Simulations suggest that a richer social network, like that of natural (signed) languages, conventionalizes faster than a sparser social network, like that of homesign systems. We discuss our behavioral and computational results in light of other work on language emergence, and other work of behavior on complex networks. Copyright © 2013 Cognitive Science Society, Inc.

  11. Implementing a nationwide criteria-based emergency medical dispatch system

    DEFF Research Database (Denmark)

    Andersen, Mikkel S; Johnsen, Søren Paaske; Sørensen, Jan Nørtved

    2013-01-01

    A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.......A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks....

  12. Recent Directions in Telemedicine: Review of Trends in Research and Practice

    Science.gov (United States)

    Wilson, Laurence S.

    2015-01-01

    Objectives Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. Methods To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. Results The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. Conclusions It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare. PMID:26618026

  13. 46 CFR 112.01-10 - Automatic emergency lighting and power system.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Automatic emergency lighting and power system. 112.01-10... EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-10 Automatic emergency lighting and power system. An automatic emergency lighting and power system is one in...

  14. 46 CFR 112.01-5 - Manual emergency lighting and power system.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Manual emergency lighting and power system. 112.01-5... EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-5 Manual emergency lighting and power system. A manual emergency lighting and power system is one in which a single...

  15. Telemedicine and diabetes: achievements and prospects.

    Science.gov (United States)

    Franc, S; Daoudi, A; Mounier, S; Boucherie, B; Dardari, D; Laroye, H; Neraud, B; Requeda, E; Canipel, L; Charpentier, G

    2011-12-01

    Health authorities currently have high expectations for telemedicine (TM), as it addresses several major challenges: to improve access to healthcare (especially for patients in underserved or remote areas); to overcome the scarcity of specialists faced with epidemic disease; and to reduce the costs of healthcare while improving quality. The aims of TM in the field of diabetes differ according to the type of diabetes. In type 1 diabetes (T1DM) associated with complex insulin regimens, the goal of TM is to help patients achieve better control of their blood glucose levels through accurate adjustment of insulin doses. In type 2 diabetes (T2DM), while therapeutic adjustments may be necessary, improvement in blood glucose control is based primarily on behavioural changes (reduced calorie and carbohydrate intakes, increased physical activity). Many TM studies focusing on management of blood glucose levels have been published, but most failed to demonstrate any superiority of TM vs traditional care. While previously published meta-analyses have shown a slight advantage at best for TM, these meta-analyses included a mix of studies of varying durations and different populations (both T1DM and T2DM patients, adults and children), and tested systems of inconsistent quality. Studies published to date on TM suggest two currently promising approaches. First, handheld communicating devices, such as smartphones, loaded with software to apply physicians' prescriptions, have been shown to improve glycaemic control. These systems provide immediate assistance to the patient (such as insulin-dose calculation and food choice optimization at meals), and all data stored in the smartphone can be transmitted to authorized caregivers, enabling remote monitoring and even teleconsultation. These systems, initially developed for T1DM, appear to offer many possibilities for T2DM, too. Second, systems combining an interactive Internet system (or a mobile phone coupled to a remote server) with a

  16. Application of Telemedicine Technologies to Long Term Spaceflight Support

    Science.gov (United States)

    Orlov, O. I.; Grigoriev, A. I.

    Space medicine passed a long way of search for informative methods of medical data collection and analysis and worked out a complex of effective means of countermeasures and medical support. These methods and means aimed at optimization of the habitation conditions and professional activity of space crews enabled space medicine specialists to create a background for the consecutive prolongation of manned space flights and providing their safety and effectiveness. To define support systems perspectives we should consider those projects on which bases the systems are implemented. According to the set opinion manned spaceflights programs will develop in two main directions. The first one is connected with the near space exploration, first of all with the growing interest in scientific-applied and in prospect industrial employment of large size orbit manned complexes, further development of transport systems and in long-run prospect - reclamation of Lunar surface. The second direction is connected with the perspectives of interplanetary missions. There's no doubt that the priority project of the near-earth space exploration in the coming decenaries will be building up of the International Space Station. This trend characteristics prove the necessity to provide crews whose members may differ in health with individual approach to the schedule of work, rest, nutrition and training, to the medical control and therapeutic-prophylactic procedures. In these conditions the importance of remote monitoring and distance support of crew members activities by the earth- based medical control services will increase. The response efficiency in such cases can only be maintained by means of advanced telemedicine systems. The international character of the International Space Station (ISS) gives a special importance to the current activities on integrating medical support systems of the participating countries. Creation of such a system will allow to coordinate international research

  17. Future Research on Cyber-Physical Emergency Management Systems

    Directory of Open Access Journals (Sweden)

    Fang-Jing Wu

    2013-06-01

    Full Text Available Cyber-physical systems that include human beings and vehicles in a built environment, such as a building or a city, together with sensor networks and decision support systems have attracted much attention. In emergencies, which also include mobile searchers and rescuers, the interactions among civilians and the environment become much more diverse, and the complexity of the emergency response also becomes much greater. This paper surveys current research on sensor-assisted evacuation and rescue systems and discusses the related research issues concerning communication protocols for sensor networks, as well as several other important issues, such as the integrated asynchronous control of large-scale emergency response systems, knowledge discovery for rescue and prototyping platforms. Then, we suggest directions for further research.

  18. Research on the Emergence Modeling of Equipment System

    OpenAIRE

    He Xin-Hua; Zhang Wei-Chao; Qu Qiang; Lu Wan-Lin

    2017-01-01

    Under the conditions of information, the network-centric system and the confrontation in the system has developed into a major combat style. But the traditional line of sexual assessment method is difficult to accurately assess the information equipment system combat capability. Therefore, this paper studies the effective evaluation method of the operational capability of the information equipment system from the perspective of emerge. Based on the simulation modeling and evaluation method, b...

  19. Emergency escape system protects personnel from explosion and fire

    Science.gov (United States)

    Offik, W. G.

    1966-01-01

    Elevator-type emergency escape system evacuates personnel from tall structures, especially when the possibility of explosion or fire exists. The system consists of a spike shaped rescue cabin which descends along a vertical guide cable, penetrates the dome shaped roof of an underground blast shelter and stops in a deceleration bed of granular material.

  20. Reliability and validity of emergency department triage systems

    NARCIS (Netherlands)

    van der Wulp, I.

    2010-01-01

    Reliability and validity of triage systems is important because this can affect patient safety. In this thesis, these aspects of two emergency department (ED) triage systems were studied as well as methodological aspects in these types of studies. The consistency, reproducibility, and criterion

  1. Medical Optimization Network for Space Telemedicine Resources

    Science.gov (United States)

    Shah, R. V.; Mulcahy, R.; Rubin, D.; Antonsen, E. L.; Kerstman, E. L.; Reyes, D.

    2017-01-01

    INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. NASA recognizes the need to improve capabilities for autonomous care on such missions. As the medical system is developed, it is important to have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources was developed for this reason, and is now a system to gauge the relative importance of medical resources in addressing medical conditions. METHODS: A list of medical conditions of potential concern for an exploration mission was referenced from the Integrated Medical Model, a probabilistic model designed to quantify in-flight medical risk. The diagnostic and treatment modalities required to address best and worst-case scenarios of each medical condition, at the terrestrial standard of care, were entered into a database. This list included tangible assets (e.g. medications) and intangible assets (e.g. clinical skills to perform a procedure). A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program ranked each of the items listed according to its criticality. Data was then obtained from the IMM for the probability of occurrence of the medical conditions, including a breakdown of best case and worst case, during a Mars reference mission. The probability of occurrence information and criticality for each resource were taken into account during analytics performed using Tableau software. RESULTS: A database and weighting system to evaluate all the diagnostic and treatment modalities was created by combining the probability of condition occurrence data with the criticalities assigned by the physician team. DISCUSSION: Exploration Medical Capabilities research at NASA is focused on providing a medical system to

  2. Japan introduces a SPEEDI response to emergencies. [System for Prediction of Environmental Emergency Dose Information

    Energy Technology Data Exchange (ETDEWEB)

    Fukuyama, Shigeru (Nuclear Safety Technology Center, Tokyo (Japan))

    1993-01-01

    The system for Prediction of Environmental Emergency Dose Information (SPEEDI), has been under development since 1980 by the Science and Technology Agency of Japan (STA), JAERI, and the Japan Meteorological Research Institute. SPEEDI provides realistic dose assessments and estimates of radiation concentrations they may result from an atmospheric release of radioactive materials, using advanced computer-based data communications and processing systems to calculate atmospheric dispersion for radiation consequence assessments. These assessments include applicable meteorological data and source term information. (Author).

  3. Mobile emergency, an emergency support system for hospitals in mobile devices: pilot study.

    Science.gov (United States)

    Bellini, Pierfrancesco; Boncinelli, Sergio; Grossi, Francesco; Mangini, Marco; Nesi, Paolo; Sequi, Leonardo

    2013-05-23

    Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed

  4. Integration of telemedicine in graduate medical informatics education.

    Science.gov (United States)

    Demiris, George

    2003-01-01

    An essential part of health informatics is telemedicine, the use of advanced telecommunications technologies to bridge distance and support health care delivery and education. This report discusses the integration of telemedicine into a medical informatics curriculum and, specifically, a framework for a telemedicine course. Within this framework, the objectives and exit competencies are presented and course sections are described: definitions, introduction to technical aspects of telemedicine, evolution of telemedicine and its impact on health care delivery, success and failure factors, and legal and ethical issues. The emphasis is on literature review tools, practical exposure to products and applications, and problem-based learning. Given the rapid advances in the telecommunication field, keeping the course material up to date becomes a challenge for the instructor who at the same time aims to equip students with the knowledge and tools they will need in their future role as decision makers to detect a need for, design, implement, maintain, or evaluate a telemedicine application.

  5. Building team and technical competency for obstetric emergencies: the mobile obstetric emergencies simulator (MOES) system.

    Science.gov (United States)

    Deering, Shad; Rosen, Michael A; Salas, Eduardo; King, Heidi B

    2009-01-01

    The infrequent and high-stakes nature of obstetric emergencies requires staff members to respond quickly and proficiently to a complex and high-stress situation, a situation they have likely had little opportunity to experience. This situation requires a systematic approach to preparing personnel to manage these situations. Therefore, this article seeks to contribute to the growing literature on training programs for obstetric emergencies by documenting the development and implementation of the Mobile Obstetric Emergencies Simulator (MOES) system. MOES is a comprehensive package of simulation technology, standardized curriculum, and instructional features that combines traditional classroom learning activities and simulation-based training on the actual labor and delivery (L&D) ward. Specifically, the MOES system leverages the TeamSTEPPS teamwork training being implemented throughout the US military healthcare system with opportunities to practice teamwork and technical skills using mannequin-based patient simulation embedded within L&D units. The primary goals of this article are twofold. First, this article explicitly identifies the unique training needs for preparing staff for obstetric emergencies through a comprehensive review and synthesis of the literature. Second, this article documents the approach taken in MOES to meet these needs.

  6. GPS and GPRS Based Telemonitoring System for Emergency Patient Transportation

    Directory of Open Access Journals (Sweden)

    K. Satyanarayana

    2013-01-01

    Full Text Available Telemonitoring during the golden hour of patient transportation helps to improve medical care. Presently there are different physiological data acquisition and transmission systems using cellular network and radio communication links. Location monitoring systems and video transmission systems are also commercially available. The emergency patient transportation systems uniquely require transmission of data pertaining to the patient, vehicle, time of the call, physiological signals (like ECG, blood pressure, a body temperature, and blood oxygen saturation, location information, a snap shot of the patient, and voice. These requirements are presently met by using separate communication systems for voice, physiological data, and location that result in a lot of inconvenience to the technicians, maintenance related issues, in addition to being expensive. This paper presents design, development, and implementation of such a telemonitoring system for emergency patient transportation employing ARM 9 processor module. This system is found to be very useful for the emergency patient transportation being undertaken by organizations like the Emergency Management Research Institute (EMRI.

  7. Telemedicine and biomedical care in Africa: Prospects and challenges.

    Science.gov (United States)

    Okoroafor, I J; Chukwuneke, F N; Ifebunandu, N; Onyeka, T C; Ekwueme, C O; Agwuna, K K

    2017-01-01

    The use of information and communication technology for health care delivery, particularly in poor settings where access to medical services is inadequate, holds promise in expanding health care access. In rural or impoverished environment, where disease is prevalent, doctors are scarce, and health care infrastructure is inadequate, telemedicine holds a good prospect in improving the health conditions of the people. However, telemedical practice in Africa cannot be without challenges because some aspects are often difficult to implement in underdeveloped settings where ignorance and poverty are rife. Apart from nonavailability of facilities and poor communication, most Africans have different understanding of ailments, which often affect the health system. Considering the increasing disease burden in Africa and the need for tremendous progress in achieving the health component of the millennium development goals, telemedicine should be of concern to health policy makers. This paper critically examines the prospects and challenges of telemedical practice in Africa through a systematic review of 31 relevant publications which, in addition to the authors' knowledge and experience in biomedical care in Africa, supported the information as presented.

  8. Paediatric echocardiography by telemedicine--nine years' experience.

    Science.gov (United States)

    Finley, J P; Sharratt, G P; Nanton, M A; Chen, R P; Bryan, P; Wolstenholme, J; MacDonald, C

    1997-01-01

    In 1987 we established a realtime echocardiography service by telemedicine from the paediatric cardiology department of a tertiary-care hospital in Halifax. The service was initially provided to single regional hospital but was expanded to six regional hospitals in the three Canadian Maritime Provinces. The system used a dial-up broadband video-transmission service provided by the telephone companies. Records of all transmissions were kept prospectively and reviewed to January 1997. A total of 324 transmissions were made. During 1995-96 there were 135 studies: 69 (51%) were urgent examinations of newborn children and 30 (22%) were urgent examinations of older children; repeat studies and postoperative checks (usually for pericardial effusion) accounted for the other 36 studies (27%). The images were of broadcast quality except in five cases where problems with transmission or poor sedation occurred. A comparison of 26 transmitted studies with repeat, 'in person' studies showed no important discrepancies in diagnosis. During the two-year study period, the cost of the network (equipment leasing costs and telecommunications costs) was C$90,000. Use of the telemedicine network saved unnecessary patient transfer in 31 cases. The cost of the transportation avoided was C$100,000-C$118,000. This review confirms our preliminary findings that broadband echocardiography transmission provides a service comparable in availability and accuracy to that provided in our paediatric cardiology division.

  9. Scheduling in Sensor Grid Middleware for Telemedicine Using ABC Algorithm

    Directory of Open Access Journals (Sweden)

    T. Vigneswari

    2014-01-01

    Full Text Available Advances in microelectromechanical systems (MEMS and nanotechnology have enabled design of low power wireless sensor nodes capable of sensing different vital signs in our body. These nodes can communicate with each other to aggregate data and transmit vital parameters to a base station (BS. The data collected in the base station can be used to monitor health in real time. The patient wearing sensors may be mobile leading to aggregation of data from different BS for processing. Processing real time data is compute-intensive and telemedicine facilities may not have appropriate hardware to process the real time data effectively. To overcome this, sensor grid has been proposed in literature wherein sensor data is integrated to the grid for processing. This work proposes a scheduling algorithm to efficiently process telemedicine data in the grid. The proposed algorithm uses the popular swarm intelligence algorithm for scheduling to overcome the NP complete problem of grid scheduling. Results compared with other heuristic scheduling algorithms show the effectiveness of the proposed algorithm.

  10. An intelligent IoT emergency vehicle warning system using RFID and WiFi technologies for emergency medical services.

    Science.gov (United States)

    Lai, Yeong-Lin; Chou, Yung-Hua; Chang, Li-Chih

    2017-10-13

    Collisions between emergency vehicles for emergency medical services (EMS) and public road users have been a serious problem, impacting on the safety of road users, emergency medical technicians (EMTs), and the patients on board. The aim of this study is to develop a novel intelligent emergency vehicle warning system for EMS applications. The intelligent emergency vehicle warning system is developed by Internet of Things (IoT), radio-frequency identification (RFID), and WiFi technologies. The system consists of three major parts: a system trigger tag, an RFID system in an emergency vehicle, and an RFID system at an intersection. The RFID system either in an emergency vehicle or at an intersection contains a controller, an ultrahigh-frequency (UHF) RFID reader module, a WiFi module, and a 2.4-GHz antenna. In addition, a UHF ID antenna is especially designed for the RFID system in an emergency vehicle. The IoT system provides real-time visual warning at an intersection and siren warning from an emergency vehicle in order to effectively inform road users about an emergency vehicle approaching. The developed intelligent IoT emergency vehicle warning system demonstrates the capabilities of real-time visual and siren warnings for EMS safety.

  11. Expediting Time from Symptoms to Medical Contact Utilizing a Telemedicine Call Center.

    Science.gov (United States)

    Leshem-Rubinow, Eran; Assa, Eyal Ben; Shacham, Yacov; Zatelman, Avivit; Oren-Shamir, Ayelet; Malov, Nomi; Golovner, Michal; Roth, Arie

    2015-10-01

    No definitive solution has been forthcoming for the often dangerously long interval between symptom onset and seeking medical care in the prehospital setting. We examined the implementation of telemedicine technology and characterization of its utilizers for its efficacy in reducing this possibly life-threatening time lag. A retrospective observational study was performed on the working database of an operational telemedicine facility that included all subscribers. Time-to-contact measurements throughout 2012 were retrieved from its medical files, and data on age, gender, medical history, and main complaint were analyzed. Throughout 2012, 22,274 of a total of 46,556 calls (47.8%) were made ≤60 min from symptom onset. It is important that 26.9% of all calls (12,522/46,556) were made in 60 years (19,386/40,839 [47%], p<0.001). Patients with prior resuscitation and/or myocardial infarction contacted significantly more rapidly than those with other cardiac diseases. Over one-half of patients with cardiac complaints contacted the call center ≤60 min from symptom onset, as did those who suffered physical trauma, but not patients with gastrointestinal symptoms or pain elsewhere. A telemedicine system with rapid accessibility to a professional call center and prompt triage thereafter could be an additional promising strategy for shortening the interval between symptom onset and call for medical assistance. Implementation of a widespread telemedicine infrastructure may bridge the unmet gap between occurrence of symptoms to initiation of medical treatment.

  12. Patients following their echoes: the effect of telemedicine on institutional referral patterns.

    Science.gov (United States)

    Rendina, M C

    2001-01-01

    Increasing market share by attracting patient referrals has long been cited as a justification for implementing telemedicine. At the onset of this study, there were two level III NICUs in North Carolina that did not have on-site cardiology support. During the study period, both institutions set up telemedicine links to the University of North Carolina Health Care System for the provision of rapid cardiology support. This paper tests the hypothesis that telemedicine was associated with an increase in the percentage of newborn referrals transferred to UNC instead of the other academic medical centers. Analysis of a total of 201 transfers over a three and a half year period shows that the percentage of acute transfers to UNC increased from 58 % during the pre-intervention phase to 86 % in the post-intervention phase (p = 0.001). An increase in transfers to UNC was observed from both of the level III centers. Telemedicine was an effective tool to attract patient referrals in a competitive tertiary care environment.

  13. Emergency motorcycle: has it a place in a medical emergency system?

    Science.gov (United States)

    Soares-Oliveira, Miguel; Egipto, Paula; Costa, Isabel; Cunha-Ribeiro, Luis Manuel

    2007-07-01

    In an emergency medical service system, response time is an important factor in determining the prognosis of a victim. There are well-documented increases in response time in urban areas, mainly during rush hour. Because prehospital emergency care is required to be efficient and swift, alternative measures to achieve this goal should be addressed. We report our experience with a medical emergency motorcycle (MEM) and propose major criteria for dispatching it. This work presents a prospective analysis of the data relating to MEM calls from July 2004 to December 2005. The analyzed parameters were age, sex, reason for call, action, and need for subsequent transport. A comparison was made of the need to activate more means and, if so, whether the MEM was the first to arrive. There were 1972 calls. The average time of arrival at destination was 4.4 +/- 2.5 minutes. The main action consisted of administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport. The MEM can intervene in a wide variety of clinical situations and a quick response is guaranteed. Moreover, in specific situations, MEM safely and efficiently permits better management of emergency vehicles. We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.

  14. System Would Predictively Preempt Traffic Lights for Emergency Vehicles

    Science.gov (United States)

    Bachelder, Aaron; Foster, Conrad

    2004-01-01

    Two electronic communication-and-control systems have been proposed as means of modifying the switching of traffic lights to give priority to emergency vehicles. Both systems would utilize the inductive loops already installed in the streets of many municipalities to detect vehicles for timing the switching of traffic lights. The proposed systems could be used alone or to augment other automated emergency traffic-light preemption systems that are already present in some municipalities, including systems that recognize flashing lights or siren sounds or that utilize information on the positions of emergency vehicles derived from the Global Positioning System (GPS). Systems that detect flashing lights and siren sounds are limited in range, cannot "see" or "hear" well around corners, and are highly vulnerable to noise. GPS-based systems are effective in rural areas and small cities, but are often ineffective in large cities because of frequent occultation of GPS satellite signals by large structures. In contrast, the proposed traffic-loop forward prediction system would be relatively invulnerable to noise, would not be subject to significant range limitations, and would function well in large cities -- even in such places as underneath bridges and in tunnels, where GPS-based systems do not work. One proposed system has been characterized as "car-active" because each participating emergency vehicle would be equipped with a computer and a radio transceiver that would communicate with stationary transceivers at the traffic loops. The other proposed system has been characterized as "car-passive" because a passive radio transponder would be installed on the underside of a participating vehicle.

  15. Report on emergency electrical power supply systems for nuclear fuel cycle and reactor facilities security systems

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    The report includes information that will be useful to those responsible for the planning, design and implementation of emergency electric power systems for physical security and special nuclear materials accountability systems. Basic considerations for establishing the system requirements for emergency electric power for security and accountability operations are presented. Methods of supplying emergency power that are available at present and methods predicted to be available in the future are discussed. The characteristics of capacity, cost, safety, reliability and environmental and physical facility considerations of emergency electric power techniques are presented. The report includes basic considerations for the development of a system concept and the preparation of a detailed system design.

  16. How is Telemedicine perceived? A qualitative study of perspectives from the UK and India.

    Science.gov (United States)

    Martínez Álvarez, Melisa; Chanda, Rupa; Smith, Richard D

    2011-05-20

    Improvements in communication and information technologies have allowed for the globalisation of health services, especially the provision of health services from other countries, such as the use of telemedicine. This has led countries to evaluate their position on whether and to what extent they should open their health systems to trade. This often takes place from the context of multi-lateral trade agreements (under the auspices of the World Trade Organisation), which is misplaced as a significant amount of trade takes place regionally or bi-laterally. We report here the results of a qualitative study assessing stakeholders' views on the potential for a bi-lateral trade relationship between India and the UK, where India acts as an exporter and the UK as an importer of telemedicine services. 19 semi-structured interviews were carried out with stakeholders from India and the UK. The themes discussed include prospects on the viability of a bi-lateral relationship between the UK and India on telemedicine, current activities and operations, barriers, benefits and risks. The participants in general believed there were good prospects for telemedicine trade, and that this could bring benefits to "importing" countries in terms of cost-savings and faster delivery of care and to "exporting" countries in the form of foreign exchange and quality improvement. However, there were some concerns regarding quality of care, regulation, accreditation and data security. There is potential for trade in this type of health services to succeed and bring about important benefits to the countries involved. However, issues around data security and accreditation need to be taken into consideration. Countries may wish to consider entering bi-lateral agreements, as they provide more potential to address the concerns and capitalise on the benefits. Finally, this paper concludes that more data should be collected, both on the volume of telemedicine trade and on the impact it is having on health

  17. Potentials of telemedicine for green health care

    Directory of Open Access Journals (Sweden)

    Heinrich Audebert

    2010-08-01

    Full Text Available Neurological facilities are traditionally centred in academic hospitals and often far away from the patients’ living area. Both, the transfer of patients to remote hospitals and inpatient treatment are associated with high energy consumption. Numbers of patients with neurological diseases are expected to increase along with the demographical changes and the environmental impact of neurological treatment should become a target for health policy, therefore. Positive effects have been demonstrated for the use of telemedicine by improving inpatient treatment in local community hospitals or avoiding hospital admissions via monitoring of complex diseases in outpatient settings. We discuss the potentials of telemedicine in the field of in- and outpatient neurological care as well as the need for more scientific evaluation on environmental impacts.

  18. Avoiding compressor surge during emergency shutdown hybridturbine systems

    Energy Technology Data Exchange (ETDEWEB)

    Pezzini, Paolo [University of Genova, Italy; Tucker, David [U.S. DOE; Traverso, Alberto [University of Genova, Italy

    2013-01-01

    A new emergency shutdown procedure for a direct-fired fuel cell turbine hybrid power system was evaluated using a hardware-based simulation of an integrated gasifier/fuel cell/turbine hybrid cycle (IGFC), implemented through the Hybrid Performance (Hyper) project at the National Energy Technology Laboratory, U.S. Department of Energy (NETL). The Hyper facility is designed to explore dynamic operation of hybrid systems and quantitatively characterize such transient behavior. It is possible to model, test, and evaluate the effects of different parameters on the design and operation of a gasifier/fuel cell/gas turbine hybrid system and provide a means of quantifying risk mitigation strategies. An open-loop system analysis regarding the dynamic effect of bleed air, cold air bypass, and load bank is presented in order to evaluate the combination of these three main actuators during emergency shutdown. In the previous Hybrid control system architecture, catastrophic compressor failures were observed when the fuel and load bank were cut off during emergency shutdown strategy. Improvements were achieved using a nonlinear fuel valve ramp down when the load bank was not operating. Experiments in load bank operation show compressor surge and stall after emergency shutdown activation. The difficulties in finding an optimal compressor and cathode mass flow for mitigation of surge and stall using these actuators are illustrated.

  19. Hydrothermal systems as environments for the emergence of life.

    Science.gov (United States)

    Shock, E L

    1996-01-01

    Analysis of the chemical disequilibrium provided by the mixing of hydrothermal fluids and seawater in present-day systems indicates that organic synthesis from CO2 or carbonic acid is thermodynamically favoured in the conditions in which hyperthermophilic microorganisms are known to live. These organisms lower the Gibbs free energy of the chemical mixture by synthesizing many of the components of their cells. Primary productivity is enormous in hydrothermal systems because it depends only on catalysis of thermodynamically favourable, exergonic reactions. It follows that hydrothermal systems may be the most favourable environments for life on Earth. This fact makes hydrothermal systems logical candidates for the location of the emergence of life, a speculation that is supported by genetic evidence that modern hyperthermophilic organisms are closer to a common ancestor than any other forms of life. The presence of hydrothermal systems on the early Earth would correspond to the presence of liquid water. Evidence that hydrothermal systems existed early in the history of Mars raises the possibility that life may have emerged on Mars as well. Redox reactions between water and rock establish the potential for organic synthesis in and around hydrothermal systems. Therefore, the single most important parameter for modelling the geochemical emergence of life on the early Earth or Mars is the composition of the rock which hosts the hydrothermal system.

  20. Designing of an emergency call system for traffic accidents

    Directory of Open Access Journals (Sweden)

    Ziya Ekşi

    2013-06-01

    Full Text Available In our country, many people have been seriously injured or died in traffic accidents. Fatal accidents often occur because of not complying with traffic rules or carelessness. Except these driver mistakes, heavy injuries can result in deaths because of emergency aid teams failing to arrive to accident scene in time. In this study, an accident emergency call system is designed to help injured people's treatment as soon as possible by notifying emercengy team automatically in accidents. The designed system sends messages, including information such as vehicle location, exploding airbag number, vehicle model, age and registration plate, to emergency aid team using GPS module at the moment of crashed vehicle's airbag explosion.

  1. Ethical practice in Telehealth and Telemedicine.

    Science.gov (United States)

    Chaet, Danielle; Clearfield, Ron; Sabin, James E; Skimming, Kathryn

    2017-10-01

    This article summarizes the report of the American Medical Association's (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and telemedicine. Through its reports and recommendations, CEJA is responsible for maintaining and updating the AMA Code of Medical Ethics (Code). CEJA reports are developed through an iterative process of deliberation with input from multiple stakeholders; report recommendations, once adopted by the AMA House of Delegates, become ethics policy of the AMA and are issued as Opinions in the Code. To provide enduring guidance for the medical profession as a whole, CEJA strives to articulate expectations for conduct that are as independent of specific technologies or models of practice as possible. The present report, developed at the request of the House of Delegates, provides broad guidance for ethical conduct relating to key issues in telehealth/telemedicine. The report and recommendations were debated at meetings of the House in June and November 2015; recommendations were adopted in June 2016 and published as Opinion E-1.2.12, Ethical Practice in Telemedicine, in November 2016. A summary of the key points of the recommendations can be found in Appendix A (online), and the full text of the opinion can be found in Appendix B (online).

  2. Telemedicine and Plastic Surgery: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Denis Souto Valente

    2015-01-01

    Full Text Available Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions.

  3. Resource Document: Coordination of Pediatric Emergency Care in EMS Systems.

    Science.gov (United States)

    Remick, Katherine; Gross, Toni; Adelgais, Kathleen; Shah, Manish I; Leonard, Julie C; Gausche-Hill, Marianne

    2017-01-01

    Citing numerous pediatric-specific deficiencies within Emergency Medical Services (EMS) systems, the Institute of Medicine (IOM) recommended that EMS systems appoint a pediatric emergency care coordinator (PECC) to provide oversight of EMS activities related to care of children, to promote the integration of pediatric elements into day-to-day services as well as local and/or regional disaster planning, and to promote pediatric education across all levels of EMS providers. A systematic review of the literature was undertaken to describe the evidence for pediatric coordination across the emergency care continuum. The search strategy was developed by the investigators in consultation with a medical librarian and conducted in OVID, Medline, PubMed, Embase, Web of Science, and CINAHL databases from January 1, 1983 to January 1, 2016. All research articles that measured a patient-related or system-related outcome associated with pediatric coordination in the setting of emergency care, trauma, or disaster were included. Opinion articles, commentaries, and letters to the editors were excluded. Three investigators independently screened citations in a hierarchical manner and abstracted data. Of 149 identified titles, nine were included in the systematic review. The nine articles included one interventional study, five surveys, and three consensus documents. All articles favored the presence of pediatric coordination. The interventional study demonstrated improved documentation, clinical management, and staff awareness of high priority pediatric areas. The current literature supports the identification of pediatric coordination to facilitate the optimal care of children within EMS systems. In order for EMS systems to provide high quality care to children, pediatric components must be integrated into all aspects of care including day-to-day operations, policies, protocols, available equipment and medications, quality improvement efforts, and disaster planning. This systematic

  4. The State of Emergency Medical Services (EMS) Systems in Africa.

    Science.gov (United States)

    Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

    2017-06-01

    Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

  5. Research on Innovation Systems and Social Inclusion in Emerging ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Research on Innovation Systems and Social Inclusion in Emerging Economies and Beyond: RISSI at BRICS+. How can science, technology, and innovation contribute to poverty reduction and inclusive development, especially in Brazil, Russia, India, China, and South Africa, otherwise known as the BRICS countries?

  6. Challenges in designing interactive systems for emergency response

    DEFF Research Database (Denmark)

    Kristensen, Margit; Kyng, Morten; Nielsen, Esben Toftdahl

    2007-01-01

    This paper presents research on participatory design of interactive systems for emergency response. We present the work by going through the design method with a focus on the new elements that we developed for the participatory design toolkit, in particular we emphasize the use of challenges and ...... and maintenance of a situational overview....

  7. Low compliance with a validated system for emergency department triage

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Jensen, Nanna Martin; Maaløe, Rikke

    2011-01-01

    a "primary criterion" or a BEWS = 5 are presumed to be critically ill or severely injured and should be received by a multidisciplinary team, termed the Emergency Call (EC) and Trauma Call (TC), respectively. The aim of this study was to examine compliance with this triage system at Bispebjerg Hospital....

  8. Low compliance with a validated system for emergency department triage

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Jensen, Nanna Martin; Maaløe, Rikke

    2011-01-01

    a "primary criterion" or a BEWS ≥ 5 are presumed to be critically ill or severely injured and should be received by a multidisciplinary team, termed the Emergency Call (EC) and Trauma Call (TC), respectively. The aim of this study was to examine compliance with this triage system at Bispebjerg Hospital....

  9. An Experimental Study of the Emergence of Human Communication Systems

    Science.gov (United States)

    Galantucci, Bruno

    2005-01-01

    The emergence of human communication systems is typically investigated via 2 approaches with complementary strengths and weaknesses: naturalistic studies and computer simulations. This study was conducted with a method that combines these approaches. Pairs of participants played video games requiring communication. Members of a pair were…

  10. Attitudes Toward Telemedicine in Urban, Rural, and Highly Rural Communities.

    Science.gov (United States)

    Call, Vaughn R A; Erickson, Lance D; Dailey, Nancy K; Hicken, Bret L; Rupper, Randall; Yorgason, Jeremy B; Bair, Byron

    2015-08-01

    The rate of telemedicine adoption using interactive video between patient and provider has not met expectations. Technology, regulations, and physician buy-in are cited reasons, but patient acceptance has not received much consideration. We examine attitudes regarding telemedicine to better understand the subjective definitions of its acceptability and utility that shape patients' willingness to use telemedicine. Using the Montana Health Matters study (a random, statewide survey [n=3,512]), we use latent class analysis to identify groups with similar patterns of attitudes toward telemedicine followed by multinomial logistic regression to estimate predictors of group membership. Although only 5% are amenable to telemedicine regardless of circumstance, 23% would be comfortable if it could be convenient, whereas 29% would be situationally amenable but uncomfortable using telemedicine. Still, a substantial percentage (43%) is unequivocally averse to telemedicine despite the inconvenience of in-person visits. Educational attainment, prior Internet use, and rural residence are main predictors that increase the likelihood of being in an amenable group. From the patient's perspective, the advantages of reduced travel and convenience are recognized, but questions remain about the equivalence to physician visits. Many people are averse to telemedicine, indicating a perceived incompatibility with patient needs. Only 1.7% of the respondents reported using telemedicine in the previous year; about half were veterans. Hence, few have used telemedicine, and key innovation adoption criteria-trialability and observability-are low. Increased attention to public awareness in the adoption process is needed to increase willingness to embrace telemedicine as a convenient way to obtain quality healthcare services.

  11. Telemedicine Spending by Medicare: A Snapshot from 2012.

    Science.gov (United States)

    Neufeld, Jonathan D; Doarn, Charles R

    2015-08-01

    Medicare has been one of the principal payers for healthcare services delivered via telemedicine to rural beneficiaries since 1997. Early projections of the cost of covering telemedicine for Medicare beneficiaries made legislators cautious to take on such a large obligation, but subsequent reports showed actual expenditures to be far below early estimates. As interest in expanding Medicare's coverage for services delivered via telemedicine grows, further examination of the extent of telemedicine use within the Medicare program and the costs associated with this use is warranted. Medicare claims data from 2012 were examined. All valid claims associated with a Current Procedural Terminology code and modifier indicative of delivery via telemedicine were extracted and linked to the state of origin using carrier codes. Claims were summarized by clinical procedure code, medical specialty, and state. Expenditures were also calculated on a per member per month basis by state to compare the relative penetration of telemedicine among states. Total Medicare telemedicine-related expenditures in 2012 were found to be a little over $5 million, 65.2% of the total allowed telemedicine-related charges of $7.7 million. This figure represents an expenditure of approximately $0.09 annually per Medicare enrollee, or about three-quarters of a penny per member per month. Wide variation was found among states in telemedicine use. Mental health services and service providers accounted for nearly 70% of total telemedicine-related professional fees, and originating site facility fee claims accounted for only 28% of the total number of paid claims. Medicare spending on telemedicine is largely for mental health services and represents only a tiny fraction of overall Medicare spending. Adoption of telehealth is driven by multiple factors beyond need and rurality.

  12. Conditions for success in introducing telemedicine in diabetes foot care: a qualitative inquiry.

    Science.gov (United States)

    Kolltveit, Beate-Christin Hope; Gjengedal, Eva; Graue, Marit; Iversen, Marjolein M; Thorne, Sally; Kirkevold, Marit

    2017-01-01

    The uptake of various telehealth technologies to deliver health care services at a distance is expanding; however more knowledge is needed to help understand vital components for success in using telehealth in different work settings. This study was part of a larger trial designed to investigate the effect of an interactive telemedicine platform. The platform consisted of a web based ulcer record linked to a mobile phone to provide care for people with diabetic foot ulcers in outpatient clinics in specialist hospital care in collaboration with primary health care. The aim of this qualitative study was to identify perceptions of health care professionals in different working settings with respect to facilitators to engagement and participation in the application of telemedicine. Ten focus groups were conducted with health care professionals and leaders in Western Norway between January 2014 and June 2015 using Interpretive Description, an applied qualitative research strategy. Four key conditions for success in using telemedicine as a new technology in diabetes foot care were identified: technology and training that were user-friendly; having a telemedicine champion in the work setting; the support of committed and responsible leaders; and effective communication channels at the organizational level. Successful larger scale implementation of telemedicine must involve consideration of complex contextual and organizational factors associated with different work settings. This form of new care technology in diabetes foot care often involves health care professionals working across different settings with different management systems and organizational cultures. Therefore, attention to the distinct needs of each staff group seems an essential condition for effective implementation.

  13. [Telemedicine in Bolivia: RAFT-Altiplano project, experiences, future prospects, and recommendations].

    Science.gov (United States)

    Vargas, Alejandro; Ugalde, Miguel; Vargas, Reynaldo; Narvaez, Ramiro; Geissbuhler, Antoine

    2014-01-01

    The objective of the RAFT-Altiplano project (RAFT: Réseau en Afrique Francophone pour la Télémédecine, or African Francophone Telemedicine Network) is to evaluate the viability, potential, and risks of implementing and developing a telemedicine network in the context of a developing country-specifically, the Altiplano region of Bolivia-to improve access to medical care and continuing education in a rural area. The activities described in this report took place between 2011 and 2013. Digital telemedicine equipment was donated to the health centers and a Microsoft®-based platform capable of integration with other technologies (using standardized formats) was developed to manage documents and clinical content electronically. Health professionals were trained in teleconsultation and the teleconsultation workflow was designed. The tele-education system used is Dudal, which requires only a small bandwidth. After three years of implementation, an organized working structure of teleconsultation and tele-education tools, adapted to the Latin American context, is now in place and connections have been established with hospitals, institutions, and health centers. The project has improved access to specialized medical care in remote health centers and third-level hospitals in urban areas, and it has become the foundation for development of the national project "TeleSalud for Bolivia" promoted by the Ministry of Health, which involves use of the new Bolivian satellite, Túpac Katari. It is viable to develop and set up telemedicine tools to serve the population in remote regions of Bolivia when they are made available to government and municipal health institutions and communication between them and the health centers takes place in a coordinated manner. The sharing of experiences, challenges, and risks encountered is very useful in designing and implementing the telemedicine project "TeleSalud for Bolivia" on a national scale.

  14. Model Based Mission Assurance: Emerging Opportunities for Robotic Systems

    Science.gov (United States)

    Evans, John W.; DiVenti, Tony

    2016-01-01

    The emergence of Model Based Systems Engineering (MBSE) in a Model Based Engineering framework has created new opportunities to improve effectiveness and efficiencies across the assurance functions. The MBSE environment supports not only system architecture development, but provides for support of Systems Safety, Reliability and Risk Analysis concurrently in the same framework. Linking to detailed design will further improve assurance capabilities to support failures avoidance and mitigation in flight systems. This also is leading new assurance functions including model assurance and management of uncertainty in the modeling environment. Further, the assurance cases, a structured hierarchal argument or model, are emerging as a basis for supporting a comprehensive viewpoint in which to support Model Based Mission Assurance (MBMA).

  15. Meaning Emergence in the Ecology of Dialogical Systems

    DEFF Research Database (Denmark)

    Trasmundi, S. B.; Steffensen, S. V.

    2016-01-01

    This article is an empirically based theoretical contribution to the investigation of meaningmaking in the ecology of human interaction and interactivity. It presents an ecological perspective on meaning-making that pivots on how agents pick up information directly in their organism-environment-system...... Analysis to investigate how the agents oscillate between being a multi-agent-system with shared, tightly coordinated agency and a loosely coupled dialogical system where the individuals bring forth an understanding based on their professional backgrounds and expertise. On this view, an ecological approach...... to meaning-making takes a starting point in how local interaction is constrained by previous events, emergent affordances in the environment, and real-time inter-bodily dynamics. Accordingly, meaning-making is seen as a joint activity emerging from the system's coordinative actions rather than as a result...

  16. Chemical systems, chemical contiguity and the emergence of life.

    Science.gov (United States)

    Kee, Terrence P; Monnard, Pierre-Alain

    2017-01-01

    Charting the emergence of living cells from inanimate matter remains an intensely challenging scientific problem. The complexity of the biochemical machinery of cells with its exquisite intricacies hints at cells being the product of a long evolutionary process. Research on the emergence of life has long been focusing on specific, well-defined problems related to one aspect of cellular make-up, such as the formation of membranes or the build-up of information/catalytic apparatus. This approach is being gradually replaced by a more "systemic" approach that privileges processes inherent to complex chemical systems over specific isolated functional apparatuses. We will summarize the recent advances in system chemistry and show that chemical systems in the geochemical context imply a form of chemical contiguity in the syntheses of the various molecules that precede modern biomolecules.

  17. ["Baltic Declaration"--telemedicine and mHealth as support for clinical processes in cardiology. The opinion of the Committee of Informatics and Telemedicine of the Polish Society of Cardiology and Telemedicine Clinical Sciences Committee of the PAS].

    Science.gov (United States)

    Piotrowicz, Ryszard; Grabowski, Marcin; Balsam, Paweł; Kołtowski, Łukasz; Kozierkiewicz, Adam; Zajdel, Justyna; Piotrowicz, Ewa; Kowalski, Oskar; Mitkowski, Przemysław; Kaźmierczak, Jarosław; Kalarus, Zbigniew; Opolski, Grzegorz

    2015-01-01

    For several decades we have observed the development of data transmission technology on an unprecedented scale. With the development of such technology there has also appeared concepts on the use of these solutions in health care systems. Over the last decade telemedicine has been joined by the concept of mHealth, which is based on mobile devices mainly to monitor selected biomedical parameters. On 10 October 2014, during the conference Baltic Electrocardiology Autumn - Telemedicine and Arrhythmia (BEATA), a debate was held with the participation of physicians, politicians, businessmen, and representatives of the Government (Ministry of Health, National Health Fund, Social Insurance Institution) concerning the use of telecardiology services in daily practice. During the meeting issues were discussed such as: telemedicine solutions available throughout the world, analysis of their effectiveness based on clinical trials, funding opportunities, their legal status, and the development perspectives of telecardiology in Poland. The result of the meeting was a document called the "Baltic Declaration". The declaration is a call for proven and profitable technologies to be introduced into clinical practice. The declaration also indicates that the variety of available technological solutions are merely tools, and the utility of such tools stems not only from their modernity, but also primarily from matching their functionality to the features of the health interventions that are to be improved.

  18. A "matter of communication": A new classification to compare and evaluate telehealth and telemedicine interventions and understand their effectiveness as a communication process.

    Science.gov (United States)

    Colucci, Massimiliano; Baldo, Vincenzo; Baldovin, Tatjana; Bertoncello, Chiara

    2017-12-01

    This article attempts to define functions and applications of telemedicine and telehealth in order to achieve a simplified and comprehensive taxonomy. This may be used as a tool to evaluate their efficacy and to address health policies from the perspective of the centrality of information in the healthcare. Starting from a lexical frame, telemedicine or telehealth is conceived as a communication means and their action as a communication process. As a performance, the communication is related to the health outcome. Three functions ( telemetry, telephasis, and telepraxis) and nine applications are identified. Understanding the mechanisms of telemedicine and telehealth effectiveness is crucial for a value-driven healthcare system. This new classification-focusing on the end effect of telemedicine and telehealth and on the type of interactions between involved actors-moves toward a new and simplified methodology to compare different studies and practices, design future researches, classify new technologies and guide their development, and finally address health policies and the healthcare provision.

  19. CAPITALISM EMERGING ERA TAX SYSTEMS OF THE EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Tsokova Viktoria Aleksandrovna

    2013-04-01

    Full Text Available Three phases should be distinguished in the development of tax systems: I. The Ancient World and Middle Ages (from the IV - III centuries. BC. till. XVII - XVIII centuries AD. II. The new time (from the XVII - XVIII centuries till the end of XIX century. - the era of the emerging capitalism. III. Modern History (from the XX century and up to the present time. The capitalism emerging era scientific ideas and tax systems research relevance (importance is caused by the emergence of the main distinct characteristics of any state, that is by the permanently increasing demand of that institution for money. This fact, in its turn, contributes to the formation of the state tax system, and, of course, the evolution of scientific views on taxation. Nowadays, some theoretical ideas in the field of taxation, clarifying the nature and the role of taxes in the European countries budget formation begin to appear in Europe, especially in the UK. The development of tax systems in England, France and Germany have been analyzed; and , basing on the dialectical, historical and logical approaches, and the method of scientific abstraction, the authors identify the following common features of the capitalism emerging era tax systems in the European countries: the taxation on a regular (permanent basis, the expansion of the tax-payers range – all citizens of the state are becoming tax payers, the introduction of the income tax and the abolishment of the revenue leasing – creation of government agencies system responsible for the administration of taxes, to establishing and collecting taxes only with the Parliament approval and permission. Classical theoretical and practical approaches to creation of tax systems of the states have been formulated in Europe in the era of nascent capitalism and they haven’t lost the relevance yet.

  20. Telemedicine Can Replace the Neurologist on a Mobile Stroke Unit.

    Science.gov (United States)

    Wu, Tzu-Ching; Parker, Stephanie A; Jagolino, Amanda; Yamal, Jose-Miguel; Bowry, Ritvij; Thomas, Abraham; Yu, Amy; Grotta, James C

    2017-02-01

    The BEST-MSU study (Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit) is a comparative effectiveness trial in patients randomized to mobile stroke unit or standard management. A substudy tested interrater agreement for tissue-type plasminogen activator eligibility between a telemedicine vascular neurologist and onboard vascular neurologist. On scene, both the telemedicine vascular neurologist and onboard vascular neurologist independently evaluated the patient, documenting their tissue-type plasminogen activator treatment decision, National Institutes of Health Stroke Scale score, and computed tomographic interpretation. Agreement was determined using Cohen κ statistic. Telemedicine-related technical failures that impeded remote assessment were recorded. Simultaneous and independent telemedicine vascular neurologist and onboard vascular neurologist assessment was attempted in 174 patients. In 4 patients (2%), the telemedicine vascular neurologist could not make a decision because of technical problems. The telemedicine vascular neurologist agreed with the onboard vascular neurologist on 88% of evaluations (κ=0.73). Remote telemedicine vascular neurologist assessment is reliable and accurate, supporting either telemedicine vascular neurologist or onboard vascular neurologist assessment on our mobile stroke unit. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02190500. © 2017 American Heart Association, Inc.

  1. Informed consent for telemedicine in South Africa: A survey of ...

    African Journals Online (AJOL)

    2013-11-02

    Nov 2, 2013 ... for written informed consent.[15] Telemedicine is no different, with written informed consent typically being obtained for more complex procedures, such as robotic assisted ultrasonography or even robotic surgery.[16-18] But is this required for all forms of telemedicine? In several specialities, there is enough ...

  2. Why is telemedicine a challenge to the regulators? | Mars | South ...

    African Journals Online (AJOL)

    Regulators feel that telemedicine presents challenges. In part this is because of the assumption that telemedicine is new and unproven, and must therefore be regulated in order to protect the patient. Regulation requires clear and careful definition of what is to be regulated. The Health Professions Council of South Africa's ...

  3. Informed consent for telemedicine in South Africa: A survey of ...

    African Journals Online (AJOL)

    Informed consent for telemedicine in South Africa: A survey of consent practices among healthcare professionals in Durban, KwaZulu-Natal. C Jack, M Mars. Abstract. Background. The Health Professions Council of South Africa is drafting guidelines to regulate the practice of telemedicine. These emphasise the need for ...

  4. Is there a contradiction between telemedicine and business?

    Science.gov (United States)

    Lievens, Frank; Jordanova, Malina

    2004-01-01

    Is there a contradiction between telemedicine and business? The driving forces in the telemedicine market are: competition within the health-care industry, newly developed cheap information technology (especially the Internet) and 21st-century health-care consumers, with their expectations of free choice and a high level of health-care. The market has four segments (citizens, patients, professionals and employees) and the boundaries between these segments are blurred. The telemedicine market is obviously growing, but it is still unstructured, fractured and disorganized. The telemedicine market needs a meeting place where the status of telemedicine and telecare can be reviewed. This would be a place in which to explore new ways to improve the efficiency of health-care services and a forum in which to draw a roadmap for future developments. One such place is the International Trade Event and Conference for eHealth, Telemedicine and Health ICT, Med-e-Tel. At the 2004 event, there were 32 exhibitors from 23 countries and over 400 industry and medical participants. A survey of participants showed that the event was judged to be a success. There is no conflict between telemedicine and business. On the contrary, telemedicine is a promising area of business development.

  5. Emergent hydrodynamics in integrable quantum systems out of equilibrium

    CERN Document Server

    Castro-Alvaredo, Olalla A; Yoshimura, Takato

    2016-01-01

    Understanding the general principles underlying strongly interacting quantum states out of equilibrium is one of the most important tasks of current theoretical physics. With experiments now able to access the intricate dynamics of many-body quantum systems, it is paramount to develop powerful and widely applicable methods that encode the emergent physics. Up to now, the strong dichotomy observed between integrable and non-integrable evolutions made an overarching theory difficult to build, especially for transport phenomena where space-time profiles show drastically different behaviours. We present a novel framework for studying transport in integrable systems: that of emergent hydrodynamics with infinitely-many conservation laws. This method bridges the conceptual gap between integrable and non-integrable quantum dynamics. We apply it to the description of energy transport between heat baths in interacting integrable systems. We provide for the first time a full description of the current-carrying non-equil...

  6. Control system of roll crushes in emergency situations

    Science.gov (United States)

    Nikitin, A. G.; Tagiltsev-Galeta, K. V.; Chaynikov, K. A.

    2017-09-01

    The system of emergency control of a roll crusher is developed, which allows the hardness of the crushed material to be evaluated indirectly estimating the current strength of the unit, or directly by swing of the deflecting the crusher jaw, and the pieces with the increased hardness to be recrushed, increasing compression, reducing the motor rotation frequency. This system reduces the number of emergencies and provides less downtime for equipment in the event of an accident than crushers using conventional safety elements: toggle plates and restraining spring or hydraulic fuses. Besides, this system is extensible, i.e. it does not interfere with the inclusion of additional devices (for example, mechanical breakers such as toggle plates), sensors (for example, angle protractor to improve the accuracy of measurements). With the combined use of direct and indirect evaluation of the crusher condition the accuracy and efficiency of the crusher control increases improving the reliability of a crushing unit as a whole.

  7. Pressure transient analysis of CANDU 6 emergency core cooling system

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Sub; Oh, Kwang Suk; Kim, Sun Chul; Lee, Byung Ju; Kim, Do Hyun [Korea Atomic Energy Research Institute, Daeduk (Korea, Republic of)

    1996-06-01

    Waterhammer transient loadings are major considerations in the CANDU 6 Emergency Core Cooling System (ECCS) design. The ECCS is a special safety system. It acts following a loss of coolant accident (LOCA) to refill the primary heat transport system and to remove residual and decay heat from the reactor core, thus, limiting fuel damage. Emergency coolant injection to the primary heat transport system is provided in three stage. In the high pressure (HP) injection stage, water pressurized by compressed gas is injected from the ECC accumulator tanks into the PHT system. In the medium pressure (MP) injection stage, the ECC pumps take water from the dousing tank and discharge to the reactor headers. In the low pressure (LP) stage, the ECC pumps recirculate the H{sub 2}O-D{sub 2}O mixture collected in the basement of the reactor building through heat exchangers back into the PHT system. Six cases for HP and MP injection have been considered for the design of the piping and supports for the ECC system. The pressure transient behavior for the ECC system for all the identified scenarios is predicted by a computer program PTRAN which is based on the method of characteristics. The highest maximum transient pressure for each of six cases is lower than design pressure. The maximum differential pressure for each cases will be used in piping stress analysis to determine the adequacy of the system piping support design. 6 tabs., 8 figs., 13 refs. (Author) .new.

  8. Ecological Systems as Complex Systems: Challenges for an Emerging Science

    Directory of Open Access Journals (Sweden)

    Lael Parrott

    2010-03-01

    Full Text Available Complex systems science has contributed to our understanding of ecology in important areas such as food webs, patch dynamics and population fluctuations. This has been achieved through the use of simple measures that can capture the difference between order and disorder and simple models with local interactions that can generate surprising behaviour at larger scales. However, close examination reveals that commonly applied definitions of complexity fail to accommodate some key features of ecological systems, a fact that will limit the contribution of complex systems science to ecology. We highlight these features of ecological complexity—such as diversity, cross-scale interactions, memory and environmental variability—that continue to challenge classical complex systems science. Further advances in these areas will be necessary before complex systems science can be widely applied to understand the dynamics of ecological systems.

  9. 33 CFR 150.519 - What are the requirements for emergency lighting and power systems?

    Science.gov (United States)

    2010-07-01

    ... emergency lighting and power systems? 150.519 Section 150.519 Navigation and Navigable Waters COAST GUARD... Specialty Equipment Emergency Lighting and Power Systems § 150.519 What are the requirements for emergency lighting and power systems? (a) The operator must test and inspect the emergency lighting and power systems...

  10. Recommendations for implementing telemedicine in the developing world.

    Science.gov (United States)

    Alajmi, Dana; Almansour, Shaima; Househ, Mowafa S

    2013-01-01

    Telemedicine is a tool used to deliver health care from a distance. Developing countries can benefit from telemedicine because these countries face such issues as a lack of specialists and medical infrastructure. Telemedicine in the developing world can offer solutions to healthcare access for people in rural areas, reduce healthcare costs, and possibly improve healthcare quality. A major benefit for patients is that they will be more involved in maintaining their health without the constant need to visit healthcare centers. The purpose of this paper is to provide solutions and recommendations for the implementation of telemedicine in the developing world. A comprehensive search of both academic and gray literature was conducted in September 2012. The results show that there are potential benefits of and challenges in the implementation of telemedicine in developing countries. How to overcome the key challenges related to financial issues, acceptance, health infrastructure, and legal and privacy issues is discussed.

  11. Emerging Trends in Computing, Informatics, Systems Sciences, and Engineering

    CERN Document Server

    Elleithy, Khaled

    2013-01-01

    Emerging Trends in Computing, Informatics, Systems Sciences, and Engineering includes a set of rigorously reviewed world-class manuscripts addressing and detailing state-of-the-art research projects in the areas of  Industrial Electronics, Technology & Automation, Telecommunications and Networking, Systems, Computing Sciences and Software Engineering, Engineering Education, Instructional Technology, Assessment, and E-learning. This book includes the proceedings of the International Joint Conferences on Computer, Information, and Systems Sciences, and Engineering (CISSE 2010). The proceedings are a set of rigorously reviewed world-class manuscripts presenting the state of international practice in Innovative Algorithms and Techniques in Automation, Industrial Electronics and Telecommunications.

  12. Challenges in telemedicine and eHealth: lessons learned from 20 years with telemedicine in Tromsø.

    Science.gov (United States)

    Hartvigsen, Gunnar; Johansen, Monika A; Hasvold, Per; Bellika, Johan Gustav; Arsand, Eirik; Arild, Eli; Gammon, Deede; Pettersen, Sture; Pedersen, Steinar

    2007-01-01

    The Norwegian Centre for Telemedicine (NST) has, over the past two decades, contributed to the development and implementation of telemedicine and ehealth services in Norway. From 2002, NST has been a WHO Collaboration Center for telemedicine. In August 1996, Norway became the first country to implement an official telemedicine fee schedule making telemedicine services reimbursable by the national health insurer. Telemedicine is widely used in Northern Norway. Since the late 1980's, the University Hospital of North-Norway has experience in the following areas: teleradiology, telepathology, teledermatology, teleotorhinolaryngology (remote endoscopy), remote gastroscopy, tele-echocardiography, remote transmission of ECGs, telepsychiatry, teleophthalmology, teledialysis, teleemergency medicine, teleoncology, telecare, telegeriatric, teledentistry, maritime telemedicine, referrals and discharge letters, electronic delivery of laboratory results and distant teaching for healthcare personnel and patients. Based on the result achieved, the health authority in North-Norway plans to implement several large-scale telemedicine services: Teleradiology (incl. solutions for neurosurgery, orthopedic, different kinds of surgery, nuclear medicine, acute traumatic and oncology), digital communication and integration of patient data, and distant education. In addition, the following services will also be considered for large-scale implementation: teledialysis, prehospital thrombolysis, telepsychiatry, teledermatology. Last in line for implementation are: pediatric, district medical center (DMS), teleophthalmology and ear-nose-throat (ENT).

  13. Content Aware Burst Assembly - Supporting Telesurgery and Telemedicine in Optical Burst Switching Networks

    Directory of Open Access Journals (Sweden)

    Henry Orosco

    2010-08-01

    Full Text Available The emerging Telemedicine and Telesurgery technologies allow patients to share medical experts remotely through communication networks. However, network bandwidth, network latency and jitter (variation of latency, are the obstacles to the widespread use of this technology remotely. Optical Burst Switching (OBS networks greatly expand network bandwidth in existing network infrastructure by utilizing multiple DWDM channels within a single fiber, enabling high bandwidth applications. However, the burst assembly process in OBS networks introduces latency and jitter, making it unsuitable for high bandwidth, latency sensitive applications such as telesurgery and telemedicine. In this paper, we propose a content aware burst assembly scheme which dynamically adjusts the burst assembly parameters based on the content being assembled. The proposed content aware burst assembly minimizes the latency and jitter within a video frame, as well as across the left-view and right-view frames for 3D vision generation. Simulation results have shown that the proposed scheme can effectively reduce the latency and jitter experienced by video streams, making OBS a promising candidate for supporting telesurgery and telemedicine applications.

  14. Telebation: next-generation telemedicine in remote airway management using current wireless technologies.

    Science.gov (United States)

    Mosier, Jarrod; Joseph, Bellal; Sakles, John C

    2013-02-01

    Since the first remote intubation with telemedicine guidance, wireless technology has advanced to enable more portable methods of telemedicine involvement in remote airway management. Three voice over Internet protocol (VoIP) services were evaluated for quality of image transmitted, data lag, and audio quality with remotely observed and assisted intubations in an academic emergency department. The VoIP clients evaluated were Apple (Cupertino, CA) FaceTime(®), Skype™ (a division of Microsoft, Luxembourg City, Luxembourg), and Tango(®) (TangoMe, Palo Alto, CA). Each client was tested over a Wi-Fi network as well as cellular third generation (3G) (Skype and Tango). All three VoIP clients provided acceptable image and audio quality. There is a significant data lag in image transmission and quality when VoIP clients are used over cellular broadband (3G) compared with Wi-Fi. Portable remote telemedicine guidance is possible with newer technology devices such as a smartphone or tablet, as well as VoIP clients used over Wi-Fi or cellular broadband.

  15. Research on the Emergence Modeling of Equipment System

    Directory of Open Access Journals (Sweden)

    He Xin-Hua

    2017-01-01

    Full Text Available Under the conditions of information, the network-centric system and the confrontation in the system has developed into a major combat style. But the traditional line of sexual assessment method is difficult to accurately assess the information equipment system combat capability. Therefore, this paper studies the effective evaluation method of the operational capability of the information equipment system from the perspective of emerge. Based on the simulation modeling and evaluation method, building the capability model of the weapon equipment system to evaluate the operational capability of the information weapon weaponry equipment. Through the example analysis, the validity of the simulation model and the practicability of the evaluation system is analyzed by analyzing the examples.

  16. Evaluation of a Telemedicine System for the Transmission of Morpho/Immunological Data Aiming at the Inclusion of Patients in a Therapeutic Trial

    Directory of Open Access Journals (Sweden)

    Jean-François Lesesve

    2009-01-01

    Full Text Available Due to their high levels of achievement and efficiency, image digitalization and teletransmission tools are more and more frequently used. Applied to cellular haematology, these tools often contribute to diagnosis confrontation, sometimes within the framework of therapeutic trials. We present one of the first approaches of the use of telehaematology for the inclusion of patients in the GOELAMS chronic lymphocytic leukaemia 98 trial. The advantages were (1 the creation of a unique, protected, stable data bank that could be remotely consulted, (2 the use of digitized pictures which made expertise on identical documents possible, (3 the facility of computer exchanges between experts, in terms of reception as well as replying time delays. We were able to set out new standards of image sampling for CLL, solve the semantic divergences, and point out interobserver variability as regards morphology. The limiting factors were the important need for expert investment, but they more importantly concerned the first line morphologists who should benefit from adequate tools, in terms of computer equipment as well as members of staff, so as to apprehend this second reading system as a quality control procedure.

  17. Federal Emergency Management Information System (FEMIS) Installation Guide for FEMIS Version 1.5

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, Robert A.(BATTELLE (PACIFIC NW LAB)); Carter, Richard J.(BATTELLE (PACIFIC NW LAB)); Downing, Timothy R.(BATTELLE (PACIFIC NW LAB)); Dunkle, Julie R.(BATTELLE (PACIFIC NW LAB)); Homer, Brian J.(BATTELLE (PACIFIC NW LAB)); Johnson, Daniel M.(BATTELLE (PACIFIC NW LAB)); Johnson, Ranata L.(BATTELLE (PACIFIC NW LAB)); Johnson, Sharon M.(BATTELLE (PACIFIC NW LAB)); Loveall, Robert M.(BATTELLE (PACIFIC NW LAB)); Ramos Jr., Juan (BATTELLE (PACIFIC NW LAB)); Stephan, Alex J.(BATTELLE (PACIFIC NW LAB)); Wood, Blanche M.(BATTELLE (PACIFIC NW LAB))

    2001-12-01

    The Federal Emergency Management System (FEMIS) is an emergency management planning and response tool. The FEMIS Installation Guide provides instructions for installing and configuring the FEMIS software package.

  18. Risk management: application of early warning systems to emergency plans

    Science.gov (United States)

    Garcia, C.; Sterlacchini, S.; Pasuto, A.; de Amicis, M.

    2009-04-01

    Warning System and emergency plans are two fundamental elements of risk management and governance, but unfortunately, most of the times, they are developed independently one from the other, as sequential steps not necessary linked. The main goal of this research is to develop a methodology for applying Early Warning Systems - Community Based to the emergency plan using the results of social surveys and quantitative risk assessment, taking into account the administrative structure and the planning system of the study area, as well as the legislative obligations of each entity involved in the risk governance and emergency management. Using a integrative scientific and social approach to natural hazards the research aim to contribute to fill the gap between scientists, policy makers, stakeholders and community. Initially applied in Comunità Montana Valtellina di Tirano, Italy, the methodology involves the application of two comprehensive surveys. The first is addressed to stakeholders (including policy makers, emergency managers, emergency volunteers, consultants and scientists) in order to determine their needs, points of view, concerns and constraints. The second survey is addressed specifically to local community to assess risk perception, awareness, needs, capacity and level of trust towards stakeholders, besides asking for their willingness to participate in future risk communication activities. The Early Warning System developed includes all the stages of the early warning process (hazard evaluation and forecasting; warning and dissemination and public response) and would be based on a multidisciplinary partnership that takes into account the different actors involved in the risk management in order to accomplish a more reliable and credible result, including an emergency plan specifically designed for each study area. After evaluating the results of the surveys, information and education campaigns will be developed with the objective of reducing vulnerability

  19. Relating Systems Thinking & Design 2013. Emerging Contexts for Systemic Design

    Directory of Open Access Journals (Sweden)

    Birger Sevaldson

    2013-08-01

    Full Text Available AHO – Oslo School of Architecture & Design, Norway, invites to the Relating Systems Thinking and Design to a free and open symposium over two days 9th-11th October 2013, with a preceding full day with diverse workshops and a subsequent special issue in FORMakademisk.

  20. Telemedicine and medical informatics in the multimedia super corridor: the Malaysian vision.

    Science.gov (United States)

    Abidi, S S; Goh, A; Yusoff, Z

    1998-01-01

    The practice of medicine, with its wide range of environmental conditions and complex dependencies, has long been used as a test bed for various advanced technologies. Telemedicine, as conceptualised within the Multimedia Super Corridor (MSC) context, is seen as the application of several relatively mature technologiesartificial intelligence (AI), multimedia communication and information systems (IS) amongst othersso as to benefit a large cross-section of the Malaysian population. We will discuss in general terms the Malaysian vision on the comprehensive MSC telemedicine solution, its functionality and associated operational conditions. In particular, this paper focuses on the conceptualisation of one key telemedical component i.e. the Lifetime Health Plan (LHP) system, which is eventually intended to be a distributed multi-module application for the periodic monitoring and generation of health-care advisories for upwards of 20 million Malaysians.

  1. 46 CFR 109.211 - Testing of emergency lighting and power systems.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Testing of emergency lighting and power systems. 109.211... emergency power system is tested at least once each week; (2) Each emergency generator is tested at least... emergency lighting and power systems is tested every six months under actual connected load for a period of...

  2. Telemedicine for Gestational Diabetes Mellitus (TeleGDM): A Mixed-Method Study Protocol of Effects of a Web-Based GDM Support System on Health Service Utilization, Maternal and Fetal Outcomes, Costs, and User Experience.

    Science.gov (United States)

    Rasekaba, Tshepo Mokuedi; Lim, Kwang; Blackberry, Irene; Gray, Kathleen; Furler, John

    2016-08-09

    Women with insulin-treated gestational diabetes mellitus (GDM) require close monitoring and support to manage their diabetes. Recent changes to the diagnostic criteria have implications for service provision stemming from increased prevalence, suggesting an increased burden on health services in the future. Telemedicine may augment usual care and mitigate service burdens without compromising clinical outcomes but evidence in GDM is limited. The Telemedicine for Gestational Diabetes Mellitus (TeleGDM) trial aims to explore the use of telemedicine in supporting care and management of women with GDM treated with insulin. The TeleGDM is a mixed-methods study comprising an exploratory randomized controlled trial (RCT) and a qualitative evaluation using semistructured interviews. It involves women with insulin-treated GDM who are up to 35 weeks gestation. Participating patients (n=100) are recruited face-to-face in outpatient GDM clinics at an outer metropolitan tertiary hospital with a culturally diverse catchment and a regional tertiary hospital. The second group of participants (n=8) comprises Credentialed Diabetes Educator Registered Nurses involved in routine care of the women with GDM at the participating clinics. The RCT involves use of a Web-based patient-controlled personal health record for GDM data sharing between patients and clinicians compared to usual care. Outcomes include service utilization, maternal and fetal outcomes (eg, glycemic control, 2nd and 3rd trimester fetal size, type of delivery, baby birth weight), diabetes self-efficacy, satisfaction, and costs. Semistructured interviews will be used to examine user experiences and acceptability of telemedicine. The trial recruitment is currently underway. Results are expected by the end of 2016 and will be reported in a follow-up paper. Innovative use of technology in supporting usual care delivery in women with GDM may facilitate timely access to GDM monitoring data and mitigate care burdens without

  3. 5G, an approach towards future telemedicine

    DEFF Research Database (Denmark)

    Anwar, Sadia; Prasad, Ramjee; Kumar, Ambuj

    The use of smartphones has been increasing rapidly and it is expected that in future most people will have a smartphone capable of high speed Internet connection. The capability of smartphones with high definition display, computation power and multitude of sensors made it an excellent candidate...... for telemedicine application. Telemedicine’s applications and high data medical information generally require high definition visuals and lower latency connection, in addition mobility and reliability. The next generation of wireless communication standard, known as 5G, will provide data speed in (Gigabit per...

  4. Barreras para la normalización de la telemedicina en un sistema de salud basado en la concertación de servicios Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts

    Directory of Open Access Journals (Sweden)

    Francesc Roig

    2011-10-01

    participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. Methods: We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. Results: The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (redefinition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. Conclusions: In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer.

  5. A secure mobile multimedia system to assist emergency response teams.

    Science.gov (United States)

    Belala, Yacine; Issa, Omneya; Gregoire, Jean-Charles; Wong, James

    2008-08-01

    Long wait times after injury and greater distances to travel between accident scenes and medical facilities contribute to increased, possibly unnecessary deaths. This paper describes a mobile emergency system aimed at reducing mortality by improving the readiness of hospital personnel, therefore allowing for more efficient treatment procedures to be performed when the victim arrives. The system is designed to provide a secure transmission of voice, medical data, and video in real-time over third-generation cellular networks. Test results obtained on a commercial network under real-life conditions demonstrate the ability to effectively transmit medical data over 3G networks, making them a viable option available to healthcare professionals.

  6. Emergency heat removal system for a nuclear reactor

    Science.gov (United States)

    Dunckel, Thomas L.

    1976-01-01

    A heat removal system for nuclear reactors serving as a supplement to an Emergency Core Cooling System (ECCS) during a Loss of Coolant Accident (LOCA) comprises a plurality of heat pipes having one end in heat transfer relationship with either the reactor pressure vessel, the core support grid structure or other in-core components and the opposite end located in heat transfer relationship with a heat exchanger having heat transfer fluid therein. The heat exchanger is located external to the pressure vessel whereby excessive core heat is transferred from the above reactor components and dissipated within the heat exchanger fluid.

  7. Crew emergency return vehicle - Electrical power system design study

    Science.gov (United States)

    Darcy, E. C.; Barrera, T. P.

    1989-01-01

    A crew emergency return vehicle (CERV) is proposed to perform the lifeboat function for the manned Space Station Freedom. This escape module will be permanently docked to Freedom and, on demand, will be capable of safely returning the crew to earth. The unique requirements that the CERV imposes on its power source are presented, power source options are examined, and a baseline system is selected. It consists of an active Li-BCX DD-cell modular battery system and was chosen for the maturity of its man-rated design and its low development costs.

  8. Robust mechanobiological behavior emerges in heterogeneous myosin systems

    Science.gov (United States)

    Egan, Paul F.; Moore, Jeffrey R.; Ehrlicher, Allen J.; Weitz, David A.; Schunn, Christian; Cagan, Jonathan; LeDuc, Philip

    2017-09-01

    Biological complexity presents challenges for understanding natural phenomenon and engineering new technologies, particularly in systems with molecular heterogeneity. Such complexity is present in myosin motor protein systems, and computational modeling is essential for determining how collective myosin interactions produce emergent system behavior. We develop a computational approach for altering myosin isoform parameters and their collective organization, and support predictions with in vitro experiments of motility assays with α-actinins as molecular force sensors. The computational approach models variations in single myosin molecular structure, system organization, and force stimuli to predict system behavior for filament velocity, energy consumption, and robustness. Robustness is the range of forces where a filament is expected to have continuous velocity and depends on used myosin system energy. Myosin systems are shown to have highly nonlinear behavior across force conditions that may be exploited at a systems level by combining slow and fast myosin isoforms heterogeneously. Results suggest some heterogeneous systems have lower energy use near stall conditions and greater energy consumption when unloaded, therefore promoting robustness. These heterogeneous system capabilities are unique in comparison with homogenous systems and potentially advantageous for high performance bionanotechnologies. Findings open doors at the intersections of mechanics and biology, particularly for understanding and treating myosin-related diseases and developing approaches for motor molecule-based technologies.

  9. [Telemedicine and follow up of peritoneal dialysis patients].

    Science.gov (United States)

    Gallar, P; Gutiérrez, M; Ortega, O; Rodríguez, I; Oliet, A; Herrero, J C; Mon, C; Ortiz, M; Molina, A; Vigil, A

    2006-01-01

    Mean-term experience in the use of Telemedicine in Peritoneal Dialisis (PD) patients is limited as well as its cost-benefit. The main objective of this work is to evaluate Telemedicine utility in mean-long term control of stable PD patients, analyzing if the televisit (TV) could substitute 50% of the programed inhospital consults (HC) the time spent in both visit modalities, the quality of patient-personel contact as well as how image and sound have been perceived. Visit resolution was analyzed taking into account the need of HC after a TV; We also have studied if it would be possible to retrain patients in the dialisis technique with telemedicine, and we have checked the patient perceived quality and calculate the real and social costs. during 18 months, the system has been implanted to 19 patients with 7 +/- 4 follow up (range 3-17). A Falcon videoconference kit at patient's place was used, connected to the home television set. In the hospital there was a computer with a videoconference card, webcam and software meeting point which permits the control of patient's camera from the hospital. Both are connected by a 3RDSI line system. A monthly programmed HC or TV has been made. If more controls had been required, they have been made by TV Time spent was recorded on each TV and patients and staff questionary were inquired. (a) mean age 44 +/- 8 years, 13 (68%) male. 12 (63%) had elemental educational level and 7 (37%) mean-superior. 17 (89%) were actively working. The PD technique was: CAPD 6 (32%) and APD13 (68%). (b) Televisits: 103 TV have been made. 22 +/- 9 minutes were spent on each TV less than in the HC, 33 +/- 8 minutes (p < 0.01). There were technical problems related with lines in 21 TV, but only in 4 the connection was not possible. 92 TV (89%) were made on time, 99 (96%) had a good image quality and 96 (93%) had a correct sound. 100% of patients perceived TV as close to HC. In 90 TV (87%) medical treatment was modified. Only in 4 cases (3.9%) patients

  10. Emergency Medical Service Information System:the ARES 118 experience.

    Science.gov (United States)

    Ientile, D A; Cardinale, M A; Cataldi, S; Parafati, M; Pasquarella, A; Trani, N; Corradi, M P

    2017-01-01

    In this paper we describe ARES 118, the prehospital Emergency Medical Service of the Region Lazio, Italy, focusing on its data system used to populate a data warehouse and to create ad hoc reports. ARES 118 is a regional public mono-specialized health company, established in 2004, that manages the emergency care throughout the Region Lazio. Being a peculiar company in its kind, and being the first experience of this kind in Italy, ARES 118 has begun to equip itself, in an autonomous way, with a corporate information system, starting from what already existed as data collection from the individual provincial operating Centers and then by activating a unique information system at a regional and company level by deploying a data warehouse. All operations were carried out using open source software. Currently, ARES 118 is equipped with a business information system that enables data collection with its storage, management and processing of the same in fairly and easy way. The system allows the production of specific reports and measures modulated on the user requests in order to highlight the different aspects of the activity. The production of ad hoc reports, with the possibility of developing specific indicators, allows the identification and analysis of critical areas/processes in order to implement any corrective actions and monitor the effectiveness of the sam.

  11. A cross-platform solution for light field based 3D telemedicine.

    Science.gov (United States)

    Wang, Gengkun; Xiang, Wei; Pickering, Mark

    2016-03-01

    Current telehealth services are dominated by conventional 2D video conferencing systems, which are limited in their capabilities in providing a satisfactory communication experience due to the lack of realism. The "immersiveness" provided by 3D technologies has the potential to promote telehealth services to a wider range of applications. However, conventional stereoscopic 3D technologies are deficient in many aspects, including low resolution and the requirement for complicated multi-camera setup and calibration, and special glasses. The advent of light field (LF) photography enables us to record light rays in a single shot and provide glasses-free 3D display with continuous motion parallax in a wide viewing zone, which is ideally suited for 3D telehealth applications. As far as our literature review suggests, there have been no reports of 3D telemedicine systems using LF technology. In this paper, we propose a cross-platform solution for a LF-based 3D telemedicine system. Firstly, a novel system architecture based on LF technology is established, which is able to capture the LF of a patient, and provide an immersive 3D display at the doctor site. For 3D modeling, we further propose an algorithm which is able to convert the captured LF to a 3D model with a high level of detail. For the software implementation on different platforms (i.e., desktop, web-based and mobile phone platforms), a cross-platform solution is proposed. Demo applications have been developed for 2D/3D video conferencing, 3D model display and edit, blood pressure and heart rate monitoring, and patient data viewing functions. The demo software can be extended to multi-discipline telehealth applications, such as tele-dentistry, tele-wound and tele-psychiatry. The proposed 3D telemedicine solution has the potential to revolutionize next-generation telemedicine technologies by providing a high quality immersive tele-consultation experience. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. CAPITALISM EMERGING ERA TAX SYSTEMS OF THE EUROPEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    Виктория Александровна Цокова

    2013-05-01

    Full Text Available Three phases should be distinguished in the development of tax systems:I. The Ancient World and Middle Ages (from the IV - III centuries. BC. till. XVII - XVIII centuries AD.II. The new time (from the XVII - XVIII centuries till the end of XIX century. - the era of the emerging capitalism.III. Modern History (from the XX century and up to the present time. The capitalism emerging era scientific ideas and tax systems research relevance (importance is caused by the emergence of the main distinct characteristics of any state, that is by the permanently increasing demand of that institution for money. This fact, in its turn, contributes to the formation of the state tax system, and, of course, the evolution of scientific views on taxation.Nowadays, some theoretical ideas in the field of taxation, clarifying the nature and the role of taxes in the European countries budget formation begin to appear in Europe, especially in theUK. The development of tax systems in England, France and Germany have  been analyzed;  and , basing on the  dialectical, historical and logical approaches, and the method of scientific abstraction, the authors identify the following common features of the  capitalism emerging era tax systems in the European countries: the taxation on a regular (permanent basis, the expansion of the tax-payers  range – all citizens of the state are becoming tax payers, the introduction of the income tax and the abolishment  of the revenue leasing – creation of government agencies system responsible for the administration of taxes, to establishing and collecting taxes only with the Parliament approval and permission.Classical theoretical and practical approaches to creation of tax systems of the states have been formulated in Europe in the era of nascent capitalism and they haven’t lost the relevance yet.DOI: http://dx.doi.org/10.12731/2218-7405-2013-4-55

  13. Emerging Methods and Systems for Observing Life in the Sea

    Science.gov (United States)

    Chavez, F.; Pearlman, J.; Simmons, S. E.

    2016-12-01

    There is a growing need for observations of life in the sea at time and space scales consistent with those made for physical and chemical parameters. International programs such as the Global Ocean Observing System (GOOS) and Marine Biodiversity Observation Networks (MBON) are making the case for expanded biological observations and working diligently to prioritize essential variables. Here we review past, present and emerging systems and methods for observing life in the sea from the perspective of maintaining continuous observations over long time periods. Methods that rely on ships with instrumentation and over-the-side sample collections will need to be supplemented and eventually replaced with those based from autonomous platforms. Ship-based optical and acoustic instruments are being reduced in size and power for deployment on moorings and autonomous vehicles. In parallel a new generation of low power, improved resolution sensors are being developed. Animal bio-logging is evolving with new, smaller and more sophisticated tags being developed. New genomic methods, capable of assessing multiple trophic levels from a single water sample, are emerging. Autonomous devices for genomic sample collection are being miniaturized and adapted to autonomous vehicles. The required processing schemes and methods for these emerging data collections are being developed in parallel with the instrumentation. An evolving challenge will be the integration of information from these disparate methods given that each provides their own unique view of life in the sea.

  14. Emerging Security Mechanisms for Medical Cyber Physical Systems.

    Science.gov (United States)

    Kocabas, Ovunc; Soyata, Tolga; Aktas, Mehmet K

    2016-01-01

    The following decade will witness a surge in remote health-monitoring systems that are based on body-worn monitoring devices. These Medical Cyber Physical Systems (MCPS) will be capable of transmitting the acquired data to a private or public cloud for storage and processing. Machine learning algorithms running in the cloud and processing this data can provide decision support to healthcare professionals. There is no doubt that the security and privacy of the medical data is one of the most important concerns in designing an MCPS. In this paper, we depict the general architecture of an MCPS consisting of four layers: data acquisition, data aggregation, cloud processing, and action. Due to the differences in hardware and communication capabilities of each layer, different encryption schemes must be used to guarantee data privacy within that layer. We survey conventional and emerging encryption schemes based on their ability to provide secure storage, data sharing, and secure computation. Our detailed experimental evaluation of each scheme shows that while the emerging encryption schemes enable exciting new features such as secure sharing and secure computation, they introduce several orders-of-magnitude computational and storage overhead. We conclude our paper by outlining future research directions to improve the usability of the emerging encryption schemes in an MCPS.

  15. Innovation Network Development Model in Telemedicine: A Change in Participation.

    Science.gov (United States)

    Goodarzi, Maryam; Torabi, Mashallah; Safdari, Reza; Dargahi, Hossein; Naeimi, Sara

    2015-10-01

    This paper introduces a telemedicine innovation network and reports its implementation in Tehran University of Medical Sciences. The required conditions for the development of future projects in the field of telemedicine are also discussed; such projects should be based on the common needs and opportunities in the areas of healthcare, education, and technology. The development of the telemedicine innovation network in Tehran University of Medical Sciences was carried out in two phases: identifying the beneficiaries of telemedicine, and codification of the innovation network memorandum; and brainstorming of three workgroup members, and completion and clustering ideas. The present study employed a qualitative survey by using brain storming method. Thus, the ideas of the innovation network members were gathered, and by using Freeplane software, all of them were clustered and innovation projects were defined. In the services workgroup, 87 and 25 ideas were confirmed in phase 1 and phase 2, respectively. In the education workgroup, 8 new programs in the areas of telemedicine, tele-education and teleconsultation were codified. In the technology workgroup, 101 and 11 ideas were registered in phase 1 and phase 2, respectively. Today, innovation is considered a major infrastructural element of any change or progress. Thus, the successful implementation of a telemedicine project not only needs funding, human resources, and full equipment. It also requires the use of innovation models to cover several different aspects of change and progress. The results of the study can provide a basis for the implementation of future telemedicine projects using new participatory, creative, and innovative models.

  16. AplikasiTelemedicine dalam Merujuk Pasien dari Daerah Rural

    Directory of Open Access Journals (Sweden)

    Lidwina Anissa

    2016-03-01

    Full Text Available Kusta adalah penyakit menular yang disebabkan oleh basil lepra. Penderita kusta tersebar di seluruh Indonesia. Dalam Standar Kompetensi Dokter Indonesia, penanganan kusta tanpa komplikasi merupakankompetensi tingkat 4A, sedangkan penanganan reaksi kusta merupakan kompetensi tingkat 3A. Penanganankasus reaksi kusta dengan proses rujukan konvensional ke layanan kesehatan yang memilliki tenaga ahliterkendala oleh berbagai macam penyulit. Pemanfaatan teknologi smartphone berupa aplikasi Whatsapp,dengan menerapkan konsep telemedicine, diharapkan dapat menjadi solusi untuk meretas hambatanjarak, waktu dan finansial dalam proses rujukan pasien secara konvensional. Demi memberikan pelayanan kesehatan yang bersifat paripurna, sebaiknya konsep telemedicine dipelajari lebih lanjut dan diterapkan dalam pelayanan kesehatan. Kata Kunci: kusta, reaksi kusta, rujukan, smartphone, telemedicine, Whatsapp   Telemedicine Application for Rural Patients’ Referral Abstract Leprosy is a communicable disease caused by leprosy bacillus. People with leprosy are distributed in all areas of Indonesia. In Indonesian Doctor Competence Standards, leprosy management is at level 4Acompetence; meanwhile leprosy reaction management is at level 3A competence. Management of leprosyreaction that needs a conventional referral to higher level of health centre has faced many obstacles.Smartphone instant messaging application (eg. Whatsapp utilizes the concept of telemedicine, which will bea solution in solving distance, time and financial problems in conventional referral process. In order to provideholistic health service, telemedicine should be learnt further and applied. Keywords: leprosy, leprosy reaction, referral, smartphone, telemedicine, Whatsapp

  17. [Implementation of Telemedicine in Cape Verde: Influencing Factors].

    Science.gov (United States)

    Correia, Artur; Azevedo, Vanda; Lapão, Luís Velez

    2017-04-28

    Telemedicine is the provision of health services, where distance is a critical factor, using information and communication technologies. Cape Verde has bet on using this tool to increase access of the population of its islands to specialized care. Qualitative study, covering the period between 2013 and 2014. It uses document analysis, semi-structured interviews and focus groups to collect data and analysis of content for their analysis. The participant population includes doctors, nurses and professionals from some institutions related to telemedicine. The priorities of the National Telemedicine Program are set, the cores and reference centers are operational, with trained personnel and equipment installed. Several other policy instruments and conditioning factors and facilitators of the program have been identified. Telemedicine is contributing to the reduction of inequalities in access to health, in Cape Verde. However, the full adoption of a service based on a new technology depends on conditioning factors and facilitators, and several success factors of telemedicine, identified in the literature, are not observed and in conjunction with other existing weaknesses affect the overall development of the National Telemedicine Program. However the strengths and capabilities are highlighted opportunities to act. Despite the progress, some telemedicine success factors highlighted on the literature are not seen in the country.

  18. Emergence and expansion of cosmic space in BIonic system

    Energy Technology Data Exchange (ETDEWEB)

    Sepehri, A., E-mail: alireza.sepehri@uk.ac.ir [Faculty of Physics, Shahid Bahonar University, P.O. Box 76175, Kerman (Iran, Islamic Republic of); Rahaman, Farook, E-mail: rahaman@iucaa.ernet.in [Department of Mathematics, Jadavpur University, Kolkata 700032, West Bengal (India); Pradhan, Anirudh, E-mail: pradhan@iucaa.ernet.in [Department of Mathematics, GLA University, Mathura-281 406, U.P. (India); Sardar, Iftikar Hossain, E-mail: iftikar.spm@gmail.com [Department of Mathematics, Jadavpur University, Kolkata 700032, West Bengal (India)

    2015-02-04

    Recently, Padmanabhan [ (arXiv:1206.4916 [hep-th])] argued that the expansion rate of the universe can be thought of as the emergence of space as cosmic time progresses and is related to the difference between the surface degrees of freedom on the holographic horizon and the bulk degrees of freedom inside. The main question arises as to what is the origin of emergence of space in 4D universe. We answer this question in BIonic system. The BIon is a configuration in flat space of a D-brane and a parallel anti-D-brane connected by a thin shell wormhole with F-string charge. We propose a new model that allows that all degrees of freedom inside and outside the universe are controlled by the evolutions of BIon in extra dimension and tend to degrees of freedom of black F-string in string theory or black M2-brane in M-theory.

  19. Emerging pathogen Aspergillus calidoustus colonizes water distribution systems.

    Science.gov (United States)

    Hageskal, Gunhild; Kristensen, Ralf; Fristad, Rosa F; Skaar, Ida

    2011-08-01

    Recent studies have changed the taxonomy of Aspergillus section Usti, and a novel species, Aspergillus calidoustus, has been erected. It was also demonstrated that clinical isolates previously identified as A. ustus actually belong to the emerging pathogen A. calidoustus. Aspergillus ustus were frequently isolated from Norwegian water systems, and due to the taxonomical progress, these waterborne strains could be identified more precisely. A MLST study including ITS, calmodulin, β-tubulin and actin sequences was conducted on 32 strains previously identified as A. ustus. All strains were identified as A. calidoustus, which was verified by physiological, biochemical and phylogenetic analyses. This is the first report of that A. calidoustus is able to colonize water distribution systems. In respect to the potential role of water systems as a source of nosocomial infections in patients with immunodeficiency, attention should be given to water systems in hospitals and other healthcare units, especially the heated-water installations. © 2011 ISHAM

  20. Developing a synchronous otolaryngology telemedicine Clinic: Prospective study to assess fidelity and diagnostic concordance.

    Science.gov (United States)

    Seim, Nolan B; Philips, Ramez H W; Matrka, Laura A; Locklear, Brittany; Inman, Mark; Moberly, Aaron C; Essig, Garth F

    2017-10-27

    To evaluate diagnostic concordance of a synchronous telemedicine otolaryngology clinic with use of currently available technology. Prospective. Patients in a rural otolaryngology clinic were enrolled in a pilot telemedicine clinic. To assess system fidelity, an on-site and remote (consulting) otolaryngologist conducted simultaneous patient evaluations using streaming telecommunication technology for all aspects of the clinical encounter, including high-definition examination and endoscopic images. Both physicians and patients were blinded and diagnoses recorded. Post-encounter physician surveys and an original patient-centered TeleENT Satisfaction Questionnaire (TESQ) were used to assess overall satisfaction. Twenty-one patients were enrolled consecutively. Visual technology was found acceptable in all cases, and audio technology was acceptable in 20 of 21 encounters. Patient satisfaction was 96%, and patients felt comfortable using a telemedicine system in the future. Encounters were not significantly longer than traditional encounters. Physician diagnostic agreement was found in 95% of cases, and the consulting physician indicated that all encounters provided sufficient history, examination, and high-quality images to generate an accurate diagnosis, order additional workup, and/or make an appropriate referral. A synchronous otolaryngology telemedicine clinic is comparable to a standard clinic in terms of diagnostic concordance and patient satisfaction when using streaming technology and high-definition images. Using telemedical technology may be a viable way to increase otolaryngology access in remote or underserved areas. With system validity now established, future studies will assess the feasibility of using trained on-site physician extenders (nurse practitioners or physician assistants) to conduct in-person patient encounters with remote otolaryngologist support. 2c. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society

  1. Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials.

    Science.gov (United States)

    Faruque, Labib Imran; Wiebe, Natasha; Ehteshami-Afshar, Arash; Liu, Yuanchen; Dianati-Maleki, Neda; Hemmelgarn, Brenda R; Manns, Braden J; Tonelli, Marcello

    2017-03-06

    Telemedicine, the use of telecommunications to deliver health services, expertise and information, is a promising but unproven tool for improving the quality of diabetes care. We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care. We searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases (to November 2015) and reference lists of existing systematic reviews for randomized controlled trials (RCTs) comparing telemedicine with usual care for adults with diabetes. Two independent reviewers selected the studies and assessed risk of bias in the studies. The primary outcome was glycated hemoglobin (HbA1C) reported at 3 time points (≤ 3 mo, 4-12 mo and > 12 mo). Other outcomes were quality of life, mortality and episodes of hypoglycemia. Trials were pooled using randomeffects meta-analysis, and heterogeneity was quantified using the I2 statistic. From 3688 citations, we identified 111 eligible RCTs (n = 23 648). Telemedicine achieved significant but modest reductions in HbA1C in all 3 follow-up periods (difference in mean at ≤ 3 mo: -0.57%, 95% confidence interval [CI] -0.74% to -0.40% [39 trials]; at 4-12 mo: -0.28%, 95% CI -0.37% to -0.20% [87 trials]; and at > 12 mo: -0.26%, 95% CI -0.46% to -0.06% [5 trials]). Quantified heterogeneity (I2 statistic) was 75%, 69% and 58%, respectively. In meta-regression analyses, the effect of telemedicine on HbA1C appeared greatest in trials with higher HbA1C concentrations at baseline, in trials where providers used Web portals or text messaging to communicate with patients and in trials where telemedicine facilitated medication adjustment. Telemedicine had no convincing effect on quality of life, mortality or hypoglycemia. Compared with usual care, the addition of telemedicine, especially systems that allowed medication adjustments with or without text messaging or a Web portal, improved HbA1C but not other clinically

  2. The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Villanueva JA

    2017-02-01

    specially improved by telemedicine by using remote continuous positive airway-pressure data, self-management platforms, and mobile applications for patient feedback. Incorporating new procedures with novel technologies and sensors will probably change the process. Instead of replicating traditional visits, mHealth may provide shorter and more frequent assessments; alarm systems on the patients’ devices could alert physicians or mobile applications with simple questionnaires may help on follow-up. With telemedicine, patients will not be treated in the same way. Keywords: mHealth, telemedicine, obstructive sleep apnea, continuous positive airway pressure

  3. Application of Ethics for Providing Telemedicine Services and Information Technology.

    Science.gov (United States)

    Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali

    2017-10-01

    Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients' personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in

  4. Mechanisms of security based on digital certificates applied in a telemedicine network.

    Science.gov (United States)

    Vivas, T; Zambrano, A; Huerta, M

    2008-01-01

    The medical patient's information is private and extremely sensitive. This information has to be stored and transmitted carefully because it can be exposed to a series of threats and it is necessary to be protected. This research contemplates the security mechanisms based on digital certificates applied to a pilot telemedicine network, that guarantees the confidentiality, integrity and availability of the medical information of the patients for the hospitable centers involved. The prototype telemedicine network will interconnect hospitals in the municipalities of Baruta and Hatillo Miranda State, in Venezuela by Internet, to provide and support a health care system in inaccessible areas, and the transmission of patient's biomedical signals and the health education to people through secure mechanisms such as digital certificates.

  5. Connected health: emerging disruptive technologies

    National Research Council Canada - National Science Library

    Iglehart, John K

    2014-01-01

    ... the confusion over the definitions of telemedicine, telehealth, and mHealth. The importance of an array of emerging technologies and services is certain to grow as more people who reside in rural locales or areas of provider scarcity gain coverage and team-based care becomes a more prominent feature of the delivery landscape. In addition, as former Senate M...

  6. 46 CFR 35.10-15 - Emergency lighting and power systems-T/ALL.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Emergency lighting and power systems-T/ALL. 35.10-15... Emergency Requirements § 35.10-15 Emergency lighting and power systems—T/ALL. (a) Where fitted, it shall be the duty of the master to see that the emergency lighting and power systems are tested and inspected...

  7. Socially Relevant Knowledge Based Telemedicine

    Science.gov (United States)

    2010-10-01

    can make voi ce calls to each other using Skype (free computer-to-computer calling). The integration of Skype with the system has two major benefits ...Shirmohammadi, S. (2007). Accessibility and scalability in collaborative eCommerce environments. Digital Information Management, 2007. ICDIM 󈧋. 2nd...further. Visualization of workflow is another benefit of using this tool. In ad- dition to enhancing our understanding of clinical workflow, such

  8. Telemedicine: Experience at SGPGIMS, Lucknow

    OpenAIRE

    Kapoor L; Mishra S; Singh Kartar

    2005-01-01

    Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) located in Lucknow, capital of Uttar Pradesh, a state in Northern India, is a tertiary level referral academic medical center involved in teaching and training of super specialist medical professionals with 22 academic departments. It is the first tertiary care hospital in public healthcare sector in India to adopt Information Technology (IT) for healthcare delivery. The Hospital Information System (HIS) was implemented in 19...

  9. Hydraulic tests of emergency cooling system: L-Area

    Energy Technology Data Exchange (ETDEWEB)

    Hinton, J H

    1988-01-01

    The delay in L-Area startup provided an opportunity to obtain valuable data on the Emergency Cooling System (ECS) which will permit reactor operation at the highest safe power level. ECS flow is a major input to the FLOOD code which calculates reactor ECS power limits. The FLOOD code assesses the effectiveness of the ECS cooling capacity by modeling the core and plenum hydraulics under accident conditions. Presently, reactor power is not limited by the ECS cooling capacity (power limit). However, the manual calculations of ECS flows had been recently updated to include piping changes (debris strainer, valve changes, pressure release systems) and update fitting losses. Both updates resulted in reduced calculated ECS flows. Upon completion of the current program to update, validate, and document, reactor power may be limited under certain situations by ECS cooling capacity for some present reactor charge designs. A series of special hydraulic tests (Reference 1, 3) were conducted in L-Area using all sources of emergency coolant including the ECS pumps (Reference 2). The tests provided empirical hydraulic data on the ECS piping. These data will be used in computer models of the system as well as manual calculations of ECS flows. The improved modeling and accuracy of the flow calculations will permit reactor operation at the highest safe power level with respect to an ECS power limit.

  10. Assessing advantages and barriers to telemedicine adoption in the practice setting: A MyCareTeam(TM) exemplar.

    Science.gov (United States)

    L'Esperance, Shaun T; Perry, Donna J

    2016-06-01

    Telemedicine is an evolving field that holds great potential to improve patient outcomes. The National Organization of Nurse Practitioner Faculties core competencies now require all nurse practitioners (NPs) to be competent utilizing telemedicine to address various patient and healthcare system needs. While telemedicine offers advantages to patient care, adoption of new technologies can be challenging. An assessment of perceived advantages and barriers to MyCareTeam, an online diabetes management system, was conducted at an adult diabetes clinic. Two survey questionnaires were developed based on the Diffusion of Innovations (DOI) theory. The surveys were administered to patients in the clinic waiting room and sent to all clinical staff via an e-mail link. The findings of this project suggested a novel way to classify patients with regard to their use of the technology with implications for practice. Recommendations include outreach to enhance knowledge and awareness of MyCareTeam, reinforcing the full scope of the system, and improved technical support. DOI theory is a framework that may be utilized by NPs as a tool for assessing advantages and barriers to telemedicine applications in the practice setting in order to identify strategies to promote adoption and use. ©2015 American Association of Nurse Practitioners.

  11. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.4

    Energy Technology Data Exchange (ETDEWEB)

    Arp, J.A.; Burnett, R.A.; Downing, T.R. [and others

    1997-11-21

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login privileges, and usage. The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via telecommunications links.

  12. Comprehending emergent systems phenomena through direct-manipulation animation

    Science.gov (United States)

    Aguirre, Priscilla Abel

    This study seeks to understand the type of interaction mode that best supports learning and comprehension of emergent systems phenomena. Given that the literature has established that students hold robust misconceptions of such phenomena, this study investigates the influence of using three types of interaction; speed-manipulation animation (SMN), post-manipulation animation (PMA) and direct-manipulation animation (DMA) for increasing comprehension and testing transfer of the phenomena, by looking at the effect of simultaneous interaction of haptic and visual channels on long term and working memories when seeking to comprehend emergent phenomena. The questions asked were: (1) Does the teaching of emergent phenomena, with the aid of a dynamic interactive modeling tool (i.e., SMA, PMA or DMA), improve students' mental model construction of systems, thus increasing comprehension of this scientific concept? And (2) does the teaching of emergent phenomena, with the aid of a dynamic interactive modeling tool, give the students the necessary complex cognitive skill which can then be applied to similar (near transfer) and/or novel, but different, (far transfer) scenarios? In an empirical study undergraduate and graduate students were asked to participate in one of three experimental conditions: SMA, PMA, or DMA. The results of the study found that it was the participants of the SMA treatment condition that had the most improvement in post-test scores. Students' understanding of the phenomena increased most when they used a dynamic model with few interactive elements (i.e., start, stop, and speed) that allowed for real time visualization of one's interaction on the phenomena. Furthermore, no indication was found that the learning of emergent phenomena, with the aid of a dynamic interactive modeling tool, gave the students the necessary complex cognitive skill which could then be applied to similar (near transfer) and/or novel, but different, (far transfer) scenarios

  13. Clinical- and cost-effectiveness of telemedicine in type 2 diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhai, Yun-kai; Zhu, Wei-jun; Cai, Yan-ling; Sun, Dong-xu; Zhao, Jie

    2014-12-01

    Emerging telemedicine programs offer potential low-cost solutions to the management of chronic disease. We sought to evaluate the clinical effectiveness and cost effectiveness of telemedicine approaches on glycemic control in patients with type 2 diabetes mellitus. Using terms related to type 2 diabetes and telemedicine, MEDLINE, Cochrane, EMBASE, and CINAHL Plus were searched to identify relevant studies published through February 28, 2014. Data from identified clinical trials were pooled according to telemedicine approach, and evaluated using conventional meta-analytical methods. We identified 47 articles, from 35 randomized controlled trials, reporting quantitative outcomes for hemoglobin A1c (HbA1c). Twelve of the 35 studies provided intervention via telephone, either in the form of a call or a text message; 19 studies tested internet-based programs, employing video-conferencing and/or informational websites; and four studies used interventions involving electronically transmitted recommendations made by clinicians in response to internet-based reporting by patients. Overall, pooled results from these studies revealed a small, but statistically significant, decrease in HbA1c following intervention, compared to conventional treatment (pooled difference in means=-0.37, 95% CI=-0.49 to -0.25, Z=-6.08, P<0.001). Only two of the 35 studies included assessment of cost-effectiveness. These studies were disparate, both in terms of overall expense and relative cost-effectiveness. Optimization of telemedicine approaches could potentially allow for more effective self-management of disease in type 2 diabetes patients, though evidence to-date is unconvincing. Furthermore, significant publication bias was detected, suggesting that the literature should be interpreted cautiously.

  14. Report of a national neurosurgical emergency teleconsulting system.

    LENUS (Irish Health Repository)

    Gray, W P

    2012-02-03

    OBJECTIVE: The goal was to develop a low-cost, national, neurosurgical emergency teleconsulting system that is independent of vendor computed tomographic (CT) or magnetic resonance imaging (MRI) scanner type. METHODS: Charge-coupled device scanners are used to digitize hard copies of CT and MRI scans. An enhanced optical density range is achieved by using an algorithm to fuse data from multiple exposures at different integration periods. The system is based on personal computers using Microsoft Windows 3.11. Data are transmitted on a wide-area network at 128 kilobits\\/s, over Integrated Systems Digital Network lines. The network connects both neurosurgical departments in Ireland to all major hospitals with CT\\/MRI scanners. RESULTS: The scanner optical density is 0.05 to 3.0, with 2.24 to 2.5 line pairs\\/mm. Five-megabyte images are transmitted uncompressed in 6 minutes. To date, more than 750 CT and MRI scans have been transmitted. The system is completely automated, and operator acceptance has been very high. Images are automatically stored and displayed at the receiving workstation, where the images can be viewed and manipulated on-screen. This system has significantly enhanced acute neurosurgical patient care. CONCLUSION: The system is cost effective and simple to use, has gained widespread physician acceptance, and delivers an image quality superior to that of many commercially available systems.

  15. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.2

    Energy Technology Data Exchange (ETDEWEB)

    Burford, M.J.; Burnett, R.A.; Curtis, L.M. [and others

    1996-05-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS system package. System administrators, database administrators, and general users can use this guide to install, configure, and maintain the FEMIS client software package. This document provides a description of the FEMIS environment; distribution media; data, communications, and electronic mail servers; user workstations; and system management.

  16. R and D on seismic emergency information system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-06-01

    After the Great Hansin-Awaji Earthquake Disaster occurred in 1995, the Science and Technology Agency commenced 'Frontier Research Program on Earthquake' in FY1996. As a part of this research program, four-year program on 'Research on Real-time Earthquake Information Transmission' has been carried out at JAERI since FY1997. Through the experience of the above earthquake disaster, the importance of accurate and prompt seismic information transmission immediately after the occurrence of the earthquake has been recognized from the viewpoint of disaster mitigation. Under this circumstance, the main activity in Real-time Earthquake Information Transmission Research at JAERI has been placed on the development of a seismic emergency information system. In order to respond to the above R and D, Seismic Emergency Information System Research Team was organized in JAERI in FY1998. In the meantime, a part of this R and D program is performed under the coordinated research between JAERI and NIED (National Research Institute for Earth Science and Disaster Prevention). This report summarizes the results of four years program from FY1997 to FY2000 on the above R and D. The R and D has been conducted involving the latest progress in earthquake engineering with regard to estimation techniques on the hypocenter, fault and earthquake motion parameters and in Information Technologies. The R and D was divided into two parts, i.e., development of the basic system and application system. In the basic system, earthquake information with 500 m square mesh in a local area can be estimated and transmitted in a few minutes. In the application system, the concept of the disaster management system which consists of user site and disaster information center and is capable of mutual information transmission has been established. A prototype of the application system, which include the basic system in the disaster information center, has been developed. Test operation of the

  17. Reliability of decision-support systems for nuclear emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Ionescu, Tudor B.

    2013-08-15

    Decision support systems for nuclear emergency management (DSNE) are currently used worldwide to assist decision makers in taking emergency response countermeasures in case of accidental releases of radioactive materials from nuclear facilities. The present work has been motivated by the fact that, up until now, DSNE systems have not been regarded as safetycritical software systems, such as embedded software currently being used in vehicles and aircraft. The core of any DSNE system is represented by the different simulation codes linked together to form the dispersion simulation workflow. These codes require input emission and meteorological data to produce forecasts of the atmospheric dispersion of radioactive pollutants and other substances. However, the reliability of the system not only depends on the trustworthiness of the measured (or generated) input data but also on the reliability of the simulation codes used. The main goal of this work is to improve the reliability of DSNE systems by adapting current state of the art methods from the domain of software reliability engineering to the case of atmospheric dispersion simulation codes. The current approach is based on the design by diversity principle for improving the reliability of codes and the trustworthiness of results as well as on a flexible fault-tolerant workflow scheduling algorithm for ensuring the maximum availability of the system. The author's contribution is represented by (i) an acceptance test for dispersion simulation results, (ii) an adjudication algorithm (voter) based on comparing taxonomies of dispersion simulation results, and (iii) a feedback-control based fault-tolerant workflow scheduling algorithm. These tools provide means for the continuous verification of dispersion simulation codes while tolerating timing faults caused by disturbances in the underlying computational environment and will thus help increase the reliability and trustworthiness of DSNE systems in missioncritical

  18. A pilot study describing access to emergency care in two states using a model emergency care categorization system.

    Science.gov (United States)

    Myers, Sage R; Salhi, Rama A; Lerner, E Brooke; Gilson, Rebecca; Kraus, Andrea; Kelly, John J; Hargarten, Stephen; Carr, Brendan G

    2013-09-01

    The Institute of Medicine (IOM)'s "Future of Emergency Care" report recommended the categorization and regionalization of emergency care, but no uniform system to categorize hospital emergency care capabilities has been developed. The absence of such a system limits the ability to benchmark outcomes, to develop regional systems of care, and of patients to make informed decisions when seeking emergency care. The authors sought to pilot the deployment of an emergency care categorization system in two states. A five-tiered emergency department (ED) categorization system was designed, and a survey of all Pennsylvania and Wisconsin EDs was conducted. This 46-item survey described hospital staffing, characteristics, resources, and practice patterns. Based on responses, EDs were categorized as limited, basic, advanced, comprehensive, and pediatric critical care capable. Prehospital transport times were then used to determine population access to each level of care. A total of 247 surveys were received from the two states (247 of 297, 83%). Of the facilities surveyed, roughly one-quarter of hospitals provided advanced care, 10.5% provided comprehensive care, and 1.6% provided pediatric critical care. Overall, 75.1% of the general population could reach an advanced or comprehensive ED within 60 minutes by ground transportation. Among the pediatric population (age 14 years and younger), 56.2% could reach a pediatric critical care or comprehensive ED, with another 19.5% being able to access an advanced ED within 60 minutes. Using this categorization system, fewer than half of all EDs provide advanced or comprehensive emergency care. While the majority of the population has access to advanced or comprehensive care within an hour, a significant portion (25%) does not. This article describes how an ED categorization scheme could be developed and deployed across the United States. There are implications for prehospital planning, patient decision-making, outcomes measurement

  19. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.3

    Energy Technology Data Exchange (ETDEWEB)

    Burford, M.J.; Burnett, R.A.; Downing, T.R. [and others

    1996-12-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the (Pacific Northwest National Laboratory) (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. 91 This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login, privileges, and usage. The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment.

  20. Early phase telemedicine requirements elicitation in collaboration with medical practitioners

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.; Napolitano, Carlo

    2013-01-01

    Ubiquity of Information and Communication Technology enables innovative telemedicine treatment applications for disease management of ambulant patients. Development of new treatment applications must comply with medical protocols and ‘way of working’ to obtain safety and efficacy evidence before

  1. UH-USA Agreement - A Telemedicine Research Proposal

    National Research Council Canada - National Science Library

    Burgess, Lawrence P; Birkmire-Peters, Deborah P

    2004-01-01

    The purpose of the University of Hawaii Telemedicine Curriculum Research Project is to develop an effective web-based curriculum for training military healthcare personnel in the use of contemporary...

  2. Telemedicine-Based Burn Research Initiative: Longitudinal Outcomes of Patients

    National Research Council Canada - National Science Library

    Montalvo, Alfredo

    2003-01-01

    .... All instruments were professionally printed. The consultant for the project was hired and telemedicine equipment was evaluated by the consultant based on clinical requirements defined by the research team...

  3. Telemedicine compared with standard care in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rasmussen, O. W.

    2015-01-01

    Objectives: For patients with T2DM does telemedicine, compared with standard care, provide equivalent clinical outcomes? Methods: Forty patients with type 2 diabetes mellitus allocated from October 2011 until July 2012 randomized to either treatment at home by video conferences only or the standard...... treatments, given as changes in percent of telemedicine vs. standard, showed significant differences in HbA1c (-15 vs. -11 %), mean blood glucose (-18 vs. -13 %,.and in cholesterol (-7 vs. -6 %). No differences in LDL (-4 vs. -6 %), weight (-1 vs. 2 %), diastolic diurnal blood pressure (-1 vs. -7...... %), and systolic diurnal blood pressure (0 vs. -1 %) were found. Nine consultations were missed in the standard outpatient group and none in the telemedicine group. Conclusions: The direct comparison of home video consultations versus standard outpatient treatment in T2DM, telemedicine was a safe and superior...

  4. Hageseth's principle of extraterritorial jurisdiction and international telemedicine.

    Science.gov (United States)

    McLean, Thomas R; McLean, Alexander B

    2008-01-01

    At what point does an international telemedicine transaction create a sufficient commercial nexus to allow one country the authority to impose its laws on a foreign telemedicine providers? Some light on this matter was shed by the US case of Hageseth versus Superior Court. The authority for extraterritorial jurisdiction is found in the US Constitution, which requires the states to cooperate in matters of law enforcement. Similar cooperation from foreign nations cannot be expected. Unless a defendant is charged with a capital offence, nations are rarely willing to extradite their citizens. As the unlicensed practice of medicine is not a capital offence, it is unlikely that an unlicensed telemedicine provider would be extradited to the US. Because low-volume unlicensed offshore telemedicine providers are unlikely to be extradited or to be subject to trade sanctions, they may be able to operate beyond the law.

  5. Accuracy of interpretation of full-length pediatric echocardiograms transmitted over an integrated services digital network telemedicine link.

    Science.gov (United States)

    Cotton, John L; Gallaher, Keith J; Henry, G William

    2002-09-01

    Transmission of echocardiograms via telemedicine links has allowed remote hospitals direct access to pediatric cardiology subspecialty care. This study assessed the accuracy of echocardiogram interpretation across an integrated services digital network (ISDN) telemedicine link. Telemedicine systems were installed between Cape Fear Valley Medical Center neonatal intensive care unit and University of North Carolina Hospitals. One board-certified pediatric cardiologist interpreted 105 full-length echocardiograms that were videotaped and then transmitted over the system. Six months later, the same cardiologist reinterpreted the 105 original videotape studies from the off-site hospital and results were compared with the interpretations of the transmitted data. Interpretation of transmitted echocardiograms did not differ significantly from the original studies for diagnosis, evaluation of left ventricular function, valve function evaluation, and the presence of a ductus arteriosus. Minor differences in qualitative parameters were seen. Transmission of full-length echocardiograms over the ISDN telemedicine link is comparable to videotape review. There was no loss of significant clinical information, and the minor discrepancies noted did not impact management decisions.

  6. [Chances and Risks of Telemedicine in Orthopaedics and Trauma Surgery].

    Science.gov (United States)

    Holderried, Martin; Schlipf, Madeleine; Höper, Ansgar; Meier, Reinhard; Stöckle, Ulrich; Kraus, Tobias Maximilian

    2017-08-24

    Background The use of information technology (IT) in health care has continuously increased. This includes software solutions for digitalisation, data storage and innovative approaches in diagnostics. The facilitation of the access to specific information, even by the patient, has changed daily clinical work. Patients inform themselves about symptoms, diagnostic methods and treatment options. This urge for information and the wish for the best treatment is summarised in the expression "patient empowerment". In some countries, the gap between do-it-yourself diagnosis and telemedicine via the telephone has already been closed. A sophisticated telemedical hotline may help to improve consultation and treatment of patients living in remote regions or rural communities. Traumatology telemedicine may also be used in trauma environments, such as disasters or mass casualties. Therefore, the purpose of this study was to assess the demand for e-health solutions among patients seeking the help of the emergency department in a trauma hospital. Methods A total of 255 patients (age range 18 - 75 years) were included in the study and were surveyed with the use of a questionnaire. As regards personal data, the questionnaire asked the patient about their Internet habits and about interesting topics they had researched in the world wide web. However, the questionnaire was specifically designed to ask for potential benefits and the patient's expectations for e-health solutions. Expected weaknesses and procedures for telemedical services were also included in a subsection. Results 43.5% of the patient cohort were woman and 56.5% men. The average distance to the hospital was 39.86 km. 223 patients were insured by the governmental health service providers and 32 had private insurance coverage. Aside from online shopping and online banking, the search for health topics was most frequent. The greatest fear was the lack of personal contact to the doctor (71.2%). Patients were also

  7. Mobile Videoconferencing Apps for Telemedicine.

    Science.gov (United States)

    Zhang, Kai; Liu, Wei-Li; Locatis, Craig; Ackerman, Michael

    2016-01-01

    The quality and performance of several videoconferencing applications (apps) tested on iOS (Apple, Cupertino, CA) and Android (Google, Mountain View, CA) mobile platforms using Wi-Fi (802.11), third-generation (3G), and fourth-generation (4G) cellular networks are described. The tests were done to determine how well apps perform compared with videoconferencing software installed on computers or with more traditional videoconferencing using dedicated hardware. The rationale for app assessment and the testing methodology are described. Findings are discussed in relation to operating system platform (iOS or Android) for which the apps were designed and the type of network (Wi-Fi, 3G, or 4G) used. The platform, network, and apps interact, and it is impossible to discuss videoconferencing experienced on mobile devices in relation to one of these factors without referencing the others. Apps for mobile devices can vary significantly from other videoconferencing software or hardware. App performance increased over the testing period due to improvements in network infrastructure and how apps manage bandwidth.

  8. Letting Structure Emerge: Connectionist and Dynamical Systems Approaches to Cognition

    Science.gov (United States)

    McClelland, James L.; Botvinick, Matthew M.; Noelle, David C.; Plaut, David C.; Rogers, Timothy T.; Seidenberg, Mark S.; Smith, Linda B.

    2011-01-01

    Connectionist and dynamical systems approaches explain human thought, language and behavior in terms of the emergent consequences of a large number of simple non-cognitive processes. We view the entities that serve as the basis for structured probabilistic approaches as sometimes useful but often misleading abstractions that have no real basis in the actual processes that give rise to linguistic and cognitive abilities or the development of these abilities. While structured probabilistic approaches can be useful in determining what would be optimal under certain assumptions, we suggest that approaches such as the connectionist and dynamical systems approaches, which focus on explaining the mechanisms giving rise to cognition, will be essential in achieving a full understanding of cognition and development. PMID:20598626

  9. Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations.

    Science.gov (United States)

    Müller, Kai Ivar; Alstadhaug, Karl Bjørnar; Bekkelund, Svein Ivar

    2016-05-30

    The feasibility of telemedicine in diagnosing and treating nonacute headaches, such as primary headaches (migraine and tension-type) and medication-overuse headaches has not been previously investigated. By eliminating the need of travel to specialists, telemedicine may offer significant time and money savings. Our objective was to estimate the acceptance of telemedicine and investigate the feasibility and cost savings of telemedicine consultations in diagnosing and treating nonacute headaches. From September 2012 to March 2015, nonacute headache patients from Northern Norway who were referred to neurologists through an electronic application system were consecutively screened and randomized to participate in either telemedicine or traditional specialist visits. All patients were consulted by two neurologists at the neurological department in Tromsø University Hospital. Feasibility outcomes were compared between telemedicine and traditional groups. Baseline characteristics and costs were then compared between rural and urban patients. Travel costs were calculated by using the probabilistic method of the Norwegian traveling agency: the cheapest means of public transport for each study participant. Loss of pay was calculated based on the Norwegian full-time employee's average salary: salary, > 3.5 hours spent on travel and consultation=one day's salary. Distance and time spent on travel were estimated by using Google Maps. Of 557 headache patients screened, 479 were found eligible and 402 accepted telemedicine participation (83.9%, 402/479) and were included in the final analyses. Of these, 202 received traditional specialist consultations and 200 received telemedicine. All patients in the telemedicine group were satisfied with the video quality, and 198 (99%, 198/200) were satisfied with the sound quality. The baseline characteristics as well as headache diagnostics and follow-up appointments, and the investigation, advice, and prescription practices were not

  10. Federal Emergency Management Information System (FEMIS) System Administration Guide for FEMIS Version 1.4.6

    Energy Technology Data Exchange (ETDEWEB)

    Arp, J.A.; Bower, J.C.; Burnett, R.A.; Carter, R.J.; Downing, T.R.; Fangman, P.M.; Gerhardstein, L.H.; Homer, B.J.; Johnson, D.M.; Johnson, R.L.; Johnson, S.M.; Loveall, R.M.; Martin, T.J.; Millard, W.D.; Schulze, S.A.; Stoops, L.R.; Tzemos, S.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  11. Toward computer-assisted diagnosis and telemedicine in ophthalmology

    Czech Academy of Sciences Publication Activity Database

    Marrugo, A.; Millán, M. S.; Cristóbal, G.; Gabarda, S.; Šorel, Michal; Šroubek, Filip

    2012-01-01

    Roč. 2012, č. 6 (2012), s. 1-3 ISSN 1818-2259 R&D Projects: GA MŠk 1M0572 Institutional research plan: CEZ:AV0Z10750506 Institutional support: RVO:67985556 Keywords : computer-aided diagnosis * medical and retinal image * deconvolution * telemedicine Subject RIV: JD - Computer Applications, Robotics http://library.utia.cas.cz/separaty/2012/ZOI/sorel-toward computer-assisted diagnosis and telemedicine in ophthalmology .pdf

  12. Effectiveness and acceptability of medical abortion provided through telemedicine.

    Science.gov (United States)

    Grossman, Daniel; Grindlay, Kate; Buchacker, Todd; Lane, Kathleen; Blanchard, Kelly

    2011-08-01

    To estimate the effectiveness and acceptability of telemedicine provision of early medical abortion compared with provision with a face-to-face physician visit at a Planned Parenthood affiliate in Iowa. Between November 2008 and October 2009, we conducted a prospective cohort study of women obtaining medical abortion by telemedicine or face-to-face physician visits. We collected clinical data, and women completed a self-administered questionnaire at follow-up. We also compared the prevalence of reportable adverse events between the two service delivery models among all patients seen between July 2008 and October 2009. Of 578 enrolled participants, follow-up data were obtained for 223 telemedicine patients and 226 face-to-face patients. The proportion with a successful abortion was 99% for telemedicine patients (95% confidence interval [CI] 96-100%) and 97% for face-to-face patients (95% CI 94-99%). Ninety-one percent of all participants were very satisfied with their abortion, although in multivariable analysis, telemedicine patients had a higher odds of saying they would recommend the service to a friend compared with face-to-face patients (odds ratio, 1.72; 95% CI 1.26-2.34). Twenty-five percent of telemedicine patients said they would have preferred being in the same room with the doctor. Younger age, less education, and nulliparity were significantly associated with preferring face-to-face communication. There was no significant difference in the prevalence of adverse events reported during the study period among telemedicine patients (n = 1,172) (1.3%; 95% CI 0.8-2.1%) compared with face-to-face patients (n = 2,384) (1.3%; 95% CI 0.9-1.8%) (82% power to detect difference of 1.3%). Provision of medical abortion through telemedicine is effective and acceptability is high among women who choose this model. II.

  13. Narrative review of telemedicine consultation in medical practice

    Directory of Open Access Journals (Sweden)

    Di Cerbo A

    2015-01-01

    Full Text Available Alessandro Di Cerbo,1,2 Julio Cesar Morales-Medina,3 Beniamino Palmieri,1,2 Tommaso Iannitti4 1Poliambulatorio del Secondo Parere, 2Department of General Surgery and Surgical Specialties, Surgical Clinic, University of Modena and Reggio Emilia Medical School, Modena, Italy; 3Centro de Investigación en Reproducción Animal, CINVESTAV, Universidad Autónoma de Tlaxcala, Tlaxcala de Xicohténcatl, Mexico; 4Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN, University of Sheffield, Sheffield, UK Background: The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”.Objective: This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care.Methods: A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-­medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty.Results: Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions.Conclusion: Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. Keywords: telemedicine, health care, patient

  14. Applications of telemedicine in dentistry. Review of literature

    OpenAIRE

    Elmokadem, Mohamed Said Elsayed

    2013-01-01

    The aim of this study was to review the different papers and articles that discuss applications of telemedicine in the dental field. This study is qualitative narrative review of literature Research of teledentistry literature was conducted in order to identify the relevant articles. The research focused on the electronic database of US National library of medicine .National institute of health (Pubmed.gov) and Journal of telemedicine and telecare. Specific keywords that were used in the rese...

  15. Perceived benefit of a telemedicine consultative service in a highly staffed intensive care unit.

    Science.gov (United States)

    Romig, Mark C; Latif, Asad; Gill, Randeep S; Pronovost, Peter J; Sapirstein, Adam

    2012-08-01

    The aim of this study was to evaluate whether a nocturnal telemedicine service improves culture, staff satisfaction, and perceptions of quality of care in a highly staffed university critical care system. We conducted an experiment to determine the effect of telemedicine on nursing-staff satisfaction and perceptions of the quality of care in an intensive care unit (ICU). We surveyed ICU nurses using a modified version of a previously validated tool before deployment and after a 2-month experimental program of tele-ICU. Nurses in another, similar ICU within the same hospital academic medical center served as concurrent controls for the survey responses. Survey responses were measured using a 5-point Likert scale, and results were analyzed using paired t testing. Survey responses of the nurses in the intervention ICU (n = 27) improved significantly after implementation of the tele-ICU program in the relations and communication subscale (2.99 ± 1.13 pre vs 3.27 ± 1.27 post, P burnout subscale (3.10 ± 1.10 pre vs 3.23 ± 1.11 post, P care and perceived effectiveness (3.94 ± 0.80 pre vs 3.48 ± 0.86 post, P < .01) and the education (3.95 ± 0.39 pre vs 3.50 ± 0.80 post, P < .05) subscales. Telemedicine has the potential to improve staff satisfaction and communication in highly staffed ICUs. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Design and Technical Validation of a Telemedicine Service for Rural Healthcare in Ecuador.

    Science.gov (United States)

    Vasquez-Cevallos, Leonel A; Bobokova, Jana; González-Granda, Patricia V; Iniesta, José M; Gómez, Enrique J; Hernando, M Elena

    2017-12-12

    Telemedicine is becoming increasingly important in Ecuador, especially in areas such as rural primary healthcare and medical education. Rural telemedicine programs in the country need to be strengthened by means of a technological platform adapted to local surroundings and offering advantages such as access to specialized care, continuing education, and so on, combined with modest investment requirements. This present article presents the design of a Telemedicine Platform (TMP) for rural healthcare services in Ecuador and a preliminary technical validation with medical students and teachers. An initial field study was designed to capture the requirements of the TMP. In a second phase, the TMP was validated in an academic environment along three consecutive academic courses. Assessment was by means of user polls and analyzing user interactions as registered automatically by the platform. The TMP was developed using Web-based technology and open code software. One hundred twenty-four students and 6 specialized faculty members participated in the study, conducting a total of 262 teleconsultations of clinical cases and 226 responses, respectively. The validation results show that the TMP is a useful communication tool for the documentation and discussion of clinical cases. Moreover, its usage may be recommended as a teaching methodology, to strengthen the skills of medical undergraduates. The results indicate that implementing the system in rural healthcare services in Ecuador would be feasible.

  17. Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology.

    Science.gov (United States)

    Wechsler, Lawrence R; Tsao, Jack W; Levine, Steven R; Swain-Eng, Rebecca J; Adams, Robert J; Demaerschalk, Bart M; Hess, David C; Moro, Elena; Schwamm, Lee H; Steffensen, Steve; Stern, Barney J; Zuckerman, Steven J; Bhattacharya, Pratik; Davis, Larry E; Yurkiewicz, Ilana R; Alphonso, Aimee L

    2013-02-12

    To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice, military medicine, and current federal policy. Review of practice models and published literature on primary studies of the efficacy of neurology telemedicine. Teleneurology is of greatest benefit to populations with restricted access to general and subspecialty neurologic care in rural areas, those with limited mobility, and those deployed by the military. Through the use of real-time audio-visual interaction, imaging, and store-and-forward systems, a greater proportion of neurologists are able to meet the demand for specialty care in underserved communities, decrease the response time for acute stroke assessment, and expand the collaboration between primary care physicians, neurologists, and other disciplines. The American Stroke Association has developed a defined policy on teleneurology, and the American Academy of Neurology and federal health care policy are beginning to follow suit. Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into further areas of neurology.

  18. Use and feasibility of telemedicine technology in the dissemination of Parent-Child Interaction Therapy.

    Science.gov (United States)

    Funderburk, Beverly W; Ware, Lisa M; Altshuler, Elizabeth; Chaffin, Mark

    2008-11-01

    This brief report discusses the use and feasibility of telemedicine technology in the dissemination of Parent-Child Interaction Therapy (PCIT). PCIT is an empirically supported behavioral parent training program for reducing disruptive behavior in young children and for reducing future rates of child physical abuse. The positive impact PCIT has demonstrated in reducing child maltreatment has galvanized interest in widespread dissemination of the PCIT model into child service systems. PCIT has traditionally been taught in university-based training programs in a mentored cotherapy model. By contrast, in field settings, PCIT training typically consists of workshop training supplemented by a period of telephone consultation (PC). Given concerns with the level of practitioner competency and fidelity yielded by the PC model, PCIT training programs have begun to examine Internet-based telemedicine technology to deliver live, mentored PCIT training to trainees at remote locations (Remote Real-Time or RRT) to better approximate the university-based training model. Challenges of disseminating evidence-based practices are discussed, using PCIT as a model of how these challenges are being addressed by telemedicine technology.

  19. Telemedicine: opportunities and risks; Telemedizin: Chancen und Risiken

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, R. [IT-Abteilung, Tiroler Landeskrankenanstalten GmbH, Innsbruck (Austria)

    2002-05-01

    Problem. Due to the rapid progress in the fields of information technology and data networks, telemedicine applications are growing in number. Besides curative telemedicine, the electronic exchange of medical data and the integration of health information systems between health care providers is gaining importance. Through the improved accessibility of electronic patient record information, considerable risks arise.Methods. A project for the interconnection of medical picture archiving and communication systems (PACS) between several hospitals is presented and the possibilities for further developing such networking systems utilizing new software technologies for transparent data access between different locations (GRID) and for decision support (software agents) are considered.Results. The availability of the electronic patient record via the data network and the perspective of semi intelligent software systems automatically preparing the data bears great potential for a boost in treatment quality and efficiency. Systems for unique electronic patient identification and for secure digital signature are a prerequisite, but per se not enough to ensure the protection of data against illegitimate access.Conclusion. Despite quality and efficiency benefits, challenges in the protection of sensible data and in the change of the physicians role result. (orig.) [German] Fragestellung. Durch die rasante Entwicklung der Informationstechnologie und der Datennetzwerke werden auch telemedizinische Applikationen immer zahlreicher eingesetzt. Neben der kurativen Telemedizin, die medienwirksame Erfolge verbuchen kann, gewinnen der elektronische Datenaustausch und die Gesundheitseinrichtungen uebergreifende Informationssystemintegration wachsende Bedeutung. Aus der besseren Zugaenglichkeit der elektronischen Krankengeschichtsinformation ergeben sich neben Chancen auch Risiken.Methodik. Ein Beispielprojekt fuer die Vernetzung von medizinischen Bildarchivierungssystemen (PACS

  20. Recycling Frank: Spontaneous emergence of homochirality in noncatalytic systems

    Science.gov (United States)

    Plasson, Raphaël; Bersini, Hugues; Commeyras, Auguste

    2004-01-01

    In this work, we introduce a prebiotically relevant protometabolic pattern corresponding to an engine of deracemization by using an external energy source. The spontaneous formation of a nonracemic mixture of chiral compounds can be observed in out-of-equilibrium systems via a symmetry-breaking phenomenon. This observation is possible thanks to chirally selective autocatalytic reactions (Frank's model) [Frank, F. C. (1953) Biochim. Biophys. Acta 11, 459–463]. We show that the use of a Frank-like model in a recycled system composed of reversible chemical reactions, rather than the classical irreversible system, allows for the emergence of a synergetic autoinduction from simple reactions, without any autocatalytic or even catalytic reaction. This model is described as a theoretical framework, based on the stereoselective reactivity of preexisting chiral monomeric building blocks (polymerization, epimerization, and depolymerization) maintained out of equilibrium by a continuous energy income, via an activation reaction. It permits the self-conversion of all monomeric subunits into a single chiral configuration. Real prebiotic systems of amino acid derivatives can be described on this basis. They are shown to be able to spontaneously reach a stable nonracemic state in a few centuries. In such systems, the presence of epimerization reactions is no more destructive, but in contrast is the central driving force of the unstabilization of the racemic state. PMID:15548617

  1. Social work management in emerging health care systems.

    Science.gov (United States)

    Kenney, J J

    1990-02-01

    An overview of the health care industry's trend toward multihealth systems is presented and specific adaptive strategies for social work managers in health care are suggested. The challenges to social work leaders during this transition from largely free-standing, privately owned health care institutions to corporately owned, horizontally and vertically integrated delivery systems are discussed in terms of identity, style, and substance. Directors of social work departments in multihealth corporations will need to resolve issues of institutional versus corporate identity as well as those of corporate versus professional identity. A multioptional management style that incorporates networking and political expertise should be cultivated. Substantive demands in the areas of management information systems, productivity, quality assurance, and budgeting also must be addressed. The emergence of multihealth systems poses major challenges and unique opportunities to the social work profession. Awareness of managerial strategies and critical content areas can help social work leaders enhance the role and contribution of social work in these exciting and complex health care delivery systems.

  2. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    Science.gov (United States)

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network.

  3. A systematic review of telemedicine projects in Colombia.

    Science.gov (United States)

    Rey-Moreno, Carlos; Reigadas, Javier Simó; Villalba, Estrella Everss; Vinagre, Juan Jose; Fernández, Andrés Martínez

    2010-01-01

    A systematic review of telemedicine projects in Colombia was conducted. We searched electronic databases, and also searched for relevant Internet websites. Each project manager was contacted by telephone to identify projects which had not actually been carried out. They were interviewed to request information about the projects they were managing, and whether they knew of other projects in Colombia. The search process identified 43 different projects, which were classified into two groups: telemedicine research initiatives and projects for providing health-care services via telemedicine. There were 32 projects which provided telemedicine services, of which 14 had been finished, 11 remained active, 4 were being implemented and no data were available about the state of the other 3. Health-care services had been provided using telemedicine to at least 550,000 patients. The projects had connected more than 650 health-care institutions, mainly in deprived areas of the country. Unfortunately, although many projects seem to have had a positive effect, none of them had been rigorously evaluated, and therefore in the absence of scientific evidence no general recommendations can be made. However, the methodology of the present study appears suitable for similar reviews of telemedicine in other developing countries.

  4. Telemedicine: socio-ethical considerations in the Indian milieu.

    Science.gov (United States)

    Sharma, Luv K; Rajput, Meena

    2009-01-01

    Telemedicine is the rapidly developing application of clinical medicine by telephone, the internet or other networks for the purpose of consulting, and on occasions carrying out examinations or medical procedures. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries. Telemedicine offers real benefits in a country as vast as India where the majority of the population lives in remote areas with no access to even the most basic healthcare. As the practice of telemedicine spreads, maintaining standards, security and privacy, will be a challenge especially with regard to legal and regulatory measures and who will be held responsible if telemedicine-assisted surgery fails due to failure in connectivity? Is it the surgeon, the satellite provider or the software/hardware engineer? What is the legal status of telemedicine-based diagnosis and treatment? Other legal issues involve conflicting national laws and information piracy, the dangers of prescription drugs that are banned in one country but not in another and quacks who offer medical advice and prescribe drugs over the internet. This paper discusses some of the legal, ethical and social considerations in the Indian context.

  5. Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced?

    Directory of Open Access Journals (Sweden)

    Cynthia LeRouge

    2013-11-01

    Full Text Available Barriers have challenged widespread telemedicine adoption by health care organizations for 40 years. These barriers have been technological, financial, and legal and have also involved business strategy and human resources. The article canvasses recent trends—events and activities in each of these areas as well as US health reform activities that might help to break down these barriers. The key to telemedicine success in the future is to view it as an integral part of health care services and not as a stand-alone project. Telemedicine must move from experimental and separate to integrated and equivalent to other health services within health care organizations. Furthermore, telemedicine serves as vital connective tissue for expanding health care organization networks.

  6. 46 CFR 78.17-45 - Emergency lighting and power systems.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Emergency lighting and power systems. 78.17-45 Section... OPERATIONS Tests, Drills, and Inspections § 78.17-45 Emergency lighting and power systems. (a) It shall be the duty of the master to see that the emergency lighting and power systems are operated and inspected...

  7. 46 CFR 97.15-30 - Emergency lighting and power systems.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency lighting and power systems. 97.15-30 Section... VESSELS OPERATIONS Tests, Drills, and Inspections § 97.15-30 Emergency lighting and power systems. (a) Where fitted, it shall be the duty of the master to see that the emergency lighting and power systems...

  8. 46 CFR 196.15-30 - Emergency lighting and power systems.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency lighting and power systems. 196.15-30 Section... VESSELS OPERATIONS Test, Drills, and Inspections § 196.15-30 Emergency lighting and power systems. (a) Where fitted, it shall be the duty of the master to see that the emergency lighting and power systems...

  9. 77 FR 36014 - Initial Test Program of Emergency Core Cooling Systems for Boiling-Water Reactors

    Science.gov (United States)

    2012-06-15

    ... COMMISSION Initial Test Program of Emergency Core Cooling Systems for Boiling-Water Reactors AGENCY: Nuclear...-1277, ``Initial Test Program of Emergency Core Cooling Systems for Boiling- Water Reactors.'' This... testing features of emergency core cooling systems (ECCSs) for boiling-water reactors (BWRs). DATES...

  10. USA IN THE EMERGING SYSTEM OF GLOBAL FINANCIAL REGULATION

    Directory of Open Access Journals (Sweden)

    V. K. Kulakova

    2016-01-01

    Full Text Available In the globalizing world of fi nancial and economic interdependence, a polycentric, multi-level, and hierarchical system of global financial regulation is emerging. The article highlights two vectors of recent development in international fi nancial regulation: the rise of cooperation through the mechanisms of the Group of Twenty (G-20 on the one hand, and the efforts to maintain the US leading role in global fi nance, on the other hand. In the circumstances of the global fi nancial crisis of 2008, the G-20 countries initiated an international reform of fi nancial regulation. According to G-20 decisions, international standardsetting organizations developed transnational regulatory regimes in the fi elds of banking, derivatives and bankruptcy resolution, and the states now implement these regimes in their jurisdictions. The so-called “soft law system”, which is not legally binding, allows the states to sustain national sovereignty in their fi nancial policy. The United States play a leading role in the international fi nancial reform, as well as in the shaping of the global fi nancial regulation system. The American regulators push for extraterritorial application of the US norms and take other unilateral actions on the international arena. The article also touches upon legitimacy problems of the emerging system of global fi nancial regulation. The most important constrains are the excessive infl uence of the fi nancial industry (“regulatory capture”, the weakness of civil society participation, and also the fact that for the rest of the world the American norms lack legitimacy, as they are adopted by regulators assigned by offi cials elected by population of a foreign territory.

  11. Performance Evaluation of Terrestrial Emergency Communication System in NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Son, Gwang Sub; Kim, Chang Hwoi; Kang, Hyun Gook [KAERI, Daejeon (Korea, Republic of)

    2014-08-15

    The Fukushima accident induced by the great earthquake and tsunami reveals the vulnerability of I and C System. In the severe environment, the normal I and C system did not work properly and results in false information about the internal situation in NPP. Eventually the accident was not properly handled at the early stage. Therefore advanced emergency response system using a wireless channel is necessary to cope with the severe accident. In this paper, we introduce the ERS consisting of the HMS and MCS the ECS linking the HMS with MCS and the performance requirement of the ECS is analyzed. The ECS satisfying the requirement is designed conceptually and the performance of the ECS is evaluated through analysis and simulator. The terrestrial communication system is designed based on the IEEE 802.11. Analyzed performance results prove that the performance requirement can be sufficiently achieved. But if the scalability of data capacity is considered later, use of the advanced 802.11 standard such as 802.11n and multiple signal paths between the HMS and MCS are necessary.

  12. A Systems Medicine Approach: Translating Emerging Science into Individualized Wellness

    Directory of Open Access Journals (Sweden)

    J. S. Bland

    2017-01-01

    Full Text Available In today’s aging society, more people are living with lifestyle-related noncommunicable diseases (NCDs such as cardiovascular disease, type 2 diabetes, obesity, and cancer. Numerous opinion-leader organizations recommend lifestyle medicine as the first-line approach in NCD prevention and treatment. However, there is a strong need for a personalized approach as “one-size-fits-all” public health recommendations have been insufficient in addressing the interindividual differences in the diverse populations. Advancement in systems biology and the “omics” technologies has allowed comprehensive analysis of how complex biological systems are impacted upon external perturbations (e.g., nutrition and exercise, and therefore is gradually pushing personalized lifestyle medicine toward reality. Clinicians and healthcare practitioners have a unique opportunity in advocating lifestyle medicine because patients see them as a reliable source of advice. However, there are still numerous technical and logistic challenges to overcome before personal “big data” can be translated into actionable and clinically relevant solutions. Clinicians are also facing various issues prior to bringing personalized lifestyle medicine to their practice. Nevertheless, emerging ground-breaking research projects have given us a glimpse of how systems thinking and computational methods may lead to personalized health advice. It is important that all stakeholders work together to create the needed paradigm shift in healthcare before the rising epidemic of NCDs overwhelm the society, the economy, and the dated health system.

  13. Demonstration of an Emergency Containment System. [Tritium containment

    Energy Technology Data Exchange (ETDEWEB)

    Flanagan, T.M.; Rogers, M.L.; Wilkes, W.R.

    1978-01-01

    A system called an Emergency Containment System (ECS) to be used for tertiary containment of tritium was reported at the 13th Air Cleaning Conference. This system was part of the Tritium Effluent Control Laboratory then under construction at Mound Facility. A series of experiments has recently been conducted to evaluate the performance of an ECS in capturing tritium accidentally released into an operating laboratory. The ECS is an automatically actuated laboratory air detritiation system utilizing a catalytic oxidation reactor and presaturated oxide adsorption/exchange columns. In the event of an accidental release of tritium into the laboratory, the ECS is automatically activated, and quick-acting pneumatic dampers divert the laboratory air supply and exhaust through the ECS until room concentrations are returned to safe operating levels. The results of the experiments have shown that a tertiary containment of tritium is feasible. In the event of a catastrophic accident, the ECS is capable of preventing the release of a large quantity of tritium to the environment.

  14. NETWORK SERVICES FOR DIAGNOSTIC OPTODIGITAL COMPLEX FOR TELEMEDICINE

    Directory of Open Access Journals (Sweden)

    D. S. Kopylov

    2014-03-01

    Full Text Available The paper deals with a result of the network services development for the optodigital complex for telemedicine diagnostics. This complex is designed for laboratory and clinical tests in health care facilities. Composition of network services includes the following: a client application for database of diagnostic test, a web-service, a web interface, a video server and microimage processing server. Structure of these services makes it possible to combine set of software for transferring depersonalized medical data via the Internet and operating with optodigital devices included in the complex. Complex is consisted of three systems: micro-vision, endoscopic and network. The micro-vision system includes an automated digital microscope with two highly sensitive cameras which can be controlled remotely via the Internet. The endoscopic system gives the possibility to implement video broadcasting to remote users both during diagnostic tests and also off-line after tests. The network system is the core of the complex where network services and application software are functioning, intended for archiving, storage and providing access to the database of diagnostic tests. The following subjects are developed and tested for functional stability: states transfer protocol, commands transfer protocol and video-stream transfer protocol from automated digital microscope and video endoscope. These protocols can work in web browsers on modern mobile devices without additional software.

  15. Federal Emergency Management Information System (FEMIS) system administration guide, version 1.4.5

    Energy Technology Data Exchange (ETDEWEB)

    Arp, J.A.; Burnett, R.A.; Carter, R.J. [and others

    1998-06-26

    The Federal Emergency Management Information Systems (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication, data distribution, and notification functionality necessary to operate FEMIS in a networked, client/server environment. The UNIX server provides an Oracle relational database management system (RDBMS) services, ARC/INFO GIS (optional) capabilities, and basic file management services. PNNL developed utilities that reside on the server include the Notification Service, the Command Service that executes the evacuation model, and AutoRecovery. To operate FEMIS, the Application Software must have access to a site specific FEMIS emergency management database. Data that pertains to an individual EOC`s jurisdiction is stored on the EOC`s local server. Information that needs to be accessible to all EOCs is automatically distributed by the FEMIS

  16. [Health care system sustainability and the contribution of emergency departments].

    Science.gov (United States)

    Urbanos-Garrido, Rosa María; López-Valcárcel, Beatriz G

    2015-06-01

    The purpose of this paper is to describe the main proposals for ensuring national health service sustainability, in the light of a review of the most relevant diagnostic reports and guidelines published since the onset of the economic crisis. The following proposals are among the most frequently mentioned in the literature: selective financing of technology, reorganization to provide more care for chronic conditions and better coordination between levels of care and the network of social and health care services, and the reinforcement of primary care. Also commonly suggested is the reform of health care governance. Likewise, the authors briefly examine the measures adopted to date to promote the system's sustainability and discuss how the emergency department can further this aim.

  17. Conceptual design of an emergency tritium clean-up system

    Energy Technology Data Exchange (ETDEWEB)

    Muller, M.E.

    1978-01-01

    The Los Alamos Scientific Laboratory (LASL) has been selected by the Department of Energy (DOE) to design, build, and operate a facility to demonstrate the operability of the tritium-related subsystems that would be required to successfully develop fusion reactor systems. An emergency tritium clean-up subsystem (ETC) for this facility will be designed to remove tritium from the cell atmosphere if an accident causes the primary and secondary tritium containment to be breached. Conceptually, the ETC will process cell air at the rate of 0.65 actual m/sup 3//s and will achieve an overall decontamination factor of 10/sup 6/ per tritium oxide (T/sub 2/O). Following the maximum credible release of 100 g of tritium, the ETC will restore the cell to opertional status within 24 h without a significant release of tritium to the environment.

  18. RAILWAY EMERGENCY SITUATIONS PREVENTION SYSTEM BASED ON GEOGRAPHIC INFORMATION TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    V. V. Alekseev

    2013-01-01

    Full Text Available The article deals with the system of emergency situation prevention on railway based on geographic information technologies (GIS, which makes it possible to estimate the influence of railroad defects, industrial objects (factories, plants located near investigated section of the railway and natural factors (influence of the elements on traffic safety. The procedures of area maps design for information systematization and display are offered. The algorithm of measurement information processing is developed, based on wavelet transform, that gives the possibility for the definition of railway bed defect parameters immediately after the measurements and does not require accumulation of information for further decryption. Techniques for influence estimation of natural and industrial factors on traffic safety are suggested to provide immediate representation of information for decisionmaking.

  19. How is Telemedicine perceived? A qualitative study of perspectives from the UK and India

    Directory of Open Access Journals (Sweden)

    Chanda Rupa

    2011-05-01

    Full Text Available Abstract Background Improvements in communication and information technologies have allowed for the globalisation of health services, especially the provision of health services from other countries, such as the use of telemedicine. This has led countries to evaluate their position on whether and to what extent they should open their health systems to trade. This often takes place from the context of multi-lateral trade agreements (under the auspices of the World Trade Organisation, which is misplaced as a significant amount of trade takes place regionally or bi-laterally. We report here the results of a qualitative study assessing stakeholders' views on the potential for a bi-lateral trade relationship between India and the UK, where India acts as an exporter and the UK as an importer of telemedicine services. Methods 19 semi-structured interviews were carried out with stakeholders from India and the UK. The themes discussed include prospects on the viability of a bi-lateral relationship between the UK and India on telemedicine, current activities and operations, barriers, benefits and risks. Results The participants in general believed there were good prospects for telemedicine trade, and that this could bring benefits to "importing" countries in terms of cost-savings and faster delivery of care and to "exporting" countries in the form of foreign exchange and quality improvement. However, there were some concerns regarding quality of care, regulation, accreditation and data security. Conclusions There is potential for trade in this type of health services to succeed and bring about important benefits to the countries involved. However, issues around data security and accreditation need to be taken into consideration. Countries may wish to consider entering bi-lateral agreements, as they provide more potential to address the concerns and capitalise on the benefits. Finally, this paper concludes that more data should be collected, both on the

  20. The Rescue911 Emergency Response Information System (ERIS): A Systems Development Project Case

    Science.gov (United States)

    Cohen, Jason F.; Thiel, Franz H.

    2010-01-01

    This teaching case presents a systems development project useful for courses in object-oriented analysis and design. The case has a strong focus on the business, methodology, modeling and implementation aspects of systems development. The case is centered on a fictitious ambulance and emergency services company (Rescue911). The case describes that…

  1. Telemedicine networks of EHAS Foundation in Latin America

    Directory of Open Access Journals (Sweden)

    Ignacio ePrieto-Egido

    2014-10-01

    Full Text Available Rural areas in developing countries are characterized by lack of resources, low population density and scarcity of communications infrastructure. These circumstances make it difficult to provide appropriate healthcare services. This paper explains research results achieved by EHAS (Enlace Hispano Americano de Salud - Hispano American Health Link and how they have contributed to improve healthcare in isolated areas of developing countries through the use of Information and Communication Technologies (ICT. As the first step, EHAS always collaborates with public health systems to identify its communication and information needs. Based on the analysis of needs, EHAS does research on appropriate technologies to provide communication in each context and on information systems suited to needs of health personnel. In parallel, EHAS has worked to provide applications that, making use of the communications services installed, could improve the healthcare services in these remote areas. In this line, solutions to improve epidemiological surveillance or to provide telemedicine services (like a digital stethoscope or a tele-microscopy system have been developed. EHAS has also performed several researches trying to ensure the sustainability of their solutions and has summarized them in a Management Framework for Sustainable e-Healthcare Provision. Finally, the effort to spread acquired knowledge has crystallized in a book that details all the technologies and procedures previously mentioned.

  2. Telemedicine Networks of EHAS Foundation in Latin America

    Science.gov (United States)

    Prieto-Egido, Ignacio; Simó-Reigadas, Javier; Liñán-Benítez, Leopoldo; García-Giganto, Víctor; Martínez-Fernández, Andrés

    2014-01-01

    Rural areas in developing countries are characterized by lack of resources, low population density, and scarcity of communications infrastructure. These circumstances make it difficult to provide appropriate health-care services. This paper explains research results achieved by Enlace Hispano Americano de Salud – Hispano American Health Link (EHAS) and how they have contributed to improve healthcare in isolated areas of developing countries through the use of information and communication technologies (ICT). As the first step, EHAS always collaborates with public health systems to identify its communication and information needs. Based on the analysis of needs, EHAS does research on appropriate technologies to provide communication in each context and on information systems suited to needs of health personnel. In parallel, EHAS has worked to provide applications that, making use of the communications services installed, could improve the health-care services in these remote areas. In this line, solutions to improve epidemiological surveillance or to provide telemedicine services (like a digital stethoscope or a tele-microscopy system) have been developed. EHAS has also performed several researches trying to ensure the sustainability of their solutions and has summarized them in a Management Framework for Sustainable e-Healthcare Provision. Finally, the effort to spread acquired knowledge has crystallized in a book that details all the technologies and procedures previously mentioned. PMID:25360436

  3. Integrating telemedicine instruction into the curriculum: expanding student perspectives of the scope of clinical practice.

    Science.gov (United States)

    Bulik, Robert J; Shokar, Gurjeet S

    2010-01-01

    We have developed a telemedicine elective for fourth-year medical students to learn about the delivery of primary care telemedicine. The goals were to expose medical students to telemedicine as a method for delivery of primary care and to reinforce the importance of doctor-patient communication during the health-care encounter. The elective lasted four weeks. It had three components: two online introductory courses to telemedicine; site visits to near and distant telemedicine sites; and a reflective writing paper. In the first year, seven medical students out of a class of 230 chose the telemedicine elective from a list of 188 alternatives. Evaluation ratings and the students' written comments, along with end-of-course discussions, indicated that the telemedicine elective was a valuable experience. An elective in the medical school curriculum may be a useful way of providing future physicians with an understanding of telemedicine.

  4. Telemedicine and advances in urban and rural healthcare delivery in Africa.

    Science.gov (United States)

    Mars, Maurice

    2013-01-01

    Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine. © 2013.

  5. Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study

    Science.gov (United States)

    Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

    2015-01-01

    Objectives We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members’ thoughts regarding high impact solutions to expand access to essential emergency services. Design We used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated and analysed using the content analysis approach. Setting Participants were uniformly selected from all eight of the historical Kenyan provinces (Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley and Western), with equal rural and urban community representation. Results Socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies, and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care—a lack of: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Conclusions Access to emergency care in Kenya can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre-hospital care system, improving emergency care delivery at health facilities and creating new policies at a national level. These community-generated solutions likely have a wider applicability in the region. PMID:26586324

  6. Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study.

    Science.gov (United States)

    Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

    2015-11-19

    We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members' thoughts regarding high impact solutions to expand access to essential emergency services. We used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated and analysed using the content analysis approach. Participants were uniformly selected from all eight of the historical Kenyan provinces (Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley and Western), with equal rural and urban community representation. Socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies, and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care-a lack of: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Access to emergency care in Kenya can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre-hospital care system, improving emergency care delivery at health facilities and creating new policies at a national level. These community-generated solutions likely have a wider applicability in the region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. [Use of telematics in emergency medicine].

    Science.gov (United States)

    Masić, I; Macić, A; Banjanović, B; Knezević, Z; Masić, Z; Toromanović, S; Pandza, H; Pasić, E

    2000-01-01

    Health telematics is a composite term for health-related activities, services and systems carried out over a distance by means of information and communications technololgies, for the purposes of global health promotion, disease control and health care, as well as education, management, and research for health. The concept of health telematics encompasses the following functional areas:--tele-education;--telemedicine;--telematics for health research;--telematics for health services management. Communications technologies are rapidly revolutionizing health care. For example, electronic communications support diagnosis and treatment of disease. TeleMedicine is an umbrella term for growing disciplines such as TeleRadiology, TelePathology, TeleCardiology, TelePsychiatry and TeleEducation. TeleMedicine is a component of TeleHealth, which includes the use of telecommunications technology and services for the surveillance and control of diseases and education. In this article authors describes the role of telemedicine and telematics in medical education and medical praxis.

  8. Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.

    Science.gov (United States)

    Clark, Lindsey N; Benda, Natalie C; Hegde, Sudeep; McGeorge, Nicolette M; Guarrera-Schick, Theresa K; Hettinger, A Zachary; LaVergne, David T; Perry, Shawna J; Wears, Robert L; Fairbanks, Rollin J; Bisantz, Ann M

    2017-04-01

    This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. EDISs assist emergency medicine staff with tracking patient care and ED resource allocation. Participants performed patient planning and orientation tasks using the EDIS displays and rated the display's ability to support various cognitive performance objectives along with the usability, usefulness, and predicted frequency of use for 18 system components. Mean ratings were positive for cognitive performance support objectives, usability, usefulness, and frequency of use, demonstrating the successful application of design methods to create useful and usable EDIS concepts that provide cognitive support for emergency medicine staff. Nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study

    OpenAIRE

    Pierfrancesco, Bellini; Sergio, Boncinelli; Francesco, Grossi; Marco, Mangini; Paolo, Nesi; Leonardo, Sequi

    2013-01-01

    Background Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literatur...

  10. Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review

    OpenAIRE

    Littauer, Sydney L.; Dixon, Dave L.; Mishra, Vimal K.; Sisson, Evan M.; Salgado, Teresa M.

    2017-01-01

    Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up tele...

  11. Parsing interindividual drug variability: an emerging role for systems pharmacology

    Science.gov (United States)

    Turner, Richard M; Park, B Kevin; Pirmohamed, Munir

    2015-01-01

    There is notable interindividual heterogeneity in drug response, affecting both drug efficacy and toxicity, resulting in patient harm and the inefficient utilization of limited healthcare resources. Pharmacogenomics is at the forefront of research to understand interindividual drug response variability, but although many genotype-drug response associations have been identified, translation of pharmacogenomic associations into clinical practice has been hampered by inconsistent findings and inadequate predictive values. These limitations are in part due to the complex interplay between drug-specific, human body and environmental factors influencing drug response and therefore pharmacogenomics, whilst intrinsically necessary, is by itself unlikely to adequately parse drug variability. The emergent, interdisciplinary and rapidly developing field of systems pharmacology, which incorporates but goes beyond pharmacogenomics, holds significant potential to further parse interindividual drug variability. Systems pharmacology broadly encompasses two distinct research efforts, pharmacologically-orientated systems biology and pharmacometrics. Pharmacologically-orientated systems biology utilizes high throughput omics technologies, including next-generation sequencing, transcriptomics and proteomics, to identify factors associated with differential drug response within the different levels of biological organization in the hierarchical human body. Increasingly complex pharmacometric models are being developed that quantitatively integrate factors associated with drug response. Although distinct, these research areas complement one another and continual development can be facilitated by iterating between dynamic experimental and computational findings. Ultimately, quantitative data-derived models of sufficient detail will be required to help realize the goal of precision medicine. WIREs Syst Biol Med 2015, 7:221–241. doi: 10.1002/wsbm.1302 PMID:25950758

  12. Emergent Hydrodynamics in Integrable Quantum Systems Out of Equilibrium

    Science.gov (United States)

    Castro-Alvaredo, Olalla A.; Doyon, Benjamin; Yoshimura, Takato

    2016-10-01

    Understanding the general principles underlying strongly interacting quantum states out of equilibrium is one of the most important tasks of current theoretical physics. With experiments accessing the intricate dynamics of many-body quantum systems, it is paramount to develop powerful methods that encode the emergent physics. Up to now, the strong dichotomy observed between integrable and nonintegrable evolutions made an overarching theory difficult to build, especially for transport phenomena where space-time profiles are drastically different. We present a novel framework for studying transport in integrable systems: hydrodynamics with infinitely many conservation laws. This bridges the conceptual gap between integrable and nonintegrable quantum dynamics, and gives powerful tools for accurate studies of space-time profiles. We apply it to the description of energy transport between heat baths, and provide a full description of the current-carrying nonequilibrium steady state and the transition regions in a family of models including the Lieb-Liniger model of interacting Bose gases, realized in experiments.

  13. Emergent Hydrodynamics in Integrable Quantum Systems Out of Equilibrium

    Directory of Open Access Journals (Sweden)

    Olalla A. Castro-Alvaredo

    2016-12-01

    Full Text Available Understanding the general principles underlying strongly interacting quantum states out of equilibrium is one of the most important tasks of current theoretical physics. With experiments accessing the intricate dynamics of many-body quantum systems, it is paramount to develop powerful methods that encode the emergent physics. Up to now, the strong dichotomy observed between integrable and nonintegrable evolutions made an overarching theory difficult to build, especially for transport phenomena where space-time profiles are drastically different. We present a novel framework for studying transport in integrable systems: hydrodynamics with infinitely many conservation laws. This bridges the conceptual gap between integrable and nonintegrable quantum dynamics, and gives powerful tools for accurate studies of space-time profiles. We apply it to the description of energy transport between heat baths, and provide a full description of the current-carrying nonequilibrium steady state and the transition regions in a family of models including the Lieb-Liniger model of interacting Bose gases, realized in experiments.

  14. 3D stacked chips from emerging processes to heterogeneous systems

    CERN Document Server

    Fettweis, Gerhard

    2016-01-01

    This book explains for readers how 3D chip stacks promise to increase the level of on-chip integration, and to design new heterogeneous semiconductor devices that combine chips of different integration technologies (incl. sensors) in a single package of the smallest possible size.  The authors focus on heterogeneous 3D integration, addressing some of the most important challenges in this emerging technology, including contactless, optics-based, and carbon-nanotube-based 3D integration, as well as signal-integrity and thermal management issues in copper-based 3D integration. Coverage also includes the 3D heterogeneous integration of power sources, photonic devices, and non-volatile memories based on new materials systems.   •Provides single-source reference to the latest research in 3D optoelectronic integration: process, devices, and systems; •Explains the use of wireless 3D integration to improve 3D IC reliability and yield; •Describes techniques for monitoring and mitigating thermal behavior in 3D I...

  15. Posttraumatic stress disorder treatment for Operation Enduring Freedom/Operation Iraqi Freedom combat veterans through a civilian community-based telemedicine network.

    Science.gov (United States)

    Ziemba, Steven J; Bradley, Nicola S; Landry, Lori-Ann P; Roth, Claire H; Porter, Linda S; Cuyler, Robert N

    2014-05-01

    Telemedicine holds great potential to improve access to care and to reduce barriers to treatment for military populations with posttraumatic stress disorder (PTSD). This study sought to integrate the use of telemedicine mental health treatment services by a community healthcare provider to military populations residing in a rural location and to compare the equivalency of cognitive behavioral therapy (CBT) administered via telemedicine and traditional face-to-face therapy. Study subjects were men or women 18 years of age or older who had served in Operation Enduring Freedom (OEF) and/or Operation Iraqi Freedom (OIF) and were diagnosed with PTSD. The 18 study subjects were randomized and provided 10 weekly therapy sessions of CBT. Pre- and post-intervention assessments were conducted using the Clinician Administered PTSD Scale (CAPS), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Life Events Checklist, and SF-36v2® (QualityMetric, Lincoln, RI) Health Survey. The CAPS, HAM-A, and MADRS each demonstrated lower scores, signifying improvement, and 69% of subjects experienced a clinically significant change in the CAPS. Patient satisfaction results indicated greater satisfaction for telemedicine as opposed to traditional face-to-face treatment. Findings reveal a trend expressing the equivalence of telemedicine and face-to-face therapy when treating OEF/OIF veterans with PTSD among rural populations by a community provider. It further demonstrates the successful collaboration between a community healthcare provider and the military healthcare system.

  16. Telemedicine and mHealth odyssey: a journey from the battlefield to academia

    Science.gov (United States)

    Poropatich, Ronald; Presson, Nora; Gilbert, Gary

    2016-05-01

    Since 1992, military medicine has considered the relevance, sustainability, and promise of telemedicine in the context of its mission and obligations for service members at home and in war zones. The US Army telemedicine program covers 22 time zones and generates over 5000 tele-consults per month for over 20 medical specialties. More recently the advances in mobile computing and increased adoption of the Smartphone with evolving capabilities for imaging and body-worn sensor integration has emerged in the field called mobile health, or mHealth. This presentation highlights the first 10 years of the U.S. Army mHealth program and includes how similar technologies have translated to wide-scale civilian health care implementation, including a relevant project for Veterans at the University of Pittsburgh. Examples include the successful US Army "mCare" program developed to augment soldier rehabilitation management with USbased geographically dispersed providers that utilizes secure mobile messaging and the soldier's own cell phone. Additional research interests will describe the use of smartphones on the battlefield enabling capture of operational medical data to improve casualty evacuation and outcome. A DoD-funded traumatic brain injury research project developed for Veterans at the University of Pittsburgh includes a mobile health application that demonstrates the effectiveness of communicating with patients through their personal mobile devices with care managers. Preliminary data for all the projects presented are encouraging for adoption and utilization of a mobile telemedicine platform to meet the complex needs of casualties injured or recovering from a broad range of injuries in unique geographic settings.

  17. Assessing the Impact of Telemedicine on Nursing Care in Intensive Care Units.

    Science.gov (United States)

    Kleinpell, Ruth; Barden, Connie; Rincon, Teresa; McCarthy, Mary; Zapatochny Rufo, Rebecca J

    2016-01-01

    Information on the impact of tele-intensive care on nursing and priority areas of nursing care is limited. To conduct a national benchmarking survey of nurses working in intensive care telemedicine facilities in the United States. In a 2-phased study, an online survey was used to assess nurses' perceptions of intensive care telemedicine, and a modified 2-round Delphi study was used to identify priority areas of nursing. In phase 1, most of the 1213 respondents agreed to strongly agreed that using tele-intensive care enables them to accomplish tasks more quickly (63%), improves collaboration (65.9%), improves job performance (63.6%) and communication (60.4%), is useful in nursing assessments (60%), and improves care by providing more time for patient care (45.6%). Benefits of tele-intensive care included ability to detect trends in vital signs, detect unstable physiological status, provide medical management, and enhance patient safety. Barriers included technical problems (audio and video), interruptions in care, perceptions of telemedicine as an interference, and attitudes of staff. In phase 2, 60 nurses ranked 15 priority areas of care, including critical thinking skills, intensive care experience, skillful communication, mutual respect, and management of emergency patient care. The findings can be used to further inform the development of competencies for tele-intensive care nursing, match the tele-intensive care nursing practice guidelines of the American Association of Critical-Care Nurses, and highlight concepts related to the association's standards for establishing and sustaining healthy work environments. ©2016 American Association of Critical-Care Nurses.

  18. IEA Response System for Oil Supply Emergencies (2012 update)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-05

    Emergency response to oil supply disruptions has remained a core mission of the International Energy Agency since its founding in 1974. This information pamphlet explains the decisionmaking process leading to an IEA collective action, the measures available -- focusing on stockdraw -- and finally, the historical background of major oil supply disruptions and the IEA response to them. It also demonstrates the continuing need for emergency preparedness, including the growing importance of engaging key transition and emerging economies in dialogue about energy security.

  19. Emerging Subsea Networks: SMART Cable Systems for Science and Society

    Science.gov (United States)

    Howe, B. M.; Butler, R.; Joint Task Force, U.

    2016-02-01

    The subsea telecommunications cable industry is approaching a prospective new era: deploying SMART subsea cable systems (SMART = Science Monitoring And Reliable Telecommunication). The current global, commercial cable infrastructure consists of 1 Gm of cable, being refreshed now and expanding in the future. The SMART concept is to add a small external sensor package along the cable system at its optical repeaters to transmit important real-time environmental data via a dedicated wavelength or overhead channel in the transmission system, avoiding any impact on the commercial traffic. These small, reliable, existing sensors would precisely measure temperature, pressure and three-axis acceleration across the world's ocean floor over an extended period of time, being deployed using standard cable-laying procedures on new or refurbished cables, but not requiring maintenance through the 2-3 decade life of the cable systems. The game-changing factor is the urgent international need for ocean environmental data related to mitigating climate and sea-level change and improving tsunami and slope failure hazard warnings. Societal costs incurred by these are reaching billions of dollars and hundreds of thousands of deaths. Pressures for new and urgent public policies are evident from the 5th IPCC Assessment, USA-China agreement on limiting greenhouse gas emissions, clear evidence for rapid global warming, 21st Session of the Conference of the Parties to the UNFCCC (December 2015, Paris), and the scale of the costs of inaction. To support revised public policies and actions, decision-makers, industry leaders, and the public are seeking key scientific data, which will necessitate new sources of funding. Hence, the emergence of new SMART cable systems offered by the subsea telecommunications industry will provide new market opportunities, engage additional non-traditional users, and make profound societal contributions. The Joint Task Force (JTF) on SMART Subsea Cable Systems

  20. Quality assurance of teleconsultations in a store-and-forward telemedicine network - obtaining patient follow-up data and user feedback

    Directory of Open Access Journals (Sweden)

    Richard eWootton

    2014-11-01

    Full Text Available User surveys in telemedicine networks confirm that follow up data are essential, both for the specialists who provide advice and for those running the system. We have examined the feasibility of a method for obtaining follow-up data automatically in a store-and-forward network. We distinguish between follow-up, which is information about the progress of a patient and is based on outcomes, and user feedback, which is more general information about the telemedicine system itself, including user satisfaction and the benefits resulting from the use of telemedicine. In the present study, we were able to obtain both kinds of information using a single questionnaire. During a 9-month pilot trial in the MSF telemedicine network, an email request for follow-up was sent automatically by the telemedicine system to each referrer exactly 21 days after the initial submission of the case. A total of 201 requests for follow-up were issued by the system and these elicited 41 responses (a response rate of 20%. The responses were largely positive. For example, 95% of referrers found the advice helpful, 90% said that it clarified their diagnosis, 94% said that it assisted with management of the patient and 95% said that the telemedicine response was of educational benefit to them. Analysis of the characteristics of the referrers who did not respond, and their cases, did not suggest anything different about them in comparison with referrers who did respond. We were not able to identify obvious factors associated with a failure to respond. Obtaining data by automatic request is feasible. It provides useful information for specialists and for those running the network. Since obtaining follow-up data is essential to best practice, one proposal to improve the response rate is to simplify the automatic requests so that only patient follow-up information is asked for, and to restrict user feedback requests to the cases being assessed each month by the quality assurance