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Sample records for emergency telemedicine system

  1. Portable emergency telemedicine system over wireless broadband and 3G networks.

    Science.gov (United States)

    Hong, SungHye; Kim, SangYong; Kim, JungChae; Lim, DongKyu; Jung, SeokMyung; Kim, DongKeun; Yoo, Sun K

    2009-01-01

    The telemedicine system aims at monitoring patients remotely without limit in time and space. However the existing telemedicine systems exchange medical information simply in a specified location. Due to increasing speed in processing data and expanding bandwidth of wireless networks, it is possible to perform telemedicine services on personal digital assistants (PDA). In this paper, a telemedicine system on PDA was developed using wideband mobile networks such as Wi-Fi, HSDPA, and WiBro for high speed bandwidths. This system enables to utilize and exchange variety and reliable patient information of video, biosignals, chatting messages, and triage data. By measuring bandwidths of individual data of the system over wireless networks, and evaluating the performance of this system using PDA, we demonstrated the feasibility of the designed portable emergency telemedicine system.

  2. Emerging technologies for telemedicine.

    Science.gov (United States)

    Cao, Minh Duc; Minh, Cao Duc; Shimizu, Shuji; Antoku, Yasuaki; Torata, Nobuhiro; Kudo, Kuriko; Okamura, Koji; Nakashima, Naoki; Tanaka, Masao

    2012-01-01

    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. 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.

  4. Emerging Technologies for Telemedicine

    International Nuclear Information System (INIS)

    Minh, Cao Duc; Shimizu, Shuji; Antoku, Yasuaki; Torata, Nobuhiro; Kudo, Kuriko; Okamura, Koji; Nakashima, Naoki; Tanaka, Masao

    2012-01-01

    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.

  5. Telemedicine using an image transfer system in the treatment of neurosurgical emergent cases

    International Nuclear Information System (INIS)

    Saito, Atsushi; Numagami, Yoshihiro; Kamiyama, Hironaga; Furuno, Yuuichi; Nishimura, Shinjitsu; Nishijima, Michiharu

    2007-01-01

    Our department is located in the Tsugaru district, which is famous for heavy snow fall, and the small number of neurosurgeon centers in the urban areas leads to an inadequate distribution of neurosurgeons for patients in this region. Such geographical and social constraints have made it difficult to offer sufficient neurosurgical care to all patients in the region. We describe the usefulness of a telemedicine triage system using an image transfer system in the treatment of neurosurgical emergent cases. Image transfer systems have been installed at our hospital and 11 regional hospitals in the Tsugaru district, and have been utilized for teleconsultation regarding neurosurgical patients via transferred computed tomography images since 1989. Consultations regarding 2,858 cases were directed to our department between 1989 and 2006, including 1,615 cases of stroke, 869 cases of head trauma, 97 cases of brain tumor, and 277 cases with other disorders. 84% of subarachnoid hemorrhage cases and 22% of head trauma cases needed emergent transfer. The state of consciousness in intracerebral hemorrhage, and the state of consciousness and time of consultation in head trauma were statistically significant factors for emergent transfer. The presert telemedicine triage system was useful for ensuring correct diagnosis and appropriate primary neurosurgical care in the regional hospitals without neurosurgical units, resulting in a reinforcement of the relationships among the regional hospitals and the efficient transfer of emergent neurosurgical patients. (author)

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

    Science.gov (United States)

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

    2014-01-01

    Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that emergency medical services (EMS) in several countries worldwide are facing. In order to improve quality in EMS, highly trained personnel and well-equipped ambulances are essential. 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. Hence our aim is to develop and test a specific teleconsultation system. During the development process several use cases were defined and technically specified by medical experts and engineers in the areas of: system administration, start-up of EMS assistance systems, audio communication, data transfer, routine tele-EMS physician activities and research capabilities. Upon completion, technical field tests were performed under realistic conditions to test system properties such as robustness, feasibility and usability, providing end-to-end measurements. Six ambulances were equipped with telemedical facilities based on the results of the requirement analysis and 55 scenarios were tested under realistic conditions in one month. The results indicate that the developed system performed well in terms of usability and robustness. The major challenges were, as expected, mobile communication and data network availability. Third generation networks were only available in 76.4% of the cases. Although 3G (third generation), such as Universal Mobile Telecommunications System (UMTS), provides beneficial conditions for higher bandwidth, system performance for most features was also acceptable under adequate 2G (second generation) test conditions. An innovative concept for the use of telemedicine for medical consultations in EMS was developed. Organisational and technical aspects were considered and practical requirements specified. Since technical feasibility was demonstrated in these

  7. 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

  8. Multipurpose Health Care Telemedicine System

    National Research Council Canada - National Science Library

    Kyriacou, E

    2001-01-01

    .... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

  9. Telemedicine: an enhanced emergency care program for older adults

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2014-07-01

    Full Text Available Paul Y Takahashi,1 Anupam Chandra,1 Frederick North,1 Jennifer L Pecina,2 Benjavan Upatising,3 Gregory J Hanson11Mayo Clinic Division of Primary Care Internal Medicine, 2Mayo Clinic Department of Family Medicine, Rochester, MN, USA; 3Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, USAAbstract: Recent changes and consolidations in health care systems have resulted in an increase in new health care delivery models. Telemedicine holds great promise as one of these models. There is a great potential for new patient evaluation and treatment models in emergency care (EC, especially when patients are miles away from a medical team. Evaluations can be performed in a patient's home, a nursing care facility, and in hospitals that focus on advanced subspecialty care. Due to rapid developments in this area, current care models are constantly being evaluated and modified. This review article outlines current telemedicine models for EC and summarizes their potential benefits to patients and the health care system. The review examines the role that the telephone, a fundamental tool of telemedicine, plays in these new models. The review also examines evidence of improved health care outcomes by highlighting the role of telemedicine in reducing hospitalizations. The patient is the primary focus; as a result, this review also examined patient experiences and satisfaction levels regarding telemedicine health care teams. The authors support these technological advances and their potential for information transfer. Health care providers need to continue developing these models by making use of increasing amounts of information. One of the main implementation barriers of these new models in the US and other countries is the issue of payment and reimbursement. Despite this, advancements in EC telemedicine continue.Keywords: telemedicine, emergency care, geriatric, patient evaluation models

  10. A multimedia telemedicine system.

    Science.gov (United States)

    Ling, Li; Dezhong, Yao; Jianqing, Li; Bin, Li; Ling, Wang

    2005-01-01

    A multimedia telemedicine system (MTS) using Transfer Control Protocol and Internet Protocol (TCP/IP) over the Internet is developed. Doctor with patient and doctor can communicate each other using this system. Real-time data, including audio, video and instant message (IM), and non-real-time data, including vital sign signals, radiological images with DICOM 3.0, file, bio-signal, bio-data and so on, can be exchanged on the system. This system's architecture is client/server mode. All data are encoded/compressed before transferring through Internet/Intranet. The real-time audio is encoded and decoded by MPEG (Moving Picture Experts Group) audio layer 3 algorithm and real-time video is encoded and decoded by MPEG-4. The software implementation of needed functionality without any externally attached hardware CODEC (Coder/Decoder) units enables the compact design with low cost. The real-time video has 25 frames per second at Local Area Network (LAN) and more than 20 frames per second at ADSL.

  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. Making medical treatments resilient to technological disruptions in telemedicine systems

    NARCIS (Netherlands)

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

    Telemedicine depends on Information and Communication Technology (ICT) to support remote treatment of patients. This dependency requires the telemedicine system design to be resilient for ICT performance degradation or subsystem failures. Nevertheless, using telemedicine systems create a dependency

  13. Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

    Science.gov (United States)

    Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P

    2015-08-01

    Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.

  14. Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

    Science.gov (United States)

    Rockwell, Kimberly Lovett; Gilroy, Alexis

    2018-03-12

    Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

  15. Characterizing New England Emergency Departments by Telemedicine Use.

    Science.gov (United States)

    Zachrison, Kori S; Hayden, Emily M; Schwamm, Lee H; Espinola, Janice A; Sullivan, Ashley F; Boggs, Krislyn M; Raja, Ali S; Camargo, Carlos A

    2017-10-01

    Telemedicine connects emergency departments (ED) with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195) in the six New England states (excluding federal hospitals and college infirmaries). Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Of the 169 responding EDs (87% response rate), 82 (49%) reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03); less likely to be academic (1% of users vs. 11% of non-users, p=0.01); and less likely to have 24/7 access to neurology (ptelemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30-14.86), and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09-0.49]), and annual volume Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

  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. Characterizing New England Emergency Departments by Telemedicine Use

    Directory of Open Access Journals (Sweden)

    Kori S. Zachrison

    2017-09-01

    Full Text Available Introduction: Telemedicine connects emergency departments (ED with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. Methods: We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195 in the six New England states (excluding federal hospitals and college infirmaries. Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Results: Of the 169 responding EDs (87% response rate, 82 (49% reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03; less likely to be academic (1% of users vs. 11% of non-users, p=0.01; and less likely to have 24/7 access to neurology (p<0.001, neurosurgery (p<0.001, orthopedics (p=0.01, plastic surgery (p=0.01, psychiatry (p<0.001, and hand surgery (p<0.001 consultants. Neuro/stroke (68%, pediatrics (11%, psychiatry (11%, and trauma (10% were the most commonly reported applications. On multivariable analysis, telemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30–14.86, and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09–0.49], and annual volume <20,000 (OR 0.24, 95% CI [0.08–0.68]. Conclusion: Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

  19. Telemedicine.

    Science.gov (United States)

    Dorman, T

    2000-09-01

    Telemedicine began from the humble beginnings of the first telephone call from Alexander Graham Bell to his associate, Watson. These systems already have been used for educational programs, consultative care, image transfer, second opinions, and direct acute patient care. Most of the original programs failed because of several reasons, primarily because of lack of funding when a grant ended. The major lesson of these programs is that a solid business plan is needed initially for long-term survival. The reliability of telemedical examinations has been demonstrated superficially, but more conclusive work in this area is needed. Studies that evaluate clinical, financial, and satisfaction outcomes are required simultaneously. Further integration of medical informatics into telemedicine systems is needed before these systems can achieve more acceptance. Twenty years ago, few people predicted this technologic revolution. Innovations arise almost daily. The future seems promising for telemedical systems, but much work is required. Partnerships with industry must move beyond niche projects, and regulatory and medicolegal issues must be resolved. Anesthesiologists can expect their practice to be affected directly by technology, and should embrace it, evaluate it, and help lead its use in this millennium.

  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. A biometric method to secure telemedicine systems.

    Science.gov (United States)

    Zhang, G H; Poon, Carmen C Y; Li, Ye; Zhang, Y T

    2009-01-01

    Security and privacy are among the most crucial issues for data transmission in telemedicine systems. This paper proposes a solution for securing wireless data transmission in telemedicine systems, i.e. within a body sensor network (BSN), between the BSN and server as well as between the server and professionals who have assess to the server. A unique feature of this solution is the generation of random keys by physiological data (i.e. a biometric approach) for securing communication at all 3 levels. In the performance analysis, inter-pulse interval of photoplethysmogram is used as an example to generate these biometric keys to protect wireless data transmission. The results of statistical analysis and computational complexity suggest that this type of key is random enough to make telemedicine systems resistant to attacks.

  2. Licensing telemedicine: the need for a national system.

    Science.gov (United States)

    Jacobson, P D; Selvin, E

    2000-01-01

    The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. This system is inadequate to address the emerging medical practices and future uses of medical technology in the telecommunications age. To respond to the changes offered by the telecommunications revolution, we need to design a new regulatory structure for the 21st century. The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.

  3. Multistandard Receiver Design for Telemedicine Monitoring System

    Directory of Open Access Journals (Sweden)

    Hongmei Wang

    2018-01-01

    Full Text Available In short-distance wireless communications for telemedicine monitoring, different medical data measurement equipment has different wireless transmission modes. A multistandard receiver is designed that can adapt to different medical data measuring equipment. Using a second-order bandpass sampling for the design of antialiasing filters, two aliasing signals can be separated. Simultaneously, constraint conditions for sampling frequency are not as critical. The design is useful for a multistandard receiver in a telemedicine monitoring system and has the advantages such as saving spectrum resources and facilitating spectrum planning.

  4. 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...... 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....

  5. Telemedicine Use Decreases Rural Emergency Department Length of Stay for Transferred North Dakota Trauma Patients.

    Science.gov (United States)

    Mohr, Nicholas M; Vakkalanka, J Priyanka; Harland, Karisa K; Bell, Amanda; Skow, Brian; Shane, Dan M; Ward, Marcia M

    2018-03-01

    Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014. Records were linked to a telemedicine network's call records, indicating whether telemedicine was available and/or used at the institution at the time of the care. Multivariable generalized estimating equations were developed to identify associations between telemedicine consultation and availability and outcomes such as transfer, timeliness of care, trauma imaging, and mortality. Of the 7,500 North Dakota trauma patients seen in CAH, telemedicine was consulted for 11% of patients in telemedicine-capable EDs and 4% of total trauma patients. Telemedicine utilization was independently associated with decreased initial ED length of stay (LOS) (30 min, 95% confidence interval [CI] 14-45 min) for transferred patients. Telemedicine availability was associated with an increase in the probability of interhospital transfer (adjusted odds ratio [aOR] 1.2, 95% CI 1.1-1.4). Telemedicine availability was associated with increased total ED LOS (15 min, 95% CI 10-21 min), and computed tomography scans (aOR 1.6, 95% CI 1.3-1.9). ED-based telemedicine consultation is requested for the most severely injured rural trauma patients. Telemedicine consultation was associated with more rapid interhospital transfer, and telemedicine availability is associated with increased radiography use and transfer. Future work should evaluate how telemedicine could target patients likely to benefit from telemedicine consultation.

  6. Telemedicine optoelectronic biomedical data processing system

    Science.gov (United States)

    Prosolovska, Vita V.

    2010-08-01

    The telemedicine optoelectronic biomedical data processing system is created to share medical information for the control of health rights and timely and rapid response to crisis. The system includes the main blocks: bioprocessor, analog-digital converter biomedical images, optoelectronic module for image processing, optoelectronic module for parallel recording and storage of biomedical imaging and matrix screen display of biomedical images. Rated temporal characteristics of the blocks defined by a particular triggering optoelectronic couple in analog-digital converters and time imaging for matrix screen. The element base for hardware implementation of the developed matrix screen is integrated optoelectronic couples produced by selective epitaxy.

  7. Multi-purpose HealthCare Telemedicine Systems with mobile communication link support

    Directory of Open Access Journals (Sweden)

    Karayiannis D

    2003-03-01

    Full Text Available Abstract The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile unit. This integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3–12 lead ECG, SPO2, NIBP, IBP, Temp and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available or through Plain Old Telephony Systems (POTS where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunication means; in addition the system has been clinically validated in three

  8. 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...

  9. A telemedicine support for improving medical emergency management

    Directory of Open Access Journals (Sweden)

    Massimo Canonico

    2017-12-01

    Full Text Available In this paper, we introduce a telemedicine architecture for supporting emergency patient stabilization and patient transportation to a fully equipped health care center. In particular, we focus on the description of a set of mobile apps, designed for supporting data recording and transmission during patient transportation by ambulance. Some of the apps are interfaced to the monitoring devices in the ambulance, and automatically send all the recorded data to a server at the destination center. One additional app enables the travelling personnel to input and transmit further significant patient data, or comments. At the destination center, the specialist physician is allowed to inspect the data as soon as they are received, possibly providing immediate advice. The exploitation of the apps also allows to maintain the transportation data over time, for medico-legal purposes, or to perform a-posteriori analyses. Some first evaluation results are discussed in the paper.

  10. 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.

  11. [Telemedicine with digital video transport system].

    Science.gov (United States)

    Hahm, Joon Soo; Shimizu, Shuji; Nakashima, Naoki; Byun, Tae Jun; Lee, Hang Lak; Choi, Ho Soon; Ko, Yong; Lee, Kyeong Geun; Kim, Sun Il; Kim, Tae Eun; Yun, Jiwon; Park, Yong Jin

    2004-06-01

    The growth of technology based on internet protocol has affected on the informatics and automatic controls of medical fields. The aim of this study was to establish the telemedical educational system by developing the high quality image transfer using the DVTS (digital video transmission system) on the high-speed internet network. Using telemedicine, we were able to send surgical images not only to domestic areas but also to international area. Moreover, we could discuss the condition of surgical procedures in the operation room and seminar room. The Korean-Japan cable network (KJCN) was structured in the submarine between Busan and Fukuoka. On the other hand, the Korea advanced research network (KOREN) was used to connect between Busan and Seoul. To link the image between the Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan, we started teleconference system and recorded image-streaming system with DVTS on the circumstance with IPv4 network. Two operative cases were transmitted successfully. We could keep enough bandwidth of 60 Mbps for two-line transmission. The quality of transmitted moving image had no frame loss with the rate 30 per second. The sound was also clear and the time delay was less than 0.3 sec. Our study has demonstrated the feasibility of domestic and international telemedicine. We have established an international medical network with high-quality video transmission over internet protocol. It is easy to perform, reliable, and also economical. Thus, it will be a promising tool in remote medicine for worldwide telemedical communication in the future.

  12. A PDA-based flexible telecommunication system for telemedicine applications.

    Science.gov (United States)

    Nazeran, Homer; Setty, Sunil; Haltiwanger, Emily; Gonzalez, Virgilio

    2004-01-01

    Technology has been used to deliver health care at a distance for many years. Telemedicine is a rapidly growing area and recently there are studies devoted to prehospital care of patients in emergency cases. In this work we have developed a compact, reliable, and low cost PDA-based telecommunication device for telemedicine applications to transmit audio, still images, and vital signs from a remote site to a fixed station such as a clinic or a hospital in real time. This was achieved based on a client-server architecture. A Pocket PC, a miniature camera, and a hands-free microphone were used at the client site and a desktop computer running the Windows XP operating system was used as a server. The server was located at a fixed station. The system was implemented on TCP/IP and HTTP protocol. Field tests have shown that the system can reliably transmit still images, audio, and sample vital signs from a simulated remote site to a fixed station either via a wired or wireless network in real time. The Pocket PC was used at the client site because of its compact size, low cost and processing capabilities.

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

    Science.gov (United States)

    Bossen, Ann L; Kim, Heejung; Williams, Kristine N; Steinhoff, Andreanna E; Strieker, Molly

    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.

  14. 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.

  15. Arizona TeleMedicine Network: System Procurement Specifications.

    Science.gov (United States)

    Atlantic Research Corp., Alexandria, VA.

    Providing general specifications and system descriptions for segments within the Arizona TeleMedicine Project (a telecommunication system designed to deliver health services to rurally isolated American Indians in Arizona), this document, when used with the appropriate route segment document, will completely describe the project's required…

  16. 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

  17. 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

  18. 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,

  19. High-Intensity Telemedicine Decreases Emergency Department Use by Senior Living Community Residents.

    Science.gov (United States)

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

    2016-03-01

    The failure to provide timely acute illness care can lead to adverse consequences or emergency department (ED) use. We evaluated the effect on ED use of a high-intensity telemedicine program that provides acute illness care for senior living community (SLC) residents. We performed a prospective cohort study over 3.5 years. Six SLCs cared for by a primary care geriatrics practice were intervention facilities, with the remaining 16 being controls. Consenting patients at intervention facilities could access telemedicine for acute illness care. Patients were provided patient-to-provider, real-time, or store-and-forward high-intensity telemedicine (i.e., technician-assisted with resources beyond simple videoconferencing) to diagnose and treat acute illnesses. The primary outcome was the rate of ED use. We enrolled 494 of 705 (70.1%) subjects/proxies in the intervention group; 1,058 subjects served as controls. Control and intervention subjects visited the ED 2,238 and 725 times, respectively, with 47.3% of control and 43.4% of intervention group visits resulting in discharge home. Among intervention subjects, ED use decreased at an annualized rate of 18% (rate ratio [RR]=0.82; 95% confidence interval [CI], 0.70-0.95), whereas in the control group there was no statistically significant change in ED use (RR=1.01; 95% CI, 0.95-1.07; p=0.009 for group-by-time interaction). Primary care use and mortality were not significantly different. High-intensity telemedicine significantly reduced ED use among SLC residents without increasing other utilization or mortality. This alternative to traditional acute illness care can enhance access to acute illness care and should be integrated into population health programs.

  20. Secure Wireless Military Healthcare Telemedicine Enterprise System

    National Research Council Canada - National Science Library

    Lucas, Kenneth

    2006-01-01

    .... In theory clinicians should be able to select and use the information modalities and electronic medical record systems they prefer, with the technical systems integration issues of information...

  1. 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

    teleophthalmology system as used by three federal healthcare agencies for detecting proliferative diabetic retinopathy . Telemedicine and e-Health. 2005;11: 641-651...a telemedicine system for comprehensive diabetes management andassessment of diabetic retinopathy that provides increased access for diabetic ...CDMP developed under this collaborative effort. 15. SUBJECT TERMS Joslin Vision Network, telemedicine, diabetes mellitus, diabetic retinopathy

  2. 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

  3. 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

    detecting proliferative diabetic retinopathy . Telemedicine and e-Health. 2005;11: 641-651. MILESTONES AND DELIVERABLES: Completion of data...telemedicine system for comprehensive diabetes management and assessment of diabetic retinopathy that provides increased access for diabetic patients to...CDMP developed under this collaborative effort. 15. SUBJECT TERMS Joslin Vision Network, telemedicine, diabetes mellitus, diabetic retinopathy

  4. [Telemedicine in dermatological practice: teledermatology].

    Science.gov (United States)

    Danis, Judit; Forczek, Erzsébet; Bari, Ferenc

    2016-03-06

    Technological advances in the fields of information and telecommunication technologies have affected the health care system in the last decades, and lead to the emergence of a new discipline: telemedicine. The appearance and rise of internet and smart phones induced a rapid progression in telemedicine. Several new applications and mobile devices are published every hour even for medical purposes. Parallel to these changes in the technical fields, medical literature about telemedicine has grown rapidly. Due to its visual nature, dermatology is ideally suited to benefit from this new technology and teledermatology became one of the most dynamically evolving fields of telemedicine by now. Teledermatology is not routinely practiced in Hungary yet, however, it promises the health care system to become better, cheaper and faster, but we have to take notice on the experience and problems faced in teledermatologic applications so far, summarized in this review.

  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. Advances in Telemedicine Using Mobile Communications

    National Research Council Canada - National Science Library

    Istepanian, Robert S. H

    2001-01-01

    Future telemedicine systems will exploit mobile communications technology so that patients who are free to move around at home or at work, or in emergency medical situations, can be monitored in a hospital...

  7. Navy Telemedicine: Current Research and Future Directions

    National Research Council Canada - National Science Library

    Reed, Cheryl

    2002-01-01

    .... An assessment of Navy telemedicine as a complex healthcare support system is needed to demonstrate how current practices, training, equipment, and expenditures measure up to the emerging needs of the Fleet...

  8. Health information systems to improve health care: A telemedicine case study

    Directory of Open Access Journals (Sweden)

    Liezel Cilliers

    2013-03-01

    Full Text Available Background: E-health has been identified as an integral part of the future of South African public healthcare. Telemedicine was first introduced in South Africa in 1997 and since then the cost of running the Telemedicine projects has increased substantially. Despite these efforts to introduce the system, only 34% of the Telemedicine sites in South Africa are functional at present. Objectives: Literature has suggested that one of the barriers to the successful implementation of health information systems is the user acceptance by health care workers of systems such as Telemedicine. This study investigated the user acceptance of Telemedicine in the public health care system in the Eastern Cape Province, making use of the Unified Theory of the Use and Acceptance of Technology. Method: The study employed a quantitative survey approach. A questionnaire was developed making use of existing literature and was distributed to various clinics around the province where Telemedicine has been implemented. Statistics were produced making use of Statistical Package for the Social Sciences (SPSS. Results: In general, the health care workers did understand the value and benefit of health information systems to improve the effectiveness and efficiency of the health care system. The barriers to the effective implementation of a health information system include the lack of knowledge and the lack of awareness regarding the Telemedicine system. This in turn means that the user is apprehensive when making use of the system thus contributing to less frequent usage. Conclusion: Health care workers do acknowledge that information systems can help to increase the effectiveness of the health care system. In general, the acceptance of Telemedicine in the Eastern Cape Department of Health is positive, but in order to integrate it into standard work practices, more must be done with regards to the promotion and education of telemedicine.

  9. 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

    2018-02-01

    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.

  10. 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.

  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. 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.

  13. Lifelink: 3G-based mobile telemedicine system.

    Science.gov (United States)

    Alis, Christian; del Rosario, Carlos; Buenaobra, Bernardino; Mar Blanca, Carlo

    2009-04-01

    Current wired telemedicine systems encounter difficulties when implemented in archipelagic developing countries because of the high cost of fixed infrastructure. In this research, we devised Lifelink, a mobile real-time telemonitoring and diagnostic facility to command and control remote medical devices through mobile phones. The whole process is phone-based, effectively freeing offsite medical specialists from stationary monitoring consoles and endowing the system with the potential to increase the number participating consultants. The electrocardiogram (ECG) readings are analyzed using a detrended fluctuation technique and classified into pathological cases using an unassisted K-means clustering algorithm. We analyzed 30 batches of 2-hour ECG signals taken from cardiac patients (20 males, 10 females, mean age 46.7 years) with pre-diagnosed pathologies. The method successfully categorized the 30 subjects without user intervention into the following cases: normal (at 86.7% accuracy), congestive heart failure (86.7%), and atrial fibrillation (80.0%). The synergy of mobile monitoring and fluctuation analysis presents a powerful platform to reach remote, underserved communities with poor or nonexistent wired communication structures. It is likely to be essential in the development of new mobile diagnostic and prognostic measures.

  14. Feasibility of AmbulanCe-Based Telemedicine (FACT) Study : Safety, Feasibility and Reliability of Third Generation Ambulance Telemedicine

    NARCIS (Netherlands)

    Yperzeele, Laetitia; Van Hooff, Robbert-Jan; De Smedt, Ann; Espinoza, Alexis Valenzuela; Van Dyck, Rita; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; Lauwaert, Door; De Keyser, Jacques; Brouns, Raf

    2014-01-01

    Background: Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third

  15. 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).

  16. Navy Telemedicine: Current Research and Future Directions

    National Research Council Canada - National Science Library

    Reed, Cheryl

    2002-01-01

    .... This report reviews military and civilian models for evaluating telemedicine systems in order to determine future directions for Navy telemedicine research within the current funding environment...

  17. An overview of recent end-to-end wireless medical video telemedicine systems using 3G.

    Science.gov (United States)

    Panayides, A; Pattichis, M S; Pattichis, C S; Schizas, C N; Spanias, A; Kyriacou, E

    2010-01-01

    Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven.

  18. Telemedicine-based system for quality management and peer review in radiology.

    Science.gov (United States)

    Morozov, Sergey; Guseva, Ekaterina; Ledikhova, Natalya; Vladzymyrskyy, Anton; Safronov, Dmitry

    2018-06-01

    Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective. A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images. The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

  19. 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. ©Sruthy Agnisarman, Shraddhaa Narasimha, Kapil Chalil Madathil, Brandon Welch, FNU Brinda, Aparna Ashok, James McElligott. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 24.04.2017.

  20. 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

    diagnoses established by telemedicine confirmed on hospital arrival, and we determined system delay in patients diagnosed before hospital arrival and triaged directly to the catheterisation laboratory. Methods: Design: Population-based follow-up study. Setting: Central Denmark Region. Participants: 15 992...... patients diagnosed using telemedicine. Results: During the study period, a tentative diagnosis of STEMI was established in 1061 patients, of whom 919 were triaged directly to the PCI centre. In 771 (84%) patients, a diagnosis of STEMI was confirmed. Patients transported ... living telemedicine for prehospital 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...

  1. 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

  2. Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study.

    Science.gov (United States)

    Akhtar, Moneeb; Van Heukelom, Paul G; Ahmed, Azeemuddin; Tranter, Rachel D; White, Erinn; Shekem, Nathaniel; Walz, David; Fairfield, Catherine; Vakkalanka, J Priyanka; Mohr, Nicholas M

    2018-02-22

    Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa values ranged from 0 to 0.434, and telemedicine was best for detecting abnormal coloration of the palate and tender superficial cervical lymph nodes (anterior structures), but poor for detecting abnormal submandibular lymph nodes or asymmetry of the posterior pharynx (posterior structures). In survey responses, telemedicine was judged easier to use and more comfortable for providers than patients; however, neither patients nor providers preferred in-person to telemedicine evaluation. Telemedicine exhibited poor agreement with the in-person physical examination on the primary outcome of tonsil size, but exhibited moderate agreement on coloration of the palate and cervical lymphadenopathy. Future work should better characterize the importance of

  3. Telemedicine Program

    Science.gov (United States)

    1996-01-01

    Since the 1970s, NASA has been involved in the research and demonstration of telemedicine for its potential in the care of astronauts in flight and Earth-bound applications. A combination of NASA funding, expertise and off-the-shelf computer and networking systems made telemedicine possible for a medically underserved hospital in Texas. Through two-way audio/video relay, the program links pediatric oncology specialists at the University of Texas Health Science Center in San Antonio to South Texas Hospital in Harlingen, providing easier access and better care to children with cancer. Additionally, the hospital is receiving teleclinics on pediatric oncology nursing, family counseling and tuberculosis treatment. VTEL Corporation, Sprint, and the Healthcare Open Systems and Trials Consortium also contributed staff and hardware.

  4. Web-based telemedicine system is useful for monitoring glucose control in pregnant women with diabetes.

    Science.gov (United States)

    Carral, Florentino; Ayala, María del Carmen; Fernández, Juan Jesús; González, Carmen; Piñero, Antonia; García, Gloria; Cañavate, Concepción; Jiménez, Ana Isabel; García, Concepción

    2015-05-01

    The aim of this study was to examine the impact of a Web-based telemedicine system for monitoring glucose control in pregnant women with diabetes on healthcare visits, metabolic control, and pregnancy outcomes. A prospective, single-center, interventional study with two parallel groups was performed in Puerto Real University Hospital (Cadiz, Spain). Women were assigned to two different glucose monitoring groups: the control group (CG), which was managed only by follow-ups with the Gestational Diabetes Unit (GDU), and the telemedicine group (TMG), which was monitored by both more spaced GDU visits and a Web-based telemedicine system. The number of healthcare visits, degree of metabolic control, and maternal and neonatal outcomes were evaluated. One hundred four pregnant women with diabetes (77 with gestational diabetes, 16 with type 1 diabetes, and 11 with type 2 diabetes) were included in the TMG (n=40) or in the CG (n=64). There were no significant differences in mean glycated hemoglobin level during pregnancy or after delivery, despite a significantly lower number of visits to the GDU (3.2±2.3 vs. 5.9±2.3 visits; P3.0±1.7 visits; PWeb-based telemedicine system can be a useful tool facilitating the management of pregnant diabetes patients, as a complement to conventional outpatient clinic visits.

  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. 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.

  7. Evaluation of telemedicine systems for impacted third molars diagnosis

    Directory of Open Access Journals (Sweden)

    Duka Miloš

    2009-01-01

    Full Text Available Background/Aim. In the last twenty years significant advances have been made in the fields of information and telecommunication technology in health care applications, with a positive impact on the health care practice. The need for remote diagnosis and planning of interventions is of special importance in military health care, and health management of immobile persons, and those with special needs. In cases such as these, availability of specialist health care is mainly limited by geographic and financial factors. The aim of this study was to investigate practical usability of telemedicine approaches in everyday management of oral surgery patients in terms of reliability of established diagnosis and indications for oral surgery treatment of the third molars. Methods. Our experimental randomized study enrolled 432 randomly selected patients of both genders, aged 20 to 87 years, undergoing panoramic radiography for some reason in the Centre for Dental Radiography in Belgrade. In addition to radiography, photographs of the face and mouth cavity were taken. These images were uploaded to the web server specially dedicated to the study purposes, and then transmitted to teledentists, i.e. oral surgeons, who made remote diagnoses. Diagnostic agreement was determined by way of the Cohen's kappa coefficient, and diagnostic sensitivity (SE, specificity (SP, and effectiveness (EFF were also established. Statistical significance was determined and comparisons performed by using the z-test, and testing of non-parametric characteristics by using the McNemar's χ2 test for p = 0.05 significance cut-off. Results. The results obtained by analyzed images and diagnostic assessment of the clinical diagnosis (kappa = 0.99, SE = 99%, SP = 99%, EFF = 99%, for 95% CI indicate an almost complete diagnostic agreement. The differences in diagnosis were not statistically significant. Conclusion. Diagnostic assessment of the clinical diagnosis of impacted or semi

  8. Reconstruction method for data protection in telemedicine systems

    Science.gov (United States)

    Buldakova, T. I.; Suyatinov, S. I.

    2015-03-01

    In the report the approach to protection of transmitted data by creation of pair symmetric keys for the sensor and the receiver is offered. Since biosignals are unique for each person, their corresponding processing allows to receive necessary information for creation of cryptographic keys. Processing is based on reconstruction of the mathematical model generating time series that are diagnostically equivalent to initial biosignals. Information about the model is transmitted to the receiver, where the restoration of physiological time series is performed using the reconstructed model. Thus, information about structure and parameters of biosystem model received in the reconstruction process can be used not only for its diagnostics, but also for protection of transmitted data in telemedicine complexes.

  9. 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...

  10. 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.

  11. Telemedicine in Greenland: Citizens' Perspectives.

    Science.gov (United States)

    Nielsen, Lasse O; Krebs, Hans J; Albert, Nancy M; Anderson, Nick; Catz, Sheryl; Hale, Timothy M; Hansen, John; Hounsgaard, Lise; Kim, Tae Youn; Lindeman, David; Spindler, Helle; Marcin, James P; Nesbitt, Thomas; Young, Heather M; Dinesen, Birthe

    2017-05-01

    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. 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. Case study design was chosen as the overall research design. Qualitative interviews (n = 14) were performed and participant observations (n = 80 h) carried out in the local healthcare center in the settlements and towns. A logbook was kept and updated each day during the field research in Greenland. Observations were made of activities in the settlements. 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. Regarding challenges in using telemedicine in Greenland, the geographical and cultural context hinders accessibility to the Greenlandic healthcare system, and telemedicine equipment is not sufficiently mobile. Greenlandic citizens are positive toward telemedicine and regard telemedicine as a facilitator for improved access for healthcare in the Greenlandic settlements. We have identified challenges, such as geographical and cultural context, that hinder accessibility to the Greenlandic healthcare system.

  12. Cost-Benefit Analysis of Telemedicine Systems/Units in Greek Remote Areas.

    Science.gov (United States)

    Kouskoukis, Marios-Nikolaos; Botsaris, Charalambos

    2017-06-01

    Telemedicine units and information technology systems provide special healthcare services to remote populations using telecommunication technology, in order to reduce or even remove the usual and typical face-to-face contact between doctor and patient. This innovative approach to medical care delivery has been expanding for several years and currently covers various medical specialties. To facilitate installation of telemedicine systems/units in Greek remote areas, this article presents results of a cost-benefit analysis for two Greek islands, Patmos and Leros, using specific economic criteria. Net present value (NPV), internal rate of return (IRR), and payback period were calculated, in order to monetize the economic benefits and the costs savings, estimate the depreciation of each project, and highlight the social benefits. Costs were reduced (through saved air medical transportations) by €19,005 for Patmos and €78,225 for Leros each year. NPV and IRR were positive; NPV was €29,608 for Patmos and €293,245 for Leros, and IRR was 21.5% for Patmos and 140.5% for Leros. Each project depreciated faster than the 5-year life-cycle period, and specifically in 3.13 years for Patmos and in 0.70 years for Leros. The establishment of telemedicine systems/units in Patmos and Leros was evaluated and assessed positively, with large savings, economical and social, gained by reducing or even removing the face-to-face contact between doctor and patient. Telemedicine systems/units seem to be a promising solution, especially in Greece, where the problem of primary healthcare services in remote/inaccessible areas is of great concern.

  13. Telemedicine: Pediatric Applications

    Science.gov (United States)

    Burke, Bryan L.; Hall, R. W.

    2017-01-01

    Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine’s current use bears testimony to its effectiveness and potential. Telemedicine’s widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits. PMID:26122813

  14. 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. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  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. Telemedicine perspectives in medical emergencies Perspectivas de la telemedicina en las emergencias y urgencias médicas

    Directory of Open Access Journals (Sweden)

    Antonio Cuadrado Ruiz

    2001-03-01

    Full Text Available Telemedicine already exists in emergency departments. The development of HECTOR and WETS projects in Andalusia (Spain is a proof of that. This review article shows how new technologies support changes in the traditional form of medical practice and health care services. Our minds must change as times change. La telemedicina ya ha llegado a los departamentos de urgencias y emergencias. El desarrollo de proyectos como el HECTOR y el WETS, actualmente en ejecución en Andalucía (España son buena prueba de ello. Este artículo de revisión muestra como las nuevas tecnologías van apoyando cambios en la práctica tradicional de los servicios de salud. Nuestros pensamientos deben cambiar cuando los tiempos cambian.

  17. Using Telemedicine to Address Crowding in the ED.

    Science.gov (United States)

    Guss, Benjamin; Mishkin, David; Sharma, Rahul

    2016-11-01

    Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach. However, an earlier telemedicine program piloted at the University of San Diego Health System’s (UCSD) Hillcrest Hospital in 2013 got bogged down due to administrative and insurance reimbursement hurdles, although the approach showed enough promise that there is interest in restarting the program. In the NYP program, patients are identified as appropriate candidates for the program at triage. They can opt to be seen remotely or through traditional means in the ED’s fast-track section. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators. An earlier ED-based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive.

  18. Diabetes Care and Treatment Project: A Diabetes Institute of the Walter Reed Health Care System and Joslin (and University of Hawaii) Telemedicine Initiative

    Science.gov (United States)

    2010-04-01

    digital teleophthalmology system as used by three federal healthcare agencies for detecting proliferative diabetic retinopathy . Telemedicine and e...Research Group. Detection of diabetic macular edema: ophthalmoscopy versus photography—Early Treatment Diabetic Retinopathy Study report number 5...project are the establishment of a telemedicine system for comprehensive diabetes management and the assessment of diabetic retinopathy that

  19. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    the documented and shared information to support organizational learning, increase effectiveness of interaction with callers and support social practice in the control center. The reflections are a result of the health professional backgrounds of the emergency medical dispatch staff that enable them...

  20. Information systems of telemedicine for the regions with high levels of radiation

    International Nuclear Information System (INIS)

    Yanchuk, V.; Svistelnyk, S.

    2002-01-01

    The necessity of the telemedicine system creation for the consulting of people living on the territory contaminated with radionuclides is stipulated by requirements of consulting people and well-qualified medical staff shortage in such region. The amount of patients rise year by year caused by increasing people by means of two nodes creation: the node of investigation using Ultrasound and MRT Equipment supporting the information about investigation and the node of consulting centre supporting the consultation on the basis of the investigation data analysis. (authors)

  1. Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study.

    Science.gov (United States)

    Lokkerbol, Joran; Adema, Dirk; Cuijpers, Pim; Reynolds, Charles F; Schulz, Richard; Weehuizen, Rifka; Smit, Filip

    2014-03-01

    Depressive disorders are significant causes of disease burden and are associated with substantial economic costs. It is therefore important to design a healthcare system that can effectively manage depression at sustainable costs. This article computes the benefit-to-cost ratio of the current Dutch healthcare system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall. A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compared a base case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome was the benefit-to-cost ratio, also known as return-on-investment (ROI). In terms of ROI, a healthcare system with preventive telemedicine for depressive disorders offers better value for money than a healthcare system without Internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base case scenario to €1.76 ($2.09) in the alternative scenario in which preventive telemedicine is offered. In a scenario in which the costs of offering preventive telemedicine are balanced by reducing the expenditures for curative interventions, ROI increases to €1.77 ($2.10), while keeping the healthcare budget constant. For a healthcare system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. [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.

  3. Tripartite Evolutionary Game Analysis on Selection Behavior of Trans-Regional Hospitals and Patients in Telemedicine System

    Directory of Open Access Journals (Sweden)

    Yuxuan Gao

    2017-01-01

    Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.

  4. 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.

  5. Telemedicine: the slow revolution.

    Science.gov (United States)

    Moncrief, Jack W

    2014-01-01

    The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas. That project had 6 connected telemedicine sites: 3 in Austin, Texas, and 3 in Giddings, Texas (a small community 55 miles to the southeast of Austin). The sites in Giddings included a chronic outpatient dialysis facility, an inpatient psychiatric hospital, and the emergency department at Giddings Hospital. Patient contact began in April 1991 and continued through March 1993. During that period, data on the 1500 patient contacts made were recorded. After termination of the Texas Telemedicine Project, AT&T continued to provide the transmission lines, and between 1993 and 1996, another 12,000 patient contacts were made. Approximately 80% were dialysis evaluations and 20% were non-dialysis primary care contacts. The original cost of materials and equipment in the Texas Telemedicine Project exceeded $50,000 per site. Today, a secure Internet connection with full-motion video and wireless data transfer to almost any location in the world is achievable with an iPad. Multiple inexpensive applications with connections for electrocardiogram, otoscope, and stethoscope, among others, make this technology extremely inexpensive and user-friendly. The revolution now is rapidly moving forward, with Medicare reimbursing telemedicine contacts in medically underserved areas. Multiple bills are before Congress to expand Medicare and therefore private insurance payment for this service.

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

    International Nuclear Information System (INIS)

    Pavlopoulos, S.; Koutsouris, D.

    1999-01-01

    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.)

  7. 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.)

  8. A sensor monitoring system for telemedicine, safety and security applications

    Science.gov (United States)

    Vlissidis, Nikolaos; Leonidas, Filippos; Giovanis, Christos; Marinos, Dimitrios; Aidinis, Konstantinos; Vassilopoulos, Christos; Pagiatakis, Gerasimos; Schmitt, Nikolaus; Pistner, Thomas; Klaue, Jirka

    2017-02-01

    A sensor system capable of medical, safety and security monitoring in avionic and other environments (e.g. homes) is examined. For application inside an aircraft cabin, the system relies on an optical cellular network that connects each seat to a server and uses a set of database applications to process data related to passengers' health, safety and security status. Health monitoring typically encompasses electrocardiogram, pulse oximetry and blood pressure, body temperature and respiration rate while safety and security monitoring is related to the standard flight attendance duties, such as cabin preparation for take-off, landing, flight in regions of turbulence, etc. In contrast to previous related works, this article focuses on the system's modules (medical and safety sensors and associated hardware), the database applications used for the overall control of the monitoring function and the potential use of the system for security applications. Further tests involving medical, safety and security sensing performed in an real A340 mock-up set-up are also described and reference is made to the possible use of the sensing system in alternative environments and applications, such as health monitoring within other means of transport (e.g. trains or small passenger sea vessels) as well as for remotely located home users, over a wired Ethernet network or the Internet.

  9. Dual-Use Telemedicine Support System for Pathology.

    Science.gov (United States)

    1998-12-01

    software Baxter Travenol to Sheppard AFB, TX McDonald Douglas to Camp Lejeune, NC 75 SAIC (with VA-DHCP) to Ft Knox, KY Technicon Data Systems (TDS...in a GIF file. KFC ~ieGlFlmageLlst CVoidPtrArray A list of GIE Images derived as CPtrArray<KFCFileGIF~mage>. KFCFilelmage KFCFiIe A generic image file...handler. KFCFiIeJPEG KFCFilelmage A robust JPEG file manager. KFC ~le.JPEGlmage N/A A JPEG Image in a JPEG file. KFCFileJPEGlmageList CVoidPtrArray A

  10. Development of a Multidisciplinary and Telemedicine Focused System Database.

    Science.gov (United States)

    Paštěka, Richard; Forjan, Mathias; Sauermann, Stefan

    2017-01-01

    Tele-rehabilitation at home is one of the promising approaches in increasing rehabilitative success and simultaneously decreasing the financial burden on the healthcare system. Novel and mostly mobile devices are already in use, but shall be used in the future to a higher extent for allowing at home rehabilitation processes at a high quality level. The combination of exercises, assessments and available equipment is the basic objective of the presented database. The database has been structured in order to allow easy-to-use and fast access for the three main user groups. Therapists - looking for exercise and equipment combinations - patients - rechecking their tasks for home exercises - and manufacturers - entering their equipment for specific use cases. The database has been evaluated by a proof of concept study and shows a high degree of applicability for the field of rehabilitative medicine. Currently it contains 110 exercises/assessments and 111 equipment/systems. Foundations of presented database are already established in the rehabilitative field of application, but can and will be enhanced in its functionality to be usable for a higher variety of medical fields and specifications.

  11. Web Health Monitoring Survey: A New Approach to Enhance the Effectiveness of Telemedicine Systems.

    Science.gov (United States)

    Romano, Maria Francesca; Sardella, Maria Vittoria; Alboni, Fabrizio

    2016-06-06

    Aging of the European population and interest in a healthy population in western countries have contributed to an increase in the number of health surveys, where the role of survey design, data collection, and data analysis methodology is clear and recognized by the whole scientific community. Survey methodology has had to couple with the challenges deriving from data collection through information and communications technology (ICT). Telemedicine systems have not used patients as a source of information, often limiting them to collecting only biometric data. A more effective telemonitoring system would be able to collect objective and subjective data (biometric parameters and symptoms reported by the patients themselves), and to control the quality of subjective data collected: this goal be achieved only by using and merging competencies from both survey methodology and health research. The objective of our study was to propose new metrics to control the quality of data, along with the well-known indicators of survey methodology. Web questionnaires administered daily to a group of patients for an extended length of time are a Web health monitoring survey (WHMS) in a telemedicine system. We calculated indicators based on paradata collected during a WHMS study involving 12 patients, who signed in to the website daily for 2 months. The patients' involvement was very high: the patients' response rate ranged between 1.00 and 0.82, with an outlier of 0.65. Item nonresponse rate was very low, ranging between 0.0% and 7.4%. We propose adherence to the chosen time to connect to the website as a measure of involvement and cooperation by the patients: the difference from the median time ranged between 11 and 24 minutes, demonstrating very good cooperation and involvement from all patients. To measure habituation to the questionnaire, we also compared nonresponse rates to the items between the first and the second month of the study, and found no significant difference. We

  12. 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

  13. Improved technical performance of a multifunctional prehospital telemedicine system between the research phase and the routine use phase - an observational study.

    Science.gov (United States)

    Felzen, Marc; Brokmann, Jörg C; Beckers, Stefan K; Czaplik, Michael; Hirsch, Frederik; Tamm, Miriam; Rossaint, Rolf; Bergrath, Sebastian

    2017-04-01

    Introduction Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. Methods The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014. Telemedical applications included mobile vital data, 12-lead, picture transmission and video streaming from inside the ambulances. The tele-EMS physician filled in a questionnaire regarding the technical performance of the applications, background noise and assessed clinical values of the transmitted pictures and videos after each mission between 15 May 2014-15 October 2014. Results Teleconsultation was established during 539 emergency cases. In 83% of the cases ( n = 447), only the paramedics and the tele-EMS physician were involved. Transmission success rates ranged from 98% (audio connection) to 93% (12-lead electrocardiogram (ECG) transmission). All functionalities, except video transmission, were significantly better than the pilot project ( p < 0.05). Severe background noise was detected to a lesser extent ( p = 0.0004) and the clinical value of the pictures and videos were considered significantly more valuable. Discussion The multifunctional system is now sufficient for routine use and is the most reliable mobile emergency telemedicine system compared to other published projects. Dropouts were due to user errors and network coverage problems. These findings enable widespread use of this system in the future, reducing the critical time intervals until medical therapy is started.

  14. Evaluation of a realtime, remote monitoring telemedicine system using the Bluetooth protocol and a mobile phone network.

    Science.gov (United States)

    Jasemian, Yousef; Arendt-Nielsen, Lars

    2005-01-01

    A generic, realtime wireless telemedicine system has been developed that uses the Bluetooth protocol and the general packet radio service for mobile phones. The system was tested on 10 healthy volunteers, by continuous monitoring of their electrocardiograms (ECGs). Under realistic conditions, the system had 96.5% uptime, a data throughput of 3.3 kbit/s, a mean packet error rate of 8.5x10(-3) packet/s and a mean packet loss rate of 8.2x10(-3) packet/s. During 24 h testing, the total average downtime was 66 min and 90% of the periods of downtime were of only 1-3 min duration. Less than 10% of the ECGs were of unacceptable quality. Thus, the generic telemedicine system showed high reliability and performance, and the design may provide a foundation for realtime monitoring in clinical practice, for example in cardiology.

  15. 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.

  16. Computer-aided diagnosis workstation and telemedicine network system for chest diagnosis based on multislice CT images

    Science.gov (United States)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kakinuma, Ryutaru; Moriyama, Noriyuki

    2009-02-01

    Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. To overcome these problems, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The functions to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and "Success in login" effective. As a result, patients' private information is protected. We can share the screen of Web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with workstation. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and

  17. Comparative study on system requirements and success factors of telemedicine solutions in resource-poor settings

    OpenAIRE

    Dawson, Joanna Adobea

    2011-01-01

    Rationale: Attempts to successfully develop telemedicine solutions by specifying the require-ments and critical success factors of these solutions are on-going in sub-Saharan Africa (SSA) countries as a means of improving access to high-quality healthcare. European Space Agency (ESA) (Dario et al. 2005) have explored the challenges and benefits of telemedicine solutions in these regions in the domains of eGovernment such as billing and administrative data management to support the healthcare ...

  18. 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......: 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...

  19. A Web-based telemedicine system for diabetic retinopathy screening using digital fundus photography.

    Science.gov (United States)

    Wei, Jack C; Valentino, Daniel J; Bell, Douglas S; Baker, Richard S

    2006-02-01

    The purpose was to design and implement a Web-based telemedicine system for diabetic retinopathy screening using digital fundus cameras and to make the software publicly available through Open Source release. The process of retinal imaging and case reviewing was modeled to optimize workflow and implement use of computer system. The Web-based system was built on Java Servlet and Java Server Pages (JSP) technologies. Apache Tomcat was chosen as the JSP engine, while MySQL was used as the main database and Laboratory of Neuro Imaging (LONI) Image Storage Architecture, from the LONI-UCLA, as the platform for image storage. For security, all data transmissions were carried over encrypted Internet connections such as Secure Socket Layer (SSL) and HyperText Transfer Protocol over SSL (HTTPS). User logins were required and access to patient data was logged for auditing. The system was deployed at Hubert H. Humphrey Comprehensive Health Center and Martin Luther King/Drew Medical Center of Los Angeles County Department of Health Services. Within 4 months, 1500 images of more than 650 patients were taken at Humphrey's Eye Clinic and successfully transferred to King/Drew's Department of Ophthalmology. This study demonstrates an effective architecture for remote diabetic retinopathy screening.

  20. UH Telemedicine Proposal

    National Research Council Canada - National Science Library

    Friedman, Richard

    2001-01-01

    The purpose of the University of Hawaii Telemedicine Project (UHTP) is to assess and establish an effective telemedicine curriculum uniquely tailored for the training of military healthcare personnel...

  1. WAP - based telemedicine applications

    International Nuclear Information System (INIS)

    Hung, K.; Zhang, Y.T.

    2001-01-01

    Telemedicine refers to the utilization of telecommunication technology for medical diagnosis, treatment, and patient care. Its aim is to provide expert-based health care to remote sites through telecommunication and information technologies. The significant advances in technologies have enabled the introduction of a broad range of telemedicine applications, which are supported by computer networks, wireless communication, and information superhighway. For example, some hospitals are using tele-radiology for remote consultation. Such a system includes medical imaging devices networked with computers and databases. Another growing area is patient monitoring, in which sensors are used to acquire biomedical signals, such as electrocardiogram (ECG), blood pressure, and body temperature, from a remote patient, who could be in bed or moving freely. The signals are then relayed to remote systems for viewing and analysis. Telemedicine can be divided into two basic modes of operations: real-time mode, in which the patient data can be accessed remotely in real-time, and store-and-forward mode, in which the acquired data does not have to be accessed immediately. In the recent years, many parties have demonstrated various telemedicine applications based on the Internet and cellular phone as these two fields have been developing rapidly. A current, recognizable trend in telecommunication is the convergence of wireless communication and computer network technologies. This has been reflected in recently developed telemedicine systems. For example, in 1998 J. Reponen, et al. have demonstrated transmission and display of computerized tomography (CT) examinations using a remote portable computer wirelessly connected to a computer network through TCP/IP on a GSM cellular phone. Two years later, they carried out the same tests with a GSM-based wireless personal digital assistant (PDA). The WAP (Wireless Application Protocol) Forum was founded in 1997 to create a global protocol

  2. Barriers and Benefits in Telemedicine Arising Between a High-Technology Hospital Service Provider and Remote Public Healthcare Units: A Qualitative Study in Brazil.

    Science.gov (United States)

    de Souza, Carlos Henrique Amaral; Morbeck, Renata Albaladejo; Steinman, Milton; Hors, Cora Pereira; Bracco, Mario Maia; Kozasa, Elisa H; Leão, Eliseth Ribeiro

    2017-06-01

    In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants. An individual, semistructured recorded interview was conducted with 28 physicians (17 HT; 11 RU) encompassing telemedicine resources and interaction among HT and RU physicians. Data analysis was performed by Discourse of Collective Subject. We identified the following barriers in the telemedicine service: (1) lack of experience in the use of technology or the quality of the internet signal; (2) the multiplicity of different telemedicine platforms; (3) the quality of the image sent to the HT hospital; (4) the misunderstanding that telemedicine is a time-consuming technology instead of a resource that may help to save lives; (5) not feeling comfortable exposing doubts to other HT colleagues; (6) problems in the management of telemedicine use in the RUs; and (7) political and legal issues. However, important benefits in telemedicine service were also described. The structural barriers should be the target of hospital managers. Development of standard remote care protocols may increase the use of telemedicine and create new work routines. Given the relationship difficulties among the RU and HT doctors during telemedicine consultations, other meetings should be organized to allow more interpersonal interactions. These meetings may also have the goal of sharing outcome indicators of their joint activity in telemedicine to stimulate and make them aware of the benefits of their interaction.

  3. 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 (passessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pquality of spirometry 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.

  4. Telemedicine on the move: health care heads down the information superhighway.

    Science.gov (United States)

    Berek, B; Canna, M

    1994-01-01

    Telemedicine has drawn increasing attention as one of the emerging new service delivery vehicles that will run on the information superhighway. In reality, remote diagnosis and consultation through the application of telecommunications technology have been practiced for many years. But advances in technology and reform imperatives to extend access beyond traditional boundaries are pushing telemedicine into new applications. This is evidenced by the explosion in the number of pilot projects begun within the last 12 months. While demonstrating telemedicine's growing capabilities--for education and administration, as well as medical practice--these projects also raise a number of legal, clinical, and technical questions that must be answered before government and other payers will routinely reimburse for remote services. Academic and industry consortia are springing up to deal with the most compelling issues, including documenting telemedicine's safety and efficacy, developing uniform data and transmission standards, and determining the minimum resolution needed to maintain the integrity of clinical transmissions. Almost every type of medical specialty has proved amenable to performing evaluations via telemedicine links; however, specialties with less direct patient contact, like radiology and pathology, are generally identified as better candidates for telemedicine interactions. The telemedicine equipment required for these consults ranges from the simple to the ultra-sophisticated, depending on the type of system used and its clinical application. The most common system configuration involves a base station in the main facility where specialists and other consultants are housed and a number of remote referral sites. Consults are performed by interactively sharing voice, video, or image data. Increasingly, systems are being introduced that use easy-to-learn, intuitive displays and controls. Systems also require the use of any number of different communication media

  5. A Review of Telemedicine Services in Finland

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...

  6. Emergence in Dynamical Systems

    Directory of Open Access Journals (Sweden)

    John Collier

    2013-12-01

    Full Text Available Emergence is a term used in many contexts in current science; it has become fashionable. It has a traditional usage in philosophy that started in 1875 and was expanded by J. S. Mill (earlier, under a different term and C. D. Broad. It is this form of emergence that I am concerned with here. I distinguish it from uses like ‘computational emergence,’ which can be reduced to combinations of program steps, or its application to merely surprising new features that appear in complex combinations of parts. I will be concerned specifically with ontological emergence that has the logical properties required by Mill and Broad (though there might be some quibbling about the details of their views. I restrict myself to dynamical systems that are embodied in processes. Everything that we can interact with through sensation or action is either dynamical or can be understood in dynamical terms, so this covers all comprehensible forms of emergence in the strong (nonreducible sense I use. I will give general dynamical conditions that underlie the logical conditions traditionally assigned to emergence in nature.The advantage of this is that, though we cannot test logical conditions directly, we can test dynamical conditions. This gives us an empirical and realistic form of emergence, contrary those who say it is a matter of perspective.

  7. 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

  8. Wind emergency response system

    International Nuclear Information System (INIS)

    Garrett, A.J.; Buckner, M.R.; Mueller, R.A.

    1981-01-01

    The WIND system is an automated emergency response system for real-time predictions of the consequences of liquid and airborne releases from SRP. The system consists of a minicomputer and associated peripherals necessary for acquisition and handling of large amounts of meteorological data from a local tower network and the National Weather Service. The minicomputer uses these data and several predictive models to assess the impact of accidental releases. The system is fast and easy to use, and output is displayed both in tabular form and as trajectory map plots for quick interpretation. The rapid response capabilities of the WIND system have been demonstrated in support of SRP operations

  9. US and territory telemedicine policies: identifying gaps in perinatal care

    Science.gov (United States)

    Okoroh, Ekwutosi M.; Kroelinger, Charlan D.; Smith, Alexander M.; Goodman, David A.; Barfield, Wanda D.

    2016-01-01

    BACKGROUND Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories). OBJECTIVE We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified. STUDY DESIGN We conducted a 2014 systematic World Wide Web–based review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N=59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis. RESULTS Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care. CONCLUSION The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource

  10. 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.

  11. Application of Telemedicine in Gansu Province of China

    Science.gov (United States)

    Cai, Hui; Wang, Hongjing

    2016-01-01

    Telemedicine has become an increasingly popular option for long-distance health care and continuing education. As information and communication technology is underdeveloped in China, telemedicine develops slowly. At present, telemedicine consultation centers are situated mainly in developed cities, such as Beijing, Shanghai, and Guangzhou. In many less developed regions, such as northwest China, the conditions or related facilities are not available for the application of a better medical service. Accordingly, the aim of this paper was to introduce the construction and application of a telemedicine consultation center in Gansu Province in the northwest of China. In addition, the function of Gansu Provincial Telemedicine Consultation Center on emergency public events was introduced. As a whole, there was a great demand for telemedicine service in the local medical institutions. In the telemedicine consultation center, the telemedicine equipments and regulations were needed to be improved. The function of telemedicine service was not fully used, there was a large space to be applied and the publicity of telemedicine service was important. What is important was that telemedicine played a significance role in promoting the medical policy reform, improving the medical environment and launching the remote rescue in the emergency public events. This paper emphasizes the health care challenges of poor regions, and indicates how to share the high-quality medical service of provincial hospitals effectively and how to help residents in resource-poor environments. PMID:27332894

  12. 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.

  13. 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

    2017-01-01

    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. PMID:28994720

  14. 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.

  15. Telemedicine for health issues while abroad: interest and willingness to pay among travellers prior to departure.

    Science.gov (United States)

    Rochat, Laurence; Genton, Blaise

    2018-01-01

    Telemedicine is emerging as a useful tool to provide expert medical advice to individuals facing health issues while travelling in remote areas. Before embarking on the development of a telemedicine system, we conducted a survey to assess the needs and expectations of travellers for such a service, and evaluate opinions about the importance of various travel criteria that may determine the contract of such insurance. (i) To assess whether a telemedicine service is considered useful by travellers, (ii) to investigate which telecommunication medium is preferred, (iii) to determine which subgroup of travellers would be most interested in this service and (iv) to estimate the amount of money travellers would be willing to pay for a telemedicine service. Travellers coming to our clinic for pre-travel advice were given a questionnaire to be filled in before consultation. The questionnaire focused on demographics, travel details, health status, interest and willingness to pay for a telemedicine service. Among 307 returned questionnaires, 59% of travellers were interested in a telemedicine service. Email was the preferred communication medium for 63%, mobile phone for 46% and video calls for 31% individuals (multiple answers). Travellers aged ≥60 years and those with an immunocompromising condition tended to be more interested in telemedicine (respectively OR = 1.65; 95% CI: 0.75-3.62 and OR = 3.56; 95% CI: 0.41-30.95). The 99% of travellers were willing to pay for such a service. Median price was 50 USD (IQR: 30-50 USD). There was no correlation between travel duration and amount to be paid. Among individuals consulting for pre-travel advice at a specialized clinic, there is considerable interest in telemedicine, particularly among older and immunocompromised travellers. Based on these data, a pilot system using email communication to help travellers confronted with health issues while abroad was developed and implemented in our travel clinic.

  16. Emergency operation determination system

    International Nuclear Information System (INIS)

    Miki, Tetsushi.

    1993-01-01

    The system of the present invention can determine an emergency operation coping with abnormal events occurring during nuclear plant operation without replying on an operator's judgement. That is, the system of the present invention comprises an intelligence base which divides and classifies the aims of the plant operation for the function, structure and operation manual and puts them into network. Degree of attainment for the extend of the status normality is determined on every aim of operation based on various kinds of measured data during plant operation. For a degree of attainment within a predetermined range, it is judged that an emergency operation is possible although this is in an abnormal state. Degree of emergency is determined by a fuzzy theory based on the degree of attainment, variation coefficient for the degree of attainment and the sensitivity to external disturbance as parameters. Priority for the degree of emergency on every operation aims is determined by comparison. Normality is successively checked for the determined operation aims. As a result, equipments as objects of abnormality suppressing operation are specified, and the operation amount of the equipments as objects are determined so that the measuring data are within a predetermined range. (I.S.)

  17. Communication system for emergency

    International Nuclear Information System (INIS)

    Ajioka, Yoshiteru

    1996-01-01

    People are apprehensive that a strong earthquake with a magnitude of nearly 8 may occur in Tokai area. The whole area of Shizuoka Prefecture has been specified as the specially strengthened region for earthquake disaster measures. This report outlines the communication system for emergency with respect to atomic disaster caused by an earthquake. Previously, wireless receiving system is stationed in the whole area to simultaneously inform the related news to the residents and so, communications with them are possible at any time by using the system. Since mobile wireless receiving sets are stationed in all town halls, self defense organizations and all the places of refuge, mutual communications are possible. These communication system can be utilized for either earthquake or nuclear disaster. Further, Shizuoka general information network system has been established as a communication system for anti-disaster organization and a wireless network via a communication satellite, ''super bird'' has been constructed in addition to the ground network. Therefore, the two communication routes became usable at emergency and the systems are available in either of nuclear disaster or earthquake. (M.N.)

  18. Emergency core cooling system

    International Nuclear Information System (INIS)

    Ando, Masaki.

    1987-01-01

    Purpose: To actuate an automatic pressure down system (ADS) and a low pressure emergency core cooling system (ECCS) upon water level reduction of a nuclear reactor other than loss of coolant accidents (LOCA). Constitution: ADS in a BWR type reactor is disposed for reducing the pressure in a reactor container thereby enabling coolant injection from a low pressure ECCS upon LOCA. That is, ADS has been actuated by AND signal for a reactor water level low signal and a dry well pressure high signal. In the present invention, ADS can be actuated further also by AND signal of the reactor water level low signal, the high pressure ECCS and not-operation signal of reactor isolation cooling system. In such an emergency core cooling system thus constituted, ADS operates in the same manner as usual upon LOCA and, further, ADS is operated also upon loss of feedwater accident in the reactor pressure vessel in the case where there is a necessity for actuating the low pressure ECCS, although other high pressure ECCS and reactor isolation cooling system are not operated. Accordingly, it is possible to improve the reliability upon reactor core accident and mitigate the operator burden. (Horiuchi, T.)

  19. Telemedicine expanding the scope of health care information.

    Science.gov (United States)

    Balch, D C; Tichenor, J M

    1997-01-01

    The definition of health information is growing to include multimedia audio, video, and high-resolution still images. This article describes the telemedicine program at East Carolina University School of Medicine, including the telemedicine applications presently in use and the virtual reality applications currently under development' Included are the major design criteria that shape the telemedicine network some of the lessons learned in developing the network, and a discussion of the future of telemedicine, including efforts to incorporate telemedicine within a fully integrated health information system.

  20. Emergency core cooling system

    International Nuclear Information System (INIS)

    Abe, Nobuaki.

    1993-01-01

    A reactor comprises a static emergency reactor core cooling system having an automatic depressurization system and a gravitationally dropping type water injection system and a container cooling system by an isolation condenser. A depressurization pipeline of the automatic depressurization system connected to a reactor pressure vessel branches in the midway. The branched depressurizing pipelines are extended into an upper dry well and a lower dry well, in which depressurization valves are disposed at the top end portions of the pipelines respectively. If loss-of-coolant accidents should occur, the depressurization valve of the automatic depressurization system is actuated by lowering of water level in the pressure vessel. This causes nitrogen gases in the upper and the lower dry wells to transfer together with discharged steams effectively to a suppression pool passing through a bent tube. Accordingly, the gravitationally dropping type water injection system can be actuated faster. Further, subsequent cooling for the reactor vessel can be ensured sufficiently by the isolation condenser. (I.N.)

  1. The Impact of Telemedicine on Pediatric Critical Care Triage.

    Science.gov (United States)

    Harvey, Jillian B; Yeager, Brooke E; Cramer, Christina; Wheeler, David; McSwain, S David

    2017-11-01

    To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. Retrospective evaluation of consultations occurring between April 2012 and March 2016. Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina. Pediatric patients receiving critical care telemedicine or telephone consultations. Telemedicine consultations. Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers' self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.

  2. A Tiered Approach to Retinopathy of Prematurity Screening (TARP) Using a Weight Gain Predictive Model and a Telemedicine System.

    Science.gov (United States)

    Gurwin, Jaclyn; Tomlinson, Lauren A; Quinn, Graham E; Ying, Gui-Shuang; Baumritter, Agnieshka; Binenbaum, Gil

    2017-01-05

    The Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study telemedicine system of remote fundus image grading and The Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOP-ROP) postnatal weight gain predictive model are 2 approaches for improving ROP screening efficiency. Current screening has low specificity for severe ROP. To describe a tiered approach to ROP screening (TARP) for identifying children who develop severe ROP using telemedicine and a predictive model synergistically. This investigation was a post hoc analysis of a cohort in the e-ROP Study (a multicenter prospective telemedicine study) and the Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study (a multicenter retrospective cohort study). The setting was neonatal intensive care units at The Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania. Participants in the e-ROP Study were premature infants with a birth weight less than 1251 g and a known ROP outcome enrolled between May 25, 2011, and October 31, 2013. The G-ROP Study enrolled all infants undergoing ROP examinations with a known ROP outcome who were born between January 1, 2006, and December 31, 2011. The mean outcomes were the sensitivity for type 1 ROP, reductions in infants requiring imaging or examinations, numbers of imaging sessions and examinations, and total clinical encounters (imaging sessions and examinations combined). The following 4 screening approaches were evaluated: ROUTINE (only diagnostic examinations by an ophthalmologist), CHOP-ROP (birth weight and gestational age, with weekly weight gain initiating examinations when the risk cut point is surpassed), e-ROP IMAGING (trained reader grading of type 1 or 2 ROP initiates diagnostic examinations), and TARP (CHOP-ROP alarm initiates imaging, and imaging finding of severe ROP initiates diagnostic examinations). A total of 242 infants were included in the study, with a median birth

  3. The utilization of mobile devices for telemedicine services in a South African public healthcare system.

    Science.gov (United States)

    Hartmann, André; Van Dyk, Liezl

    2014-01-01

    The purpose of this study is to develop an understanding in the use of mobile devices in administering telemedicine services within the public health care sector of South Africa. An online questionnaire was developed and distributed amongst medical officers, specialists, students and medical staff of one of the health districts of South Africa. This paper describes the design of the questionnaire as well as the most significant outcomes. Results are presented in terms of reasons why healthcare workers use mobile devices, as well as perceptions in terms of transmission security and quality of transmitted information.

  4. 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...

  5. 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.

  6. Evaluating the potential impact of a mobile telemedicine system on coordination of specialty care for 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

    2016-04-01

    Mobile telemedicine involves the use of mobile device (e.g., cell phones, tablets) technology to exchange information to assist in the provision of patient care. Throughout the world, mobile telemedicine initiatives are increasing in number and in scale, but literature on their impact on patient outcomes in low-resource areas is limited. This study explores the potential impact of a mobile oral telemedicine system on the oral health specialty referral system in Botswana. Analysis of 26 eligible cases from June 2012 to July 2013 reveals high diagnosis concordance between dental officers and oral health specialists at 91.3% (21/23) but significant management plan discordance at 64.0% (16/25), over two-thirds of which involved the specialists disagreeing with the referring clinicians about the need for a visit to a specialist. These findings suggest mobile telemedicine can optimize the use of insights and skills of specialists remotely in regions where they are scarce. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. 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.

  8. Telemedicine: opportunities and risks

    International Nuclear Information System (INIS)

    Vogl, R.

    2002-01-01

    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.) [de

  9. Arizona TeleMedicine Project.

    Science.gov (United States)

    Arizona Univ., Tucson. Coll. of Medicine.

    Designed to provide health services for American Indians living on rurally isolated reservations, the Arizona TeleMedicine Project proposes to link Phoenix and Tucson medical centers, via a statewide telecommunications system, with the Hopi, San Carlos Apache, Papago, Navajo, and White Mountain Apache reservations. Advisory boards are being…

  10. Emergency core cooling system

    International Nuclear Information System (INIS)

    Sato, Akira; Kobayashi, Masahide.

    1983-01-01

    Purpose: To enable a stable operation of an emergency core cooling system by preventing the system from the automatic stopping at an abnormally high level of the reactor water during its operation. Constitution: A pump flow rate signal and a reactor water level signal are used and, when the reactor water level is increased to a predetermined level, the pump flow rate is controlled by the reactor water level signal instead of the flow rate signal. Specifically, when the reactor water level is gradually increased by the water injection from the pump and exceeds a setting signal for the water level, the water level deviation signal acts as a demand signal for the decrease in the flow rate of the pump and the output signal from the water level controller is also decreased depending on the control constant. At a certain point, the output signal from the water level controller becomes smaller than the output signal from the flow rate controller. Thus, the output signal from the water level controller is outputted as the output signal for the lower level preference device. In this way, the reactor water level and the pump flow rate can be controlled within a range not exceeding the predetermined pump flow rate. (Horiuchi, T.)

  11. 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.

  12. COMMUNICA TION NETWORK FOR TELEMEDICINE Debretsion G ...

    African Journals Online (AJOL)

    (3) continuing medical education and (4) Training the medical ... Telemedicine system consists of at least five major subsystems. [l,4]. ... and wire-line (optical network) telecommunication facilities .... An ATM network needs certain traffic control.

  13. Video-Enhanced Telemedicine Improves the Care of Acutely Injured Burn Patients in a Rural State.

    Science.gov (United States)

    Wibbenmeyer, Lucy; Kluesner, Karen; Wu, Hongqian; Eid, Anas; Heard, Jason; Mann, Benjamin; Pauley, Alison; Peek-Asa, Corrine

    The acute care of burn patients is critical and can be a daunting experience for emergency personnel because of the scarcity of burn injuries. Telemedicine that incorporates a visual component can provide immediate expertise in the treatment and management of these injuries. The authors sought to evaluate the addition of video telemedicine to our current telephone burn transfer program. During a 2-year period, 282 patients, 59.4% of all burn patients transferred from outside hospitals, were enrolled in the study. In addition to the scripted call with the charge nurse (ChargeRN) and the accepting physician, nine hospitals also transmitted video images of the wounds before transfer as part of a store and forward telemedicine transfer program (77, 27.6%). The accuracy of burn size estimations (BSA burned) and management changes (fluid requirements, transfer mode, and final disposition) were analyzed between the telephones-only sites (T only) and the video-enhanced sites. Referringstaff participating in video-enhanced telemedicine were sent a Google survey assessing their experience the following day. The referring staff (Referringstaff) was correct in their burn assessment 20% of the time. Video assessment improved the ChargeRN BSA burned and resulted in more accurate fluid resuscitation (P = .030), changes in both transportation mode (P = .042), and disposition decisions (P = .20). The majority of the Referringstaff found that video-enhanced telemedicine helped them communicate with the burn staff more effectively (3.4 ± 0.37, scale 1-4). This study reports the successful implementation of video-enhanced telemedicine pilot project in a rural state. Video-enhanced telemedicine using a store and forward process improved burn size estimation and facilitated management changes. Although not quantitatively assessed, the low cost of the system coupled with the changes in transportation and disposition strongly suggests a decrease in healthcare costs associated with

  14. 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.

  15. 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.

  16. 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...

  17. The Brazilian emergency response system

    International Nuclear Information System (INIS)

    Santos, Raul dos

    1997-01-01

    With the objective of improving the response actions to potential or real emergency situations generated by radiological or nuclear accidents, the Brazilian National Nuclear Energy Commission (CNEN) installed an integrated response system on a 24 hours basis. All the natiowide notifications on events that may start an emergency situation are converged to this system. Established since July 1990, this system has received around 300 notifications in which 5% were classified as potential emergency situation. (author)

  18. 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.

  19. SICOEM: emergency response data system

    International Nuclear Information System (INIS)

    Martin, A.; Villota, C.; Francia, L.

    1993-01-01

    The main characteristics of the SICOEM emergency response system are: -direct electronic redundant transmission of certain operational parameters and plant status informations from the plant process computer to a computer at the Regulatory Body site, - the system will be used in emergency situations, -SICOEM is not considered as a safety class system. 1 fig

  20. SICOEM: emergency response data system

    Energy Technology Data Exchange (ETDEWEB)

    Martin, A.; Villota, C.; Francia, L. (UNESA, Madrid (Spain))

    1993-01-01

    The main characteristics of the SICOEM emergency response system are: -direct electronic redundant transmission of certain operational parameters and plant status informations from the plant process computer to a computer at the Regulatory Body site, - the system will be used in emergency situations, -SICOEM is not considered as a safety class system. 1 fig.

  1. 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.

  2. Telemedicine: history, applications, and impact on librarianship.

    OpenAIRE

    Zundel, K M

    1996-01-01

    This paper traces the uses of telecommunications in health care from the Civil War era to the present. Topics include the National Aeronautics and Space Administration's involvement in the origins of current telemedicine systems and the impact of television. Applications of telemedicine discussed include remote consultation and diagnosis, specialty clinical care (including examples from anesthesia, dermatology, cardiology, psychiatry, radiology, critical care, and oncology), and others (inclu...

  3. Adoption of routine telemedicine in Norway: the current picture

    Science.gov (United States)

    Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

    2014-01-01

    Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

  4. Feasibility of AmbulanCe-Based Telemedicine (FACT study: safety, feasibility and reliability of third generation in-ambulance telemedicine.

    Directory of Open Access Journals (Sweden)

    Laetitia Yperzeele

    Full Text Available Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation.A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ≥ 18 years transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis.Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%. The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high.Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and development, especially with regard to high

  5. Telemedicine Services for the Arctic: A Systematic Review

    Science.gov (United States)

    Walderhaug, Ståle; Hartvigsen, Gunnar

    2017-01-01

    Background Telemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges. Objective The purpose of this review was to assess and analyze the current status of telemedicine services in the context of maritime conditions, extreme weather (ie, Arctic weather), and remote accidents and emergencies. Moreover, the paper aimed to identify successfully implemented telemedicine services in the Arctic region and in maritime settings and remote emergency situations and present state of the art systems for these areas. Finally, we identified the status quo of telemedicine services in the context of search and rescue (SAR) scenarios in these extreme conditions. Methods A rigorous literature search was conducted between September 7 and October 28, 2015, through various online databases. Peer reviewed journals and articles were considered. Relevant articles were first identified by reviewing the title, keywords, and abstract for a preliminary filter with our selection criteria, and then we reviewed full-text articles that seemed relevant. Information from the selected literature was extracted based on some predefined categories, which were defined based on previous research and further elaborated upon via iterative brainstorming. Results The initial hits were vetted using the title, abstract, and keywords, and we retrieved a total of 471 papers. After removing duplicates from the list, 422 records remained. Then, we did an independent assessment of the articles and screening based on the inclusion and exclusion criteria, which eliminated

  6. 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.

  7. Evaluating the success of an emergency response medical information system.

    Science.gov (United States)

    Petter, Stacie; Fruhling, Ann

    2011-07-01

    STATPack™ is an information system used to aid in the diagnosis of pathogens in hospitals and state public health laboratories. STATPack™ is used as a communication and telemedicine diagnosis tool during emergencies. This paper explores the success of this emergency response medical information system (ERMIS) using a well-known framework of information systems success developed by DeLone and McLean. Using an online survey, the entire population of STATPack™ users evaluated the success of the information system by considering system quality, information quality, system use, intention to use, user satisfaction, individual impact, and organizational impact. The results indicate that the overall quality of this ERMIS (i.e., system quality, information quality, and service quality) has a positive impact on both user satisfaction and intention to use the system. However, given the nature of ERMIS, overall quality does not necessarily predict use of the system. Moreover, the user's satisfaction with the information system positively affected the intention to use the system. User satisfaction, intention to use, and system use had a positive influence on the system's impact on the individual. Finally, the organizational impacts of the system were positively influenced by use of the system and the system's individual impact on the user. The results of the study demonstrate how to evaluate the success of an ERMIS as well as introduce potential changes in how one applies the DeLone and McLean success model in an emergency response medical information system context. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. 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

  9. On the performance of telemedicine system using 17-GHz orthogonally polarized microwave links under the influence of heavy rainfall.

    Science.gov (United States)

    Fong, Bernard; Fong, A C M; Hong, G Y

    2005-09-01

    This paper describes the design of a telemedicine system based on next-generation wireless local area networks (WLANs) operating at 17 GHz. Seventeen gigahertz is proposed for next-generation WLAN services offering numerous advantages over traditional IEEE 802.11 networks that operate in the range of 2.4-5 GHz. Orthogonal polarization is often used to increase spectrum efficiency by utilizing signal paths of horizontal and vertical polarization. Radio waves exceeding 10 GHz are particularly vulnerable to signal degradation under the influence of rain which causes an effective reduction in isolation between polarized signal paths. This paper investigates the influence of heavy rain in a tropical region on wide-band microwave signals at 17 GHz using two links provided by a fixed broad-band wireless access system for two-way data exchange between paramedics attending an accident scene and the hospital via microwave equipment installed in the ambulance. We also study the effects of cross polarization and phase rotation due to persistent heavy rainfall in tropical regions.

  10. Emergency management information system (EMINS)

    International Nuclear Information System (INIS)

    Desonier, L.M.

    1987-01-01

    In a time of crisis or in an emergency, a manager is required to make many decisions to facilitate the proper solution and conclusion to the emergency or crisis. In order to make these decisions, it is necessary for the manager to have correct up-to-date information on the situation, which calls for an automated information display and entry process. The information handling needs are identified in terms of data, video, and voice. Studies of existing Emergency Operations Centers and evaluations of hardware and software have been completed. The result of these studies and investigations is the design and implementation of an automated Emergency Management Information System. Not only is the system useful for Emergency Management but for any information management requirement

  11. Emergency core cooling system

    International Nuclear Information System (INIS)

    Arai, Kenji; Oikawa, Hirohide.

    1990-01-01

    The device according to this invention can ensure cooling water required for emerency core cooling upon emergence such as abnormally, for example, loss of coolant accident, without using dynamic equipments such as a centrifugal pump or large-scaled tank. The device comprises a pressure accumulation tank containing a high pressure nitrogen gas and cooling water inside, a condensate storage tank, a pressure suppression pool and a jet stream pump. In this device there are disposed a pipeline for guiding cooling water in the pressure accumulation tank as a jetting water to a jetting stream pump, a pipeline for guiding cooling water stored in the condensate storage tank and the pressure suppression pool as pumped water to the jetting pump and, further, a pipeline for guiding the discharged water from the jet stream pump which is a mixed stream of pumped water and jetting water into the reactor pressure vessel. In this constitution, a sufficient amount of water ranging from relatively high pressure to low pressure can be supplied into the reactor pressure vessel, without increasing the size of the pressure accumulation tank. (I.S.)

  12. Emergency core cooling system

    International Nuclear Information System (INIS)

    Kato, Ken.

    1989-01-01

    In PWR type reactors, a cooling water spray portion of emergency core cooling pipelines incorporated into pipelines on high temperature side is protruded to the inside of an upper plenum. Upon rupture of primary pipelines, pressure in a pressure vessel is abruptly reduced to generate a great amount of steams in the reactor core, which are discharged at a high flow rate into the primary pipelines on high temperature side. However, since the inside of the upper plenum has a larger area and the steam flow is slow, as compared with that of the pipelines on the high temperature side, ECCS water can surely be supplied into the reactor core to promote the re-flooding of the reactor core and effectively cool the reactor. Since the nuclear reactor can effectively be cooled to enable the promotion of pressure reduction and effective supply of coolants during the period of pressure reduction upon LOCA, the capacity of the pressure accumulation vessel can be decreased. Further, the re-flooding time for the reactor is shortened to provide an effect contributing to the improvement of the safety and the reduction of the cost. (N.H.)

  13. 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

  14. Detection of cyst using image segmentation and building knowledge-based intelligent decision support system as an aid to telemedicine

    Science.gov (United States)

    Janet, J.; Natesan, T. R.; Santhosh, Ramamurthy; Ibramsha, Mohideen

    2005-02-01

    An intelligent decision support tool to the Radiologist in telemedicine is described. Medical prescriptions are given based on the images of cyst that has been transmitted over computer networks to the remote medical center. The digital image, acquired by sonography, is converted into an intensity image. This image is then subjected to image preprocessing which involves correction methods to eliminate specific artifacts. The image is resized into a 256 x 256 matrix by using bilinear interpolation method. The background area is detected using distinct block operation. The area of the cyst is calculated by removing the background area from the original image. Boundary enhancement and morphological operations are done to remove unrelated pixels. This gives us the cyst volume. This segmented image of the cyst is sent to the remote medical center for analysis by Knowledge based artificial Intelligent Decision Support System (KIDSS). The type of cyst is detected and reported to the control mechanism of KIDSS. Then the inference engine compares this with the knowledge base and gives appropriate medical prescriptions or treatment recommendations by applying reasoning mechanisms at the remote medical center.

  15. Sustainable Telemedicine: Designing and Building Infrastructure to Support a Comprehensive Telemedicine Practice.

    Science.gov (United States)

    Kreofsky, Beth L H; Blegen, R Nicole; Lokken, Troy G; Kapraun, Susan M; Bushman, Matthew S; Demaerschalk, Bart M

    2018-04-16

    Telemedicine services in medical institutions are often developed in isolation of one another and not as part of a comprehensive telemedicine program. The Center for Connected Care is the administrative home for a broad range of telehealth services at Mayo Clinic. This article speaks of real-time video services, referenced as telemedicine throughout. This article discusses how a large healthcare system designed and built the infrastructure to support a comprehensive telemedicine practice. Based on analysis of existing services, Mayo Clinic developed a multifaceted operational plan that addressed high-priority areas and outlined clear roles and responsibilities of the Center for Connected Care and that of the clinical departments. The plan set priorities and a direction that would lead to long-term success. The plan articulated the governing and operational infrastructure necessary to support telemedicine by defining the role of the Center for Connected Care as the owner of core administrative operations and the role of the clinical departments as the owners of clinical telemedicine services. Additional opportunities were identified to develop product selection processes, implementation services, and staffing models that would be applied to ensure successful telemedicine deployment. The telemedicine team within the Center for Connected Care completed 45 business cases resulting in 54 implementations. The standardization of core products along with key operational offerings around implementation services, and the establishment of a 24/7 support model resulted in improved provider satisfaction and fewer reported technical issues. The foundation for long-term scalability and growth was developed by centralizing operations of telemedicine services, implementing sustainable processes, employing dedicated qualified personnel, and deploying robust products.

  16. Safety of Medical Abortion Provided Through Telemedicine Compared With In Person.

    Science.gov (United States)

    Grossman, Daniel; Grindlay, Kate

    2017-10-01

    To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service. We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided α=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year. During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients [95% CI 0.23-0.45%]). The difference in adverse event prevalence was 0.13% (95% CI -0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion. Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant

  17. 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,...

  18. UH Telemedicine Proposal

    National Research Council Canada - National Science Library

    Friedman, Richard

    2001-01-01

    .... To accomplish this task, a clinical telemedicine service was established such that a hub of physician specialists in Honolulu is available to primary care providers and patients in rural and/or remote clinics...

  19. 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.

  20. VA Telemedicine: An Analysis of Cost and Time Savings.

    Science.gov (United States)

    Russo, Jack E; McCool, Ryan R; Davies, Louise

    2016-03-01

    The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

  1. 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.

  2. Telemedicine and burns: an overview.

    Science.gov (United States)

    Atiyeh, B; Dibo, S A; Janom, H H

    2014-06-30

    Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency.

  3. 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.

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

    Science.gov (United States)

    León, Agathe; Cáceres, César; Fernández, Emma; Chausa, Paloma; Martin, Maite; Codina, Carles; Rousaud, Araceli; Blanch, Jordi; Mallolas, Josep; Martinez, Esteban; Blanco, Jose L; Laguno, Montserrat; Larrousse, Maria; Milinkovic, Ana; Zamora, Laura; Canal, Neus; Miró, Josep M; Gatell, Josep M; Gómez, Enrique J; García, Felipe

    2011-01-21

    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 of

  5. A qualitative study of the organizational consequences of telemedicine.

    Science.gov (United States)

    Aas, I H

    2001-01-01

    The organizational consequences of telemedicine have frequently been mentioned in the telemedicine community, but there are few empirical studies. A study was therefore carried out of what happens in organizations when telemedicine is implemented. Qualitative interviews were undertaken with 30 persons working in teledermatology, telepsychiatry, a telepathology frozen-section service and tele-otolaryngology. Almost all respondents reported numerous organizational changes, some important. Changes in work processes were the most common. Examples of the organizational consequences of telemedicine were organizational restructuring, new organizational units, changed mechanisms for internal coordination, different flows of patients through the health-care system, improved coordination of care, new job descriptions, relocation of the place of work, employment of personnel living far away from the workplace, effects on employees not directly involved in telemedicine, sharing of experiences, minor staffing changes, clinical teamwork independent of co-location, administrative meetings arranged by telemedicine, merger of organizations independent of location, less travel by staff (and patients), a possible beneficial effect on the quality of care, and limited opposition to the adoption of the technology. Telemedicine may be important in the future organization of the disciplines studied and in health-care generally. The infrastructure of electronic networks may play an important role for organizations as the volume of telemedicine activity increases and economies of scale are realized.

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

    Directory of Open Access Journals (Sweden)

    Abdulellah Alaboudi

    2016-11-01

    Full Text Available Summary: 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

  7. The Centralization and Decentralization of Telemedicine Networks in Korea and Japan

    Directory of Open Access Journals (Sweden)

    Soo-kyung Park

    2013-06-01

    Full Text Available This study scrutinizes telemedicine networks with regard to regionalization and the propensities and determinants of core telemedicine users (doctors and patients by employing two case areas, Choongbook in Korea and Kagawa in Japan. According to the results, telemedicine networks in Choongbook are dominated by an inter-regional level (in particular, a national level, and most of the telemedicine networks are observed between clinical sites in Choongbook and tertiary care centers in Kyunggi. In contrast, telemedicine networks in Kagawa are dispersed within the diagnostic boundary of Kagawa at a regional level. Interviews with crucial decision-makers revealed the reasons why many patients enjoy health care via telemedicine at an inter-regional level, which include psychological considerations regarding quality and level of health care services, personal stakes in telemedicine service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. In Kagawa, both the existing health care system and the telemedicine system support the maintenance of stable regional health care within Kagawa. Importantly, human relationships based on the regional health care system contribute to creating telemedicine networks within the original purpose of the telemedicine system regarding regionalization. Also, telemedicine’s technological value, convenience, and utility are associated with the regionalization of telemedicine networks within one diagnostic area.

  8. Artificial Intelligence Base Telemedicine Robotic

    OpenAIRE

    Hakika, Kisti; TS, Hendra Yunianto; Afriyanti, Liza

    2009-01-01

    Telemedicine atau pelayanan kesehatan jarak jauh bukan hal yang baru lagi dalam dunia kesehatan.Penggunaan teknologi sangat membantu dalam mengimplementasikan telemedicine. Namun perkembangantelemedicine mengalami kemajuan seiring dengan perkembangan teknologi informasi. Salah satu perkembanganteknologi adalah robot. Secara umum kegunaan robot adalah untuk menggantikan tugas manusia. Padamakalah ini, akan dibuat simulasi telemedicine berupa konsultasi antara dokter dan pasien menggunakansebua...

  9. 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.

  10. Validation of a real-time wireless telemedicine system, using bluetooth protocol and a mobile phone, for remote monitoring patient in medical practice.

    Science.gov (United States)

    Yousef, Jasemian; Lars, A N

    2005-06-22

    This paper validates the integration of a generic real-time wireless telemedicine system utilising Global System for Mobile Communications (GSM), BLUETOOTH protocol and General Packet Radio Service (GPRS) for cellular network in clinical practice. In the first experiment, the system was tested on 24 pacemaker patients at Aalborg Hospital (Denmark), in order to see if the pacemaker implant would be affected by the system. I the second experiment, the system was tested on 15 non risky arrhythmia heart patients, in order to evaluate and validate the system application in clinical practice, for patient monitoring. Electrocardiograms were selected as the continuously monitored parameter in the present study. The results showed that the system had no negative effects on the pacemaker implants. The experiment results showed, that in a realistic environment for the patients, the system had 96.1 % up-time, 3.2 (kbps) throughput, 10(-3) (packet/s) Packet Error Rate and 10(-3) (packet/s) Packet Lost Rate. During 24 hours test the network did not respond for 57 minutes, from which 83.1 % was in the range of 0-3 minutes, 15.4 % was in the range of 3-5 minutes, and only 0.7 % of the down-time was > or = 5 and < or = 6 minutes. By a subjective evaluation, it was demonstrated that the system is applicable and the patients as well as the healthcare personals were highly confident with the system. Moreover, the patients had high degree of mobility and freedom, employing the system. In conclusion, this generic telemedicine system showed a high reliability, quality and performance, and the design can provide a basic principle for real-time wireless remote monitoring systems used in clinical practice.

  11. Telemedicine in otolaryngology.

    Science.gov (United States)

    Holtel, Michael R; Burgess, Lawrence P A

    2002-12-01

    More research is needed in otolaryngology telemedicine, but it would be a mistake to stop at only determining if telemedicine is as good as an in-person exam. The digital image recorded in a telemedicine encounter can be manipulated to increase diagnostic information not currently available. Radiologists currently take a chest radiograph in which a chest mass or the tip of an nasogastric tube is difficult to visualize, and by inverting the gray scale or viewing other digital manipulations of that image, the mass or tube tip becomes obvious. Examples in otolaryngology might include images of the larynx manipulated to better demonstrate the inflamed tissue of reflux, or images of the tympanic membrane manipulated to better demonstrate early retraction. Despite dramatic and likely continued decreases, equipment cost is still an issue. Current research points to good consumer acceptance, and certainly with each new generation the technology is more readily accepted. As Nesbitt [4] points out, it is certainly not difficult to look to the future and see ubiquitous broadband with video as common as telephone, or even extreme broadband enabling robotics and virtual reality TV with three-dimensional touch. Robotics and genomics will eventually play a greater role in telemedicine and our lives in general. Applications for remote diagnosis in biologic warfare defense and homeland security are currently raising interest in telemedicine. Telemedicine will be combined with new technological advances such as virtual "fly-through" computerized axial tomography examinations. Instead of performing an exploratory tympanotomy, surgeons will use computer programs to "fly through" and examine all aspects of a patient's middle or even inner ear. Spectral imaging of the eardrum, larynx, or oropharynx will immediately identify bacteria without cultures, or gram stain, and potential malignancy without biopsy. By measuring fluorescence emitted from an oropharynx illuminated with a specific

  12. 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...

  13. Japanese experience of telemedicine in oncology.

    Science.gov (United States)

    Mizushima, H; Uchiyama, E; Nagata, H; Matsuno, Y; Sekiguchi, R; Ohmatsu, H; Hojo, F; Shimoda, T; Wakao, F; Shinkai, T; Yamaguchi, N; Moriyama, N; Kakizoe, T; Abe, K; Terada, M

    2001-05-01

    We started telemedicine projects from 1990 with a telepathology system within Tsukiji Campus of National Cancer Center. In 1994, we connected Tsukiji Campus and Kashiwa Campus by 6 Mbps optical fiber leased line using IP protocol for data transmission, for teleconference, telepathology, and teleradiology projects. We also started connection of regional cancer centers and are now forming a cancer center network of 14 cancer centers. We are at present organizing 130 teleconferences per year with an attendance of more than 16000 people as summary. We have also used a high-resolution image transferring system, such as SHD (2000 pixelsx2000 pixels resolution) system on one side, and an economical telemedicine system using JAVA and a WWW browser (NCC_image) on the other side. We think that providing information is another field of telemedicine. We began the experimental gopher and WWW service in 1993. We are now providing official up-to-date cancer information for patients and healthcare professionals. We are getting more than 400000 hits per month. We are also providing a teleconference video session which is held every week on the Internet using a Real Video system with synchronized slide presentation on the WWW browser. We are also organizing a Cancer Image Reference Database System including DICOM images with viewer software. This paper is a summary of the telemedicine projects performed at the National Cancer Center.

  14. Automated emergency meteorological response system

    International Nuclear Information System (INIS)

    Pepper, D.W.

    1980-01-01

    A sophisticated emergency response system was developed to aid in the evaluation of accidental releases of hazardous materials from the Savannah River Plant to the environment. A minicomputer system collects and archives data from both onsite meteorological towers and the National Weather Service. In the event of an accidental release, the computer rapidly calculates the trajectory and dispersion of pollutants in the atmosphere. Computer codes have been developed which provide a graphic display of predicted concentration profiles downwind from the source, as functions of time and distance

  15. ICU Telemedicine Program Financial Outcomes.

    Science.gov (United States)

    Lilly, Craig M; Motzkus, Christine; Rincon, Teresa; Cody, Shawn E; Landry, Karen; Irwin, Richard S

    2017-02-01

    ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge. Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars using Producer Price Index for Health-Care Facilities. Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The annual direct contribution margin improved from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) to $60,586,397 (logistic center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay. The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  16. Telemedicine: Development of a distance care system for pre-dialysis chronic kidney disease patients.

    Science.gov (United States)

    Fernandes, Natália Maria da Silva; Bastos, Marcus Gomes; Oliveira, Nivalda A C de; Costa, Alex do Vale; Bernardino, Heder Soares

    2015-01-01

    The focus in the treatment of CKD is to prevent its progression through optimal medical control. The large number of patients with CKD has pressed nephrologists to assess more patients into ever-smaller periods of consultation. The use of light technologies as a promising form of health care. The internet offers the opportunity to manipulate the doctor in his professional contact with the user. To develop a web system to attend the patients with CKD not on dialysis and clinically stable stages at distance. Developed a system using the Java language, MySQL database and PrimeFaces framework; available on a Glassfish application server. The initial access is performed by the nephrologist, which registers the patients with their personal information and access data. After being registered, the patient (or family doctor) can enter the data of your query and these will be following, passed on to the nephrologist for evaluation. The form with the data of interest is pre-determined, but there is possibility to add free-form information. The system enables, in addition, there is exchange of messages between doctors and patients. In addition, users receive messages via e-mail alerting them of their duties. Confidentiality is guaranteed by individual passwords for doctors and patients. This tool will enable to increase the coverage area of nephrologists, reduce costs and bring the patient to the primary care physician, using the Family Health Program as an interface between the patient and the nephrology secondary care.

  17. 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.

  18. Telemedicine in the 'Hood.

    Science.gov (United States)

    Elgrably, Jordan

    1998-01-01

    Telemedicine, the ability to examine patients while physically removed from them by using high-tech virtual treatment, is used increasingly to diagnose and prescribe treatment for patients in nontraditional settings. In Los Angeles (California), Charles R. Drew University of Medicine and King-Drew Medical Center communicate in real time with…

  19. Economic Evaluation of Telemedicine for Patients in ICUs.

    Science.gov (United States)

    Yoo, Byung-Kwang; Kim, Minchul; Sasaki, Tomoko; Melnikow, Joy; Marcin, James P

    2016-02-01

    Despite telemedicine's potential to improve patients' health outcomes and reduce costs in the ICU, hospitals have been slow to introduce telemedicine in the ICU due to high up-front costs and mixed evidence on effectiveness. This study's first aim was to conduct a cost-effectiveness analysis to estimate the incremental cost-effectiveness ratio of telemedicine in the ICU, compared with ICU without telemedicine, from the healthcare system perspective. The second aim was to examine potential cost saving of telemedicine in the ICU through probabilistic analyses and break-even analyses. Simulation analyses performed by standard decision models. Hypothetical ICU defined by the U.S. literature. Hypothetical adult patients in ICU defined by the U.S. literature. The intervention was the introduction of telemedicine in the ICU, which was assumed to affect per-patient per-hospital-stay ICU cost and hospital mortality. Telemedicine in the ICU operation costs included the telemedicine equipment-installation (start-up) costs with 5-year depreciation, maintenance costs, and clinician staffing costs. Telemedicine in the ICU effectiveness was measured by cumulative quality-adjusted life years for 5 years after ICU discharge. The base case cost-effectiveness analysis estimated telemedicine in the ICU to extend 0.011 quality-adjusted life years with an incremental cost of $516 per patient compared with ICU without telemedicine, resulting in an incremental cost-effectiveness ratio of $45,320 per additional quality-adjusted life year (= $516/0.011). The probabilistic cost-effectiveness analysis estimated an incremental cost-effectiveness ratio of $50,265 with a wide 95% CI from a negative value (suggesting cost savings) to $375,870. These probabilistic analyses projected that cost saving is achieved 37% of 1,000 iterations. Cost saving is also feasible if the per-patient per-hospital-stay operational cost and physician cost were less than $422 and less than $155, respectively, based on

  20. 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.

  1. Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine.

    Science.gov (United States)

    Torabi, Elham; Froehle, Craig M; Lindsell, Christopher J; Moomaw, Charles J; Kanter, Daniel; Kleindorfer, Dawn; Adeoye, Opeolu

    2016-01-01

    The objective of this study was to evaluate operational policies that may improve the proportion of eligible stroke patients within a population who would receive intravenous recombinant tissue plasminogen activator (rt-PA) and minimize time to treatment in eligible patients. In the context of a regional stroke team, the authors examined the effects of staff location and telemedicine deployment policies on the timeliness of thrombolytic treatment, and estimated the efficacy and cost-effectiveness of six different policies. A process map comprising the steps from recognition of stroke symptoms to intravenous administration of rt-PA was constructed using data from published literature combined with expert opinion. Six scenarios were investigated: telemedicine deployment (none, all, or outer-ring hospitals only) and staff location (center of region or anywhere in region). Physician locations were randomly generated based on their zip codes of residence and work. The outcomes of interest were onset-to-treatment (OTT) time, door-to-needle (DTN) time, and the proportion of patients treated within 3 hours. A Monte Carlo simulation of the stroke team care-delivery system was constructed based on a primary data set of 121 ischemic stroke patients who were potentially eligible for treatment with rt-PA. With the physician located randomly in the region, deploying telemedicine at all hospitals in the region (compared with partial or no telemedicine) would result in the highest rates of treatment within 3 hours (80% vs. 75% vs. 70%) and the shortest OTT (148 vs. 164 vs. 176 minutes) and DTN (45 vs. 61 vs. 73 minutes) times. However, locating the on-call physician centrally coupled with partial telemedicine deployment (five of the 17 hospitals) would be most cost-effective with comparable eligibility and treatment times. Given the potential societal benefits, continued efforts to deploy telemedicine appear warranted. Aligning the incentives between those who would have to fund

  2. Telemedicine in the Solomon Islands: 2006 to 2009.

    Science.gov (United States)

    Martiniuk, Alexandra; Negin, Joel; Hersch, Fred; Dalipanda, Tenneth; Jagilli, Rooney; Houasia, Patrick; Gorringe, Lilijana; Christie, Annie

    2011-01-01

    Telemedicine has been used in the Solomon Islands since 2000. We used quantitative and qualitative methods to examine telemedicine use in the Solomon Islands from January 2006 to June 2009. During the study period 66 telemedicine cases were submitted to the store and forward telemedicine system being used there. These included orthopaedic, oncology, cardiothoracic, infectious, congenital, gastroenterology and dermatology cases. Most cases (52%) were submitted by doctors at the National Referral Hospital (NRH) in Honiara. The majority of responses came from the NRH (27%). A final, firm recommendation regarding patient diagnosis and/or care was given for 46% of the cases. Interviews were conducted with 23 stakeholders in the Solomon Islands and in Australia to better understand the current and future use of telemedicine. The interviews identified the fragility of the Solomon Islands infrastructure, including the lack of training, as the largest barrier to the future use of telemedicine. The best use of telemedicine appears to be case sharing within the Solomon Islands, with connections to clinicians in other countries as a secondary benefit when particular expertise is required.

  3. 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.

  4. 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. PMID:23573082

  5. 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.

  6. 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.

  7. [Telecardiology: Tasks and duties of telemedicine].

    Science.gov (United States)

    Borbás, János; Forczek, Erzsébet; Sepp, Róbert; Bari, Ferenc

    2017-11-01

    Telemedicine is a young science that integrates innovations of information-technology and telecommunications into medical science. A successful telemedicine procedure should guarantee reduced workload of the healthcare system with well secured and cost-effective processes. Our goal was to collect the development phases of telemedicine projects through existing telecardiology solutions. Subsequent to reviewing international publications we analyzed the past and present situation of blood pressure monitoring, remote diagnostics of electrocardiography, implantable cardioverter defibrillator monitoring and pocket ultrasound devices. In case of new solutions (a) several internationally accepted, confidently reproducible "good practices" are needed for creating (b) guidelines and recommendations of international medical associations. They have to ensure (c) cost-effective work, with well-designed sustainability and (d) patient confidentiality. Improving (e) education for professionals and patients is essential. We recommend to telemedicine developers to use our standards in order to introduce their products more effectively into clinical practice. It is encouraging that current possibilities of telecardiology partly or fully meet the aforementioned criteria. Further development of the topic can contribute to financial sustainability of our healthcare and might be able to resolve limitations of human resources. Orv Hetil. 2017; 158(44): 1741-1746.

  8. Emergency system for nuclear reactors

    International Nuclear Information System (INIS)

    1976-01-01

    The invention concerns a circuit called 'of emergency help' intended to remove, in a safe and quick manner, the residual thermal power on the safety vessel of a fast neutron reactor cooled by a liquid metal flow, in the event of a failure occurring inside the main reactor vessel or on it. This system includes a network of spray nozzle tubes, distributed around and near the external surface of the safety vessel, to project on to the surface of the vessel a mist of a liquid having high latent vaporisation heat. The steam produced on contact with the safety vessel is collected in the space provided between the safety vessel and the external protection vessel by at least one collector pipe for dischaging this steam outside the vessel. Under a preferred design mode of the invention the liquid is water the use of which turns out to be particularly advantageous in practice owing to its favourable physical properties and its low cost [fr

  9. Telemedicine and anaesthesia

    Directory of Open Access Journals (Sweden)

    Veena Chatrath

    2010-01-01

    Full Text Available Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article.

  10. Telemedicine and anaesthesia.

    Science.gov (United States)

    Chatrath, Veena; Attri, Joginder Pal; Chatrath, Raman

    2010-05-01

    Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article.

  11. Medical high-resolution image sharing and electronic whiteboard system: A pure-web-based system for accessing and discussing lossless original images in telemedicine.

    Science.gov (United States)

    Qiao, Liang; Li, Ying; Chen, Xin; Yang, Sheng; Gao, Peng; Liu, Hongjun; Feng, Zhengquan; Nian, Yongjian; Qiu, Mingguo

    2015-09-01

    There are various medical image sharing and electronic whiteboard systems available for diagnosis and discussion purposes. However, most of these systems ask clients to install special software tools or web plug-ins to support whiteboard discussion, special medical image format, and customized decoding algorithm of data transmission of HRIs (high-resolution images). This limits the accessibility of the software running on different devices and operating systems. In this paper, we propose a solution based on pure web pages for medical HRIs lossless sharing and e-whiteboard discussion, and have set up a medical HRI sharing and e-whiteboard system, which has four-layered design: (1) HRIs access layer: we improved an tile-pyramid model named unbalanced ratio pyramid structure (URPS), to rapidly share lossless HRIs and to adapt to the reading habits of users; (2) format conversion layer: we designed a format conversion engine (FCE) on server side to real time convert and cache DICOM tiles which clients requesting with window-level parameters, to make browsers compatible and keep response efficiency to server-client; (3) business logic layer: we built a XML behavior relationship storage structure to store and share users' behavior, to keep real time co-browsing and discussion between clients; (4) web-user-interface layer: AJAX technology and Raphael toolkit were used to combine HTML and JavaScript to build client RIA (rich Internet application), to meet clients' desktop-like interaction on any pure webpage. This system can be used to quickly browse lossless HRIs, and support discussing and co-browsing smoothly on any web browser in a diversified network environment. The proposal methods can provide a way to share HRIs safely, and may be used in the field of regional health, telemedicine and remote education at a low cost. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. 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.

  13. [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

  14. 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.

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

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... information is a result of collaboration between accident response personnel. ... Tactical Emergency Response Management System (TERMS) which unifies all these different ... purpose of handling crisis and emergency.

  16. Telemedicine and distributed medical intelligence.

    Science.gov (United States)

    Warner, D; Tichenor, J M; Balch, D C

    1996-01-01

    Recent trends in health care informatics and telemedicine indicate that systems are being developed with a primary focus on technology and business, not on the process of medicine itself. The authors present a new model of health care information, distributed medical intelligence, which promotes the development of an integrative medical communication system addressing the process of providing expert medical knowledge to the point of need. The model incorporates audio, video, high-resolution still images, and virtual reality applications into an integrated medical communications network. Three components of the model (care portals, Docking Station, and the bridge) are described. The implementation of this model at the East Carolina University School of Medicine is also outlined.

  17. 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

  18. 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.

  19. 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 (ptelemedicine systems, as predicted using the extended UTAUT model. Our results showed that the use of telemedicine by clinicians in the Nigerian context is perceived as a dual responsibility which requires suitable reinforcement. In addition, performance 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.

  20. Current Landscape of Telemedicine Practice in Inflammatory Bowel Disease.

    Science.gov (United States)

    Patil, Seema A; Cross, Raymond K

    2018-04-28

    Inflammatory bowel disease (IBD), comprised of Crohn's disease and ulcerative colitis, affects 1.6 million people in the United States. Although effective medical treatments exist to treat the disease, outcomes are still suboptimal. The reasons for poor outcomes vary but include nonadherence to therapy, inadequate monitoring of patients, limited access to IBD specialty care, concurrent psychiatric disease, limited patient knowledge of the disease and treatments, and patient provider discordance. Telemedicine is a candidate intervention that can be used to improve patient outcomes through more frequent monitoring, patient self-management, delivery of education (patient and provider), and to increase access to multidisciplinary IBD care. Telemedicine includes remote monitoring, telehealth, teleconsultation, and teleconferencing.Telemedicine systems have been used in patients with IBD with widespread patient acceptance of the technology. However, early clinical trials demonstrated high attrition rates among intervention patients. In general, use of telemedicine systems have been associated with improved quality of life, improved patient knowledge, and decreased utilization of health care resources. Early studies evaluating telehealth visits report high patient satisfaction, decreased indirect costs to patients, and no decrease in quality of care delivered.Due to widespread access to computers and smart phones among patients, telemedicine will continue to expand in the care of patients with IBD. To optimize use and effectiveness of telemedicine, barriers for use including concerns over increased liability, need for informed consent, licensure restrictions to providing interstate telehealth visits, and cybersecurity need to be addressed.

  1. 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

  2. Patient empowerment and involvement in telemedicine

    DEFF Research Database (Denmark)

    Konge Nielsen, Marie; Johannessen, Helle

    2018-01-01

    Basic ideas of empowerment and user involvement in relation to telemedicine are presented, as is a case implying user resistance to telemedicine. Four logics of empowerment are employed to identify the underlying rationale of specific cases of telemedicine. The article concludes, that although...... telemedicine is acknowledged as relevant, the approach to it is often too mechanical to imply empowerment of the patient. Some patient groups may not feel safe by using telemedicine, and user involvement and empowerment will not be possible....

  3. The evolution of telemedicine and nano-technology

    Science.gov (United States)

    Park, Dong Kyun; Young Jung, Eun; Chan Moon, Byung

    2012-10-01

    This paper will cover definition and history of telemedicine, changes in medical paradigm and roll of telemedicine and roll of nano-technology for evolution of telemedicine. Hypothetically, telemedicine is distance communication for medical purpose and modern definition explains telemedicine as `a system of health care delivery in which physicians examine distant patients through the use of telecommunications technology. Medical service will change to personalized medicine based on gene information to prevent and manage diseases due to decrease of acute diseases, population aging and increase of prevalence in chronic diseases, which means current medical services based on manualized treatment for diseases will change to personalized medicine based on individual gene information. Also, international healthcare will be activated to provide high quality medical services with low cost using developed transportation. Moreover, hospital centered medical services will change to patients centered medical service due to increase of patient's rights. Development in sensor technology is required for telemedicine to be applied as basic infrastructure for medical services. Various researches in nano-biosensor field are conducted due to introduction of new technologies. However, most researches are in fundamental levels that requires more researches for stability and clinical usefulness. Nano technology is expected to achieve innovative development and define new criteria for disease prevention and management.

  4. Perceptual Image Compression in Telemedicine

    Science.gov (United States)

    Watson, Andrew B.; Ahumada, Albert J., Jr.; Eckstein, Miguel; Null, Cynthia H. (Technical Monitor)

    1996-01-01

    The next era of space exploration, especially the "Mission to Planet Earth" will generate immense quantities of image data. For example, the Earth Observing System (EOS) is expected to generate in excess of one terabyte/day. NASA confronts a major technical challenge in managing this great flow of imagery: in collection, pre-processing, transmission to earth, archiving, and distribution to scientists at remote locations. Expected requirements in most of these areas clearly exceed current technology. Part of the solution to this problem lies in efficient image compression techniques. For much of this imagery, the ultimate consumer is the human eye. In this case image compression should be designed to match the visual capacities of the human observer. We have developed three techniques for optimizing image compression for the human viewer. The first consists of a formula, developed jointly with IBM and based on psychophysical measurements, that computes a DCT quantization matrix for any specified combination of viewing distance, display resolution, and display brightness. This DCT quantization matrix is used in most recent standards for digital image compression (JPEG, MPEG, CCITT H.261). The second technique optimizes the DCT quantization matrix for each individual image, based on the contents of the image. This is accomplished by means of a model of visual sensitivity to compression artifacts. The third technique extends the first two techniques to the realm of wavelet compression. Together these two techniques will allow systematic perceptual optimization of image compression in NASA imaging systems. Many of the image management challenges faced by NASA are mirrored in the field of telemedicine. Here too there are severe demands for transmission and archiving of large image databases, and the imagery is ultimately used primarily by human observers, such as radiologists. In this presentation I will describe some of our preliminary explorations of the applications

  5. 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

  6. 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.

  7. 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/

  8. 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

  9. The principles of telemedicine in practice

    Directory of Open Access Journals (Sweden)

    Ilvana Vučković

    2003-11-01

    Full Text Available Telemedicine (distance medicine represents a field of medicine that has been in a tremendous expansion over the last couple of years thanks to the fast development of telecommunications and reduction of their costs. It enables a direct communication (visual between the peripheral hospitals and referral facilities in the interior of the country as well as a connection of centres with referral centres abroad in the fields of diagnostics, consultations or education. The main objective is to encourage interest in telemedicine among physicians and other health care experts, initiate an exchange of opinions, and experience about the application of telecommunication technology in medicine, so to reach a common perception of its role in the context of future development of the health care system in Bosnia and Herzegovina. As a standard, current equipment consists of computers, which are equipped with frame grabbers and communication modem for communication through a public telecommunication system. Input data can all be visual data (X-Ray, CT, MRI, ultrasound, ECG, histological finding, cariogram, and of course photos of the patients, of operational/surgical field. The Institute of Pathology of the Sarajevo Medical Faculty has actively participated in the experimental project “SHARED” (1996-2000 together with the Radiology and Ophthalmology Clinic of the Sarajevo Clinical Centre. The past experience in using telemedicine has shown that the introduction of such a telemedicine system in B&H would be of great significance in the future in the context of providing better and more efficient health services to the patients. In practice, that means a more simple approach to some services and data for patients, a better and faster circulation of information and experience of medical experts and health care workers with cost control at the same time. 

  10. 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.

  11. 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.

  12. DEVELOPMENT OF A MATURITY MODEL FOR TELEMEDICINE#

    Directory of Open Access Journals (Sweden)

    L. Van Dyk

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: For more than a decade, the South African National Department of Health (DoH has recognised the potential benefit of information and communication technology (ICT in the delivery of health care to rural areas. Despite generous funding and proven technology, not many telemedicine systems have proved sustainable after the pilot phase. The purpose of this paper is to develop a maturity model that can be implemented to measure and manage the capability of a health system, for use in the delivery of sustainable health care after the pilot phase of a telemedicine project. The validity of the telemedicine maturity model (TMMM is tested within the context of the South African public health sector.

    AFRIKAANSE OPSOMMING: Die Suid Afrikaanse Nasionale Departement van Gesondheid het reeds meer as ’n dekade gelede die voordeel besef wat inligtings- en kommunikasietegnologie kan bied ten opsigte van die lewering van gesondheidsorg in afgeleë gebiede. Ten spyte van ruim befondsing en bewese tegnologie, is daar egter min volgehoue telegeneeskundedienste in die publieke gesondheidstelsel van Suid Afrika. Die doel van hierdie artikel is om ’n volwassenheids-model te ontwikkel wat gebruik kan word om die vermoë van ’n gesondheidstelsel te bepaal en bestuur, ten einde telegeneeskunde loodsprojekte vol te hou. Die geldigheid van hierdie telegeneeskunde volwassenheidsmodel (TMMM is getoets binne konteks van die publieke gesondheidsektor van Suid Afrika.

  13. Emergency Department Telepsychiatry Service Model for a Rural Regional Health System: The First Steps.

    Science.gov (United States)

    Meyer, James D; McKean, Alastair J S; Blegen, Rebecca N; Demaerschalk, Bart M

    2018-05-09

    Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds). We conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015. The data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED. Based upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed. Emergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

  14. Wavelet-based compression of pathological images for telemedicine applications

    Science.gov (United States)

    Chen, Chang W.; Jiang, Jianfei; Zheng, Zhiyong; Wu, Xue G.; Yu, Lun

    2000-05-01

    In this paper, we present the performance evaluation of wavelet-based coding techniques as applied to the compression of pathological images for application in an Internet-based telemedicine system. We first study how well suited the wavelet-based coding is as it applies to the compression of pathological images, since these images often contain fine textures that are often critical to the diagnosis of potential diseases. We compare the wavelet-based compression with the DCT-based JPEG compression in the DICOM standard for medical imaging applications. Both objective and subjective measures have been studied in the evaluation of compression performance. These studies are performed in close collaboration with expert pathologists who have conducted the evaluation of the compressed pathological images and communication engineers and information scientists who designed the proposed telemedicine system. These performance evaluations have shown that the wavelet-based coding is suitable for the compression of various pathological images and can be integrated well with the Internet-based telemedicine systems. A prototype of the proposed telemedicine system has been developed in which the wavelet-based coding is adopted for the compression to achieve bandwidth efficient transmission and therefore speed up the communications between the remote terminal and the central server of the telemedicine system.

  15. Emergency warning via automated distribution system

    International Nuclear Information System (INIS)

    Glasser, J.C.

    1981-01-01

    Due to the Three Mile Island Nuclear Power Plant accident of March 28, 1979, the Nuclear Regulatory Commission and the Federal Emergency Management Agency require a general upgrading of existing Emergency Preparedness Plans. NUREG-0654/FEMA REP-1, Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants, dated October 1980, describes the Emergency Plans required and includes the Plant Operator's Onsite Plan, as well as the State, County, and Local Offsite Plans. As part of these Emergency Preparedness Plans, an Emergency Notification System is required to alert the general population within the Emergency Planning Zone surrounding a Nuclear Power Plant that a general emergency has occurred and that they should tune to an Emergency Broadcast Station for further information and instructions. The emergency notification system for Beaver Valley Power Station is described. The system is the capability of alerting 100% of the population with 5 mi of Beaver Valley Power Station within 15 min, and the capability of alerting 100% of the population within 10 mi of Beaver Valley Power Station within 45 min

  16. Offsite emergency radiological monitoring system and technology

    International Nuclear Information System (INIS)

    Mao Yongze

    1994-01-01

    The study and advance of the offsite radiological monitoring system and technology which is an important branch in the field of nuclear monitoring technology are described. The author suggests that the predicting and measuring system should be involved in the monitoring system. The measuring system can further be divided into four sub-systems, namely plume exposure pathway, emergency worker, ingestion exposure pathway and post accident recovery measuring sub-systems. The main facilities for the monitoring system are concluded as one station, one helicopter, one laboratory and two vehicles. The instrumentation for complement of the facilities and their good performance characteristics, up-to-date technology are also introduced in brief. The offsite emergency radiation monitoring system and technology are compared in detail with those recommended by FEMA U.S.A.. Finally the paper discusses some trends in development of emergency radiation monitoring system and technology in the developed countries

  17. 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.

  18. Study on Korean Radiological Emergency System-Care System- and National Nuclear Emergency Preparedness System Development

    International Nuclear Information System (INIS)

    Akhmad Khusyairi; Yudi Pramono

    2008-01-01

    Care system; Radiological Emergency Supporting System. Environmental radiology level is the main aspect that should be concerned deal with the utilization of nuclear energy. The usage of informational technology in nuclear area gives significant contribution to anticipate and to protect human and environment. Since 1960, South Korea has developed environment monitoring system as the effort to protect the human and environment in the radiological emergency condition. Indonesia has possessed several nuclear installations and planned to build and operate nuclear power plants (PLTN) in the future. Therefore, Indonesia has to prepare the integrated system, technically enables to overcome the radiological emergency. Learning from the practice in South Korea, the system on the radiological emergency should be prepared and applied in Indonesia. However, the government regulation draft on National Radiological Emergency System, under construction, only touches the management aspect, not the technical matters. Consequently, when the regulation is implemented, it will need an additional regulation on technical aspect including the consideration on the system (TSS), the organization of operator and the preparation of human resources development of involved institution. For that purpose, BAPETEN should have a typical independence system in regulatory frame work. (author)

  19. Emergency automatic signalling system using time scheduling

    Science.gov (United States)

    Rayavel, P.; Surenderanath, S.; Rathnavel, P.; Prakash, G.

    2018-04-01

    It is difficult to handle traffic congestion and maintain roads during traffic mainly in India. As the people migrate from rural to urban and sub-urban areas, it becomes still more critical. Presently Roadways is a standout amongst the most vital transportation. At the point when a car crash happens, crisis vehicles, for example, ambulances and fire trucks must rush to the mischance scene. There emerges a situation where a portion of the crisis vehicles may cause another car crash. Therefore it becomes still more difficult for emergency vehicle to reach the destination within a predicted time. To avoid that kind of problem we have come out with an effective idea which can reduce the potential in the traffic system. The traffic system is been modified using a wireless technology and high speed micro controller to provide smooth and clear flow of traffic for ambulance to reach the destination on time. This is achieved by using RFID Tag at the ambulance and RFID Reader at the traffic system i.e., traffic signal. This mainly deals with identifying the emergency vehicle and providing a green signal to traffic signal at time of traffic jam. — By assigning priorities to various traffic movements, we can control the traffic jam. In some moments like ambulance emergency, high delegates arrive people facing lot of trouble. To overcome this problem in this paper we propose a time priority based traffic system achieved by using RFID transmitter at the emergency vehicle and RFID receiver at the traffic system i.e., traffic signal. The signal from the emergency vehicle is sent to traffic system which after detecting it sends it to microcontroller which controls the traffic signal. If any emergency vehicle is detected the system goes to emergency system mode where signal switch to green and if it is not detected normal system mode.

  20. The use of telemedicine in Italian Blood Banks: a nationwide survey.

    Science.gov (United States)

    Berti, Pierluigi; Verlicchi, Franco; Fiorin, Francesco; Guaschino, Roberto; Cangemi, Adelio

    2014-01-01

    Telemedicine is defined as the use of electronic information and communication technologies to provide health care between distant people. Many activities in transfusion medicine could benefit from the application of telemedicine. To map the spread of the use of telemedicine in transfusion medicine in Italy, the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) performed a nationwide survey: the results are presented in this paper. A survey, dealing with different aspects of the use of telemedicine, was performed by sending a questionnaire to 280 Italian Blood Centres. The survey was designed to evaluate the diffusion of telemedicine and the features of the systems, with special attention to the systems' safety and legal adequacy. One section of the questionnaire was designed to identify the features of the systems considered essential by the respondents. Out of 280 Blood Services contacted, 196 (70%) filled in at least one of the questions of the online questionnaire. Globally the use of some form of telemedicine was reported by 70% of the respondents. Telemedicine is used for remote validation of laboratory tests by 32% of the Centres that responded, for remote biological validation of blood units by 34% and for assignment of blood components by 29%. Less frequently, telemedicine is used to control electronic refrigerators, for electronic blood requests and for bed-side identification of patients. The use of telemedicine is widespread in Italian Blood Services. There appears to be some heterogeneity between structures with regards to the evaluation of the systems' safety and their legal adequacy. No telemedicine system should be introduced into practice until it has proven to have the same standards of safety as the corresponding "on site" activity.

  1. 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.

  2. 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.

  3. One hundred case studies of Asia-Pacific telemedicine using a digital video transport system over a research and education network.

    Science.gov (United States)

    Shimizu, Shuji; Nakashima, Naoki; Okamura, Koji; Tanaka, Masao

    2009-01-01

    Although the use of video in telemedicine is most helpful, the transmission of high-quality moving images is difficult in conventional systems due to the limitation of network bandwidth and the quality of service. We have established a new system via the academic broadband network that can preserve the original quality and assure smooth movement of the image. Here we report on 100 case studies and discuss the lessons we have learned. Kyushu University Hospital in Fukuoka, Japan, was linked to 53 medical institutions and meeting venues in 13 countries and regions over the Asia-Pacific Advanced Network, an international research and education consortium. The digital video transport system (DVTS), free software that transforms digital video signals directly into Internet Protocol, was installed on a personal computer (PC) with a network bandwidth of 30 Mbps per channel. Between February 2003 and June 2007, 100 telecommunication sessions were held, 94 of which were international and 6 domestic. Furthermore, 47 involved real-time demonstrations and 53 interactive teleconferences using video or PC presentations. Multiple stations were connected in 37 events, and the number of connected stations in total reached 269. The time delay was restricted to 0.3-1.0 seconds between the stations. Participants provided feedback via questionnaires, and with respect to image quality, 509 (68.3%) participants reported "very good," 206 (27.7%) reported "good," 19 (2.6%) reported "poor," and 11 (1.5%) reported "very poor." DVTS is both economical, with a minimal initial investment, and simple to set up, and this is the first time that this advanced system has been used so widely in the Asia-Pacific region. Because the high-speed academic network for research and education is available worldwide, we believe our cutting-edge technology will facilitate medical standardization beyond geographic borders in the world.

  4. 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

  5. Telemedicine in radiotherapy treatment planning: requirements and applications

    International Nuclear Information System (INIS)

    Olsen, D.R.; Bruland, O.S.; Davis, B.J.

    2000-01-01

    Telemedicine facilitates decentralized radiotherapy services by allowing remote treatment planning and quality assurance of treatment delivery. A prerequisite is digital storage of relevant data and an efficient and reliable telecommunication system between satellite units and the main radiotherapy clinic. The requirements of a telemedicine system in radiotherapy is influenced by the level of support needed. In this paper we differentiate between three categories of telemedicine support in radiotherapy. Level 1 features video conferencing and display of radiotherapy images and dose plans. Level 2 involves replication of selected data from the radiotherapy database - facilitating remote treatment planning and evaluation. Level 3 includes real-time, remote operations, e.g. target volume delineation and treatment planning performed by the team at the satellite unit under supervision and guidance from more experienced colleagues at the main clinic. (author)

  6. Synchronization and emergence in complex systems

    Indian Academy of Sciences (India)

    ... complex systems. Fatihcan M Atay. Synchronization, Coupled Systems and Networks Volume 77 Issue 5 November 2011 pp 855-863 ... 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 ...

  7. 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.

  8. 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.

  9. The Current State of Telemedicine in Urology.

    Science.gov (United States)

    Miller, Adam; Rhee, Eugene; Gettman, Matthew; Spitz, Aaron

    2018-03-01

    Telemedicine use in urology is an evolving practice. In this article, the authors review the early experience of telemedicine specifically as it relates to urologic practice and discuss the future implications and the utility of telemedicine as it applies to other fields. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Emergency cooling system for the PHENIX reactor

    International Nuclear Information System (INIS)

    Megy, J.M.; Giudicelli, A.G.; Robert, E.A.; Crette, J.P.

    Among various engineered safeguards of the reactor plant, the authors describe the protective system designed to remove the decay heat in emergency, in case of complete loss of all normal decay heat removal systems. First the normal decay heat rejection systems are presented. Incidents leading to the loss of these normal means are then analyzed. The protective system and its constructive characteristics designed for emergency cooling and based on two independent and highly reliable circuits entirely installed outside the primary containment vessel are described

  11. 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.

  12. Impact of telemedicine in hospital culture and its consequences on quality of care and safety

    Science.gov (United States)

    Steinman, Milton; Morbeck, Renata Albaladejo; Pires, Philippe Vieira; Abreu, Carlos Alberto Cordeiro; Andrade, Ana Helena Vicente; Terra, Jose Claudio Cyrineu; Teixeira, José Carlos; Kanamura, Alberto Hideki

    2015-01-01

    ABSTRACT Objective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care. PMID:26676268

  13. FEMA's Integrated Emergency Management Information System (IEMIS)

    International Nuclear Information System (INIS)

    Jaske, R.T.; Meitzler, W.

    1987-01-01

    FEMA is implementing a computerized system for use in optimizing planning, and for supporting exercises of these plans. Called the Integrated Emergency Management Information System (IEMIS), it consists of a base geographic information system upon which analytical models are superimposed in order to load data and report results analytically. At present, it supports FEMA's work in offsite preparedness around nuclear power stations, but is being developed to deal with a full range of natural and technological accident hazards for which emergency evacuation or population movement is required

  14. Telemedicine and the law

    International Nuclear Information System (INIS)

    Pilloy, W.J.; Lewalle, L.; Pilloy, S.

    2004-01-01

    Full text: Aim: To identify the legal and ethical obstacles to the development of tele (nuclear) medicine, and to propose solutions. Material and method: Lessons have been drawn from 4 years practice of telemedicine between Luxemburg and 5 European centres. Problems so raised have been confronted with the US and EU literature. Results: Academic applications (web sites, teaching, hospital networks) are yet functional and are not dealt with here. Difficulties arise in case of 1st reading (e.g. 24 hour service), 2nd reading (expert advice) or distant reading (locum, service in remote places). In most applications, the relation is doctor to doctor; patient issues like quality of content, freedom of choice are minor. A body of laws, rules and directives apply to other issues. Confidentiality is ruled by the EU Directives on the Protection of Individuals and on Data Protection. Data are commonly encrypted/anonymized. Consent and free choice are ruled by the law of medicine. A doctor requiring 2nd advice stays in charge of the patient (no need to consent). Remote reading or 1st reading is usually based on prior agreement between doctors (like after hours service), and information or consent is recommended. Registration and accreditation are ruled by the Directives of the European Internal Market for Services. No obstacle to the delivery of services across the EU would remain if it is perceived that a tele-patient consults abroad rather than a tele-doctor practices abroad. (author)

  15. The TransPetro emergency response system

    Energy Technology Data Exchange (ETDEWEB)

    Filho, A.T.F.; Cardoso, V.F.; Carbone, R.; Berardinelli, R.P. [Petrobras-TransPetro, Rio de Janeiro (Brazil); Carvalho, M.T.M.; Casanova, M.A. [Pontificia Univ. Catolica, Rio de Janeiro (Brazil). Dept. de Informatica, TeCGraf

    2004-07-01

    Petrobras-TransPetro developed the TransPetro Emergency Response System in response to emergency situations at large oil pipelines or at terminal facilities located in sea or river harbour areas. The standard of excellence includes full compliance with environmental regulations set by the federal government. A distributed workflow management software called InfoPAE forms the basis of the system in which actions are defined, along with geographic and conventional data. The first prototype of InfoPAE was installed in 1999. Currently it is operational in nearly 80 installations. The basic concepts and functionality of the TransPetro Emergency Response System were outlined in this paper with reference to the mitigative actions that are based on an evaluation of the organization of the emergency teams; the communication procedures; characterization of the installations; definition of accidental scenarios; environmental sensitivity maps; simulation of oil spill trajectories and dispersion behaviour; geographical data of the area surrounding the installations; and, other conventional data related to the installations, including available equipment. The emergency response team can take action as soon as an accident is detected. The action plan involves characterizing several scenarios and delegating mitigative actions to specific sub-teams, each with access to geographic data on the region where the emergency occurred. 13 refs., 3 figs.

  16. Automatic Emergence Detection in Complex Systems

    Directory of Open Access Journals (Sweden)

    Eugene Santos

    2017-01-01

    Full Text Available Complex systems consist of multiple interacting subsystems, whose nonlinear interactions can result in unanticipated (emergent system events. Extant systems analysis approaches fail to detect such emergent properties, since they analyze each subsystem separately and arrive at decisions typically through linear aggregations of individual analysis results. In this paper, we propose a quantitative definition of emergence for complex systems. We also propose a framework to detect emergent properties given observations of its subsystems. This framework, based on a probabilistic graphical model called Bayesian Knowledge Bases (BKBs, learns individual subsystem dynamics from data, probabilistically and structurally fuses said dynamics into a single complex system dynamics, and detects emergent properties. Fusion is the central element of our approach to account for situations when a common variable may have different probabilistic distributions in different subsystems. We evaluate our detection performance against a baseline approach (Bayesian Network ensemble on synthetic testbeds from UCI datasets. To do so, we also introduce a method to simulate and a metric to measure discrepancies that occur with shared/common variables. Experiments demonstrate that our framework outperforms the baseline. In addition, we demonstrate that this framework has uniform polynomial time complexity across all three learning, fusion, and reasoning procedures.

  17. 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.

  18. Characterizing the Danish telemedicine ecosystem

    DEFF Research Database (Denmark)

    Manikas, Konstantinos; Hansen, Klaus Marius

    2013-01-01

    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...... actors of the ecosystem can be characterised as both being beneficial and inhibitory to the ecosystem prosperity....

  19. Performance diagnostic system for emergency diesel generators

    International Nuclear Information System (INIS)

    Logan, K.P.

    1991-01-01

    Diesel generators are commonly used for emergency backup power at nuclear stations. Emergency diesel generators (EDGs) are subject to both start-up and operating failures, due to infrequent and fast-start use. EDG reliability can be critical to plant safety, particularly when station blackout occurs. This paper describes an expert diagnostic system designed to consistently evaluate the operating performance of diesel generators. The prototype system is comprised of a suite of sensor monitoring, cylinder combustion analyzing, and diagnostic workstation computers. On-demand assessments of generator and auxiliary equipment performance are provided along with color trend displays comparing measured performance to reference-normal conditions

  20. State Policies Influence Medicare Telemedicine Utilization.

    Science.gov (United States)

    Neufeld, Jonathan D; Doarn, Charles R; Aly, Reem

    2016-01-01

    Medicare policy regarding telemedicine reimbursement has changed little since 2000. Many individual states, however, have added telemedicine reimbursement for either Medicaid and/or commercial payers over the same period. Because telemedicine programs must serve patients from all or most payers, it is likely that these state-level policy changes have significant impacts on telemedicine program viability and utilization of services from all payers, not just those services and payers affected directly by state policy. This report explores the impact of two significant state-level policy changes-one expanding Medicaid telemedicine coverage and the other introducing telemedicine parity for commercial payers-on Medicare utilization in the affected states. Medicare claims data from 2011-2013 were examined for states in the Great Lakes region. All valid claims for live interactive telemedicine professional fees were extracted and linked to their states of origin. Allowed encounters and expenditures were calculated in total and on a per 1,000 members per year basis to standardize against changes in the Medicare population by state and year. Medicare telemedicine encounters and professional fee expenditures grew sharply following changes in state Medicaid and commercial payer policy in the examined states. Medicare utilization in Illinois grew by 173% in 2012 (over 2011) following Medicaid coverage expansion, and Medicare utilization in Michigan grew by 118% in 2013 (over 2012) following adoption of telemedicine parity for commercial payers. By contrast, annual Medicare telemedicine utilization growth in surrounding states (in which there were no significant policy changes during these years) varied somewhat but showed no discernible pattern. Although Medicare telemedicine policy has changed little since its inception, changes in state policies with regard to telemedicine reimbursement appear to have significant impacts on the practical viability of telemedicine programs

  1. 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.

  2. 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

  3. Emergency power systems at nuclear power plants

    International Nuclear Information System (INIS)

    1982-01-01

    This Guide applies to nuclear power plants for which the total power supply comprises normal power supply (which is electric) and emergency power supply (which may be electric or a combination of electric and non-electric). In its present form the Guide provides general guidance for all types of emergency power systems (EPS) - electric and non-electric, and specific guidance (see Appendix A) on the design principles and the features of the emergency electric power system (EEPS). Future editions will include a second appendix giving specific guidance on non-electric power systems. Section 3 of this Safety Guide covers information on considerations that should be taken into account relative to the electric grid, the transmission lines, the on-site electrical supply system, and other alternative power sources, in order to provide high overall reliability of the power supply to the EPS. Since the nuclear power plant operator does not usually control off-site facilities, the discussion of methods of improving off-site reliability does not include requirements for facilities not under the operator's control. Sections 4 to 11 of this Guide provide information, recommendations and requirements that would apply to any emergency power system, be it electric or non-electric

  4. Telemedicine in the acute health setting: A disruptive innovation for specialists (an example from stroke).

    Science.gov (United States)

    Bagot, Kathleen L; Cadilhac, Dominique A; Vu, Michelle; Moss, Karen; Bladin, Christopher F

    2015-12-01

    Telemedicine is a disruptive innovation within health care settings as consultations take place via audio-visual technology rather than traditional face-to-face. Specialist perceptions and experiences of providing audio-visual consultations in emergency situations, however, are not well understood. The aim of this exploratory study was to describe the experience of medical specialists providing acute stroke decision-making support via telemedicine. Data from the Victorian Stroke Telemedicine (VST) programme were used. The experiences of specialists providing an acute clinical telemedicine service to rural emergency departments were explored, drawing on disruptive innovation theory. Document analysis of programme consultation records, meeting minutes and in-depth individual interviews with three neurologists were analysed using triangulation. Since February 2014, 269 stroke telemedicine consultations with 12 neurologists have occurred. Retention on the roster has varied between 1 and >4 years. Overall, neurologists reported benefits of participation, as they were addressing health equity gaps for rural patients. Negative effects were the unpredictability of consultations impacting on their personal life, the mixed level of experience of colleagues initiating the consult and not knowing patient outcomes since follow-up communication was not routine. Insights into workforce experience and satisfaction were identified to inform strategies to support specialists to adapt to the disruptive innovation of telemedicine. © The Author(s) 2015.

  5. Requirements Elicitation in a Telemedicine Pain-treatment Trial

    NARCIS (Netherlands)

    Widya, I.A.; Bults, Richard G.A.; van Beijnum, Bernhard J.F.; Sandsjö, L.; Schaake, L.; Huis in 't Veld, M.H.A.; Jones, Valerie M.; Hermens, Hermanus J.; Ryan, K.; Robinson, W.

    2009-01-01

    This paper presents the early phase requirements elicitation for a work-related neck-shoulder pain teletreatment trial and the assessment of those requirements in respect of their importance to the trial and the feasibility of the needed software adaptations of the telemedicine system within the

  6. Arizona TeleMedicine Network: Engineering Master Plan.

    Science.gov (United States)

    Atlantic Research Corp., Alexandria, VA.

    As the planning document for establishing a statewide health communications system initially servicing the Papago, San Carlos and White Mountain Apache, Navajo, and Hopi reservations, this document prescribes the communications services to be provided by the Arizona TeleMedicine Network. Specifications include: (1) communications services for each…

  7. Telemedicine: The Assessment of an Evolving Health Care Technology.

    Science.gov (United States)

    Reich, Joel J.

    Telemedicine, the use of bidirectional telecommunications systems for the delivery of health care at a distance, could create a more equitable distribution of medical care. Many medical tasks can be performed at a distance although some require the presence of a physician's assistant. Cost-benefit analysis of this service is difficult and requires…

  8. Stakeholders' resistance to telemedicine with focus on physicians: utilizing the Delphi technique.

    Science.gov (United States)

    Choi, Woo Seok; Park, Joowoong; Choi, Jin Young Brian; Yang, Jae-Suk

    2018-01-01

    Introduction Sufficient infrastructure for information and communications technology (ICT) and a well-established policy are necessary factors for smooth implementation of telemedicine. However, despite these necessary conditions being met, there are situations where telemedicine still fails to be accepted as a system due to the low receptivity of stakeholders. In this study, we analyse stakeholders' resistance to an organization's implementation of telemedicine. Focusing on the physicians' interests, we propose a strategy to minimize conflicts and improve acceptance. Methods The Delphi study involved 190 telemedicine professionals who were recommended by 485 telemedicine-related personnel in South Korea. Results Out of 190 professionals, 60% of enrolled participants completed the final questionnaires. The stakeholders were categorized into four groups: policy-making officials, physicians, patients, and industrialists. Among these, the physicians were most opposed to the adoption of telemedicine. The main causes of such opposition were found to be the lack of a medical services delivery system and the threat of disruption for primary care clinics. Very little consensus was observed among the stakeholders, except on the following points: the need for expansion of the national health insurance budget by the government, and the need for enhancement of physicians' professional autonomy to facilitate smooth agreements. Discussion Our analysis on the causes of the resistance to telemedicine, carried out with the groups mentioned above, has important implications for policy-makers deriving strategies to achieve an appropriate consensus.

  9. Effectiveness and future prospects of telemedicine/remote health care management applications in Pakistan

    International Nuclear Information System (INIS)

    Iqbal, S.; Khan, N.

    2017-01-01

    Medical/Health care system is spraining in Pakistan because of innovative technology, activities and services as per their financial cost (position) which is increasing day by day. This research is intended for the assessment of Telemedicine/Remote Health Care Management practices (system), which encompasses usability, acceptance and impact in public/private hospitals. To improve the existing remote health care/telemedicine practices in Pakistan by using EM (Engineering Management) based approach. It has been widely and successfully implemented and is considered as a strategic and operational tool. In the 21st century due to the Technological advancements the mode of operation of service and business sector have been changed drastically. In the same way the health sectors activities also have been altered, new methods and techniques have also been devised for the treatment of the patients that were never even thought before. In the health sector Telemedicine/Remote Health Care Management is one of the development which was experienced lately. Telemedicine/Remote Health Careistaken exactly "medicine at a distance". Therefore, hypothetically, some procedures performed with medication which does not take place "face-to-face"and"in person"which can be considered as Telemedicine/Remote Health Care. In the industrialized world telemedicine is being used in full capacity to provide the health care services to remote and un-accessible areas. But Telemedicine/Remote Health Care Management is not very popular and admired in Pakistan; few applications are being functional presently. (author)

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

    African Journals Online (AJOL)

    pc

    2017-10-05

    Oct 5, 2017 ... 3.2.3.Satellite-Based Communication. Satellite-based communication is another alternative for communication in the event of disaster. Japan, United States of America and Russia are the countries that have utilised the system to disseminate emergency messages during previous disasters. Satellite-based.

  11. REALM: an expert system for classifying emergencies

    International Nuclear Information System (INIS)

    Touchton, R.A.; Gunter, A.D.; Cain, D.G.

    1987-01-01

    In late 1983, EPRI began a program to encourage and stimulate the development of Artificial Intelligence Applications for the nuclear industry. As a part of that effort, EPRI has contracted Technology Applications, Inc., (TAI) to develop an artificially intelligent Emergency Classification system Prototype. This paper presents a description of and a status report on the recently completed prototype

  12. Telemedicine and Diabetic Eye Disease

    Centers for Disease Control (CDC) Podcasts

    We know that the leading cause of blindness in working-age adults is eye disease related to poorly managed diabetes. In a prevention research study, telemedicine was shown to increase the number of people getting screened for diabetic eye disease.

  13. Communications systems for emergency deployment applications

    International Nuclear Information System (INIS)

    Gladden, C.A.

    1987-01-01

    The Emergency Response Team (ERT) communications system was developed by the US Department of Energy (DOE) to provide radio and telecommunications service for scientific and management elements located in, and adjacent to, an emergency area. The telephone system consists of six nodes, interconnected via microwave links that support T-1 data links and simultaneous two-way live video. The radio network is a self-contained VHF system arranged around portable and programmable repeaters. The system is comprised of approximately 183 DES voice-private radios and 168 clear text radios. Capability is available in the form of portable International Maritime Satellite (INMARSAT) terminals that allow direct dial access to coast earth stations in the US or other countries

  14. 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.

  15. CLASSIFICATION OF THE MGR EMERGENCY RESPONSE SYSTEM

    International Nuclear Information System (INIS)

    Zeigler, J.A.

    1999-01-01

    The purpose of this analysis is to document the Quality Assurance (QA) classification of the Monitored Geologic Repository (MGR) emergency response system structures, systems and components (SSCs) performed by the MGR Safety Assurance Department. This analysis also provides the basis for revision of YMP/90-55Q, Q-List (YMP 1998). The Q-List identifies those MGR SSCs subject to the requirements of DOE/RW-0333P7 ''Quality Assurance Requirements and Description'' (QARD) (DOE 1998)

  16. PWR auxiliary systems, safety and emergency systems, accident analysis, operation

    International Nuclear Information System (INIS)

    Meyer, P.J.

    1976-01-01

    The author presents a description of PWR auxiliary systems like volume control, boric acid control, coolant purification, -degassing, -storage and -treatment system and waste processing systems. Residual heat removal systems, emergency systems and containment designs are discussed. As an accident analysis the author gives a survey over malfunctions and disturbances in the field of reactor operations. (TK) [de

  17. 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.

  18. Hungarian system for nuclear emergency preparedness

    International Nuclear Information System (INIS)

    Borsi, Laszlo; Szabo, Laszlo; Ronaky, Jozsef

    2000-01-01

    The Hungarian Government had established in 1989 on the basis of national and international experience the National System for Nuclear Emergency Preparedness (NSNEP). Its guidance is ad-ministered by the Governmental Commission for Nuclear Emergency Preparedness (GCNEP). The work of the Governmental Commission is designated to be assisted by the Secretariat, the Operational Staff and by the Technical Scientific Council. The leading and guiding duties of the relevant ministries and national agencies are performed by the Sectional Organisations for Nuclear Emergency Preparedness (SONEP), together with those of the Metropolitan Agencies and of the county agencies by the Metropolitan Local Committee (MLCNEP) and by County Local Committees. The chairman of the Governmental Commission is the Minister of the Interior whose authority covers the guidance of the NSNEP's activities. The Secretariat of the Governmental Commission (SGC) co-ordinates the activities of the bodies of the Governmental Commission, the sectional organisations, the local committees for nuclear emergency preparedness and those of the other bodies responsible for implementing action. The Emergency Information Centre (EIC) of GCNEP as the central body of the National Radiation Monitoring, Warning and Surveillance System provides the information needed for preparing decisions at Governmental Commission level. The technical-scientific establishment of the governmental decisions in preparation for nuclear emergency situations and the elimination of their consequences are tasks of the Technical-Scientific Council. The Centre for Emergency Response, Training and Analysis (CERTA) of the Hungarian Atomic Energy Authority (HAEA) may be treated as a body of the Governmental Commission as well. The National Radiation Monitoring, Warning and Surveillance System (NRMWSS) is integral part of the NSNEP. The NRMWSS consists of the elements operated by the ministries and the operation of nation-wide measuring network in

  19. Digital image display system for emergency room

    International Nuclear Information System (INIS)

    Murry, R.C.; Lane, T.J.; Miax, L.S.

    1989-01-01

    This paper reports on a digital image display system for the emergency room (ER) in a major trauma hospital. Its objective is to reduce radiographic image delivery time to a busy ER while simultaneously providing a multimodality capability. Image storage, retrieval, and display will also be facilitated with this system. The system's backbone is a token-ring network of RISC and personal computers. The display terminals are higher- function RISC computers with 1,024 2 color or gray-scale monitors. The PCs serve as administrative terminals. Nuclear medicine, CT, MR, and digitized film images are transferred to the image display system

  20. Emergency Response Data System (ERDS) implementation

    International Nuclear Information System (INIS)

    Jolicoeur, J.

    1990-04-01

    The US Nuclear Regulatory Commission has begun implementation of the Emergency Response Data System (ERDS) to upgrade its ability to acquire data from nuclear power plants in the event of an emergency at the plant. ERDS provides a direct real-time transfer of data from licensee plant computers to the NRC Operations Center. The system has been designed to be activated by the licensee during an emergency which has been classified at an ALERT or higher level. The NRC portion of ERDS will receive the data stream, sort and file the data. The users will include the NRC Operations Center, the NRC Regional Office of the affected plant, and if requested the States which are within the ten mile EPZ of the site. The currently installed Emergency Notification System will be used to supplement ERDS data. This report provides the minimum guidance for implementation of ERDS at licensee sites. It is intended to be used for planning implementation under the current voluntary program as well as for providing the minimum standards for implementing the proposed ERDS rule

  1. Emergency Response Data System (ERDS) implementation

    International Nuclear Information System (INIS)

    Jolicoeur, J.

    1991-06-01

    The US Nuclear Regulatory Commission has begun implementation of the Emergency Response Data System (ERDS) to upgrade its ability to acquire data from nuclear power plants in the event of an emergency at the plant. ERDS provides a direct real-time transfer of data from licensee plant computers to the NRC Operations Center. The system has been designed to be activated by the licensee during an emergency which has been classified at an ALERT or higher level. The NRC portion of ERDS will receive the data stream, sort and file the data. The users will include the NRC Operations Center, the NRC Regional Office of the affected plant, and if requested the States which are within the ten mile EPZ of the site. The currently installed Emergency Notification System will be used to supplement ERDS data. This report provides the minimum guidance for implementation of ERDS at licensee sites. It is intended to be used for planning implementation under the current voluntary program as well as for providing the minimum standards for implementing the proposed ERDS rule. 4 refs., 3 figs

  2. Engaging Elderly People in Telemedicine Through Gamification

    Science.gov (United States)

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

    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 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. Objective 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. Methods 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. Results 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

  3. 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

  4. Blueprint for multimedia telemedicine networks in the Rocky Mountain Veterans Integrated Service Network (VISN-19).

    Science.gov (United States)

    Terreros, D A; Martinez, R

    1997-01-01

    A multimedia telemedicine network is proposed for a VISN-19 test bed and it will include picture archiving and communication systems (PACS). Initial tests have been performed, and the technical feasibility of the basic plan has been demonstrated.

  5. Enhanced 911/global position system wizard: a telemedicine application for the prevention of severe hypoglycemia--monitor, alert, and locate.

    Science.gov (United States)

    Dassau, Eyal; Jovanovic, Lois; Doyle, Francis J; Zisser, Howard C

    2009-11-01

    Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.

  6. 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.

  7. CRNL research reactor retrofit Emergency Filtration System

    International Nuclear Information System (INIS)

    Philippi, H.M.

    1990-01-01

    This paper presents a brief history of NRX and NRU research reactor effluent air treatment systems before describing the selection and design of an appropriate retrofit Emergency Filtration System (EFS) to serve these reactors and the future MX-10 isotope production reactor. The conceptual design of the EFS began in 1984. A standby concrete shielding filter-adsorber system, sized to serve the reactor with the largest exhaust flow, was selected. The standby system, bypassed under normal operating conditions, is equipped with normal exhaust stream shutoff and diversion valves to be activated manually when an emergency is anticipated, or automatically when emergency levels of gamma radiation are detected in the exhaust stream. The first phase of the EFS installation, that is the construction of the EFS and the connection of NRU to the system, was completed in 1987. The second phase of construction, which includes the connection of NRX and provisions for the future connection of MX-10, is to be completed in 1990

  8. Evaluation of telemedicine centres in Madhya Pradesh, Central India.

    Science.gov (United States)

    Bali, Surya; Gupta, Arti; Khan, Asif; Pakhare, Abhijit

    2016-04-01

    In a developing country such as India, there is substantial inequality in health care distribution. Telemedicine facilities were established in Madhya Pradesh in 2007-2008. The purpose of this study was to evaluate the infrastructure, equipment, manpower, and functional status of Indian Space and Research Organisation (ISRO) telemedicine nodes in Madhya Pradesh. All district hospitals and medical colleges with nodes were visited by a team of three members. The study was conducted from December 2013-January 2014. The team recorded the structural facility situation and physical conditions on a predesigned pro forma. The team also conducted interviews with the nodal officers, data entry operator and other relevant people at these centres. Of the six specialist nodes, four were functional and two were non-functional. Of 10 patient nodes, two nodes were functional, four were semi-functional and four were non-functional. Most of the centres were not working due to a problem with their satellite modem. The overall condition of ISRO run telemedicine centres in Madhya Pradesh was found to be poor. Most of these centres failed to provide telemedicine consultations. We recommend replacing this system with another cost effective system available in the state wide area network (SWAN). We suggest the concept of the virtual out-patient department. © The Author(s) 2015.

  9. Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke : Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

    NARCIS (Netherlands)

    Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study

  10. 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

  11. 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.

  12. High-Surety Telemedicine in a Distributed, 'Plug-and-Play' Environment

    International Nuclear Information System (INIS)

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

    1999-01-01

    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

  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. Electric power system / emergency power supply

    International Nuclear Information System (INIS)

    Dorn, P.G.

    1980-01-01

    One factor of reliability of reactor safety systems is the integrity of the power supply. The purpose of this paper is a review and a discussion of the safety objectives required for the planning, licensing, manufacture and erection of electrical power systems and components. The safety aspects and the technical background of the systems for - the electric auxiliary power supply system and - the emergency power supply system are outlined. These requirements result specially from the safety standards which are the framework for the studies of safety analysis. The overall and specific requirements for the electrical power supply of the safety systems are demonstrated on a 1300 MW standard nuclear power station with a pressurized water reactor. (orig.)

  15. 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

  16. State of the Art Telemedicine/Telehealth

    National Research Council Canada - National Science Library

    Bashshur, Rashid

    2001-01-01

    .... Reports were derived for the following topics: network organizational models, technology development and application, clinical applications, public health, disease surveillance and personal health, education, and telemedicine diffusion...

  17. The Research Agenda in ICU Telemedicine

    Science.gov (United States)

    Hill, Nicholas S.; Lilly, Craig M.; Angus, Derek C.; Jacobi, Judith; Rubenfeld, Gordon D.; Rothschild, Jeffrey M.; Sales, Anne E.; Scales, Damon C.; Mathers, James A. L.

    2011-01-01

    ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care. PMID:21729894

  18. Telemedicine in the context of different medical specialities. The Polish perspective.

    Science.gov (United States)

    Rudowski, Robert

    2003-01-01

    Two types of telemedicine are considered in the paper: pre-recorded and real-time. The advantages and disadvantages of each type are described.The choice of telemedicine type depends on medical speciality. The separate branch of telemedicine--teleprevention of civilization diseases is discussed and examples of relevant WWW services in Poland are given. The own work examples of the Dept. of Medical Informatics, MUW, namely Onco-service of 200 protocols used in hematology and oncology and Cardio.net--a distributed teleinformation system for cardiology, are presented. the barriers of the development of telemedicine in Poland are caused by the organization of health service--Patients Funds using different software, no messaging standards and different reimbursement systems.

  19. 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...

  20. Emergency notification systems for the general public

    International Nuclear Information System (INIS)

    Stearns, J.R.

    1989-01-01

    This paper describes various aspects of the design, installation, and evaluation of a system to alert the public in the event of an incident at a nuclear generating plant. It is based on experience in the development of alerting systems for 20 U.S. nuclear plants. An alerting system for the community surrounding a nuclear plant is generally referred to as a prompt notification system (PNS). The area within a 10-mile radius surrounding a nuclear plant where the public must be alerted is referred to as an emergency planning zone (EPZ). This circle is usually adjusted to follow the boundaries of local political jurisdictions and to enclose any concentration of population which my be on the border of the EPZ. The following aspects of PNS implementation are addressed in this paper: regulatory perspective, alternative alerting methods, PNS implementation and design, and evaluation and documentation

  1. Operating Protocol and Networking Issues of a Telemedicine Platform Integrating from Wireless Home Sensors to the Hospital Information System

    Directory of Open Access Journals (Sweden)

    Massimiliano Donati

    2013-01-01

    Full Text Available Chronic heart failure (CHF is among the major causes of hospitalization for elderly citizens. Its considerable impact on patient quality of life, the resources congestion, and the related costs can be efficiently mitigated using remote wireless biosensors networks placed at patient home, able to communicate in secure way over the public Internet with the cardiology departmental Hospital Information System (HIS. In this way, physicians can monitor the situation of several patients at distance and quickly realize and act alterations in vital parameters. In this scenario, the Health@Home (H@H platform is conceived. The pool of Bluetooth sensors enables patients to daily collect vital signs at home in noninvasive fashion. A home gateway receives and processes all signals before sending them to a server node in charge of interfacing with the usual HIS. The novel concept of operating protocol (OP represents a list of actions, remotely configurable, that the domestic network has to follow (required measurements, transmissions, comparisons with personalized thresholds, etc.. The first medical tests on 30 patients (1 month allowed to verify the model, both from the patient and the medical perspective. The main evaluation metrics were usability, flexibility, and reliability of the communication from sensors to HIS.

  2. State of the art in telemedicine - concepts, management, monitoring and evaluation of the telemedicine programme in Alentejo (Portugal).

    Science.gov (United States)

    Oliveira, Tiago Cravo; Branquinho, Maria José; Gonçalves, Luís

    2012-01-01

    Alentejo - one of five Portuguese continental regions - faces major problems impacting the health and social system of the region. Here, the low population density, the low educational and income level as well as an aging population have to be mentioned. Faced with the task of ensuring equal access to healthcare for all its inhabitants, the regional health authorities created the telemedicine program. From 1998 until 2000, the program developed in an experimental fashion, with teleconsultations involving a number of providers: primary health care centers, regional hospitals, and central hospitals. Between 2000 and 2010, there were a total of 135,000 telemedicine acts including teleconsultations, teleradiology (computerised tomography and x-rays), ultrasound telemedicine and telepathology. Presently, the network comprises 20 health centers and 6 hospitals, covering 4 districts. The platform is composed of high resolution videoconferencing equipment, software with patients' clinical records, an image archive, and a number of peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are provided by fifteen medical specialties, across 3 district hospitals, ranging from neurology to pediatric surgery. In 2008, health authorities started the telelearning program, initially using point to point videoconferencing, and by the end of 2010, 848 healthcare professionals, across 52 locations, had participated in remote learning sessions, covering topics from chronic wound treatment, to infection control, to medical error. As of 2011, point to multipoint telelearning is also in operation. This paper provides an overview of the telemedicine program in Alentejo, including both infrastructure and operations. Preliminary results of an ongoing evaluation of the impact of teleconsultations on key indicators of the regional healthcare system are also presented (including current utilization and plans for future expansion). This article builds on the experience

  3. 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.

  4. Identifying Obstacles and Research Gaps of Telemedicine Projects: Approach for a State-of-the-Art Analysis.

    Science.gov (United States)

    Harst, Lorenz; Timpel, Patrick; Otto, Lena; Wollschlaeger, Bastian; Richter, Peggy; Schlieter, Hannes

    2018-01-01

    This paper presents an approach for an evaluation of finished telemedicine projects using qualitative methods. Telemedicine applications are said to improve the performance of health care systems. While there are countless telemedicine projects, the vast majority never makes the threshold from testing to implementation and diffusion. Projects were collected from German project databases in the area of telemedicine following systematically developed criteria. In a testing phase, ten projects were subject to a qualitative content analysis to identify limitations, need for further research, and lessons learned. Using Mayring's method of inductive category development, six categories of possible future research were derived. Thus, the proposed method is an important contribution to diffusion and translation research regarding telemedicine, as it is applicable to a systematic research of databases.

  5. Automated data system for emergency meteorological response

    International Nuclear Information System (INIS)

    Kern, C.D.

    1975-01-01

    The Savannah River Plant (SRP) releases small amounts of radioactive nuclides to the atmosphere as a consequence of the production of radioisotopes. The potential for larger accidental releases to the atmosphere also exists, although the probability for most accidents is low. To provide for emergency meteorological response to accidental releases and to conduct research on the transport and diffusion of radioactive nuclides in the routine releases, a series of high-quality meteorological sensors have been located on towers in and about SRP. These towers are equipped with instrumentation to detect and record temperature and wind turbulence. Signals from the meterological sensors are brought by land-line to the SRL Weather Center-Analysis Laboratory (WC-AL). At the WC-AL, a Weather Information and Display (WIND) system has been installed. The WIND system consists of a minicomputer with graphical displays in the WC-AL and also in the emergency operating center (EOC) of SRP. In addition, data are available to the system from standard weat []er teletype services, which provide both routine surface weather observations and routine upper air wind and temperature observations for the southeastern United States. Should there be an accidental release to the atmosphere, available recorded data and computer codes would allow the calculation and display of the location, time, and downwind concentration of the atmospheric release. These data are made available to decision makers in near real-time to permit rapid decisive action to limit the consequences of such accidental releases. (auth)

  6. Telemedicine in trauma and disasters--from war to earthquake: are we ready?

    Science.gov (United States)

    Benner, T; Schachinger, U; Nerlich, M

    2004-01-01

    Every year many disasters cause thousands of injuries, deaths, refugees. Earthquakes and war often cause severe injuries (burns; amputations; Crush-Syndrome; gunshots; landmines; nuclear, biological or chemical warfare / hazardous material; infectious diseases; pediatric specialties). Referring to big earthquakes in the last few years up to 20.000 thousand people were killed (India 2001). 310.000 deaths were caused by war in 2001. The Mass Casualty Incident is characterized by the disbalance between victims and the normal community emergency response. Because of this a lot of different institutions and organizations are involved in coping with the disaster. This produces an extensive demand of qualified Command, Control and Communication (C3). Furthermore a lot of data has to be collected during the treatment and the injuries need special medical treatment. The use of health telematics in disaster response helps to cope with the scenario. Modern technologies provide support for building up medical aid although the normal infrastructure is destroyed. To cope with disaster scenarios there are some telematic tools which can be used: computer based Command and Control System, telemedical support, and data-resources-network/Medical Intelligence. The International Center for Telemedicine at the University of Regensburg Medical Center provides support for Health Care Professionals as a competence center for telemedicine. For the eastern part of Bavaria it develops a telemedical network with many components: The mobile emergency care system NOAH (Notfall-Organisations- und Arbeits-Hilfe) supports the Emergency Medical Service. Local Health Networks and the Clinical Network of Eastern Bavaria connect physicians and hospitals with the Regensburg Medical Center. With an online-education tool participants from all over the country can take part in trainings and courses.

  7. 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

  8. 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...

  9. 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 ...

  10. An advanced system for environmental emergency response

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, James S.; Sullivan, Thomas J. [Lawrence Livermore National Laboratory, Livermore, California (United States)

    2000-05-01

    The Atmospheric Release Advisory Capability, better known as ARAC, is a hybrid system of models, computers, databases, communications and highly skilled staff dedicated to emergency consequence analysis and prediction of atmospheric hazardous material releases. The ARAC system is located at and operated by Lawrence Livermore National Laboratory (in Livermore, California, USA). It's development and operational support for the U.S. government have been funded by the U.S. Departments of Energy and Defense for the purpose of providing real-time, down-wind consequence assessments for emergency responders and managers for radiological and other hazardous releases. This service is available for both fixed facilities and any location in the world whenever and wherever the U.S. government has interest or concern. Over the past 26 years ARAC has provided consequence assessments for more than 160 potential and actual hazardous releases. This capability has been applied to diverse real-world releases such as the 1978 reentry of the COSMOS 954 nuclear powered satellite over Canada, the Three Mile Island and Chernobyl nuclear powerplant accidents, the Tomsk nuclear facility accident in Russia, two radiological accidents at Tokai (Japan) the Algeciras (Spain) melt of a radiotherapy source, and several non-radiological events such as chemical releases, toxic fires including the Kuwait oil fires, and even volcanic ash emissions. (author)

  11. 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.

  12. Vascular neurology nurse practitioner provision of telemedicine consultations.

    Science.gov (United States)

    Demaerschalk, Bart M; Kiernan, Terri-Ellen J; Investigators, Starr

    2010-01-01

    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.

  13. An Assessment Methodology for Emergency Vehicle Traffic Signal Priority Systems

    OpenAIRE

    McHale, Gene Michael

    2002-01-01

    Emergency vehicle traffic signal priority systems allow emergency vehicles such as fire and emergency medical vehicles to request and receive a green traffic signal indication when approaching an intersection. Such systems have been around for a number of years, however, there is little understanding of the costs and benefits of such systems once they are deployed. This research develops an improved method to assess the travel time impacts of emergency vehicle traffic signal priority system...

  14. 30 CFR 57.18013 - Emergency communications system.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency communications system. 57.18013... Programs Surface and Underground § 57.18013 Emergency communications system. A suitable communication system shall be provided at the mine to obtain assistance in the event of an emergency. ...

  15. 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.

  16. 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.

  17. Telemedicine services in the Republic of Ireland: an evolving policy context.

    Science.gov (United States)

    MacFarlane, Anne; Murphy, Andrew William; Clerkin, Pauline

    2006-05-01

    The Republic of Ireland is characterised by few urban conurbations and a high rural population, including significant numbers of island dwellers. Information communication technologies (ICT), including telemedicine, present opportunities to address rural health-service delivery issues. As in other countries, the recent National Health Information Strategy is regarded as pivotal to the modernisation of the Irish health care system. There is, however, a dearth of research about telemedicine in Ireland. This paper reports, to the best of our knowledge, the first systematic review of telemedicine in the two regional health boards in the Republic of Ireland. Details of 11 telemedicine services, all initiated by local policy, will be presented. Results of an interview study with service providers about their experiences of the practices and processes involved in telemedicine service delivery are also provided. The focus of our analysis is two-fold. We assess the resonance of these Irish data with the international literature with particular reference to a recently developed model for the normalisation of telemedicine. For the first time, this model which was developed in the United Kingdom is applied to a fresh set of empirical data in a different health care context. We then discuss a number of health information policy issues for Ireland and elsewhere arising from our analysis.

  18. Demonstration of an Emergency Containment System

    International Nuclear Information System (INIS)

    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

  19. [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.

  20. An expert system for emergency response

    International Nuclear Information System (INIS)

    Sebo, D.

    1989-01-01

    An expert system, the Reactor Safety Assessment System (RSAS), is being developed by the Idaho National Engineering Laboratory and the US Nuclear Regulatory Commission (NRC) for the NRC Operations Center. The RSAS is intended to aid the reactor safety team (RST) at the operations center in monitoring and projecting core and containment status during an emergency at a licensed nuclear power plant. The RSAS system development has two major aspects. The first is the compilation and storage of knowledge required for RST assessment tasks. The knowledge structure used by RSAS is a goal tree-success tree (GTST) model. The upper level structure of the GTST model is generic in nature. This allows development of models for generic plant-specific GTST models. The second aspect of the RSAS is the development of inferencing techniques for the access, display, and manipulation of the knowledge to meet RST requirements in a real-time manner during the activation of the operations center. This objective is achieved by critical safety function and success path monitoring. This basic strategy is used to determine the current status and estimate future challenges to the status of the reactor, identify procedures and equipment required to maintain or regain the critical safety functions, identify critical equipment, determine information requirements, and display pertinent information concerning current reactor status

  1. 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.

  2. 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.

  3. 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…

  4. Online Decision Support System (IRODOS) - an emergency preparedness tool for handling offsite nuclear emergency

    International Nuclear Information System (INIS)

    Vinod Kumar, A.; Oza, R.B.; Chaudhury, P.; Suri, M.; Saindane, S.; Singh, K.D.; Bhargava, P.; Sharma, V.K.

    2009-01-01

    A real time online decision support system as a nuclear emergency response system for handling offsite nuclear emergency at the Nuclear Power Plants (NPPs) has been developed by Health, Safety and Environment Group, Bhabha Atomic Research Centre (BARC), Department of Atomic Energy (DAE) under the frame work of 'Indian Real time Online Decision Support System 'IRODOS'. (author)

  5. A model for assessment of telemedicine applications

    DEFF Research Database (Denmark)

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

    2012-01-01

    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.......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...

  6. Telemedicine Workplace Environments: Designing for Success

    OpenAIRE

    Elizabeth A. Krupinski

    2014-01-01

    When designing a facility for telemedicine, there are several things to consider from a human factors point of view, as well as from a practicality point of view. Although the future practice of telemedicine is likely to be more of a mobile-based practice and centered more in the home than it is now, it is still very important to consider ways to optimize the design of clinic-based telemedicine facilities. This is true on both ends of a consultation?where the patient is and where the consulta...

  7. Telemedicine and EHR Integrated Approach for An Effective E-Governance Healthcare Framework

    Directory of Open Access Journals (Sweden)

    Alpana Kakkar

    2017-05-01

    Full Text Available In the recent years, people have been more inclined towards the use of technology to reduce human effort. Telemedicine is one such concept which has gained popularity among the people, providing them easy access to health care. Telemedicine refers to the concept of providing health care from a distance through an integrated approach using information and communication technology (ICT. India, being a geographically wide country has its difficulties when it comes to providing health care facilities to people belonging to the different regions. This is one of the few reasons why India is the best stage to introduce a concept like telemedicine. The use of this technology to counter the various challenges has been highly regarded and termed as something which can revolutionize the medical field. Integrating telemedicine with electronic health record (EHR, which is a digital document of a person’s medical history is said to be a perfect combination which can help improve clinical efficiency. The country has seen initiatives taken up by various organizations, with the main motive of connecting the rural to the urban. Through this paper, we have discussed the potential we have with this technology, and also propose an EHR integrated telemedicine model to make the best use of it in an emergency healthcare situation to help save lives. We have also touched a few factors which can help the government better the current health scenario.

  8. Development of telemedicine technology in India: ′′Sanjeevani′′-An integrated telemedicine application

    Directory of Open Access Journals (Sweden)

    Sood S

    2005-01-01

    Full Text Available Telemedicine has been a technological takeaway for the developed countries. Even in the developing countries, it is increasingly being viewed as a tool for improving care and enhancing access to healthcare. Countries like India where the majority of the population lives in rural areas, where healthcare facilities are inefficient and inadequate, tools like telemedicine can contribute substantially in bridging the gap between the demand and supply. "Sanjeevani"-is an integrated telemedicine application that offers a suite of high utility features as a part of an Indian telemedicine technology. Sanjeevani is based on store and forward as well as real-time models.

  9. 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....

  10. Telemedicine + OCT: toward design of optimized algorithms for high-quality compressed images

    Science.gov (United States)

    Mousavi, Mahta; Lurie, Kristen; Land, Julian; Javidi, Tara; Ellerbee, Audrey K.

    2014-03-01

    Telemedicine is an emerging technology that aims to provide clinical healthcare at a distance. Among its goals, the transfer of diagnostic images over telecommunication channels has been quite appealing to the medical community. When viewed as an adjunct to biomedical device hardware, one highly important consideration aside from the transfer rate and speed is the accuracy of the reconstructed image at the receiver end. Although optical coherence tomography (OCT) is an established imaging technique that is ripe for telemedicine, the effects of OCT data compression, which may be necessary on certain telemedicine platforms, have not received much attention in the literature. We investigate the performance and efficiency of several lossless and lossy compression techniques for OCT data and characterize their effectiveness with respect to achievable compression ratio, compression rate and preservation of image quality. We examine the effects of compression in the interferogram vs. A-scan domain as assessed with various objective and subjective metrics.

  11. 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.

  12. 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.

  13. 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...

  14. 'It was like he was in the room with us': patients' and carers' perspectives of telemedicine in acute stroke.

    Science.gov (United States)

    Gibson, Josephine; Lightbody, Elizabeth; McLoughlin, Alison; McAdam, Joanna; Gibson, Alison; Day, Elaine; Fitzgerald, Jane; May, Carl; Price, Chris; Emsley, Hedley; Ford, Gary A; Watkins, Caroline

    2016-02-01

    Telemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients' and carers' views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff. We recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken. We conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to 'live' telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48 h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions. Although telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The 'remote' nature of the consultation posed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking. © 2015 John Wiley & Sons Ltd.

  15. A prototype nuclear emergency response decision making expert system

    International Nuclear Information System (INIS)

    Chang, C.; Shih, C.; Hong, M.; Yu, W.; Su, M.; Wang, S.

    1990-01-01

    A prototype of emergency response expert system developed for nuclear power plants, has been fulfilled by Institute of Nuclear Energy Research. Key elements that have been implemented for emergency response include radioactive material dispersion assessment, dynamic transportation evacuation assessment, and meteorological parametric forecasting. A network system consists of five 80386 Personal Computers (PCs) has been installed to perform the system functions above. A further project is still continuing to achieve a more complicated and fanciful computer aid integral emergency response expert system

  16. 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.

  17. Safety of emerging nuclear energy systems

    International Nuclear Information System (INIS)

    Novikov, V.M.; Slesarev, I.S.

    1989-01-01

    The first stage of world nuclear power development based on light water fission reactors has demonstrated not only rather high rate but at the same time too optimistic attitude to safety problems. Large accidents at Three Mile Island and Chernobyl essentially affects the concept of NP development. As a result the safety and social acceptance of NP became of absolute priority among other problems. That's why emerging nuclear power systems should be first of all estimated from this point of view. In the paper some quantitative criteria of safety derived from estimations of social risk and economic-ecological damage from hypothetical accidents are formulated. On the base of these criteria we define two stages of possible way to meet safety demands: first--development of high safety fission reactors and second--that of asymptotic high safety ENEs. The limits of tolorated expenses for safety are regarded. The basis physical factors determining hazards of NES accidents are considered. This permits to classify the ways of safety demands fulfillment due to physical principals used

  18. Millstone nuclear power plant emergency system assessment

    International Nuclear Information System (INIS)

    Akhmad Khusyairi

    2011-01-01

    U.S.NRC determined an obligation to build a nuclear power plant emergency response organization for both on-site and off-site. Millstone Nuclear Power Plants have 3 nuclear reactors and 2 of 3 still in commercial operation. Reactor unit 1, BWR type has been permanently shut down in 1998, while the two others, units 2 and 3 obtain the extended operating license respectively until 2035 and 2045. As a nuclear installation has the high potential radiological impact, Millstone nuclear power plant emergency response organization must establish both on-site or off-site. Emergency response organization that is formed must involve several state agencies, both state agencies and municipality. They have specific duties and functions in a state of emergency, so that protective measures can be undertaken in accordance with the community that has been planned. Meanwhile, NRC conduct their own independent assessment of nuclear power plant emergencies. (author)

  19. Trends in telemedicine utilizing artificial intelligence

    Science.gov (United States)

    Pacis, Danica Mitch M.; Subido, Edwin D. C.; Bugtai, Nilo T.

    2018-02-01

    With the growth and popularity of the utilization of artificial intelligence (AI) in several fields and industries, studies in the field of medicine have begun to implement its capabilities in handling and analyzing data to telemedicine. With the challenges in the implementation of telemedicine, there has been a need to expand its capabilities and improve procedures to be specialized to solve specific problems. The versatility and flexibility of both AI and telemedicine gave the endless possibilities for development and these can be seen in the literature reviewed in this paper. The trends in the development of the utilization of this technology can be classified in to four: patient monitoring, healthcare information technology, intelligent assistance diagnosis, and information analysis collaboration. Each trend will be discussed and presented with examples of recent literature and the problems they aim to address. Related references will also be tabulated and categorized to see the future and potential of this current trend in telemedicine.

  20. 5G, an approach towards future telemedicine

    DEFF Research Database (Denmark)

    Anwar, Sadia; Prasad, Ramjee; Kumar, Ambuj

    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...... second) Gb/s with lower latency and higher reliability connection, and can be better approach for future telemedicine. In this paper we survey the current state of telemedicine along with examining the characteristics of 5G technology. We also present research challenges concerning 5G and telemedicine.......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...

  1. 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.

  2. 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...

  3. UH - USA Agreement - A Telemedicine Research Proposal

    National Research Council Canada - National Science Library

    Burgess, Lawrence

    2003-01-01

    The purpose of the University of Hawaii Telemedicine Curriculum Research Project is to develop an effective web-based curriculum for training military health care personnel in the use of contemporary...

  4. Technology and quality control in telemedicine

    International Nuclear Information System (INIS)

    Barman, Mallika Roy; Pratik Kumar; Subramaniam, Kailash

    2003-01-01

    Transferring of medical electronic data from one place to another is known as telemedicine. All relevant medical opinions and investigations, like EGG, x-ray, sonography, GT scan, MRI and angiography can be transferred from one location to another by telemedicine. In developing countries like India where rural population is more and specialized doctors and hospital are few and located more in cities, it should be very useful

  5. Telemedicine in interdisciplinary work practices: On an IT system that met the criteria for success set out by its sponsors, yet failed to become part of every-day clinical routines

    Directory of Open Access Journals (Sweden)

    Bal Roland

    2008-10-01

    system and the way the care process was structured. Conclusion To conceptualize what telemedicine does in interdisciplinary work practices, a fine-tuned analysis is needed to assess how IT systems re-shape the social relations between professional groups. Such transformations should not be exclusively attributed to the technology itself or to the professionals working with it. Instead we need to assess these technologies through an empirically grounded study of the sociotechnical functioning of telemedicine.

  6. 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.

  7. 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.

  8. 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.

  9. Telemedicine in education: bridging the gap.

    Science.gov (United States)

    O'Shea, Jesse; Berger, Ryan; Samra, Cynthia; Van Durme, Daniel

    2015-01-01

    The increasing cost and inequitable access to quality healthcare, coupled with the merger of the information technology and health service sectors, has given rise to the modern field of telemedicine. Telemedicine, meaning medicine at a distance, allows us to transcend geographic and socioeconomic boundaries to deliver high quality care to remote and/or in-need patients. As technology becomes more affordable and a physician shortage looms, telemedicine is gaining attention as a possible solution to healthcare delivery. Simultaneously, telemedicine holds great promise with regard to medical education. Several studies integrating telemedicine in medical education have shown positive outcomes, demonstrating similar or greater efficacy compared with traditional educational methods with high student-reported enthusiasm. Other domestic and international telemedicine projects, largely spearheaded by universities, have also achieved great success. In a novel approach, by pairing medical schools with in-need partner communities, utilizing similar faculty resources as traditional learning methods with standardized patients, students can gain valuable experience and skills while serving actual patients. This progressive approach to medical education fosters collaboration, communication, longitudinal care and teaches students needed skills for their future practices as 21 st Century healthcare providers.

  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. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

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

    2016-01-01

    participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care......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...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...

  12. System for prediction of environmental emergency dose information network system

    International Nuclear Information System (INIS)

    Misawa, Makoto; Nagamori, Fumio

    2009-01-01

    In cases when an accident happens to arise with some risk for emission of a large amount radioactivity from the nuclear facilities, the environmental emergency due to this accident should be predicted rapidly and be informed immediately. The SPEEDI network system for such purpose was completed and now operated by Nuclear Safety Technology Center (NUSTEC) commissioned to do by Ministry of Education, Culture, Sports, Science and Technology, Japan. Fujitsu has been contributing to this project by developing the principal parts of the network performance, by introducing necessary servers, and also by keeping the network in good condition, such as with construction of the system followed by continuous operation and maintenance of the system. Real-time prediction of atmospheric diffusion of radionuclides for nuclear accidents in the world is now available with experimental verification for the real-time emergency response system. Improvement of worldwide version of the SPEEDI network system, accidental discharge of radionuclides with the function of simultaneous prediction for multiple domains and its evaluation is possible. (S. Ohno)

  13. Use of mobile low-bandwith telemedical techniques for extreme telemedicine applications.

    Science.gov (United States)

    Rosser, J C; Bell, R L; Harnett, B; Rodas, E; Murayama, M; Merrell, R

    1999-10-01

    Telemedicine is traditionally associated with the use of very expensive and bulky telecommunications equipment along with substantial bandwidth requirements (128 kilobytes per second [kbps] or greater). Telementoring is an educational technique that involves real-time guidance of a less experienced physician through a procedure in which he or she has limited experience. This technique has been especially dependent on the aforementioned requirements. Traditionally, telemedicine and telementoring have been restricted to technically sophisticated sites. The telemedicine applications through the existing telecommunication infrastructure has not been possible for underdeveloped parts of the world. Telemedicine and telementoring were applied using low-bandwidth mobile telemedicine applications to support a mobile surgery program in rural Ecuador run by the Cinterandes Foundation and headed by Edgar Rodas, MD. A mobile operating room traveled to a remote region of Ecuador. Using a laptop computer equipped with telemedicine software, a videoconferencing system, and a digital camera, surgical patients were evaluated and operative decisions were made over low-bandwidth telephone lines. Similarly, surgeons in the mobile unit in Ecuador were telementored by an experienced surgeon located thousands of miles away at Yale University School of Medicine. Five preoperative evaluations were conducted from Sucua to Cuenca, Ecuador, with excellent clinical correlation. Additionally, a laparoscopic cholecystectomy was successfully telementored from the department of surgery at Yale University School of Medicine to the mobile surgery unit in Ecuador. The telementored surgery was performed using a telephone line with a baud rate of 12 kbps. Mobile, low-bandwidth telemedicine applications used in the proper technical and clinical algorithms can be very effective in supporting remote health care delivery efforts. Advantages of such applications include increased cost-effectiveness by

  14. System Dynamics Modeling for Emergency Operating System Resilience

    Energy Technology Data Exchange (ETDEWEB)

    Eng, Ang Wei; Kim, Jong Hyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2014-10-15

    The purpose of this paper is to present a causal model which explain human error cause-effect relationships of emergency operating system (EOS) by using system dynamics (SD) approach. The causal model will further quantified by analyzes nuclear power plant incidents/accidents data in Korea for simulation modeling. Emergency Operating System (EOS) is generally defined as a system which consists personnel, human-machine interface and procedures; and how these components interact and coordinate to respond to an incident or accident. Understanding the behavior of EOS especially personnel behavior and the factors influencing it during accident will contribute in human reliability evaluation. Human Reliability Analysis (HRA) is a method which assesses how human decisions and actions affect to system risk and further used to reduce the human errors probability. There are many HRA method used performance influencing factors (PIFs) to identify the causes of human errors. However, these methods have several limitations. In HRA, PIFs are assumed independent each other and relationship between them are not been study. Through the SD simulation, users able to simulate various situation of nuclear power plant respond to emergency from human and organizational aspects. The simulation also provides users a comprehensive view on how to improve the safety in plants. This paper presents a causal model that explained cause-effect relationships of EOS human. Through SD simulation, users able to identify the main contribution of human error easily. Users can also use SD simulation to predict when and how a human error occurs over time. In future work, the SD model can be expanded more on low level factors. The relationship within low level factors can investigated by using correlation method and further included in the model. This can enables users to study more detailed human error cause-effect relationships and the behavior of EOS. Another improvement can be made is on EOS factors

  15. System Dynamics Modeling for Emergency Operating System Resilience

    International Nuclear Information System (INIS)

    Eng, Ang Wei; Kim, Jong Hyun

    2014-01-01

    The purpose of this paper is to present a causal model which explain human error cause-effect relationships of emergency operating system (EOS) by using system dynamics (SD) approach. The causal model will further quantified by analyzes nuclear power plant incidents/accidents data in Korea for simulation modeling. Emergency Operating System (EOS) is generally defined as a system which consists personnel, human-machine interface and procedures; and how these components interact and coordinate to respond to an incident or accident. Understanding the behavior of EOS especially personnel behavior and the factors influencing it during accident will contribute in human reliability evaluation. Human Reliability Analysis (HRA) is a method which assesses how human decisions and actions affect to system risk and further used to reduce the human errors probability. There are many HRA method used performance influencing factors (PIFs) to identify the causes of human errors. However, these methods have several limitations. In HRA, PIFs are assumed independent each other and relationship between them are not been study. Through the SD simulation, users able to simulate various situation of nuclear power plant respond to emergency from human and organizational aspects. The simulation also provides users a comprehensive view on how to improve the safety in plants. This paper presents a causal model that explained cause-effect relationships of EOS human. Through SD simulation, users able to identify the main contribution of human error easily. Users can also use SD simulation to predict when and how a human error occurs over time. In future work, the SD model can be expanded more on low level factors. The relationship within low level factors can investigated by using correlation method and further included in the model. This can enables users to study more detailed human error cause-effect relationships and the behavior of EOS. Another improvement can be made is on EOS factors

  16. 30 CFR 56.18013 - Emergency communications system.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Emergency communications system. 56.18013 Section 56.18013 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Programs § 56.18013 Emergency communications system. A suitable communication system shall be provided at...

  17. Trusting telemedicine: A discussion on risks, safety, legal implications and liability of involved stakeholders.

    Science.gov (United States)

    Parimbelli, E; Bottalico, B; Losiouk, E; Tomasi, M; Santosuosso, A; Lanzola, G; Quaglini, S; Bellazzi, R

    2018-04-01

    The main purpose of the article is to raise awareness among all the involved stakeholders about the risks and legal implications connected to the development and use of modern telemedicine systems. Particular focus is given to the class of "active" telemedicine systems, that imply a real-world, non-mediated, interaction with the final user. A secondary objective is to give an overview of the European legal framework that applies to these systems, in the effort to avoid defensive medicine practices and fears, which might be a barrier to their broader adoption. We leverage on the experience gained during two international telemedicine projects, namely MobiGuide (pilot studies conducted in Spain and Italy) and AP@home (clinical trials enrolled patients in Italy, France, the Netherlands, United Kingdom, Austria and Germany), whose development our group has significantly contributed to in the last 4 years, to create a map of the potential criticalities of active telemedicine systems and comment upon the legal framework that applies to them. Two workshops have been organized in December 2015 and March 2016 where the topic has been discussed in round tables with system developers, researchers, physicians, nurses, legal experts, healthcare economists and administrators. We identified 8 features that generate relevant risks from our example use cases. These features generalize to a broad set of telemedicine applications, and suggest insights on possible risk mitigation strategies. We also discuss the relevant European legal framework that regulate this class of systems, providing pointers to specific norms and highlighting possible liability profiles for involved stakeholders. Patients are more and more willing to adopt telemedicine systems to improve home care and day-by-day self-management. An essential step towards a broader adoption of these systems consists in increasing their compliance with existing regulations and better defining responsibilities for all the

  18. Telemedicine

    Science.gov (United States)

    ... government's Health Insurance Portability and Accountability Act (HIPAA). Communicating with your doctor using other means, such as ... reviewed: August 2016 More on this topic for: Parents Teens Electronic Health Records Talking to Your Child's ...

  19. 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.

  20. A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology.

    Science.gov (United States)

    Vyas, Krishna S; Hambrick, H Rhodes; Shakir, Afaaf; Morrison, Shane D; Tran, Duy C; Pearson, Keon; Vasconez, Henry C; Mardini, Samir; Gosman, Amanda A; Dobke, Marek; Granick, Mark S

    2017-06-01

    Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice. A total of 3119 articles were identified in the initial query. Twenty-three articles met the inclusion criteria in plastic surgery (7 wound management, 5 burn management, 5 trauma, 4 free flap care, 2 in cleft lip/palate repair). Twenty-three (100%) reported a benefit of telemedicine often related to improved postoperative monitoring, increased access to expertise in rural settings, and cost savings, either predicted or actualized. Eight (35%) reported limitations and barriers to the application of telemedicine, including overdiagnosis and dependence on functional telecommunication systems. Sixty-six articles focused on telemedicine in dermatology and also demonstrated significant promise. Telemedicine holds special promise in increasing the efficiency of postoperative care for microsurgical procedures, improving care coordination and management of burn wounds, facilitating interprofessional collaboration across time and space, eliminating a significant number of unnecessary referrals, and connecting patients located far from major medical centers with professional expertise without impinging on-and in some cases improving-the quality or accuracy of care provided. Teledermatology consultation was found to be safe and has a comparable or superior efficacy to the traditional in-patient consultation. The system was consistently rated as convenient and easy to use

  1. General framework and key technologies of national nuclear emergency system

    International Nuclear Information System (INIS)

    Yuan Feng; Li Xudong; Zhu Guangying; Song Yafeng; Zeng Suotian; Shen Lifeng

    2014-01-01

    Nuclear emergency is the important safeguard for the sustainable development of nuclear energy, and is the significant part of national public crisis management. The paper gives the definition of nuclear emergency system explicitly based on the analysis of the characteristics of the nuclear emergency, and through the research of the structure and general framework, the general framework of the national nuclear emergency management system (NNEMS) is obtained, which is constructed in four parts, including one integrative platform, six layers, eight applications and two systems, then the paper indicate that the architecture of national emergency system that should be laid out by three-tiers, i.e. national, provincial and organizations with nuclear facilities, and also describe the functions of the NNEMS on the nuclear emergency's workflow. Finally, the paper discuss the key technology that NNIEMS needed, such as WebGIS, auxiliary decision-making, digitalized preplan and the conformity and usage of resources, and analyze the technical principle in details. (authors)

  2. 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.

  3. 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.

  4. Real-time emergency forecasting technique for situation management systems

    Science.gov (United States)

    Kopytov, V. V.; Kharechkin, P. V.; Naumenko, V. V.; Tretyak, R. S.; Tebueva, F. B.

    2018-05-01

    The article describes the real-time emergency forecasting technique that allows increasing accuracy and reliability of forecasting results of any emergency computational model applied for decision making in situation management systems. Computational models are improved by the Improved Brown’s method applying fractal dimension to forecast short time series data being received from sensors and control systems. Reliability of emergency forecasting results is ensured by the invalid sensed data filtering according to the methods of correlation analysis.

  5. The Norwegian nuclear emergency preparedness system

    International Nuclear Information System (INIS)

    Naadland, E.; Stranden, E.

    1995-01-01

    A new national organisation for nuclear emergency preparedness was established in Norway in 1993, based on experiences from the Chernobyl accident. This organisation is based on authorities and research institutions which in a normal situation have responsibilities and knowledge in fields that are also of major importance in a nuclear accident situation. The national emergency preparedness organisation consists of the Ministerial Co-ordination Committee, the Advisory Committee for Nuclear Accidents and their secretariat at the Norwegian Radiation Protection Authority, and an Information Group. The organisations participating in the Advisory Committee operate measuring networks, stations and laboratories. In an early phase of an accident, a minor group from the Advisory Committee forms a Crisis Committee for Nuclear Accidents. This committee has been delegated the authority to make decisions in this phase. The organisation represented by its secretariat at the Norwegian Radiation Protection Authority is responsible for coordinating the emergency planning, the measuring capacities and the professional needs ordinarily. The secretariat is on call 24 hours a day as point of contact according to bilateral and international agreements on early notification. In this paper the features of the emergency preparedness organisation are presented. (Author)

  6. Team medicine in head injury. Usefulness of telemedicine in cooperation with medically depopulated areas

    International Nuclear Information System (INIS)

    Takazawa, Hiroki; Morita, Takahiro; Narisawa, Ayumi; Saito, Atsushi; Koyama, Shinya; Sasaki, Tatsuya; Nishijima, Michiharu

    2011-01-01

    Our hospital is located between Tsugaru and Shimokita Peninsulas that are wide medically depopulated areas. The depopulated Tsugaru District has only 2 neurosurgical units, and many patients have to be transferred from the district general hospitals. Since 1989, we have been using an image transfer system that is useful for accurately diagnosing patients with head injury. Between January 2005 and September 2010, 644 patients with head injury were admitted to our hospital. The patients who used and did not use telemedicine were 78 and 566, respectively. In both groups, the background (age, gender, and type of head injury), surgery rate, and time of entry into the operating room were analyzed. There were no significant differences in the age, gender, and type of head injuries between the 2 groups. The surgery rate was 25.6% (28 patients) in the telemedicine group and 12.4% (70 patients) in the direct admission group. The average amount of time between admission and entry into the operating room was 2 h and 13 min in the telemedicine group and 2 h and 57 min in the direct admission group. There were significant differences between the telemedicine and direct admission groups (p<0.05). These results suggest that telemedicine is useful in the treatment of patients with head injuries in a widely depopulated area. (author)

  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. 77 FR 33661 - Review of the Emergency Alert System

    Science.gov (United States)

    2012-06-07

    ... Commission's Review of the Emergency Alert System, Fifth Report and Order (Order). This document is... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 11 [EB Docket No. 04-296; FCC 12-7] Review of the Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule; announcement of...

  9. Telemedicine in a pediatric headache clinic: A prospective survey.

    Science.gov (United States)

    Qubty, William; Patniyot, Irene; Gelfand, Amy

    2018-05-08

    The aim of this prospective study was to survey our patients about their experience with our clinic's telemedicine program to better understand telemedicine's utility for families, and to improve patient satisfaction and ultimately patient care. This was a prospective survey study of patients and their families who had a routine telemedicine follow-up visit with the University of California San Francisco Pediatric Headache Program. The survey was administered to patients and a parent(s) following their telemedicine visit. Fifty-one of 69 surveys (74%) were completed. All (51/51) patients and families thought that (1) telemedicine was more convenient compared to a clinic visit, (2) telemedicine caused less disruption of their daily routine, and (3) they would choose to do telemedicine again. The mean round-trip travel time from home to clinic was 6.8 hours (SD ± 8.6 hours). All participants thought telemedicine was more cost-effective than a clinic visit. Parents estimated that participating in a telemedicine visit instead of a clinic appointment saved them on average $486. This prospective, pediatric headache telemedicine study shows that telemedicine is convenient, perceived to be cost-effective, and patient-centered. Providing the option of telemedicine for routine pediatric headache follow-up visits results in high patient and family satisfaction. © 2018 American Academy of Neurology.

  10. Research on sever accident emergency simulation system for CPR1000

    International Nuclear Information System (INIS)

    Yang Zhifei; Liao Yehong; Liang Manchun; Li Ke; Yang Jie; Chen Yali

    2015-01-01

    The enhanced capability to nuclear power plant (NPP) severe accident management and emergency response depends heavily on exercises. Since the exercise scene is usually monotonous and not realistic, and conduct of exercise has a high cost, the effect of enhancing the capability is limited. Thus, the development of a Sever Accident Emergency Simulation System (SAESS) is necessary. SAESS is able to connect NPP simulator, and simulates the process of severe accident management, personnel evacuation, the dispersion of radioactive plume, and emergency response of emergency organizations. The system helps to design several of exercise scenes and optimize the disposal strategy in different severe accidents. In addition, the system reduces the cost of emergency exercise by computer simulation, benefits the research of exercise, increases the efficiency of exercise and enhances the emergency decision-making capability. This paper introduces the design and application of SAESS. (author)

  11. Emergency distress call system for automobiles in Lagos state, Nigeria

    African Journals Online (AJOL)

    Emergency distress call system for automobiles in Lagos state, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... and communications technology capabilities to transportation and the medical care system in order to save lives, ...

  12. 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.

  13. Development and pilot testing of 24/7 in-ambulance telemedicine for acute stroke : prehospital stroke study at the Universitair Ziekenhuis Brussel-project

    OpenAIRE

    Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    Abstract: Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the develop...

  14. Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

    OpenAIRE

    Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

    2016-01-01

    Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the development and v...

  15. The influence of financial factors on the deployment of telemedicine.

    Science.gov (United States)

    Smith, Douglas L

    2005-01-01

    The basic research question that guided this investigation was "Do financial indicators play a major role in decisions to deploy telemedicine?" The study also evaluated the relative importance of five specific financial indicators. Select hospital systems were asked to participate in this research. Because much has been written about the problems of access to health care in rural settings, the study included hospital systems with rural hospitals. The study also examined the importance of financial indicators to representatives of various functional disciplines. A qualitative case study approach was used for the research project.

  16. Universality of emergent states in diverse physical systems

    Science.gov (United States)

    Guidry, Mike

    2017-12-01

    Our physics textbooks are dominated by examples of simple weakly-interacting microscopic states, but most of the real world around us is most effectively described in terms of emergent states that have no clear connection to simple textbook states. Emergent states are strongly-correlated and dominated by properties that emerge as a consequence of interactions and are not part of the description of the corresponding weakly-interacting system. This paper proposes a connection of weakly-interacting textbook states and realistic emergent states through fermion dynamical symmetries having fully-microscopic generators of the emergent states. These imply unique truncation of the Hilbert space for the weakly-interacting system to a collective subspace where the emergent states live. Universality arises because the possible symmetries under commutation of generators, which transcend the microscopic structure of the generators, are highly restricted in character and determine the basic structure of the emergent state, with the microscopic structure of the generators influencing emergent state only parametrically. In support of this idea we show explicit evidence that high-temperature superconductors, collective states in heavy atomic nuclei, and graphene quantum Hall states in strong magnetic fields exhibit a near-universal emergent behavior in their microscopically-computed total energy surfaces, even though these systems share essentially nothing in common at the microscopic level and their emergent states are characterized by fundamentally different order parameters.

  17. 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.

  18. 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.

  19. Adoption of telemedicine: from pilot stage to routine delivery

    Directory of Open Access Journals (Sweden)

    Zanaboni Paolo

    2012-01-01

    Full Text Available Abstract Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1 the process of adoption of telemedicine in comparison with other technologies; and 2 the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify

  20. Adoption of telemedicine: from pilot stage to routine delivery

    Science.gov (United States)

    2012-01-01

    Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and

  1. Integrated telemedicine workstation for intercontinental grand rounds

    Science.gov (United States)

    Willis, Charles E.; Leckie, Robert G.; Brink, Linda; Goeringer, Fred

    1995-04-01

    The Telemedicine Spacebridge to Moscow was a series of intercontinental sessions sponsored jointly by NASA and the Moscow Academy of Medicine. To improve the quality of medical images presented, the MDIS Project developed a workstation for acquisition, storage, and interactive display of radiology and pathology images. The workstation was based on a Macintosh IIfx platform with a laser digitizer for radiographs and video capture capability for microscope images. Images were transmitted via the Russian Lyoutch Satellite which had only a single video channel available and no high speed data channels. Two workstations were configured -- one for use at the Uniformed Services University of Health Sciences in Bethesda, MD. and the other for use at the Hospital of the Interior in Moscow, Russia. The two workstations were used may times during 16 sessions. As clinicians used the systems, we modified the original configuration to improve interactive use. This project demonstrated that numerous acquisition and output devices could be brought together in a single interactive workstation. The video images were satisfactory for remote consultation in a grand rounds format.

  2. A Norwegian study of seafarers' and rescuers' recommendations for maritime telemedicine services.

    Science.gov (United States)

    Norum, Jan; Moksness, Stein Gunnar; Larsen, Eli

    2002-01-01

    We studied maritime telemedicine and its potential for improvement. Twenty-four people representing 13 different shipping companies and maritime public authorities were interviewed. They covered all areas of the Norwegian maritime sector except for offshore installations. The morbidity pattern reported differed between the groups: on cruise liners and ferries the major problems were due to coronary heart disease, while on merchant ships, navy vessels and in the fishing fleet the major problems were accidents. Voice and fax systems were available in all cases. However, the Emergency Medical Dispatch Centres did not offer an email service and did not use faxes in the maritime setting. Radio Medico Norway was the only assistance provider offering two-way transfer of digital pictures. The interviewees suggested a number of areas for improvement; these included having a single emergency telephone number to call for help, email systems with the possibility of digital picture attachments, wireless communication systems on board and a standard CD-ROM reference work for medical guidance/education.

  3. Emergency cooling system for a gas-cooled nuclear reactor

    International Nuclear Information System (INIS)

    Cook, R.K.; Burylo, P.S.

    1975-01-01

    The site of the gas-cooled reactor with direct-circuit gas turbine is preferably the sea coast. An emergency cooling system with safety valve and emergency feed-water addition is designed which affects at least a part of the reactor core coolant after leaving the core. The emergency cooling system includes a water emergency cooling circuit with heat exchanger for the core coolant. The safety valve releases water or steam from the emergency coolant circuit when a certain temperature is exceeded; this is, however, replaced by the emergency feed-water. If the gas turbine exhibits a high and low pressure turbine stage, which are flowed through by coolant one behind another, a part of the coolant can be removed in front of each part turbine by two valves and be added to the haet exchanger. (RW/LH) [de

  4. Selecting a digital camera for telemedicine.

    Science.gov (United States)

    Patricoski, Chris; Ferguson, A Stewart

    2009-06-01

    The digital camera is an essential component of store-and-forward telemedicine (electronic consultation). There are numerous makes and models of digital cameras on the market, and selecting a suitable consumer-grade camera can be complicated. Evaluation of digital cameras includes investigating the features and analyzing image quality. Important features include the camera settings, ease of use, macro capabilities, method of image transfer, and power recharging. Consideration needs to be given to image quality, especially as it relates to color (skin tones) and detail. It is important to know the level of the photographer and the intended application. The goal is to match the characteristics of the camera with the telemedicine program requirements. In the end, selecting a digital camera is a combination of qualitative (subjective) and quantitative (objective) analysis. For the telemedicine program in Alaska in 2008, the camera evaluation and decision process resulted in a specific selection based on the criteria developed for our environment.

  5. Emergency response facility technical data system of Taiwan Power Company

    International Nuclear Information System (INIS)

    Lin, E.; Liang, T.M.

    1987-01-01

    Taiwan Power Company (Taipower) has developed its emergency response facility program since 1981. This program is integrated with the following activities to enhance the emergency response capability of nuclear power plants: (1) survey of the plant instrumentation based on the requirements of R.G. 1.97; (2) improvement of plant specific emergency operating procedures based on the emergency response guidelines developed by the Owners group; (3) implementation of the detailed control room design review with the consideration of human engineering and task analysis; and (4) organization, staff and communication of emergency planning of nuclear power plant. The emergency response facility programs of Taipower are implemented in Chinshan (GE BWR4/MARK I), Kuosheng (GE BWR6/MARK III) and Maanshan (W PWR). The major items included in each program are: (1) to establish new buildings for On-Site Technical Support Center, Near-Site Emergency Operation Facility; (2) to establish an Emergency Executive Center at Taipower headquarters; (3) to establish the communication network between control room and emergency response facilities; and (4) to install a dedicated Emergency Response Facility Technical Data System (ERFTDS) for each plant. The ERFTDS provides the functions of data acquisition, data processing, data storage and display in meeting with the requirements of NUREG 0696. The ERFTDS is designed with plant specific requirements. These specific requirements are expected to be useful not only for the emergency condition but also for normal operation conditions

  6. Fast response system for vacuum volume emergency separation

    International Nuclear Information System (INIS)

    Gubrienko, K.I.; Lastochkin, Yu.A.

    1982-01-01

    A system which allows to separate vacuum systems of the magnetic-optic beam channels connected with the accelerator has been worked out for case of emergency environment break through the extraction ''window''. The system, consisting of two valve - gate devices and a control unit, allows one in the emergency case to separate more than 20 m long volume from the accelerator without any pressure changes in the latter one

  7. 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.

  8. Emergency response and radiation monitoring systems in Russian regions

    International Nuclear Information System (INIS)

    Arutyunyan, R.; Osipiyants, I.; Kiselev, V.; Ogar, K; Gavrilov, S.

    2008-01-01

    Full text: Preparedness of the emergency response system to elimination of radiation incidents and accidents is one of the most important elements of ensuring safe operation of nuclear power facilities. Routine activities on prevention of emergency situations along with adequate, efficient and opportune response actions are the key factors reducing the risks of adverse effects on population and environment. Both high engineering level and multiformity of the nuclear branch facilities make special demands on establishment of response system activities to eventual emergency situations. First and foremost, while resolving sophisticated engineering and scientific problems emerging during the emergency response process, one needs a powerful scientific and technical support system.The emergency response system established in the past decade in Russian nuclear branch provides a high efficiency of response activities due to the use of scientific and engineering potential and experience of the involved institutions. In Russia the responsibility for population protection is imposed on regional authority. So regional emergence response system should include up-to-date tools of radiation monitoring and infrastructure. That's why new activities on development of radiation monitoring and emergency response system were started in the regions of Russia. The main directions of these activities are: 1) Modernization of the existing and setting-up new facility and territorial automatic radiation monitoring systems, including mobile radiation surveillance kits; 2) Establishment of the Regional Crisis Centres and Crisis Centres of nuclear and radiation hazardous facilities; 3) Setting up communication systems for transfer, acquisition, processing, storage and presentation of data for participants of emergency response at the facility, regional and federal levels; 4) Development of software and hardware systems for expert support of decision-making on protection of personnel, population

  9. The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

    Science.gov (United States)

    Shannon, Gary W.; Smith, Brian R.; Alverson, Dale C.; Antoniotti, Nina; Barsan, William G.; Bashshur, Noura; Brown, Edward M.; Coye, Molly J.; Doarn, Charles R.; Ferguson, Stewart; Grigsby, Jim; Krupinski, Elizabeth A.; Kvedar, Joseph C.; Linkous, Jonathan; Merrell, Ronald C.; Nesbitt, Thomas; Poropatich, Ronald; Rheuban, Karen S.; Sanders, Jay H.; Watson, Andrew R.; Weinstein, Ronald S.; Yellowlees, Peter

    2014-01-01

    Abstract The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings. PMID:24968105

  10. Conceptual design of the national nuclear emergency management information system

    International Nuclear Information System (INIS)

    Wang Xingyu; Shi Zhongqi

    2003-01-01

    A Conceptual Design of the National Nuclear Emergency Management Information System was brought forward in this paper, based on the summarization of some emergency management information systems used in China and some other countries. The conceptual system should have four basic characteristics, that are (1) a graphic displaying and querying interface based on GIS (2) data and results shared with the assessment software of nuclear accident (3) a complete set of databases and (4) the capability of on-line data receiving or real-time distributing of the commands and information for emergency response

  11. 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.

  12. An expert system for improving nuclear emergency response

    International Nuclear Information System (INIS)

    Salame-Alfie, A.; Goldbogen, G.C.; Ryan, R.M.; Wallace, W.A.; Yeater, M.L.

    1987-01-01

    The accidents at TMI-2 and Chernobyl have produced initiatives aimed at improving nuclear plant emergency response capabilities. Among them are the development of emergency response facilities with capabilities for the acquisition, processing, and diagnosis of data which are needed to help coordinate plant operations, engineering support and management under emergency conditions. An effort in this direction prompted the development of an expert system. EP (EMERGENCY PLANNER) is a prototype expert system that is intended to help coordinate the overall management during emergency conditions. The EP system was built using the GEN-X expert system shell. GEN-X has a variety of knowledge representation mechanisms including AND/OR trees, Decision trees, and IF/THEN tables, and runs on an IBM PC-XT or AT computer or compatible. Among the main features, EP is portable, modular, user friendly, can interact with external programs and interrogate data bases. The knowledge base is made of New York State (NYS) Procedures for Emergency Classification, NYS Radiological Emergency Preparedness Plan (REPP) and knowledge from experts of the NYS Radiological Emergency Preparedness Group and the Office of Radiological Health and Chemistry of the New York Power Authority (NYPA)

  13. MEMbrain. A software emergency management system

    International Nuclear Information System (INIS)

    Drager, K.H.; Brokke, I.

    1998-01-01

    MEMbrain is the name of the EUREKA project EU904. MEM is an abbreviation for Major Emergency Management and brain refers to computer technology. MEMbrain is a strategic European project - the consortium includes partners from six countries, covering the European continent from North to South (Finland, Norway, Denmark, France, Portugal and Greece). The strategy for the project has been to develop a dynamic decision support tool based on: information, prediction, communication, on-line training. The project's results has resulted in a set of knowledge-based software tools supporting MEM activities e.g.; public protection management, man to man communication management, environment information management, resource management, as well as an implementation of an architecture to integrate such tools. (R.P.)

  14. Emergency power systems at nuclear power plants

    International Nuclear Information System (INIS)

    1991-01-01

    This Safety Guide was prepared as part of the Nuclear Safety Standards programme for establishing Codes and Safety Guides relating to nuclear power plants (NPPs). The first edition of the present Safety Guide was developed in the early 1980s. The text has now been brought up-to-date, refined in several details and amended to include non-electrical diverse and independent power sources. This Guide applies to NPP for which the total power supply comprises a normal power supply and an emergency power supply (EPS), which may be electrical or a combination of electrical and non-electrical. The Guide provides general guidance for all types of EPS and specific guidance on the design safety requirements and the features of the electrical and non-electrical portions of the EPS. 9 figs, 2 tabs

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

    African Journals Online (AJOL)

    The purpose of this review is to provide the overview of available systems and potential future systems for communication during disaster in Malaysia. Electronic searches in major subject loci databases such as MEDLINE (via PUBMED), Ovid, Science Direct, Scopus, IEEE Xplore digital library and Springer are used in ...

  16. Caire - A real-time feedback system for emergency response

    International Nuclear Information System (INIS)

    Braun, H.; Brenk, H.D.; de Witt, H.

    1991-01-01

    In cases of nuclear emergencies it is the primary task of emergency response forces and decision making authorities to act properly. Whatever the specific reason for the contingency may be, a quick and most accurate estimate of the radiation exposure in consequence of the emergency must be made. This is a necessary prerequisite for decisions on protective measures and off-site emergency management. With respect to this fact ant the recent experience of the Chernobyl accident, remote monitoring systems have increased their importance as an inherent part of environmental surveillance installations in the FRG and in other countries. The existing systems in Germany are designed to cover both, routine operation and emergency situations. They provide site specific meteorological data, gross effluent dose rates, and dose rate measurements at on-site and approximately 30 off-site locations in the vicinity of a plant. Based on such telemetric surveillance networks an advanced automatic on-line system named CAIRE (Computer Aided Response to Emergencies) has been developed as a real time emergency response tool for nuclear facilities. this tool is designed to provide decision makers with most relevant radiation exposure data of the population at risk. The development phase of CAIRE has already been finished. CAIRE is now in an operational status and available for applications in emergency planning and response

  17. Nuclear plant data systems - some emerging directions

    International Nuclear Information System (INIS)

    Johnson, R.D.; Humphress, G.B.; McCullough, L.D.; Tashjian, B.M.

    1983-01-01

    Significant changes have occurred in recent years in the nuclear power industry to accentuate the need for data systems to support information flow and decision making. Economic conditions resulting in rapid inflation and larger investments in new and existing plants and the need to plan further ahead are primary factors. Government policies concerning environmental control, as well as minimizing risk to the public through increased nuclear safety regulations on operating plants are additional factors. The impact of computer technology on plant data systems, evolution of corporate and plant infrastructures, future plant data, system designs and benefits, and decision making capabilities and data usage support are discussed. (U.K.)

  18. An expert system for USNRC emergency response

    International Nuclear Information System (INIS)

    Sebo, D.E.; Bray, M.A.; King, M.A.

    1986-01-01

    The Reactor Safety Assessment System (RSAS) is an expert system under development for the United States Nuclear Regulatory Commission (USNRC). RSAS is intended for use at the NRO's Operations Center in the event of a serious incident at a licensed nuclear power plant. RSAS is a situation assessment expert system which uses plant parametric data to generate conclusions for use by the NRC Reactor Safety Team. RSAS uses multiple rule bases and plant specific setpoint files in order to be applicable to all licensed power plants. RSAS currently covers several generic reactor types and power plants within those classes

  19. Expert system for USNRC emergency response

    International Nuclear Information System (INIS)

    Sebo, D.E.; Bray, M.A.; King, M.A.

    1986-01-01

    The Reactor Safety Assessment System (RSAS) is an expert system under development for the United States Nuclear Regulatory Commission (USNRC). RSAS is intended for use at the NRC's Operations Center in the event of a serious incident at a licensed nuclear power plant. RSAS is a situation assessment expert system which uses plant parametric data to generate conclusions for use by the NRC Reactor Safety Team. RSAS uses multiple rule bases and plant specific setpoint files in order to be applicable to all licensed power plants. RSAS currently covers several generic reactor types and power plants within those classes

  20. The Global Emergency Observation and Warning System

    Science.gov (United States)

    Bukley, Angelia P.; Mulqueen, John A.

    1994-01-01

    Based on an extensive characterization of natural hazards, and an evaluation of their impacts on humanity, a set of functional technical requirements for a global warning and relief system was developed. Since no technological breakthroughs are required to implement a global system capable of performing the functions required to provide sufficient information for prevention, preparedness, warning, and relief from natural disaster effects, a system is proposed which would combine the elements of remote sensing, data processing, information distribution, and communications support on a global scale for disaster mitigation.

  1. Emergency cooling system for nuclear reactors

    International Nuclear Information System (INIS)

    Frisch, E.; Andrews, H.N.

    1976-01-01

    Upon the occasion of loss of coolant in a nuclear reactor as when a coolant supply or return line breaks, or both lines break, borated liquid coolant from an emergency source is supplied in an amount to absorb heat being generated in the reactor even after the control rods have been inserted. The liquid coolant flows from pressurized storage vessels outside the reactor to an internal manifold from which it is distributed to unused control rod guide thimbles in the reactor fuel assemblies. Since the guide thimbles are mounted at predetermined positions relative to heat generating fuel elements in the fuel assemblies, holes bored at selected locations in the guide thimble walls, sprays the coolant against the reactor fuel elements which continue to dissipate heat but at a reduced level. The cooling water evaporates upon contacting the fuel rods thereby removing the maximum amount of heat (970 BTU per pound of water) and after heat absorption will leave the reactor in the form of steam through the break which is the cause of the accident to help assure immediate core cooldown

  2. 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...

  3. Framework to investigate emergence in system engineering

    CSIR Research Space (South Africa)

    Oosthuizen, R

    2011-09-01

    Full Text Available System Engineering is the process of identifying, implementing and maintaining solutions to real world problems. Some problems tend to be messy with no single solution or set of effective and accurate requirements, often resulting in implementation...

  4. Advanced payload concepts and system architecture for emerging services in Indian National Satellite Systems

    Science.gov (United States)

    Balasubramanian, E. P.; Rao, N. Prahlad; Sarkar, S.; Singh, D. K.

    2008-07-01

    Over the past two decades Indian Space Research Organization (ISRO) has developed and operationalized satellites to generate a large capacity of transponders for telecommunication service use in INSAT system. More powerful on-board transmitters are built to usher-in direct-to-home broadcast services. These have transformed the Satcom application scenario in the country. With the proliferation of satellite technology, a shift in the Indian market is witnessed today in terms of demand for new services like Broadband Internet, Interactive Multimedia, etc. While it is imperative to pay attention to market trends, ISRO is also committed towards taking the benefits of technological advancement to all round growth of our population, 70% of which dwell in rural areas. The initiatives already taken in space application related to telemedicine, tele-education and Village Resource Centres are required to be taken to a greater height of efficiency. These targets pose technological challenges to build a large capacity and cost-effective satellite system. This paper addresses advanced payload concepts and system architecture along with the trade-off analysis on design parameters in proposing a new generation satellite system capable of extending the reach of the Indian broadband structure to individual users, educational and medical institutions and enterprises for interactive services. This will be a strategic step in the evolution of INSAT system to employ advanced technology to touch every human face of our population.

  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. An integration of Emergency Department Information and Ambulance Systems.

    Science.gov (United States)

    Al-Harbi, Nada; El-Masri, Samir; Saddik, Basema

    2012-01-01

    In this paper we propose an Emergency Department Information System that will be integrated with the ambulance system to improve the communication, enhance the quality of provided emergency services and facilitate information sharing. The proposed system utilizes new advanced technologies such as mobile web services that overcome the problems of interoperability between different systems, HL7 and GPS. The system is unique in that it allows ambulance officers to locate the nearest specialized hospital and allows access to the patient's electronic health record as well as providing the hospital with required information to prepare for the incoming patient.

  7. Challenges in designing interactive systems for emergency response

    DEFF Research Database (Denmark)

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

    2007-01-01

    and visions as ways to bridge between fieldwork and literature studies on the one hand and the emerging computer based prototypes on the other. Our case concerns design of innovative interactive systems for support in emergency response, including patient identification and monitoring as well as construction......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...

  8. An 802.11 n wireless local area network transmission scheme for wireless telemedicine applications.

    Science.gov (United States)

    Lin, C F; Hung, S I; Chiang, I H

    2010-10-01

    In this paper, an 802.11 n transmission scheme is proposed for wireless telemedicine applications. IEEE 802.11n standards, a power assignment strategy, space-time block coding (STBC), and an object composition Petri net (OCPN) model are adopted. With the proposed wireless system, G.729 audio bit streams, Joint Photographic Experts Group 2000 (JPEG 2000) clinical images, and Moving Picture Experts Group 4 (MPEG-4) video bit streams achieve a transmission bit error rate (BER) of 10-7, 10-4, and 103 simultaneously. The proposed system meets the requirements prescribed for wireless telemedicine applications. An essential feature of this proposed transmission scheme is that clinical information that requires a high quality of service (QoS) is transmitted at a high power transmission rate with significant error protection. For maximizing resource utilization and minimizing the total transmission power, STBC and adaptive modulation techniques are used in the proposed 802.11 n wireless telemedicine system. Further, low power, direct mapping (DM), low-error protection scheme, and high-level modulation are adopted for messages that can tolerate a high BER. With the proposed transmission scheme, the required reliability of communication can be achieved. Our simulation results have shown that the proposed 802.11 n transmission scheme can be used for developing effective wireless telemedicine systems.

  9. INFORMATION TECHNOLOGY IN PROTECTING T H E RIGHTS OF PATIENTS DURING TELEMEDICINE CONSULTATIONS

    Directory of Open Access Journals (Sweden)

    N. V. Yaremenko

    2015-05-01

    Full Text Available The problems of a regulatory legal tramewor k tor telemedicine consultations were set. Attention is drawn to the need to regulate these activities in the health system. First of all, we need prudential standards for the protection of patients’ rights.

  10. An Introduction to Telemedicine; Interactive Television for Delivery of Health Services.

    Science.gov (United States)

    Park, Ben

    Telemedicine is defined as the use of two-way or interactive television to conduct transactions in the field of health care. A history of its development to provide two-way communication between central facilities and remote locations is given, along with descriptions of pioneer systems. Technical, psychological and cultural aspects of the method…

  11. Telemedicine in Majuro Hospital, Marshall Islands.

    Science.gov (United States)

    Gunawardane, K J

    2000-09-01

    Since March 1998 up to June 2000, telemedicine activities in Marshall Islands have mainly been for Referrals to Tripler Army Medical Center (TAMC) in Hawaii. The activities are based on a computer which has the Internet connection and accessories including a digital camera, flatbed scanner with a transparency adapter, color printer, a video printer, ophthalmoscope, otoscope and a video Lens, all of which were donated by Project Akamai in Hawaii. Two sessions of training were conducted by representatives from Akamai Project and from PBMA at the very beginning of the establishment of the unit, to all levels of Health Care Providers in Ministry of Health in Majuro. The computer and Internet facility is available 24 hours. Since March 1998 to June 2000, there had been 144 telemedicine consultations to TAMC. Out of a total of 326 off-island referrals for the same period, approximately 80 patients have been sent to TAMC using the PIHCP/Telemedicine program. This accounts for approximately 25% of total off-island referrals. This represents a significant reduction in cost. In addition to cost reduction the telemedicine unit most important impact is on the health providers, especially the physicians working at Majuro Hospital. Availability of medical information through internet has helped them to feel less isolated from the constantly changing field of medical science.

  12. Pickering NGS emergency water supply system emergency start flow simulation and experiment

    Energy Technology Data Exchange (ETDEWEB)

    Davidge, E.; Misra, A. [Ontario Power Generation Inc., Nuclear Safety Analysis & Technology Department, Toronto, Ontario (Canada)

    2012-07-01

    A proposed modification to the OPG Pickering Nuclear Generation Station Emergency Water Supply (EWS) system was analyzed using the Industry Standard Toolset code GOTHIC to determine the acceptability of the proposed system configuration during pump start-up. The new configuration of the system included a vertical dead-ended pipe, initially filled with air. The simulation demonstrated that no significant water hammer effects were predicted and tests performed with the new configuration confirmed the analysis results. (author)

  13. Airborne systems for emergency radiological monitoring

    International Nuclear Information System (INIS)

    Jupiter, C.; Boyns, P.

    1976-01-01

    A variety of aerial radiological monitoring systems are available to respond to a radiological accident or incident affecting large areas. These are operated by EG and G, Inc. for ERDA's Division of Operational Safety. A survey system can be airborne within approximately two hours after notification. Both airborne and terrestrial radioactivity can be measured and mapped. Special analysis procedures allow discrimination between radioactivity from most man-made radioelements and naturally occurring radioelements. A position accuracy of +-54 feet can be maintained over a large area survey. Detection sensitivity for gamma sources employing NaI detector arrays on board an airplane flying at 500 feet altitude is better than 2 μR/hr for surface planar contaminants and approximately 10 mCi for a point gamma source

  14. Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

    Science.gov (United States)

    Lapão, Luís Velez; Correia, Artur

    2015-01-01

    This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

  15. Emergency reactor cooling systems for the experimental VHTR

    International Nuclear Information System (INIS)

    Mitake, Susumu; Suzuki, Katsuo; Miyamoto, Yoshiaki; Tamura, Kazuo; Ezaki, Masahiro.

    1983-03-01

    Performances and design of the panel cooling system which has been proposed to be equipped as an emergency reactor cooling system for the experimental multi purpose very high temperature gas-cooled reactor are explained. Effects of natural circulation flow which would develop in the core and temperature transients of the panel in starting have been precisely investigated. Conditions and procedures for settling accidents with the proposed panel cooling system have been also studied. Based on these studies, it has been shown that the panel cooling system is effective and useful for the emergency reactor cooling of the experimental VHTR. (author)

  16. 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....

  17. Feasibility study on emergency passive habitability systems of SPWR

    International Nuclear Information System (INIS)

    Obata, H.; Tabata, H.; Urakami, M.; Naito, T.

    2000-01-01

    The major characteristic of the Simplified Pressurized Water Reactor (SPWR) is that safety systems for the emergency core cooling and the core decay heat removal functions are achieved by passive equipment. The AP600 developed in the U.S adopts passive emergency habitability system for the main control room (MCR) and the electrical equipment rooms (EER) by using the concrete of the structures as a heat sink. For the SPWR, alternative natural circulation cooling systems have been investigated: for MCR cooling, a cold water reservoir is used as heat sink; for EER cooling, outside air is instead employed. The distribution of the air-velocity and temperature in those rooms were calculated by using a three-dimensional thermal fluid analysis code. The authors verified the conceptual feasibility of these systems as the emergency passive habitability systems in the SPWR. (author)

  18. Application of geographic information system for radiologic emergency response

    International Nuclear Information System (INIS)

    Best, R.G.; Doyle, J.F.; Mueller, P.G.

    1998-01-01

    Comprehensive and timely radiological, cultural, and environmental data are required in order to make informed decisions during a radiological emergency. Within the Federal Radiological Monitoring and Assessment Center (FRMAC), there is a continuing effort to improve the data management and communication process. The most recent addition to this essential function has been the development of the Field Analysis System for Emergency Response (FASER). It is an integrated system with compatible digital image processing and Geographic Information System (GIS) capabilities. FASER is configured with commercially available off-the-shelf hardware and software components. To demonstrate the potential of the FASER system for radiological emergency response, the system has been utilized in interagency FRMAC exercises to analyze the available spatial data to help determine the impact of a hypothetical radiological release and to develop mitigation plans. (R.P.)

  19. 46 CFR 112.01-10 - Automatic emergency lighting and power system.

    Science.gov (United States)

    2010-10-01

    ... 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... 46 Shipping 4 2010-10-01 2010-10-01 false Automatic emergency lighting and power system. 112.01-10...

  20. 46 CFR 112.01-5 - Manual emergency lighting and power system.

    Science.gov (United States)

    2010-10-01

    ... 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... 46 Shipping 4 2010-10-01 2010-10-01 false Manual emergency lighting and power system. 112.01-5...

  1. Digital echocardiography and telemedicine applications in pediatric cardiology.

    Science.gov (United States)

    Sable, Craig

    2002-01-01

    Digital echocardiography offers several advantages over videotape, including easy review, comparison, storage, postprocessing, and sharing of studies, quantitative analysis, and superior resolution. Newer echocardiography systems can write digital data to computer hardware, whereas older systems require digitization of analog data. Clinical and digital data compression is required to reduce study size. Clinical compression has been validated in several adult studies and one pediatric study. JPEG and MPEG digital compression ratios of 26:1 and 200:1, respectively, approximate S-videotape quality. JPEG is the DICOM 3.0 standard and is ideal for short loops, serial comparisons, and quantitative analysis. MPEG (the motion picture standard) lends itself to digitization of video streams and may be more attractive to pediatric cardiologists. Options for data storage and transfer range from limited local review to multiple offline review stations linked by a wide-area network. Telemedicine expands the capabilities of digital echocardiography in a "store and forward" or "real-time" format. Real-time neonatal telecardiology is accurate, impacts patient care, is cost-effective, and does not increase utilization. Cost, increased reliance on sonographers' skills, lack of accepted standards, and legal, licensure, and billing issues are obstacles to widespread acceptance of digital echocardiography and telemedicine.

  2. Implementation of a geographical information system in nuclear emergencies

    International Nuclear Information System (INIS)

    Sadaniowski, I.; Telleria, D.; Jordan, O.; Bruno, H.; Boutet, L.; Hernandez, D.

    2006-01-01

    From 2003, the Nuclear Regulatory Authority (RNA) has worked in the implementation of a Geographical Information System (SIG) for the planning and the intervention in emergencies, with special emphasis in the nuclear emergencies. The main objective of the SIG developed in the ARN is to give the necessary support for the planning, training and application of the actions of radiological protection necessary in front of a nuclear emergency, offering the geo referenced cartographic base, the readiness of logistical resources in the whole country, incorporating results of models of forecast of consequences and environmental measurements during the emergency, facilitating the analysis of this information in real time and facilitating the presentation of results for the decision making. The cartographic base is constituted of demographic, social, economic data identification of main actors interveners in the emergency, vial infrastructure and natural characteristics of the area in question. In this work the main characteristics of the implemented SIG are presented including the conceptual standards of design that contemplate the international requirements for the planning and answer in the event of nuclear emergencies, the current state of the system and the foreseen evolution. A description of the opposing problems during its implementation that can be common to many countries of the region is also presented, as well as the obtained experience of its use in preparation tasks for emergencies and in mocks. (Author)

  3. 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

  4. Emergency Air Rescue System in Romania

    Directory of Open Access Journals (Sweden)

    Tranca Sebastian

    2018-03-01

    Full Text Available The helicopter, as a means of transport, has facilitated a significant decrease in intervention time at the site of request, increasing the chances of survival of the critical patient. Since 2003, SMURD has managed to form a fleet composed of nine helicopters and two airplanes. From an operational and strategic point of view, the SMURD intervention unit, set up seven Aeromedical Operational Bases (A.O.B. equipped with helicopters and materials necessary for their operation. There is a dynamic increase in the number of air rescue missions in Romania, with most missions being carried out by the air rescue bases in Târgu Mureş and Bucharest. Specialty literature has clearly demonstrated the positive impact on the survival of critical patients assisted by airborne crews, so it is necessary for the Romanian air rescue system to grow up. It is necessary to increase the number of air bases, purchase new helicopters and to continue the training programs of both pilots and medical personnel.

  5. Emergency medical service systems in Japan : Past, present, and future

    OpenAIRE

    Tanigawa, Koichi; Tanaka, Keiichi

    2006-01-01

    Emergency medical services are provided by the fire defense headquarter of the local government in Japan. We have a one-tiered EMS system. The ambulance is staffed by three crews trained in rescue, stabilization, transportation, and advanced care of traumatic and medical emergencies. There are three levels of care provided by ambulance personnel including a basic-level ambulance crew (First Aid Class one, FAC-1), a second level (Standard First Aid Class, SFAC), and the highest level (Emergenc...

  6. Project SIMORAC: a wireless system for radiation monitoring in emergencies

    International Nuclear Information System (INIS)

    Gomez, D.; Serrano, J. L.; Cabrera, E.; Barbaran, J.; Llopis, L.; Diaz, M.

    2013-01-01

    The SIMORAC project includes a new system for Radiological monitoring using wireless sensor networks (RSIs), without infrastructure planning in emergency situations for a rapidly deployable by air or land, with the aim of providing a tool emergency teams capable of offering a real time x-ray map within the radius of action of an accident. Communication of quality at a great distance, resistance to weather, long autonomy and possibility of aerial deployment are some of the features of SIMORAC.

  7. 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.

  8. An experimental study of the emergence of human communication systems.

    Science.gov (United States)

    Galantucci, Bruno

    2005-09-10

    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 physically separated but exchanged graphic signals through a medium that prevented the use of standard symbols (e.g., letters). Communication systems emerged and developed rapidly during the games, integrating the use of explicit signs with information implicitly available to players and silent behavior-coordinating procedures. The systems that emerged suggest 3 conclusions: (a) signs originate from different mappings; (b) sign systems develop parsimoniously; (c) sign forms are perceptually distinct, easy to produce, and tolerant to variations. 2005 Lawrence Erlbaum Associates, Inc.

  9. 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

  10. An Emergency System for Succoring Children using Mobile GIS

    OpenAIRE

    Ismaeel, Ayad Ghany

    2012-01-01

    The large numbers of sick children in different diseases are very dreaded, and when there isn't succor at the proper time and in the type the sick child need it that makes us lose child. This paper suggested an emergency system for succoring sick child locally when he required that, and there isn't someone knows his disease. The proposed system is the first tracking system works online (24 hour in the day) but only when the sick children requiring the help using mobile GIS. In, this emergency...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Bispebjerg Hospital has introduced a triage system at the Emergency Department (ED) based on "primary criteria" and a physiological scoring system named the Bispebjerg Early Warning Score (BEWS). A BEWS is calculated on the basis of five vital signs which are accessible bedside. Patients who have...... 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....

  12. Emergency core cooling systems in CANDU nuclear power plants

    International Nuclear Information System (INIS)

    1981-12-01

    This report contains the responses by the Advisory Committee on Nuclear Safety to three questions posed by the Atomic Energy Control Board concerning the need for Emergency Core Cooling Systems (ECCS) in CANDU nuclear power plants, the effectiveness requirement for such systems, and the extent to which experimental evidence should be available to demonstrate compliance with effectiveness standards

  13. Reliability assurance program for operational emergency ac power system

    International Nuclear Information System (INIS)

    Heineman, J.B.; Ragland, W.A.; Mueller, C.J.

    1985-01-01

    A comprehensive review of emergency ac power systems in nuclear generating plants (the vast majority of these plants contain redundant diesel generator systems) delineates several operational areas that can be improved by instituting a reliability assurance program (RAP), which initially upgrades the diesel generator performance and provides for ongoing monitoring and maintenance based upon alert levels

  14. The nuclear emergency information system based on GRRS

    International Nuclear Information System (INIS)

    Wang Bairong; Fu Li; Ma Jie; Zheng Qiyan

    2012-01-01

    By utilizing high operation characteristic of GPRS and advantage of transferring largely data packets, this paper set up a wireless communication network and nuclear emergency information system. This system studies useful data, short message, picture, storage and processing function for wireless control network platform. (authors)

  15. 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

  16. Elements of a national emergency response system for nuclear accidents

    International Nuclear Information System (INIS)

    Dickerson, M.H.

    1987-01-01

    The purpose of this paper is to suggest elements for a general emergency response system, employed at a national level, to detect, evaluate and assess the consequences of a radiological atmospheric release occurring within or outside of national boundaries. These elements are focused on the total aspect of emergency response ranging from providing an initial alarm to a total assessment of the environmental and health effects. Elements of the emergency response system are described in such a way that existing resources can be directly applied if appropriate; if not, newly developed or an expansion of existing resources can be employed. The major thrust of this paper is toward a philosophical discussion and general description of resources that would be required to implementation. If the major features of this proposal system are judged desirable for implementation, then the next level of detail can be added. The philosophy underlying this paper is preparedness - preparedness through planning, awareness and the application of technology. More specifically, it is establishment of reasonable guidelines including the definition of reference and protective action levels for public exposure to accidents involving nuclear material; education of the public, government officials and the news media; and the application of models and measurements coupled to computer systems to address a series of questions related to emergency planning, response and assessment. It is the role of a proven national emergency response system to provide reliable, quality-controlled information to decision makers for the management of environmental crises

  17. 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

  18. The British Columbia Emergency Medicine Network: A Paradigm Shift in a Provincial System of Emergency Care.

    Science.gov (United States)

    Abu-Laban, Riyad B; Drebit, Sharla; Lindstrom, Ronald R; Archibald, Chantel; Eggers, Kim; Ho, Kendall; Khazei, Afshin; Lund, Adam; MacKinnon, Carolyn; Markham, Ray; Marsden, Julian; Martin, Ed; Christenson, Jim

    2018-01-04

    As generalists, emergency practitioners face challenges in providing state-of-the-art care owing to the broad spectrum of practice and the rapid rate of new knowledge generation. Networks have become increasingly prevalent in health care, and it was in this backdrop, and the resulting opportunity to advance evidence-informed emergency care in the Canadian province of British Columbia (BC), that a new "Emergency Medicine Network" (EM Network) was launched in 2017. The EM Network consists of four programs, each led by a physician with expertise and a track record in the domain: (1) Clinical Resources; (2) Innovation; (3) Continuing Professional Development; and (4) Real-time Support. This paper provides an overview of the EM Network, including its background, purpose, programs, anticipated evolution, and impact on the BC health care system.

  19. An intelligent IoT emergency vehicle warning system using RFID and Wi-Fi technologies for emergency medical services.

    Science.gov (United States)

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

    2018-01-01

    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 Wi-Fi 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 Wi-Fi 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.

  20. 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.

  1. Improvement of the Radiological system of emergency classification in Cuba

    International Nuclear Information System (INIS)

    Jerez Vegueria, Pablo F.; Yamil Lopez Forteza; Diaz Guerra, Pedro I.

    2003-01-01

    In 1998 the National Center of Nuclear Security (CNSN), on the base of the experience in the one handling of emergencies and the preparation aspects, planning and answer, it perfects and it modernizes, with the approval of the national bigger State of the Civil Defense, the approaches of the Scale of Radiological Events approved from 1992. Given the operational experience of the System of Answer to Emergency of the Ministry Of Science Technology And Environment in the year 2001 the CNSN develops, it perfects and it puts in vigor a more complete System of Classification of Emergency of unique use for all the entities that use sources of radiations ionizations and that it also includes those answer forces that are imbricate in the Plan of Measures Against Catastrophe for cases of Radiological Accidents. The setting in vigor of this Unique System of Classification of Emergencies at national level has allowed to secure the coordination, planning and answer in an effective, quick and effective way. Presently work is exposed the philosophy on which this System of Classification was elaborated, the approaches used to classify the events as much in radioactive facilities as in the practice of the transport of radioactive materials and the activation of the forces of answers in cases of radiological emergencies

  2. Health care for all: effective, community supported, healthcare with innovative use of telemedicine technology.

    Science.gov (United States)

    Shah, Tariq Kazim; Tariq, Tasneem; Phillips, Roger; Davison, Steve; Hoare, Adam; Hasan, Syed Shahzad; Babar, Zaheer-Ud-Din

    2018-01-01

    Almost half of the world's total population reside in rural and remote areas and a large number of these people remain deprived of most basic facilities like healthcare and education. It is deemed impossible for government with scarce resources in developing countries to open and run a health facility in every remote community using conventional means. One increasingly popular unconventional mean is the use of existing technology to improve exchange of medical information for the purpose of improving health of underprivileged communities. Telemedicine implies the use of information and communication technology to provide health care remotely from a distance. With the induction of telemedicine, patients who live in rural and remote areas can have increased access to medical services. In many developing countries, use of telemedicine however has been limited mainly to teleconferencing between primary and secondary/tertiary care facilities for diagnosis and management of patients. This system still requires patients from remote communities to travel, often long and arduous journeys to the centre where telecom and medical facilities are available. Health Care 4 All International, a not for profit registered charity is providing primary care to patients by taking telemedicine into their homes in remote communities, thus obviating the need and hardships of travel for patient.

  3. Cloud and traditional videoconferencing technology for telemedicine and distance learning.

    Science.gov (United States)

    Liu, Wei-Li; Zhang, Kai; Locatis, Craig; Ackerman, Michael

    2015-05-01

    Cloud-based videoconferencing versus traditional systems are described for possible use in telemedicine and distance learning. Differences between traditional and cloud-based videoconferencing systems are examined, and the methods for identifying and testing systems are explained. Findings are presented characterizing the cloud conferencing genre and its attributes versus traditional H.323 conferencing. Because the technology is rapidly evolving and needs to be evaluated in reference to local needs, it is strongly recommended that this or other reviews not be considered substitutes for personal hands-on experience. This review identifies key attributes of the technology that can be used to appraise the relevance of cloud conferencing technology and to determine whether migration from traditional technology to a cloud environment is warranted. An evaluation template is provided for assessing systems appropriateness.

  4. Interactive Control System, Intended Strategy, Implemented Strategy dan Emergent Strategy

    Directory of Open Access Journals (Sweden)

    Tubagus Ismail

    2012-09-01

    Full Text Available The purpose of this study was to examine the relationship between management control system (MCS and strategy formation processes, namely: intended strategy, emergent strategy and impelemented strategy. The focus of MCS in this study was interactive control system. The study was based on Structural Equation Modeling (SEM as its multivariate analyses instrument. The samples were upper middle managers of manufacturing company in Banten Province, DKI Jakarta Province and West Java Province. AMOS Software 16 program is used as an additional instrument to resolve the problem in SEM modeling. The study found that interactive control system brought a positive and significant influence on Intended strategy; interactive control system brought a positive and significant influence on implemented strategy; interactive control system brought a positive and significant influence on emergent strategy. The limitation of this study is that our empirical model only used one way relationship between the process of strategy formation and interactive control system.

  5. SPEEDI: system for prediction of environmental emergency dose information

    International Nuclear Information System (INIS)

    Chino, Masamichi; Ishikawa, Hirohiko; Kai, Michiaki

    1984-03-01

    In this report a computer code system for prediction of environmental emergency dose information , i.e., SPEEDI for short, is presented. In case of an accidental release of radioactive materials from a nuclear plant, it is very important for an emergency planning to predict the concentration and dose caused by the materials. The SPEEDI code system has been developed for this purpose and it has features to predict by calculation the released nuclides, wind fields, concentrations and dose based on release information, actual weather and topographical data. (author)

  6. Emerging nuclear energy systems: Economic challenge: Revision 1

    International Nuclear Information System (INIS)

    Nuckolls, J.H.

    1986-01-01

    Future nuclear energy systems may achieve substantially lower energy costs than those of existing fossil energy systems and comparable capital costs. Such low cost nuclear energy would provide a strong economic incentive to minimize the use of fossil fuels. If these low cost nuclear energy systems emerge in the next few decades, 21st century civilization may be able to avert potentially disastrous CO 2 induced global climate changes. 12 refs., 1 fig

  7. ARGOS-NT: A computer based emergency management system

    International Nuclear Information System (INIS)

    Hoe, S.; Thykier-Nielsen, S.; Steffensen, L.B.

    2000-01-01

    In case of a nuclear accident or a threat of a release the Danish Emergency Management Agency is responsible for actions to minimize the consequences in Danish territory. To provide an overview of the situation, a computer based system called ARGOS-NT has been developed in 1993/94. This paper gives an overview of the system with emphasis on the prognostic part of the system. An example calculation shows the importance of correct landscape modeling. (author)

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

    Science.gov (United States)

    2011-01-01

    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 volume of telemedicine trade

  9. Modeling the peak of emergence in systems: Design and katachi.

    Science.gov (United States)

    Cardier, Beth; Goranson, H T; Casas, Niccolo; Lundberg, Patric; Erioli, Alessio; Takaki, Ryuji; Nagy, Dénes; Ciavarra, Richard; Sanford, Larry D

    2017-12-01

    It is difficult to model emergence in biological systems using reductionist paradigms. A requirement for computational modeling is that individual entities can be recorded parametrically and related logically, but their transformation into whole systems cannot be captured this way. The problem stems from an inability to formally represent the implicit influences that inform emergent organization, such as context, shifts in causal agency or scale, and self-reference. This lack hampers biological systems modeling and its computational counterpart, indicating a need for new fundamental abstraction frameworks that support system-level characteristics. We develop an approach that formally captures these characteristics, focusing on the way they come together to enable transformation at the 'peak' of the emergent process. An example from virology is presented, in which two seemingly antagonistic systems - the herpes cold sore virus and its host - are capable of altering their basic biological objectives to achieve a new equilibrium. The usual barriers to modeling this process are overcome by incorporating mechanisms from practices centered on its emergent peak: design and katachi. In the Japanese science of form, katachi refers to the emergence of intrinsic structure from real situations, where an optimal balance between implicit influences is achieved. Design indicates how such optimization is guided by principles of flow. These practices leverage qualities of situated abstraction, which we understand through the intuitive method of physicist Kôdi Husimi. Early results indicate that this approach can capture the functional transformations of biological emergence, whilst being reasonably computable. Due to its geometric foundations and narrative-based extension to logic, the method will also generate speculative predictions. This research forms the foundations of a new biomedical modeling platform, which is discussed. Copyright © 2017. Published by Elsevier Ltd.

  10. Participatory design methods in telemedicine research

    DEFF Research Database (Denmark)

    Danbjørg, Dorthe Boe; Clemensen, Jane; Rothmann, Mette Juel

    together with the patients. Participatory design is a research design and methodology that encourages the participation of users in the design process of technological solutions. Therefore, it has a potential for designing technologies that actually reflect the needs of the users, why it is relevant within...... telemedicine. The aim of this presentation is to explain the process and theoretical framework of a PD project; give an example of a project including the applied methods, and to determine its application to telemedicine with focus on the rationale for genuine participation. Theory: Participation implies....... Methods: Key activities of a Participatory Design project comprise methods such as fieldwork; literature reviewing; development and testing, and user activities as workshops. Methods that support telling, making, enacting. For instance telling activities as drivers for participation, where practitioners...

  11. Comparative study of connectivity in telemedicine.

    Science.gov (United States)

    Singh, Indra Pratap; Kapoor, Lily; Daman, Repu; Mishra, Saroj Kanta

    2008-10-01

    Communication links are the lifelines for telemedicine practice. Various terrestrial and satellite media can be used; however, each has its own plus and minus side. The current study was designed to evaluate three types of telecommunication media used for telemedical videoconference at the Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow Telemedicine program over a period of 20 months. The evaluation was based on analysis of technical parameters recorded in a prescribed proforma designed for the study purpose and maintained prospectively after completion of each event. Only technical issues were addressed. At the end of the study period, analysis of data revealed that leased line-based terrestrial Internet Protocol (IP) was better than Sky IP. Integrated Services Digital Network media were found technically less acceptable for telemedical videoconference.

  12. 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 (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

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

    International Nuclear Information System (INIS)

    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

  14. 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.

  15. Emergency response information within the National LLW Information Management System

    International Nuclear Information System (INIS)

    Paukert, J.G.; Fuchs, R.L.

    1986-01-01

    The U.S. Department of Energy, with operational assistance from EG and G Idaho, Inc., maintains the National Low-Level Waste Information Management System, a relational data base management system with extensive information collection and reporting capabilities. The system operates on an IBM 4341 main-frame computer in Idaho Falls, Idaho and is accessible through terminals in 46 states. One of the many programs available on the system is an emergency response data network, which was developed jointly by EG and G Idaho, Inc. and the Federal Emergency Management Agency. As a prototype, the program comprises emergency response team contacts, policies, activities and decisions; federal, state and local government contacts; facility and support center locations; and news releases for nine reactor sites in the southeast. The emergency response program provides a method for consolidating currently fragmented information into a central and user-friendly system. When the program is implemented, immediate answers to response questions will be available through a remote terminal or telephone on a 24-hour basis. In view of current hazardous and low-level waste shipment rates and future movements of high-level waste, the program can offer needed and timely information for transportation as well as site incident response

  16. Internet-based surveillance systems for monitoring emerging infectious diseases.

    Science.gov (United States)

    Milinovich, Gabriel J; Williams, Gail M; Clements, Archie C A; Hu, Wenbiao

    2014-02-01

    Emerging infectious diseases present a complex challenge to public health officials and governments; these challenges have been compounded by rapidly shifting patterns of human behaviour and globalisation. The increase in emerging infectious diseases has led to calls for new technologies and approaches for detection, tracking, reporting, and response. Internet-based surveillance systems offer a novel and developing means of monitoring conditions of public health concern, including emerging infectious diseases. We review studies that have exploited internet use and search trends to monitor two such diseases: influenza and dengue. Internet-based surveillance systems have good congruence with traditional surveillance approaches. Additionally, internet-based approaches are logistically and economically appealing. However, they do not have the capacity to replace traditional surveillance systems; they should not be viewed as an alternative, but rather an extension. Future research should focus on using data generated through internet-based surveillance and response systems to bolster the capacity of traditional surveillance systems for emerging infectious diseases. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. A study on emergency preparedness for nuclear power plant/ Establishment of emergency communication network system

    International Nuclear Information System (INIS)

    Yang, Y. K.; Jung, Y. D.; Kim, S. Y.

    1991-12-01

    The objective of this study was to develop an emergency database search system for nuclear power plants during nuclear incidents / accidents. Image data reported from nuclear power plants to the regulatory body and other related data will be stored systematically in the computer. The data will be utilized during nuclear emergency to prevent the accident from spreading out and to minimize its effect. It will also be used in exchanging information on accident or incidents with the foreign countries. The operational documents in the Kori-4 nuclear power plant are used as the major source for the categorization and analysis in performing this research. It was not easy to access the detailed operational data due to its unique characteric for the security. Therefore, we strongly suggest to increase manpower for this project in Korea Institute of Nuclear Safety (KINS) and archive involvement from Korea Electric Power Company to establish better database retrieval system

  18. A study on emergency preparedness for nuclear power plant/ Establishment of emergency communication network system

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Y K; Jung, Y D; Kim, S Y [Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    1991-12-15

    The objective of this study was to develop an emergency database search system for nuclear power plants during nuclear incidents / accidents. Image data reported from nuclear power plants to the regulatory body and other related data will be stored systematically in the computer. The data will be utilized during nuclear emergency to prevent the accident from spreading out and to minimize its effect. It will also be used in exchanging information on accident or incidents with the foreign countries. The operational documents in the Kori-4 nuclear power plant are used as the major source for the categorization and analysis in performing this research. It was not easy to access the detailed operational data due to its unique characteric for the security. Therefore, we strongly suggest to increase manpower for this project in Korea Institute of Nuclear Safety (KINS) and archive involvement from Korea Electric Power Company to establish better database retrieval system.

  19. Telemedicine: licensing and other legal issues.

    Science.gov (United States)

    Siegal, Gil

    2011-12-01

    The growth of information technology and telecommunications has created promising opportunities for better, faster, more accessible, barrier-free health care; telemedicine (TM). The feasibility of many TM projects depends on resolving legal issues. Mastering technical issues or providing training remain important benchmarks for implementation of TM, but legal issues constrain progress. This article identifies the key legal issues, maps current legislation, and offers a forecast of necessary steps to expedite the dissemination of TM. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. 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.

  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. Quality and safety implications of emergency department information systems.

    Science.gov (United States)

    Farley, Heather L; Baumlin, Kevin M; Hamedani, Azita G; Cheung, Dickson S; Edwards, Michael R; Fuller, Drew C; Genes, Nicholas; Griffey, Richard T; Kelly, John J; McClay, James C; Nielson, Jeff; Phelan, Michael P; Shapiro, Jason S; Stone-Griffith, Suzanne; Pines, Jesse M

    2013-10-01

    The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services "meaningful use" incentive programs, in tandem with the boundless additional requirements for detailed reporting of quality metrics, have galvanized hospital efforts to implement hospital-based electronic health records. As such, emergency department information systems (EDISs) are an important and unique component of most hospitals' electronic health records. System functionality varies greatly and affects physician decisionmaking, clinician workflow, communication, and, ultimately, the overall quality of care and patient safety. This article is a joint effort by members of the Quality Improvement and Patient Safety Section and the Informatics Section of the American College of Emergency Physicians. The aim of this effort is to examine the benefits and potential threats to quality and patient safety that could result from the choice of a particular EDIS, its implementation and optimization, and the hospital's or physician group's approach to continuous improvement of the EDIS. Specifically, we explored the following areas of potential EDIS safety concerns: communication failure, wrong order-wrong patient errors, poor data display, and alert fatigue. Case studies are presented that illustrate the potential harm that could befall patients from an inferior EDIS product or suboptimal execution of such a product in the clinical environment. The authors have developed 7 recommendations to improve patient safety with respect to the deployment of EDISs. These include ensuring that emergency providers actively participate in selection of the EDIS product, in the design of processes related to EDIS implementation and optimization, and in the monitoring of the system's ongoing success or failure. Our recommendations apply to emergency departments using any type of EDIS: custom-developed systems, best-of-breed vendor systems, or enterprise systems

  3. The Use of Telemedicine in Oral and Maxillofacial Surgery.

    Science.gov (United States)

    Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

    2016-04-01

    To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier

  4. [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.

  5. Supporting emergency management through process-aware information systems

    NARCIS (Netherlands)

    Hagebölling, D.; Leoni, de M.; Ardagna, D.; Mecella, M.; Yang, J.

    2009-01-01

    This short paper aims at summarising the invited talk given by Dirk Hagebölling in the PM4HDPS workshop and the subsequent discussion with participants. The talk concerned the current situation of systems for emergency management and their drawbacks. Moreover, it dealt also with the expectation for

  6. 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…

  7. 77 FR 39745 - Fuel Oil Systems for Emergency Power Supplies

    Science.gov (United States)

    2012-07-05

    ... fuel oil systems for safety-related emergency diesel generators and oil-fueled gas turbine generators... Commission, Washington, DC 20555-0001. Fax comments to: RADB at 301-492-3446. For additional direction on... New Reactors, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, telephone: 301-415-8503...

  8. How Do Low-Income Urban African Americans and Latinos Feel about Telemedicine? A Diffusion of Innovation Analysis

    Directory of Open Access Journals (Sweden)

    Sheba George

    2012-01-01

    Full Text Available Introduction. Telemedicine is promoted as a means to increase access to specialty medical care among the urban underserved, yet little is known about its acceptability among these populations. We used components of a diffusion of innovation conceptual framework to analyze preexperience perceptions about telemedicine to assess its appeal among urban underserved African Americans and Latinos. Methods. Ten focus groups were conducted with African American (=43 and Latino participants (=44 in both English and Spanish and analyzed for key themes. Results. Both groups perceived increased and immediate access to multiple medical opinions and reduced wait time as relative advantages of telemedicine. However, African Americans expressed more concerns than Latinos about confidentiality, privacy, and the physical absence of the specialist. This difference may reflect lower levels of trust in new health care innovations among African Americans resulting from a legacy of past abuses in the US medical system as compared to immigrant Latinos who do not have this particular historical backdrop. Conclusions. These findings have implications for important issues such as adoption of telemedicine, patient satisfaction, doctor-patient interactions, and the development and tailoring of strategies targeted to each of these populations for the introduction, marketing, and implementation of telemedicine.

  9. Modems for emerging digital cellular-mobile radio system

    Science.gov (United States)

    Feher, Kamilo

    1991-01-01

    Digital modem techniques for emerging digital cellular telecommunications-mobile radio system applications are described and analyzed. In particular, theoretical performance, experimental results, principles of operation, and various architectures of pi/4-QPSK (pi/4-shifted coherent or differential QPSK) modems for second-generation US digital cellular radio system applications are presented. The spectral/power efficiency and performance of the pi/4-QPSK modems (American and Japanese digital cellular emerging standards) are studied and briefly compared to GMSK (Gaussian minimum-shift keying) modems (proposed for European DECT and GSM cellular standards). Improved filtering strategies and digital pilot-aided (digital channel sounding) techniques are also considered for pi/4-QPSK and other digital modems. These techniques could significantly improve the performance of digital cellular and other digital land mobile and satellite mobile radio systems. More spectrally efficient modem trends for future cellular/mobile (land mobile) and satellite communication systems applications are also highlighted.

  10. Discussion on emergency aerial survey system for practical use

    International Nuclear Information System (INIS)

    Moriuchi, Shigeru; Nagaoka, Toshi; Sakamoto, Ryuichi; Tsutsumi, Masahiro; Satio, Kimiaki; Amano, Hikaru; Matsunaga, Takeshi; Yanase, Nobuyuki; Kasai, Atsushi

    1989-02-01

    In 1980, after the occurrence of the TMI-2 accident in the United States, JAERI started the research and development of aerial survey techniques, and completed two prototype aerial survey systems in 1985 for gamma ray survey and for radioactivity monitoring. Following the Chernobyl reactor accident which occured in Soviet Union in 1986, European countries experienced environmental radiological monitoring using their aerial survey systems, and proved the effectiveness of aerial survey in the emergency. This report describes the outline of the prototype survey systems developed at JAERI, and showed the practical survey systems data processing, data analysis and the techniques including data processing, data analysis and the example outputs. Also, this report made some proposals concerning practical construction and the arrangement of the aerial survey equipments and the establishment of organization which takes charge of the practical emergency survey and the routine maintenance, based on our past experience. (author)

  11. Creation of reactor's reliable system of emergency energy supply

    International Nuclear Information System (INIS)

    Batyrbekov, G.A.; Brovkin, A.Yu.; Petukhov, V.K.; Chekushin, A.I.; Chernyaev, V.P.; Yagotinets, N.A.

    1998-01-01

    System of reliable power supply of the WWR-K reactor complex is described, which completely provides safety operation of reactor equipment in the case of total voltage loss from external power transmission lines as well as under destruction of accumulation batteries by earthquake more than 6 balls. Switching on in operation of diesel-generators and system of constant current supply from accumulator batteries is occurred automatically under cessation of voltage supply from centralized power system. Reliable reactor dampening in case it work on capacity has been ensured. Reactor cooling under its emergency shutdown during both the partial or the total loss of coolant in first counter has been carried out. Under full coolant loss the system of emergency reactor cooling has been switched on in operation

  12. 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).

  13. Reliability of emergency ac power systems at nuclear power plants

    International Nuclear Information System (INIS)

    Battle, R.E.; Campbell, D.J.

    1983-07-01

    Reliability of emergency onsite ac power systems at nuclear power plants has been questioned within the Nuclear Regulatory Commission (NRC) because of the number of diesel generator failures reported by nuclear plant licensees and the reactor core damage that could result from diesel failure during an emergency. This report contains the results of a reliability analysis of the onsite ac power system, and it uses the results of a separate analysis of offsite power systems to calculate the expected frequency of station blackout. Included is a design and operating experience review. Eighteen plants representative of typical onsite ac power systems and ten generic designs were selected to be modeled by fault trees. Operating experience data were collected from the NRC files and from nuclear plant licensee responses to a questionnaire sent out for this project

  14. ["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.

  15. Interactive Control System, Intended Strategy, Implemented Strategy dan Emergent Strategy

    OpenAIRE

    Tubagus Ismail; Darjat Sudrajat

    2012-01-01

    The purpose of this study was to examine the relationship between management control system (MCS) and strategy formation processes, namely: intended strategy, emergent strategy and impelemented strategy. The focus of MCS in this study was interactive control system. The study was based on Structural Equation Modeling (SEM) as its multivariate analyses instrument. The samples were upper middle managers of manufacturing company in Banten Province, DKI Jakarta Province and West Java Province. AM...

  16. Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study.

    Science.gov (United States)

    Meyer, Brett C; Raman, Rema; Hemmen, Thomas; Obler, Richard; Zivin, Justin A; Rao, Ramesh; Thomas, Ronald G; Lyden, Patrick D

    2008-09-01

    To increase the effective use of thrombolytics for acute stroke, the expertise of vascular neurologists must be disseminated more widely. We prospectively assessed whether telemedicine (real-time, two-way audio and video, and digital imaging and communications in medicine [DICOM] interpretation) or telephone was superior for decision making in acute telemedicine consultations. From January, 2004, to August, 2007, patients older than 18 years who presented with acute stroke symptoms at one of four remote spoke sites were randomly assigned, through a web-based, permuted blocks system, to telemedicine or telephone consultation to assess their suitability for treatment with thrombolytics, on the basis of standard criteria. The primary outcome measure was whether the decision to give thrombolytic treatment was correct, as determined by central adjudication. Secondary outcomes were the rate of thrombolytic use, 90-day functional outcomes (Barthel index [BI] and modified Rankin scale [mRS]), the incidence of intracerebral haemorrhages, and technical observations. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00283868. 234 patients were assessed prospectively. 111 patients were randomised to telemedicine, and 111 patients were randomised to telephone consultation; 207 completed the study. Mean National Institutes of Health stroke scale score at presentation was 9.5 (SD 8.1) points (11.4 [8.7] points in the telemedicine group versus 7.7 [7.0] points in the telephone group; p=0.002). One telemedicine consultation was aborted for technical reasons, although it was included in the analyses. Correct treatment decisions were made more often in the telemedicine group than in the telephone group (108 [98%] vs 91 [82%], odds ratio [OR] 10.9, 95% CI 2.7-44.6; p=0.0009). Intravenous thrombolytics were used at an overall rate of 25% (31 [28%] telemedicine vs 25 [23%] telephone, 1.3, 0.7-2.5; p=0.43). 90-day functional outcomes were not

  17. R and D of seismic emergency information transmission system

    International Nuclear Information System (INIS)

    Ebisawa, Katsumi; Kuno, Tetsuya; Shibata, Katsuyuki; Abe, Ichiro; Tuzuki, Kazuhisa

    2002-01-01

    The R and D Seismic Emergency Information Transmission System 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. This system is the disaster management system which consists of user site and disaster information center and is capable of mutual information transmission through Inter-Net and walkie-talkie. The concept of the disaster management system which is adaptable with DiMSIS (Disaster Management Spatial Information System) developed by professor Kameda et al. of Kyoto University has been established. Based on this concept, a prototype system has been developed. This system has following functions, (1) compatible application both in usual condition and emergency time, (2) the decentralized independence, and (3) the integration of space and time information. The system can estimate the earthquake motion information with 500 m square mesh in a local area and transmit in a few minutes. In the development of the system, seismometer network, surface soil database and amplification functions were prepared for the examination of system function. Demonstration against the Tokai area was carried out and the function was verified. (author)

  18. 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.

  19. 77 FR 27015 - Distance Learning and Telemedicine Grant Program

    Science.gov (United States)

    2012-05-08

    ... DEPARTMENT OF AGRICULTURE Rural Utilities Service Distance Learning and Telemedicine Grant Program AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Funding for FY 2012 of the Distance Learning and... awards for its Distance Learning and Telemedicine (DLT) Grant Program. For Fiscal Year 2012, $15 million...

  20. 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 ...

  1. Determinants of successful telemedicine implementations: a literature study

    NARCIS (Netherlands)

    Broens, T.H.F.; Huis in 't Veld, M.H.A.; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.; van Halteren, Aart; Nieuwenhuis, Lambertus Johannes Maria

    Telemedicine implementations often remain in the pilot phase and do not succeed in scaling-up to robust products that are used in daily practice. We conducted a qualitative literature review of 45 conference papers describing telemedicine interventions in order to identify determinants that had

  2. Telemedicine in dermatology: Evaluation of secondary and tertiary teledermatology

    NARCIS (Netherlands)

    van der Heijden, J.P.

    2013-01-01

    The field of dermatology was one of the first adaptors of telemedicine, dating back to 1995, and has one of the highest scientific output in the field of telemedicine. The research described in this thesis expanded on this scientific knowledge base by answering the following research questions: 1.

  3. 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.

  4. Integrating Telemedicine for Disaster Response: Testing the Emergency Telemedicine Technology Acceptance Model

    Science.gov (United States)

    Davis, Theresa M.

    2013-01-01

    Background: There is little evidence that technology acceptance is well understood in healthcare. The hospital environment is complex and dynamic creating a challenge when new technology is introduced because it impacts current processes and workflows which can significantly affect patient care delivery and outcomes. This study tested the effect…

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

    Directory of Open Access Journals (Sweden)

    Terrence P. Kee

    2017-08-01

    Full Text Available 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.

  6. Emerging nuclear energy systems and nuclear weapon proliferation

    International Nuclear Information System (INIS)

    Gsponer, A.; Sahin, S.; Jasani, B.

    1983-01-01

    Generally when considering problems of proliferation of nuclear weapons, discussions are focused on horizontal proliferation. However, the emerging nuclear energy systems currently have an impact mainly on vertical proliferation. The paper indicates that technologies connected with emerging nuclear energy systems, such as fusion reactors and accelerators, enhance the knowledge of thermonuclear weapon physics and will enable production of military useful nuclear materials (including some rare elements). At present such technologies are enhancing the arsenal of the nuclear weapon states. But one should not forget the future implications for horizontal proliferation of nuclear weapons as some of the techniques will in the near future be within the technological and economic capabilities of non-nuclear weapon states. Some of these systems are not under any international control. (orig.) [de

  7. A knowledge based system for training radiation emergency response personnel

    International Nuclear Information System (INIS)

    Kuriakose, K.K.; Peter, T.U.; Natarajan, A.

    1992-01-01

    One of the important aspects of radiation emergency preparedness is to impart training to emergency handling staff. Mock exercises are generally used for this purpose. But practical considerations limit the frequency of such exercises. A suitably designed computer software can be effectively used to impart training. With the advent of low cost personal computers, the frequency with which the training programme can be conducted is unlimited. A computer software with monotonic behaviour is inadequate for such training. It is necessary to provide human like tutoring capabilities. With the advances in knowledge based computer systems, it is possible to develop such a system. These systems have the capability of providing individualized training. This paper describes the development of such a system for training and evaluation of agencies associated with the management of radiation emergency. It also discusses the utility of the software as a general purpose tutor. The details required for the preparation of data files and knowledge base files are included. It uses a student model based on performance measures. The software is developed in C under MS-DOS. It uses a rule based expert system shell developed in C. The features of this shell are briefly described. (author). 5 refs

  8. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

    2011-01-01

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  9. Beyond Patient Monitoring: Conversational Agents Role in Telemedicine & Healthcare Support For Home-Living Elderly Individuals

    OpenAIRE

    Fadhil, Ahmed

    2018-01-01

    There is a need for systems to dynamically interact with ageing populations to gather information, monitor health condition and provide support, especially after hospital discharge or at-home settings. Several smart devices have been delivered by digital health, bundled with telemedicine systems, smartphone and other digital services. While such solutions offer personalised data and suggestions, the real disruptive step comes from the interaction of new digital ecosystem, represented by chatb...

  10. The Promise of Telemedicine for Movement Disorders: an Interdisciplinary Approach.

    Science.gov (United States)

    Ben-Pazi, H; Browne, P; Chan, P; Cubo, E; Guttman, M; Hassan, A; Hatcher-Martin, J; Mari, Z; Moukheiber, E; Okubadejo, N U; Shalash, A

    2018-04-13

    Advances in technology have expanded telemedicine opportunities covering medical practice, research, and education. This is of particular importance in movement disorders (MDs), where the combination of disease progression, mobility limitations, and the sparse distribution of MD specialists increase the difficulty to access. In this review, we discuss the prospects, challenges, and strategies for telemedicine in MDs. Telemedicine for MDs has been mainly evaluated in Parkinson's disease (PD) and compared to in-office care is cost-effective with similar clinical care, despite the barriers to engagement. However, particular groups including pediatric patients, rare MDs, and the use of telemedicine in underserved areas need further research. Interdisciplinary telemedicine and tele-education for MDs are feasible, provide similar care, and reduce travel costs and travel time compared to in-person visits. These benefits have been mainly demonstrated for PD but serve as a model for further validation in other movement disorders.

  11. Emergency towing systems for the Aleutian Islands, Alaska

    International Nuclear Information System (INIS)

    Pearson, L.A.; Brown, J.; Folley, G.; Robertson, T.; Bryant, B.

    2009-01-01

    Several incidents related to distressed or stricken vessels have occurred in the Aleutian Islands of Alaska, where vessel groundings have caused environmental and economic impacts. A disabled vessel workgroup was formed to discuss local emergency response solutions in the region, particularly for larger tramper or cargo vessels carrying fuel in bottom tanks. The Aleutian emergency towing system (ETS) group developed emergency towing capabilities for disabled vessels in the Aleutian Island sub-area using tugboats in conjunction with ETS equipment stationed in the town of Unalaska. Emergency towing systems were also purchased to serve a wider range of vessels. The ETS consisted of a lightweight towline, a messenger line to assist in deploying the towline, a line-launcher, a lighted buoy, and chafing gear. The components can be configured to deploy a disabled ship from the stern of a tugboat, or air-dropped via helicopter to a ship's deck. A procedures manual and training DVD has been published, and mobilization and deployment exercises are conducted annually. 1 ref., 2 figs

  12. Advances in e-health and telemedicine: strategy to bring health service users

    Directory of Open Access Journals (Sweden)

    Wilson Giovanni Jiménez Barbosa

    2015-08-01

    Full Text Available Background: The e-health and telemedicine have emerged as tools to facilitate access to health services, both populations far from the centres, and those who reside near them is not easily accessible or require constant controls by their professionals health traffickers. Objective: To reflect on the uses, progress and difficulties faced by Information and Communication Technologies (ICT as a strategy to bring health services to users. Methodology: qualitative hermeneutic research; advanced in two phases. The first, theoretical review by finding relevant articles in scientific databases. The second phase, critical analysis of literature found, in order to understand the dynamics generated from the use of ICT in the health sector, its current uses and prospected, and the risk that can generate its implementation for providers and patients. Results: The e-health and telemedicine have advanced in their development process andColombiahas not been outside, but there are still drawbacks of ethical, legal and operational order, which are not static and show great variation over time, becoming challenges are not independent but are associated with the dynamic progress of ICT. Conclusion: e-health and telemedicine are valid strategies to improve access to health services to communities. But require the development of processes to prevent, mitigate and / or exceed the inconveniences that may arise from its use. 

  13. 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.

  14. Application of a geographic information system for radiologic emergency response

    International Nuclear Information System (INIS)

    Best, R.G.; Doyle, J.F.

    1995-01-01

    A geographic information system (GIS) is a multifunctional analytical tool that can be used to compile available data and derive information. A GIS is a computerized database management system for the capture, storage, retrieval, analysis, and display of spatial data. Maps are the most common type of spatial data, but any type of data that can be referenced by an x-y location or geographic coordinate can be used in a GIS. In a radiological emergency, it is critical that data of all types be rapidly compiled into a common format in order to make accurate observations and informed decisions. Developing a baseline GIS for nuclear facilities would offer a significant incentive for all organizations to contribute to and utilize this powerful data management tool. The system being developed could integrate all elements of emergency planning, from the initial protective actions based on models through the emergency monitoring phase, and finally ending with the complex reentry and recovery phase. Within the Federal Radiological Monitoring and Assessment Center (FRMAC), there is a continuing effort to improve the data management and communication process. To demonstrate the potential of GIS for emergency response, the system has been utilized in interagency FRMAC exercises. An interactive GIS system has been deployed and used to analyze the available spatial data to help determine the impact of a hypothetical radiological release and to develop mitigation plans. For this application, both hardcopy and real-time spatial displays were generated with the GIS. Composite maps with different sizes, scales, and themes were produced to support the exercises

  15. Developing an electronic system to manage and track emergency medications.

    Science.gov (United States)

    Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

    2018-03-01

    The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. Robust tissue classification for reproducible wound assessment in telemedicine environments

    Science.gov (United States)

    Wannous, Hazem; Treuillet, Sylvie; Lucas, Yves

    2010-04-01

    In telemedicine environments, a standardized and reproducible assessment of wounds, using a simple free-handled digital camera, is an essential requirement. However, to ensure robust tissue classification, particular attention must be paid to the complete design of the color processing chain. We introduce the key steps including color correction, merging of expert labeling, and segmentation-driven classification based on support vector machines. The tool thus developed ensures stability under lighting condition, viewpoint, and camera changes, to achieve accurate and robust classification of skin tissues. Clinical tests demonstrate that such an advanced tool, which forms part of a complete 3-D and color wound assessment system, significantly improves the monitoring of the healing process. It achieves an overlap score of 79.3 against 69.1% for a single expert, after mapping on the medical reference developed from the image labeling by a college of experts.

  17. Access to expert stroke care with telemedicine: REACH MUSC

    Directory of Open Access Journals (Sweden)

    Abby Swanson Kazley

    2012-03-01

    Full Text Available Stroke is a leading cause of death and disability, and rtPA can significantly reduce the long-term impact of acute ischemic stroke (AIS if given within 3 hours of symptom onset. South Carolina is located in the stroke belt and has a high rate of stroke and stroke mortality. Many small rural SC hospitals do not maintain the expertise needed to treat AIS patients with rtPA. MUSC is an academic medical center using REACH MUSC telemedicine to deliver stroke care to 15 hospitals in the state, increasing the likelihood of timely treatment with rtPA. The purpose of this study is to determine the increase in access to rtPA through the use of telemedicine for AIS in the general population and in specific segments of the population based on age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality.We used a retrospective cross-sectional design examining Census data from 2000 and Geographic Information Systems (GIS analysis to identify South Carolina residents that live within 30 or 60 minutes of a Primary Stroke Center (PSC or a REACH MUSC site. We include all South Carolina citizens in our analysis and specifically examine the population’s age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality. Our sample includes 4,012,012 South Carolinians. The main measure is access to expert stroke care at a Primary Stroke Center (PSC or a REACH MUSC hospital within 30 or 60 minutes. We find that without REACH MUSC, only 38% of the population has potential access to expert stroke care in SC within sixty minutes given that most PSCs will maintain expert stroke coverage. REACH MUSC allows 76% of the population to be within sixty minutes of expert stroke care, and 43% of the population to be within 30 minute drive time of expert stroke care. These increases in access are especially significant for groups that have faced disparities in care and high rates of AIS. The use of telemedicine can

  18. Emergency air cleaning system development for LMFBR containments

    International Nuclear Information System (INIS)

    McCormack, J.D.; Hilliard, R.K.; Postma, A.K.; Muhlestein, L.D.

    1975-01-01

    Criteria for evaluating the various types of Emergency Air Cleaning Systems which may be used in LMFBR plants have been established for both single containment and containment-confinement arrangements. These two plant arrangements have quite different air cleaning requirements for postulated design base accident conditions. Work is currently in progress to select from a list of candidate air cleaning systems those which best meet the criteria requirements. By means of a weighted rating system, areas of strength or weakness can be found and the conceptual system design then optimized. The final system arrangements will be ranked and several of the most promising systems selected for large-scale tests in the former CSE vessel at Hanford. 8 references. (U.S.)

  19. Systems engineering approach towards performance monitoring of emergency diesel generator

    International Nuclear Information System (INIS)

    Nurhayati Ramli; Lee, Y.K.

    2013-01-01

    Full-text: Systems engineering is an interdisciplinary approach and means to enable the realization of successful systems. In this study, systems engineering approach towards the performance monitoring of Emergency Diesel Generator (EDG) is presented. Performance monitoring is part and parcel of predictive maintenance where the systems and components conditions can be detected before they result into failures. In an effort to identify the proposal for addressing performance monitoring, the EDG boundary has been defined. Based on the Probabilistic Safety Analysis (PSA) results and industry operating experiences, the most critical component is identified. This paper proposed a systems engineering concept development framework towards EDG performance monitoring. The expected output of this study is that the EDG reliability can be improved by the performance monitoring alternatives through the systems engineering concept development effort. (author)

  20. 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.

  1. Does nutritional counseling in telemedicine improve treatment outcomes for diabetes? A systematic review and meta-analysis of results from 92 studies.

    Science.gov (United States)

    Su, Dejun; McBride, Chelsea; Zhou, Junmin; Kelley, Megan S

    2016-09-01

    A growing number of studies and reviews have documented the impact of telemedicine on diabetes management. However, no meta-analysis has assessed whether including nutritional counseling as part of a telemedicine program has a significant impact on diabetes outcomes or what kind of nutritional counseling is most effective. Original research articles examining the effect of telemedicine interventions on HbA1c levels in patients with Type 1 or Type 2 diabetes were included in this study. A literature search was performed and 92 studies were retained for analysis. We examined stratified results by differentiating interventions using no nutritional counseling from those that used nutritional counseling. We further compared between nutritional counseling administered via short message systems (SMS) such as email and text messages, and nutritional counseling administered via telephone or videoconference. Telemedicine programs that include a nutritional component show similar effect in diabetes management as those programs that do not. Furthermore, subgroup analysis reveals that nutritional intervention via SMS such as email and text messages is at least as equally effective in reducing HbA1c when compared to personal nutritional counseling with a practitioner over videoconference or telephone. The inclusion of nutritional counseling as part of a telemedicine program does not make a significant difference to diabetes outcomes. Incorporating nutritional counseling into telemedicine programs via SMS is at least as effective as counseling via telephone or videoconference. © The Author(s) 2015.

  2. Emerging and Future Cyber Threats to Critical Systems

    OpenAIRE

    Djambazova , Edita; Almgren , Magnus; Dimitrov , Kiril; Jonsson , Erland

    2010-01-01

    Part 2: Adversaries; International audience; This paper discusses the emerging and future cyber threats to critical systems identified during the EU/FP7 project ICT-FORWARD. Threats were identified after extensive discussions with both domain experts and IT security professionals from academia, industry, and government organizations. The ultimate goal of the work was to identify the areas in which cyber threats could occur and cause serious and undesirable consequences, based on the character...

  3. Online Food Safety Information System for Nuclear or Radiological Emergencies

    International Nuclear Information System (INIS)

    Albinet, Franck; Adjigogov, Lazar; Dercon, Gerd

    2016-01-01

    Over the last year, the protocol with regards to data management and visualization requirements for food safety decision-making, developed under CRP D1.50.15 on R esponse to Nuclear Emergency Affecting Food and Agriculture , was further implemented. The development team moved away from early series of disconnected prototypes to a more advanced Information System integrating both data management and visualization components outlined in the agreed protocol

  4. Ecological user interface for emergency management decision support systems

    DEFF Research Database (Denmark)

    Andersen, V.

    2003-01-01

    The user interface for decision support systems is normally structured for presenting relevant data for the skilled user in order to allow fast assessment and action of the hazardous situation, or for more complex situations to present the relevant rules and procedures to be followed in order to ...... of this paper is to discuss the possibility of using the same principles for emergency management with the aim of improved performance in complex and unanticipated situations....

  5. 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.

  6. Application of geographic information system for emergency management

    International Nuclear Information System (INIS)

    Best, R.G.; Guber, A.L.; Kliman, D.H.

    1991-01-01

    One of the responsibilities of the DOE Nevada Operations Office, under the Federal Radiological Emergency Response Plan (FRERP) and the Aerial Measuring System (AMS) program, is the acquisition and analysis of radiological and associated environmental data. Much of the data are in the form of maps, tabular summaries, and vertical imagery. It is critical that these data be rapidly compiled into a common format in order to make accurate observations and informed decisions. This data management task is both large and complex. Within the Federal Radiological Monitoring and Assessment Center (FRMAC) there is a continuing effort to improve the data management and communication process. The most recent addition to this essential function has been the development and testing of a deployable Digital Image Processing (IP) / Geographic Information System (GIS). To demonstrate the potential of GIS for emergency response, the system was utilized at an interagency post-emergency table top exercise. A geographic database, consisting of 27 coregistered ''layers'' of cultural, radiological, satellite image,and environmental data was developed for the area within a 50-mile radius of the River Bend Station in Louisiana. In support of the exercise, maps and real time displays of individual layers and combinations of layers were produced to determine the impact of a hypothetical radiological release and to develop mitigation plans. 3 refs., 2 figs

  7. Meaning Emergence in the Ecology of Dialogical Systems

    Directory of Open Access Journals (Sweden)

    Trasmundi Sarah Bro

    2016-12-01

    Full Text Available 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; i.e. as an activity that does not presuppose inner cognitive operations. We pursue this line of thought by presenting an analysis of how a doctor and a nurse make a decision about a specific medical procedure (catheterisation based on meaning-making activity. As we do not see meaning as a linguistic (symbolic or a cognitive (representational phenomenon external to an agent/user, but as emergent in coordinated interaction, we zoom in on how the practitioners recalibrate the organism-environmentsystem by shift ing between a multi-agentive mode and an individual mode. We use Cognitive Event 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 of individual interpretation of symbolic content.

  8. The Principles Of Liability On Telemedicine Practices

    Directory of Open Access Journals (Sweden)

    Arman Anwar

    2016-09-01

    Full Text Available This research was aimed at analyzing and finding the principle of liability in telemedicine medical practice proportionally.This research is a legal research with the approach of statute approach, conceptual approach and comparative approach, as well as the approach to the case approach. According to Article 24 paragraph (1 of the 1945 Constitution and Article 5 (1 of Act No. 48 of 2009 on Judicial Authority, determine that the judge shall explore, and understand the legal values and sense of justice in society. Thus Article 1367 paragraph (3 BW and Article 46 of Act No. 44 of 2009 on Hospitals in the application must be in the context of the intended. The principle of liability risk in medical practice telemedicine in proportion refers to professional liability among medical practitioners telemedicine. The theoretical legitimacy is based on professional relationships in the delegation of medical action based on the code of ethics, professional standards, and service standards, and standard operating procedures. Consequences on liability does not necessarily have to be based on errors primary physician (primary care physician / PCP or primary nurse as subordinate as mean vicarious liability doctrine. Nomenclature "proportional" in a significant liability risk as the distribution of rights and obligations of professionals in proportion to each party's fault based on the values of equality (equitability, feasibility and appropriateness (fair and reasionableness. Accountability based on the viewpoint of interactive justice according to the values of professional skill, prudence or accuracy, responsibility, and colleague and the desire to do good for the sake of healing patients (doing good.

  9. Application of Robotic System for Emergency Response in NPP

    International Nuclear Information System (INIS)

    Jeong, Kyung Min; Seo, Yong Chil; Shin, Ho Chul; Lee, Sung Uk; Cho, Jae Wan; Choi, Young Soo; Kim, Chang Hoi; Kim, Seung Ho

    2010-01-01

    Increasing energy demand and concerns over climate change make increasing use of nuclear power plant in worldwide. Even though the probability of accident is greatly reduced, safety is the highest priority issue in the nuclear energy industry. Applying highly reliable and conservative 'defense in depth' concepts with the design and construction of NPP, there are very little possibilities with which accidents are occur and radioactive materials are released to environments in NPP. But NPP have prepared with the emergency response procedures and conduct exercises for post-accident circumstance according to the procedures. The application of robots for emergency response task for post-accident in nuclear facilities is not a new concept. Robots have been sent to recover the damaged reactor at Chernobyl where human workers could receive a lifetime dose of radiation in minutes. Based on NRC's TMI-2 Cleanup Program, several robots were built in the 1980s to help gather information and remove debris from a reactor at the Three Mile Island nuclear power plant that partially melted down in 1979. The first robot was lowered into the basement through a hatch and human operators monitoring in a control room drove it through mud, water and debris, capturing the initial post-accident images of the reactor's basement. It was used for several years equipped with various tools allowing it to scour surfaces, scoop samples and vacuum sludge. A second version carried a core sampler to determine the intensity and depth of the radiation that had permeated into the walls. To perform cleanup tasks, they built Workhorse that featured system redundancy and had a boom extendable to reach high places, but it was never used because it had too many complexities and to clean and fix. While remote robotics technology has proven to remove the human from the radioactive environment, it is also difficult to make it useful because it may requires skill about remote control and obtaining remote

  10. Application of Robotic System for Emergency Response in NPP

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kyung Min; Seo, Yong Chil; Shin, Ho Chul; Lee, Sung Uk; Cho, Jae Wan; Choi, Young Soo; Kim, Chang Hoi; Kim, Seung Ho [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2010-10-15

    Increasing energy demand and concerns over climate change make increasing use of nuclear power plant in worldwide. Even though the probability of accident is greatly reduced, safety is the highest priority issue in the nuclear energy industry. Applying highly reliable and conservative 'defense in depth' concepts with the design and construction of NPP, there are very little possibilities with which accidents are occur and radioactive materials are released to environments in NPP. But NPP have prepared with the emergency response procedures and conduct exercises for post-accident circumstance according to the procedures. The application of robots for emergency response task for post-accident in nuclear facilities is not a new concept. Robots have been sent to recover the damaged reactor at Chernobyl where human workers could receive a lifetime dose of radiation in minutes. Based on NRC's TMI-2 Cleanup Program, several robots were built in the 1980s to help gather information and remove debris from a reactor at the Three Mile Island nuclear power plant that partially melted down in 1979. The first robot was lowered into the basement through a hatch and human operators monitoring in a control room drove it through mud, water and debris, capturing the initial post-accident images of the reactor's basement. It was used for several years equipped with various tools allowing it to scour surfaces, scoop samples and vacuum sludge. A second version carried a core sampler to determine the intensity and depth of the radiation that had permeated into the walls. To perform cleanup tasks, they built Workhorse that featured system redundancy and had a boom extendable to reach high places, but it was never used because it had too many complexities and to clean and fix. While remote robotics technology has proven to remove the human from the radioactive environment, it is also difficult to make it useful because it may requires skill about remote control and

  11. Design and development of a customizable telemedicine platform for improving access to healthcare for underserved populations.

    Science.gov (United States)

    Goel, Neha A; Alam, Amal A; Eggert, Emily M R; Acharya, Soumyadipta

    2017-07-01

    Telemedicine offers a method to bridge the healthcare access gap in low and middle income countries (LMICs) by connecting providers with patients using appropriate technology. Here we describe the design and development of a novel modular telemedicine platform, Intelehealth, that would enable health systems to connect remote doctors with patients in rural clinics using a customizable Android-based platform and a cloud-based electronic health record system at the backend (OpenMRS). This open source platform enables task shifting of medically relevant information gathering by a local health worker, transmission of this information to a remote doctor, and a telephonic conversation between the doctor and the patient that subsequently allows for delivery of an appropriate therapeutic plan. Intelehealth is designed to operate on a low bandwidth internet environment, and will be tested and validated in rural health clinics in India.

  12. 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.

  13. Emergency core cooling system for a fast reactor

    International Nuclear Information System (INIS)

    Johnson, H.G.; Madsen, R.N.

    1976-01-01

    The main heat transport system for a liquid-metal-cooled nuclear reactor is constructed with elevated piping and guard vessels or pipes around all components of the system below the elevation of the elevated piping so the head developed by the pumps at emergency motor speed will be unsufficient to lift the liquid-metal-coolant over the top of the guard tanks or pipes or out of the elevated piping in the event of a loss-of-coolant accident. In addition, inlet downcomers to the reactor vessel are contained within guard standpipes having a clearance volume as small as practicable. 4 claims, 2 drawing figures

  14. Use of fiber optics in an emergency response data system

    International Nuclear Information System (INIS)

    Mahaffey, J.A.; Wahab, E.Z.

    1988-01-01

    An optical fiber communications medium has been installed in the Emergency Response Data Systems (ERDS) in the E. I. Hatch Nuclear Power Plant. These high-speed, digital communications systems are used to link together two data-collection nodes in each of two computer networks, so that the plant operating data may be shared on a real-time basis. The use of a glass-and-plastic fiber for data communications may have several advantages over a metallic medium in this special application, and it has proven to be a very reliable means of data linkage over several unit-years of operation

  15. 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.

  16. Hanford Site Emergency Alerting System siren testing report

    International Nuclear Information System (INIS)

    Weidner, L.B.

    1997-01-01

    The purpose of the test was to determine the effective coverage of the proposed upgrades to the existing Hanford Site Emergency Alerting System (HSEAS). The upgrades are to enhance the existing HSEAS along the Columbia River from the Vernita Bridge to the White Bluffs Boat Launch as well as install a new alerting system in the 400 Area on the Hanford Site. Five siren sites along the Columbia River and two sites in the 400 Area were tested to determine the site locations that will provide the desired coverage

  17. 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.

  18. 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.

  19. 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.

  20. 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.