WorldWideScience

Sample records for health telematics telemedicine

  1. European health telematics networks for positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kontaxakis, George [Universidad Politecnica de Madrid, ETSI Telecomunicacion, Madrid 28040 (Spain)]. E-mail: g.kontaxakis@upm.es; Pozo, Miguel Angel [Centro PET Complutense, Madrid 28040 (Spain); Universidad Complutense de Madrid, Instituto Pluridisciplinar, Madrid 28040 (Spain); Ohl, Roland [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Darmstadt 64283 (Germany); Visvikis, Dimitris [U650 INSERM, Lab. du Traitement de L' Information Medicale, University of Brest Occidentale, CHU Morvan, Brest 29609 (France); Sachpazidis, Ilias [Fraunhofer Institute for Computer Graphics, Darmstadt 64283 (Germany); Ortega, Fernando [Fundacion Instituto Valenciano de Oncologia, Valencia 46009 (Spain); Guerra, Pedro [Universidad Politecnica de Madrid, ETSI Telecomunicacion, Madrid 28040 (Spain); Cheze-Le Rest, Catherine [Dept. Medicine Nucleaire, CHU Morvan, Brest 29609 (France); Selby, Peter [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Darmstadt 64283 (Germany); Pan, Leyun [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg 69120 (Germany); Diaz, Javier [Fundacion Instituto Valenciano de Oncologia, Valencia 46009 (Spain); Dimitrakopoulou-Strauss, Antonia [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg 69120 (Germany); Santos, Andres [Universidad Politecnica de Madrid, ETSI Telecomunicacion, Madrid 28040 (Spain); Strauss, Ludwig [German Cancer Research Centre, Clinical Cooperation Unit Nuclear Medicine, Heidelberg 69120 (Germany); Sakas, Georgios [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Darmstadt 64283 (Germany); Fraunhofer Institute for Computer Graphics, Darmstadt 64283 (Germany)

    2006-12-20

    A pilot network of positron emission tomography centers across Europe has been setup employing telemedicine services. The primary aim is to bring all PET centers in Europe (and beyond) closer, by integrating advanced medical imaging technology and health telematics networks applications into a single, easy to operate health telematics platform, which allows secure transmission of medical data via a variety of telecommunications channels and fosters the cooperation between professionals in the field. The platform runs on PCs with Windows 2000/XP and incorporates advanced techniques for image visualization, analysis and fusion. The communication between two connected workstations is based on a TCP/IP connection secured by secure socket layers and virtual private network or jabber protocols. A teleconsultation can be online (with both physicians physically present) or offline (via transmission of messages which contain image data and other information). An interface sharing protocol enables online teleconsultations even over low bandwidth connections. This initiative promotes the cooperation and improved communication between nuclear medicine professionals, offering options for second opinion and training. It permits physicians to remotely consult patient data, even if they are away from the physical examination site.

  2. The doctor-patient relationship in telemedicine and mobile health

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    Gianluca Montanari Vergallo

    2017-02-01

    Full Text Available Telemedicine falls under the broader term of eHealth and involves the delivery of health care services, where distance is a critical factor. Thanks to telemedicine patients can access treatments that would otherwise be unavailable. The authors focus on whether doctor-patient relationship exist in telemedicine and mobile health. The answer should be found on a case-by-case basis. There is a doctor-patient relationship when the two are connected, possibly electronically, for purposes related to the prevention, diagnosis or treatment of diseases. But the doctor-patient relationship is absent when the patient downloads apps to self diagnose rather than seeing a doctor. These apps encourage the use of ‘DIY’ medicine, making the doctor superfluous and can often lead to misdiagnosis and misunderstanding. Informed consent to the use of telemedicine should have the same prerequisites as those used in traditional medical practice. However, telemedicine requires some additional information: risks related to the privacy of personal data and precautionary measures to reduce them; further risks involved in the use of technology (for example, quality and efficiency of the telematic tools. With regards to the processing of personal data in mobile health, informed consent should be even more specific than that for medical treatment via telemedicine. In order to respect the requirement of specificity, the app should be structured in a way that allows the user to express consent for each type of data that the app intends to collect. But such a solution presents various difficulties. In conclusion, direct contact between a doctor and their patient should continue to be the preferred practice with which to carry out the relationship. Telemedicine can be used when it is deemed to be in the best interest of the patient, for example when it can offer the possibility of surgical treatment otherwise unavailable, or where contact is not possible.

  3. Telemedicine

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    ... Looking for Health Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Your Child's Development ( ... is already happening. It's called telemedicine — and it's changing the way health care is done. What Is ...

  4. [Telematics in the public health sector. Where is the protection of health data?].

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    Voßhoff, Andrea; Raum, Bertram; Ernestus, Walter

    2015-10-01

    There is a long history of telematics in the German health system. Apart from the growing technical possibilities in the field, it is important to concentrate on the protection of health data in telematics applications. Health data in the hands of service providers or other third parties entails certain risks for the patient's personality rights, because these institutions may not be bound by the practice of medical confidentiality. In addition, big data processing risks make the individual lives of patients and insured persons totally transparent. Measures to reduce these risks have to be taken by the providers as well as by the users of telematics infrastructure; they are the ones who should explicitly address the relevant risks and dangers in a data protection and IT-security concept and develop adequate strategies to cope with these dangers. Additionally, the German legislator remains obliged to create a regulatory framework for the protection of patients' rights.

  5. OTE-TS--a new value-added telematics service for telemedicine applications.

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    Karavatselou, E I; Economou, G P; Chassomeris, C A; Danelli-Mylonas, V; Lymberopoulos, D K

    2001-09-01

    A new telemedicine service denoted as the Hellenic Telecommunication Organization Telemedicine Service (OTE-TS), which addresses an open multidisciplinary group of medical care providers (users), is presented in this paper. OTE-TS is supported by the Hellenic Telecommunication Organization (OTE) and is the result of the close collaboration of engineers, medical doctors, and market analysts. Its architecture provides the user with an integrated electronic working domain handling diverse types of conversational audiovisual information and medical records. It includes a stack of functions, protocols, and interfaces for data acquisition, processing, and display, and for the composition of dial-up multiparty cooperation schemes (synchronous or asynchronous), suitable for the coordination and management of high-level consult, report, and review activities. The service provider (i.e., the OTE) performs the central administration and maintenance of the service, as well as the management of medical cases and reports that are exchanged among the users. The service has been extensively tested in real-world conditions.

  6. Telemedicine and rural health care applications

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    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.

  7. Telemedicine and competitive change in health care.

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    LaMay, C L

    1997-01-01

    Telemedicine--the delivery of health care services to the underserved through communications technologies--has the potential to bring medical care to remote areas where health care is either inadequate or nonexistent. Telemedicine can be something as simple as a phone call, a network transmission of a radiograph or other diagnostic image, or, much more advanced, realtime video surgical consultations from anywhere on the globe. Telemedicine programs operate throughout Europe, Japan, and Australia. International programs, for profit and nonprofit, serve Asia, Africa, and the Middle East. The United States is also a major telemedicine developer, principally through government agencies such as the Department of Defense and the Office of Rural Health Policy, and, to a lesser extent, the private sector. But telemedicine in the United States has yet to prove itself economically viable, and it faces a number of political and regulatory barriers. Even more significantly, telemedicine's potential to increase overall health care spending by increasing access to health care has deterred private industry from investing heavily in it. In the short term, telemedicine's most important contribution to health care may be raising fundamental questions about United States health care policy.

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

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    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

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

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    Kyriacou, E; Pavlopoulos, S; Berler, A; Neophytou, M; Bourka, A; Georgoulas, A; Anagnostaki, A; Karayiannis, D; Schizas, C; Pattichis, C; Andreou, A; Koutsouris, D

    2003-03-24

    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 different countries using a

  10. Implementation of safety driving system using e-health and telematics technology.

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    Lee, Youngbum; Lee, Myoungho

    2008-08-01

    This research aimed to develop a safety driving system using e-health and telematics technology. Biosignal sensors were installed in an automobile to check the driver's health status with an automatic diagnosis system providing health information to the driver. Measured data were sent to the e-health center through a telematics device, and a medical doctor analyzed these data, sending diagnosis and prescription information to the driver. This system recognizes the driver's sleeping, drinking impairment, excitability, and fatigue using biosensors. The system initially provides alerts in the automobile. It also controls the driving environment in the car, searches for a highway service area using Global Positioning System (GPS), and provides additional information for safety driving. If a car accident has occurred, it makes an emergency call to the nearest hospital, emergency center, and insurance company. A conceptual and prototype model for an imbedded system is presented with initial data for driver condition. Such a system could prevent car accidents caused by drivers driving while intoxicated and falling asleep at the wheel using the driver's biosignals measured by biosensors. The system can provide various e-health services using a telematics system to enhance the technical compatibility of the automobile.

  11. Level of response to telematic questionnaires on Health Related Quality of Life on total knee replacement.

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    Besalduch-Balaguer, M; Aguilera-Roig, X; Urrútia-Cuchí, G; Puntonet-Bruch, A; Jordan-Sales, M; González-Osuna, A; Celaya-Ibáñez, F; Colomina-Morales, J

    2015-01-01

    Questionnaires measuring health-related quality of life are difficult to perform and obtain for patients and professionals. Computerised tools are now available to collect this information. The objective of this study was to assess the ability of patients undergoing total knee replacement to fill in health-related quality-of-life questionnaires using a telematic platform. Ninety eight consecutive patients undergoing total knee arthroplasty were included. Participants were given an access code to enter the website where they had to respond to 2 questionnaires (SF8 and the reduced WOMAC), and 3 additional questions about the difficulty in completing the questionnaires. A total of 98 patients agreed to participate: 45 males and 53 females (mean age 72.7 years). Fourteen did not agree to participate due to lack of internet access. Of the final 84 participants, 50% entered the website, and only 36 answered all questions correctly. Of the patients who answered the questionnaire, 80% were helped by a relative or friend, and 22% reported difficulty accessing internet. The use of telematic systems to respond to health-related quality of life questionnaires should be used cautiously, especially in elderly population. It is likely that the population they are directed at is not prepared to use this type of technology. Therefore, before designing telematics questionnaires it must be ensured that they are completed properly. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Potentials of telemedicine for green health care

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    Heinrich Audebert

    2010-08-01

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

  13. A telemedicine health care delivery system

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    Sanders, Jay H.

    1991-01-01

    The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

  14. An Architecture for Integrated Regional Health Telematics Networks

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    2007-11-02

    information society technologies are likely to have a significant impact include those of pre-hospital health emergencies, remote monitoring of patients with...user-oriented services, in the context of the emerging global information society , will be supported by a healthcare information infrastructure, which

  15. Telemedicine

    Science.gov (United States)

    ... a tablet, kids today are connected. Technology is woven into the fabric of their lives — and their ... Phone apps, digital watches, and other wearable devices now record health data, such as blood-glucose readings ...

  16. Telemedicine can improve the health of youths in detention.

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    Fox, Karen C; Whitt, Anna Lyn

    2008-01-01

    Young people in correctional care facilities often have physical or psychological disorders that contribute to their behavioural problems. In the US, the need for medical services in youth facilities far exceeds current resources, especially for paediatric mental health and specialty services. There is obvious potential for telemedicine to improve access to care and thus the level of health care for juvenile detainees. A few studies have indicated that in specific instances telemedicine has improved access to care, referrals, contact between providers, and has also reduced unnecessary referrals. The question remains, however, whether this improved access and timeliness to care has any effect on the major goals of the incarceration: treatment, education and rehabilitation. Further investigation of this linkage is needed.

  17. TELEMEDICINE AND E-HEALTH: TODAY AND TOMORROW

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    Deepti K

    2015-10-01

    Full Text Available Telemedicine is a generic term referring to all forms of medical information exchange, including a variety of telecommunication technologies. Applications in health and medical care include tele-communication, data and information technique are used to transfer medical information. The challenges facing developing countries (like India in delivering high-quality medical care during the next century are great. Overcoming poverty, difficult access to medical care, governmental instability, lack of trained physicians, and a large burden of existing and emerging diseases all appear at times insurmountable.

  18. Telemedicine and e-health: Today and Tomorrow

    Directory of Open Access Journals (Sweden)

    Deepti

    2014-11-01

    Full Text Available Telemedicine is a generic term referring to all forms of medical information exchange, including a variety of telecommunication technologies. Applications in health and medical care include tele-communication, data and information technique are used to transfer medical information. The challenges facing developing countries (like India in delivering high-quality medical care during the next century are great. Overcoming poverty, difficult access to medical care, governmental instability, lack of trained physicians, and a large burden of existing and emerging diseases all appear at times insurmountable.

  19. Telemedicine in Primary Health: The Virtual Doctor Project Zambia

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    Mustarde Paul

    2011-05-01

    Full Text Available Abstract This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO]. This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront.

  20. Health in old age, and patients’ approaches to telemedicine in Poland

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    Leszek Buliński

    2017-06-01

    In Poland in ageing there still dominates the experience of multiple ailments and polytherapy, something which justifies a search for new, easily accessible, and economically sound solutions for health care. Telemedicine is a promising solution although there is a need for concrete steps to be taken to raise willingness amongst geriatric patients to take advantage of telemedicine.

  1. An evolutionary examination of telemedicine: a health and computer-mediated communication perspective.

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    Breen, Gerald-Mark; Matusitz, Jonathan

    2010-01-01

    Telemedicine, the use of advanced communication technologies in the healthcare context, has a rich history and a clear evolutionary course. In this paper, the authors identify telemedicine as operationally defined, the services and technologies it comprises, the direction telemedicine has taken, along with its increased acceptance in the healthcare communities. The authors also describe some of the key pitfalls warred with by researchers and activists to advance telemedicine to its full potential and lead to an unobstructed team of technicians to identify telemedicine's diverse utilities. A discussion and future directions section is included to provide fresh ideas to health communication and computer-mediated scholars wishing to delve into this area and make a difference to enhance public understanding of this field.

  2. Telematics and nursing: does the German electronic Health Card improve patient care for persons with nursing needs?

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    Hübner, Ursula

    2006-02-01

    Full Text Available Current developments towards a German electronic Health Card raise the question whether the card is capable of improving care also for persons with special nursing needs including short-term as well as long-term care patients. The aging of the population - also in Germany - is coupled with an increase in the number of long-term care patients. They are patients who need medical as well as nursing care and who often need care provided by changing care settings (ambulatory care/home care vs. hospital during the course of their illness. Nursing Science has been recognizing the importance of an uninterrupted way of providing patient care (continuity of care as a central issue and has been developing concepts and instruments for case management and discharge management. Both approaches provide mechanisms proven under real life conditions for transferring patients safely from one to another setting. Although nursing telematics covers a wide range of topics, from semantic interoperability to telecare solutions, its primary applications, namely case management and discharge management, are only poorly supported by information and communication technology. It is therefore not surprising, that the electronic Health Card in Germany was planned without making any reference to case management and discharge management. Current concepts for the applications of the card simply ignore the scenario of transferring patients with special nursing needs between care settings. Though adjustments of the legal foundations of the electronic Health Card had been made recently, nurses will still not be able to exchange nursing summaries electronically by means of the card because nurses working in nursing homes and for ambulatory nursing services have no access rights for the data on the card. The full exploitation of the card and its potential for innovation does not only depend, however, on granting access rights to all nurses but also on issuing electronic Health

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

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    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. 

  4. Telemedicine Facilitates CHF Home Health Care for Those with Systolic Dysfunction

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    Pennie S. Seibert

    2008-01-01

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

  5. The role of telemedicine and e-health in the management of inflammatory bowel disease: improving patient outcomes

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    Ghazi LJ

    2015-01-01

    Full Text Available Leyla J Ghazi,1,2 Raymond K Cross1 1Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, 2Veterans Affairs, Maryland Heath Care System, Baltimore, MD, USA Abstract: Telemedicine has been used successfully in monitoring patients with a variety of chronic illnesses. Studies in the field of gastroenterology have shown that telemedicine is a feasible and well accepted method of patient monitoring. Several inflammatory bowel disease (IBD centers have developed telemedicine systems to improve the management of these complex diseases. Implementation of these systems is feasible, and telemedicine is well received by patients. Telemedicine has been shown to improve disease activity, quality of life, adherence with short-term treatment, and to shorten relapses. Telemedicine has also been shown to decrease health care utilization; however, use of telemedicine systems is also associated with increased “non-billable” encounters (phone calls and electronic messages. Telemedicine has also been shown to be an effective mechanism to provide remote care in areas without access to IBD specialty care. It is likely that telemedicine will be increasingly utilized in the future as an adjunct to traditional monitoring, especially for patients at high risk for nonadherence, and for those with limited access to IBD centers of excellence, to improve patient self-management, and as a mechanism to provide education, health maintenance, and medication reminders to patients. Keywords: IBD, patient self-management, remote care, adherence to treatment, quality of life, health care utilization, telemedicine

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

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    Abidi, S S; Yusoff, Z

    1999-01-01

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

  7. Telematics Options and Capabilities

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    Hodge, Cabell [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-05

    This presentation describes the data tracking and analytical capabilities of telematics devices. Federal fleet managers can use the systems to keep their drivers safe, maintain a fuel efficient fleet, ease their reporting burden, and save money. The presentation includes an example of how much these capabilities can save fleets.

  8. Telemedicine, Telehealth and m-Health: New Frontiers in Medical Practice

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    Elizabeth A. Krupinski

    2014-06-01

    Full Text Available Telemedicine is changing the practice of medicine. It is part of the ever-growing use of communications technology in health care being used in prevention, disease management, home health care, long-term (chronic care, emergency medicine, remote medical imaging, and many other applications. The pace at which telemedicine is being adopted and integrated into the healthcare enterprise is exponential and, for many (even those in the field!, it is often difficult to keep up with all of the changes occurring. Thus, it is useful periodically to stand back and summarize recent advances, to take stock, analyze where we have been, and project where we are headed. [...

  9. Telemedicine: The Up Side, and . . .

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    Risser, Joseph

    1998-01-01

    Explores universities involved with training in telemedicine and medical care provided through technology (International Telemedicine Center Inc. www.int-telemedicine.com/univ.html). Discusses the market for telemedicine, companies and university medical centers involved in its development, costs and savings to health care system, barriers to the…

  10. Network design for telemedicine--e-health using satellite technology.

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    Graschew, Georgi; Roelofs, Theo A; Rakowsky, Stefan; Schlag, Peter M

    2008-01-01

    Over the last decade various international Information and Communications Technology networks have been created for a global access to high-level medical care. OP 2000 has designed and validated the high-end interactive video communication system WinVicos especially for telemedical applications, training of the physician in a distributed environment, teleconsultation and second opinion. WinVicos is operated on a workstation (WoTeSa) using standard hardware components and offers a superior image quality at a moderate transmission bandwidth of up to 2 Mbps. WoTeSa / WinVicos have been applied for IP-based communication in different satellite-based telemedical networks. In the DELTASS-project a disaster scenario was analysed and an appropriate telecommunication system for effective rescue measures for the victims was set up and evaluated. In the MEDASHIP project an integrated system for telemedical services (teleconsultation, teleelectro-cardiography, telesonography) on board of cruise ships and ferries has been set up. EMISPHER offers an equal access for most of the countries of the Euro-Mediterranean area to on-line services for health care in the required quality of service. E-learning applications, real-time telemedicine and shared management of medical assistance have been realized. The innovative developments in ICT with the aim of realizing a ubiquitous access to medical resources for everyone at any time and anywhere (u-Health) bear the risk of creating and amplifying a digital divide in the world. Therefore we have analyzed how the objective needs of the heterogeneous partners can be joined with the result that there is a need for real integration of the various platforms and services. A virtual combination of applications serves as the basic idea for the Virtual Hospital. The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre

  11. Telematics Simulation: Recent Developments & Issues.

    Science.gov (United States)

    Sutherland, Janet; Ekker, Knut; Morgan, Konrad; Crookall, David; Carbonell, Amparo Garcia

    Recent developments in Internet technologies have enabled new, more flexible forms of telematic simulation and have raised issues that were not considered in the early days of networked learning. Ultimately, these questions revolve around: (1) the learning cost-effectiveness of telematic simulation (quality and quantity of learning as opposed to…

  12. Third Intensive Balkan Telemedicine and e-Health Seminar

    Science.gov (United States)

    2009-03-01

    healthcare providers, telemedicine is a significant tool. Every clinical discipline from pre-anesthesia consultation to robotic surgery and emergency...Conclusion: Distance is meaningless Prof. Marescau at work • Accomplishment‐ there were not  possible before Robotic Surgery • Dexterity enhanced...physician ratings be a factor?? 31 Telementoring Examples • Urology • Neurosurgery - endo-nasal surgery (UPMC) 7 • Remote robotic surgery • Laparoscopic rooms

  13. Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services, India

    Science.gov (United States)

    Acharya, Rajesh V.; Rai, Jasuma J.

    2016-01-01

    Introduction: Telemedicine incorporates electronic information and medical technology. It connects healthcare through vast distances which would benefit both patients and doctors. The aim of this questionnaire study was to evaluate the effects of telemedicine on patients and medical specialists. Methods: A cross-sectional study was conducted among 122 participants (71 patients and 51 doctors) on satisfaction in quality of service, cost-effectiveness, and problems encountered in healthcare provided by the telemedicine in Apollo Tele Health Services, Hyderabad, Telangana, India. The data for each group were calculated and compared. Results: About 80% patients and all the doctors reported their satisfaction on the quality of treatment given through telemedicine. Approximately, 90% of the participants found telemedicine cost-effective and 61% of the doctors found an increase in patient's inflow apart for their regular practice. Problems encountered in telemedicine were 47% in technical issues and 39% in time scheduling by doctors and 31% of patients were uncomfortable to face the camera, and 24% had technical issues. Conclusions: The results of the present study showed that telemedicine in healthcare could prove to be useful to patients in distant regions and to rural doctors in India. In the near future, telemedicine can be considered as an alternate to face to face patient care.

  14. Telemedicine, the effect of nurse-initiated telephone follow up, on health status and health-care utilization in COPD patients : A randomized trial

    NARCIS (Netherlands)

    Berkhof, Farida F.; van den Berg, Jan W. K.; Uil, Steven M.; Kerstjens, Huib A. M.

    2015-01-01

    Background and objectiveTelemedicine, care provided by electronic communication, may serve as an alternative or extension to traditional outpatient visits. This pilot study determined the effects of telemedicine on health-care utilization and health status of chronic obstructive pulmonary disease (C

  15. Third intensive Balkan telemedicine and e-health seminar: current principles and practices of telemedicine and e-health--clinical applications and evidence-based outcomes: International Conference on Telemedicine and e-Health February 6-7, 2009 Skopje, Macedonia.

    Science.gov (United States)

    Doarn, Charles R; Latifi, Rifat; Hadeed, George; Haxhihamza, Kadri; Bekteshi, Flamur; Lecaj, Ismet

    2009-05-01

    The region, which consists of the countries of Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Kosova, Macedonia, Montenegro, and Serbia, takes its name from the mountain range, the Balkans. The Balkans, a Turkish word for "chain of wooded mountains," covers an area of 700,000 km(2) region in Southeastern Europe and is home to over 55 million inhabitants. A decade of war and ethnic fighting in the 1990s destroyed the medical systems in place, creating a desperate need to rebuild a modern healthcare infrastructure. Telemedicine has been shown to be an effective tool in this regard. The adoption of telemedicine in the Balkans is firmly under way. Since its inception in 2001, the International Virtual e-Hospital (IVeH) has promoted the design, growth, and implementation of telemedicine in a variety of developing countries across the globe. Successful implementation of telemedicine in any region is based on a number of factors, each of great importance. However, one that is key is the education and training of community leadership. Over the past several years, the IVeH has held intensive seminars in the region to promote the application of telemedicine as an effective tool in healthcare modernization. This includes the First Intensive Balkan Telemedicine and e-Health Seminar in Prishtina, Kosova (2002) and the Second Intensive Balkan Telemedicine and e-Health Seminar in Tirana, Albania (2007). Recently, the third installment of these seminars was held in Skopje, Macedonia (February 2009). These three seminars have provided a fertile foundation for telemedicine to emerge as a significant tool in enhancing healthcare in this region. Each has broadened the understanding of the immense capability that telemedicine can offer and has acted as a catalyst for the development of telemedicine in the region. The Republic of Macedonia is the latest country to invest in telemedicine, having a formal commitment from the Ministry of Health to establish a national

  16. [Telemedicine in acute stroke care--a health economics view].

    Science.gov (United States)

    Günzel, F; Theiss, S; Knüppel, P; Halberstadt, S; Rose, G; Raith, M

    2010-05-01

    Specialized stroke units offer optimal treatment of patients with an acute stroke. Unfortunately, their installation is limited by an acute lack of experienced neurologists and the small number of stroke patients in sparsely populated rural areas. This problem is increasingly being solved by the use of telemedicine, so that neurological expertise is made available to basic and regular care. It has been demonstrated by national and international pilot studies that solidly based and rapid decisions can be made by telemedicine regrading the use of thrombolysis, as the most important acute treatment, but also of other interventions. So far studies have only evaluated improvement in the quality of care achieved by networking, but not of any lasting effect on any economic benefit. Complementary to a medical evaluation, the qualitative economic assessment presented here of German and American concepts of telemetric care indicate no difference in efficacy between various ways of networking. Most noteworthy, when comparing two large American and German studies, is the difference in their priorities. While the American networks achieved targeted improvements in efficacy of care that go beyond the immediate wishes of the doctors involved, this was of only secondary importance in the German studies. Also, in contrast to several American networks, the German telemetry networks have not tended to be organized for future growth. In terms of economic benefits, decentralized organized networks offer a greater potential of efficacy than purely local ones. Furthermore, the integration of inducements into the design of business models is a fundamental factor for achieving successful and lasting existence, especially within a highly competitive market.

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

    Directory of Open Access Journals (Sweden)

    Stela Vujosevic

    2016-01-01

    Full Text Available In Italy, the number of people living with diabetes is about 3.5 million (5.5% of the population, with an increase by about 60% in the last 20 years and with 1 person out of 3 older than 65 years. The Italian Health Service system estimates that 10 billion euros is spent annually on caring for patients with diabetes, a figure that increases yearly. No national data on prevalence and incidence of legal blindness in patients with diabetes and no national registry of patients with diabetic retinopathy (DR are currently available. However, the available epidemiological data (in several locations throughout the country are consistent with those reported in other European countries. The use of telemedicine for the screening of DR in Italy is confined to geographically limited locations. The available data in the literature on implementation and use of telematic screening proved to be successful from patient, caregiver, and authorities point of view. This review addresses the available epidemiological data on DR and telematic screening realities in Italy and thus may help in establishing a national screening program.

  19. Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

    Science.gov (United States)

    Midena, Edoardo

    2016-01-01

    In Italy, the number of people living with diabetes is about 3.5 million (5.5% of the population), with an increase by about 60% in the last 20 years and with 1 person out of 3 older than 65 years. The Italian Health Service system estimates that 10 billion euros is spent annually on caring for patients with diabetes, a figure that increases yearly. No national data on prevalence and incidence of legal blindness in patients with diabetes and no national registry of patients with diabetic retinopathy (DR) are currently available. However, the available epidemiological data (in several locations throughout the country) are consistent with those reported in other European countries. The use of telemedicine for the screening of DR in Italy is confined to geographically limited locations. The available data in the literature on implementation and use of telematic screening proved to be successful from patient, caregiver, and authorities point of view. This review addresses the available epidemiological data on DR and telematic screening realities in Italy and thus may help in establishing a national screening program. PMID:27990441

  20. 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.

  1. The 60 most highly cited articles published in the Journal of Telemedicine and Telecare and Telemedicine Journal and E-health.

    Science.gov (United States)

    Askari, Azam; Khodaie, Mahdieh; Bahaadinbeigy, Kambiz

    2014-01-01

    We analysed the most highly cited articles in two specialist telemedicine journals, the Journal of Telemedicine and Telecare (JTT) and Telemedicine Journal and E-health (TJEH). Articles were extracted from the Science Citation Index Expanded in September 2012. A total of 1810 articles were listed for the JTT and 1550 for TJEH. In the JTT, the mean number of citations was 43 (SD 13); in TJEH the mean number of citations was 30 (SD 11). The average number of citations for the JTT was significantly higher than for TJEH (P journal, the 60 articles which had the most citations were identified as highly cited publications (HCPs). The 60 HCPs in the JTT originated from 16 countries; the 60 HCPs in TJEH originated from 10 countries. Considering both journals together, the majority of HCPs came from the US, UK, Australia and Canada. In the JTT, the mean number of authors for each HCP was 4.6 (SD = 3.1); in TJEH, the mean number of authors for each HCP was 4.5 (SD = 2.3). There was no difference between the two journals (P = 0.84) and the characteristics of the HCPs published in the JTT and TJEH were broadly similar. Although HCPs are not a direct method of measuring quality, they are an indicator of the scientific impact of the articles.

  2. Localizing the HL7 Personal Health Monitoring Record for Danish Telemedicine

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak

    2014-01-01

    Telemedicine holds a promise of lowering cost in health care and improving the life quality of chronic ill patients by allowing monitoring in the home. The Personal Health Monitoring Record (PHMR) is an international HL7 standard data format for encoding measurements made by devices in the home....... However, the standard needs localization to national requirements in order to facilitate semantic interoperability between clinical systems. In this paper, we report experiences and decisions from the current effort to localize PHMR in Denmark, and highlight issues relevant for any adoption...

  3. Telemedicine and mHealth odyssey: a journey from the battlefield to academia

    Science.gov (United States)

    Poropatich, Ronald; Presson, Nora; Gilbert, Gary

    2016-05-01

    Since 1992, military medicine has considered the relevance, sustainability, and promise of telemedicine in the context of its mission and obligations for service members at home and in war zones. The US Army telemedicine program covers 22 time zones and generates over 5000 tele-consults per month for over 20 medical specialties. More recently the advances in mobile computing and increased adoption of the Smartphone with evolving capabilities for imaging and body-worn sensor integration has emerged in the field called mobile health, or mHealth. This presentation highlights the first 10 years of the U.S. Army mHealth program and includes how similar technologies have translated to wide-scale civilian health care implementation, including a relevant project for Veterans at the University of Pittsburgh. Examples include the successful US Army "mCare" program developed to augment soldier rehabilitation management with USbased geographically dispersed providers that utilizes secure mobile messaging and the soldier's own cell phone. Additional research interests will describe the use of smartphones on the battlefield enabling capture of operational medical data to improve casualty evacuation and outcome. A DoD-funded traumatic brain injury research project developed for Veterans at the University of Pittsburgh includes a mobile health application that demonstrates the effectiveness of communicating with patients through their personal mobile devices with care managers. Preliminary data for all the projects presented are encouraging for adoption and utilization of a mobile telemedicine platform to meet the complex needs of casualties injured or recovering from a broad range of injuries in unique geographic settings.

  4. The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Villanueva JA

    2017-02-01

    Full Text Available Jair A Villanueva,1,* Monique C Suarez,2,* Onintza Garmendia,2,3 Vera Lugo,2 Concepción Ruiz,2 Josep M Montserrat,2–5 1Unit of Biophysics and Bioengineering, Faculty of Medicine, University of Barcelona, 2Sleep Unit, Respiratory Medicine Department, Hospital Clinic, Barcelona, 3Center for Biomedical Research in Respiratory Diseases (CIBERES, Madrid, 4Faculty of Medicine, University of Barcelona, 5August Pi i Sunyer Biomedical Research Institute (IDIBAPS, Barcelona, Spain *These authors contributed equally to this work Abstract: Although the concepts are broad, telemedicine and mobile health (mHealth can be defined as a methodology to provide health care remotely and improve health services and outcomes using telecommunication tools. The widespread adoption of these technologies and current health care challenges, such as the aging population and increasing costs, has encouraged interest in the development of new strategies involving telemedicine. Overall, there is a lack of evidence rigorously assessing the impact of telemedicine and mHealth. Therefore, proper randomized controlled trials, with cost-effectiveness and impact on quality-of-life analysis, are urgently needed. They should also focus on specific populations and their comorbidities, since customizing telemedicine approaches is paramount to ensure success. Obstructive sleep apnea is a highly prevalent chronic condition and the most common of sleep-breathing disorders, and telemedicine and mHealth could play a pivotal role in the different phases of its management. In the future, using new devices capable of signal acquisition and analysis will refine obstructive sleep apnea diagnosis; even smartphones’ built-in sensors could offer improved comfort and the possibility of home sleep monitoring. Continuous positive airway pressure titration could be performed with wireless devices, whose parameters can be changed remotely from sleep centers. Finally, the follow-up phase could be

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

    Directory of Open Access Journals (Sweden)

    Fassil Shiferaw

    2012-04-01

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

  6. Mobile Apps in Oncology: A Survey on Health Care Professionals' Attitude Toward Telemedicine, mHealth, and Oncological Apps.

    Science.gov (United States)

    Kessel, Kerstin A; Vogel, Marco Me; Schmidt-Graf, Friederike; Combs, Stephanie E

    2016-11-24

    Mobile apps are an evolving trend in the medical field. To date, few apps in an oncological context exist. The aim was to analyze the attitude of health care professionals (HCPs) toward telemedicine, mHealth, and mobile apps in the field of oncology. We developed and conducted an online survey with 24 questions evaluating HCPs' general attitude toward telemedicine and patients using medical mobile apps. Specific questions on the possible functionality for patients and the resulting advantages and disadvantages for both the patients' and HCPs' daily clinical routine were evaluated. A total of 108 HCPs completed the survey. In all, 88.9% (96/108) considered telemedicine useful and 84.3% (91/108) supported the idea of an oncological app complementing classical treatment. Automatic reminders, timetables, and assessment of side effects and quality of life during therapy were rated as the most important functions. In contrast, uncertainty regarding medical responsibility and data privacy were reasons mostly named by critics. Most (64.8%, 70/108) were in favor of an alert function due to data input needing further clarification, and 94% (66/70) were willing to contact the patient after a critical alert. In all, 93.5% (101/108) supported the idea of using the collected data for scientific research. Moreover, 75.0% (81/108) believed establishing a mobile app could be beneficial for the providing hospital. A majority of HCPs are in favor of telemedicine and the use of oncological apps by patients. Assessing side effects can lead to quicker response and thus lower inconvenience for patients. Clinical data, such as life quality and treatment satisfaction, could be used to evaluate and improve the therapy workflow. Eventually, a mobile app would enhance the patients' relationship to their treating department because they are in permanent contact.

  7. Monitoring and telemedicine support in remote environments and in human space flight.

    Science.gov (United States)

    Cermack, M

    2006-07-01

    The common features of remote environments are geographical separation, logistic problems with health care delivery and with patient retrieval, extreme natural conditions, artificial environment, or combination of all. The exposure can have adverse effects on patients' physiology, on care providers' performance and on hardware functionality. The time to definite treatment may vary between hours as in orbital space flight, days for remote exploratory camp, weeks for polar bases and months to years for interplanetary exploration. The generic system architecture, used in any telematic support, consists of data acquisition, data-processing and storage, telecommunications links, decision-making facilities and the means of command execution. At the present level of technology, a simple data transfer and two-way voice communication could be established from any place on the earth, but the current use of mobile communication technologies for telemedicine applications is still low, either for logistic, economic and political reasons, or because of limited knowledge about the available technology and procedures. Criteria for selection of portable telemedicine terminals in remote terrestrial places, characteristics of currently available mobile telecommunication systems, and the concept of integrated monitoring of physiological and environmental parameters are mentioned in the first section of this paper. The second part describes some aspects of emergency medical support in human orbital spaceflight, the limits of telemedicine support in near-Earth space environment and mentions some open issues related to long-term exploratory missions beyond the low Earth orbit.

  8. Interactive telemedicine solution based on a secure mHealth application.

    Science.gov (United States)

    Eldeib, Ayman M

    2014-01-01

    In dynamic healthcare environments, caregivers and patients are constantly moving. To increase the healthcare quality when it is necessary, caregivers need the ability to reach each other and securely access medical information and services from wherever they happened to be. This paper presents an Interactive Telemedicine Solution (ITS) to facilitate and automate the communication within a healthcare facility via Voice over Internet Protocol (VOIP), regular mobile phones, and Wi-Fi connectivity. Our system has the capability to exchange/provide securely healthcare information/services across geographic barriers through 3G/4G wireless communication network. Our system assumes the availability of an Electronic Health Record (EHR) system locally in the healthcare organization and/or on the cloud network such as a nation-wide EHR system. This paper demonstrate the potential of our system to provide effectively and securely remote healthcare solution.

  9. 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.

  10. A Telematic Support System for Emergency Medical Services

    Directory of Open Access Journals (Sweden)

    Michael Protogerakis

    2013-08-01

    Full Text Available The presented system is part of the research project Medon-@ ix for the safe application of information technology in preclinical emergency health care. It aims at supporting members of the emergency medical services (EMS at the incident location from a remote Competence Centre. In this paper cases in which a telematic support system can be used will be outlined. This includes the assistance of medical and non-medical staff in emergency incidents. The functional and non-functional requirements for the on site medical devices, the documentation system and the medical decision support system in the Competence Centre will be outlined. This paper also presents a possible hardware and software system architecture approach to a telematic support system.

  11. Implementation of m-health applications in Botswana: telemedicine and education on mobile devices in a low resource setting.

    Science.gov (United States)

    Littman-Quinn, Ryan; Mibenge, Chikoti; Antwi, Cynthia; Chandra, Amit; Kovarik, Carrie L

    2013-02-01

    Although Botswana has recently been categorised as an upper middle income country, it is burdened by a scarcity of resources, both human and technological. There are barriers to patients' access to specialized care and healthcare providers' access to medical knowledge. Over the past three years, the Botswana-University of Pennsylvania Partnership (BUP) has piloted four mobile telemedicine projects in the specialties of women's health (cervical cancer screening utilizing visual inspection with acetic acid), radiology, oral medicine and dermatology. Mobile telemedicine has been used in 11 locations in Botswana, training a total of 24 clinicians and successfully contributing to the management of 643 cases. In addition to mobile telemedicine, BUP has initiated an m-learning programme with the University of Botswana School of Medicine. While successfully providing patients and providers with improved access to healthcare resources, the m-health projects have faced numerous technical and social challenges. These include malfunctioning mobile devices, unreliable IT infrastructure, accidental damage to mobile devices, and cultural misalignment between IT and healthcare providers. BUP has worked with its local partners to develop solutions to these problems. To ensure sustainability, m-health programmes must have strategic goals that are aligned with those of the national health and education system, and the initiatives must be owned and led by local stakeholders. Whenever possible, open source technology and local IT expertise and infrastructure should be employed.

  12. Could telemedicine enhance traditional medicine practices?

    OpenAIRE

    Kamsu-Foguem, Bernard; Foguem, Clovis

    2014-01-01

    International audience; In developing countries, telemedicine and mobile health tools promise to enhance access to high-quality healthcare, to support communication of medical information and to assist pharmacovigilance processes. In this article, we provide some arguments on the potential of telemedicine and mobile health (mHealth) applications to improve the delivery of health care in rural African regions. Specifically, the development of mobile telemedicine could help to lay the foundatio...

  13. Telematics-Supported Education for Traditional Universities in Europe

    NARCIS (Netherlands)

    Collis, Betty

    1999-01-01

    Telematics is the combination of information technology and communication technology. Telematics applications to support educational delivery and participation in traditional European universities are rapidly becoming part of the educational setting. Sometimes they are used specifically to increase

  14. Audiology telemedicine.

    Science.gov (United States)

    Krumm, Mark

    2007-01-01

    Various real-time telemedicine applications have been investigated in audiology, including pure tone audiometry, otoacoustic emission testing, auditory brainstem response recordings, hearing aid fitting and video-otoscopy. Store-and-forward applications have usually been used to transmit basic patient data including case history information and hearing screening results, although both video-nystagmography and video-otoscopy have been piloted. Remote access to computerized equipment is relevant to audiology telemedicine, although there have been few reports of the use of application sharing using computerized audiology equipment. In a pilot trial of real-time telemedicine, both pure tone and speech audiometry measures were provided remotely through application sharing. Audiology telemedicine appears promising, but it is at an early stage of development and many areas such as its cost effectiveness, patient acceptance and test efficacy require systematic investigation.

  15. 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/

  16. 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.

  17. Telemedicine in otolaryngology.

    Science.gov (United States)

    Holtel, Michael R; Burgess, Lawrence P A

    2002-12-01

    visible or nonvisible light spectrum, spectral imaging will be able to provide instant identification of bacteria or evidence of malignant changes. The underlying principles of a successful business model must continue to be applied, with the most critical ingredient for telemedicine's success being the filling of specific health care needs. As long as the need is there, telemedicine in otolaryngology will advance.

  18. 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.

  19. Telemedicine: A brief analysis

    Directory of Open Access Journals (Sweden)

    Rajani Gupta

    2014-12-01

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

  20. Survey determinant factors of telemedicine strategic planning from the managers and experts perspective in the health department, isfahan university of medical sciences.

    Science.gov (United States)

    Keshvari, Hamid; Haddadpoor, Asefeh; Taheri, Behjat; Nasri, Mehran; Aghdak, Pezhman

    2014-10-01

    Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. This is a descriptive-analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. According to the strengths, weaknesses, opportunities and threats

  1. Practice Based Versus Telemedicine Based Collaborative Care for Depression in Rural Federally Qualified Health Centers: A Pragmatic Randomized Comparative Effectiveness Trial

    Science.gov (United States)

    Fortney, John C.; Pyne, Jeffrey M.; Mouden, Sip B.; Mittal, Dinesh; Hudson, Teresa J.; Schroeder, Gary W.; Williams, David K.; Bynum, Carol A.; Mattox, Rhonda; Rost, Kathryn M

    2013-01-01

    Objective Practice Based Collaborative Care is a complex evidence-based practice that is difficult to implement in smaller primary care practices lacking on-site mental health staff. Telemedicine Based Collaborative Care virtually co-locates and integrates mental health providers into primary care settings. The objective of this multi-site randomized pragmatic comparative effectiveness trial was to compare the outcomes of patients randomized to Practice Based versus Telemedicine Based Collaborative Care. Method From 2007–2009, patients at Federally Qualified Health Centers serving medically underserved populations were screened for depression, and 364 patients screening positive were enrolled and followed for 18 months. Those randomized to Practice Based Collaborative Care received evidence-based care from an on-site primary care provider and nurse care manager. Those randomized to Telemedicine Based Collaborative Care received evidence-based care from an on-site primary care provider and off-site telephone nurse care manager, telephone pharmacist, tele-psychologist and tele-psychiatrist. The primary clinical outcomes were treatment response, remission and changes in depression severity Results There were significant group main effects for both response (OR=7.74, CI95=3.94–15.20, p<0.0001) and remission (OR=12.69, CI95=4.81–33.46, p<0.0001) and a significant overall group by time interaction effect for Hopkins Symptom Checklist depression severity (χ23=40.51, p<0.0001) with greater reductions in depression severity observed over time for those randomized to Telemedicine Based Collaborative Care. Improvements in outcomes appeared to be attributable to higher fidelity to the collaborative care evidence-base in the Telemedicine Based group. Conclusions Contracting with an off-site Telemedicine Based Collaborative Care team yields better outcomes than implementing Practice Based Collaborative Care with locally available staff. PMID:23429924

  2. A survey of physicians' acceptance of telemedicine.

    Science.gov (United States)

    Sheng, O R; Hu, P J; Chau, P Y; Hjelm, N M; Tam, K Y; Wei, C P; Tse, J

    1998-01-01

    Physicians' acceptance of telemedicine is an important managerial issue facing health-care organizations that have adopted, or are about to adopt, telemedicine. Most previous investigations of the acceptance of telemedicine have lacked theoretical foundation and been of limited scope. We examined technology acceptance and usage among physicians and specialists from 49 clinical departments at eight public tertiary hospitals in Hong Kong. Out of the 1021 questionnaires distributed, 310 were completed and returned, a 30% response rate. The preliminary findings suggested that use of telemedicine among clinicians in Hong Kong was moderate. While 18% of the respondents were using some form of telemedicine for patient care and management, it accounted for only 6.3% of the services provided. The intensity of their technology usage was also low, accounting for only 6.8% of a typical telemedicine-assisted service. These preliminary findings have managerial implications.

  3. 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

  4. 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 ...

  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. Applicability of Telemedicine in Bangladesh: Current Status and Future Prospects

    CERN Document Server

    Nessa, Ahasanun; Ullah, Sana; Kwak, Kyung Sup

    2009-01-01

    Telemedicine refers to the use of information and communication technology to provide and support health care mainly for the purpose of providing consultation. It is also a way to provide medical procedures or examinations to remote locations. It has the potential to improve both the quality and the access to health care services delivery while lowering costs even in the scarcity of resources. Understanding the potentiality of telemedicine, many developing countries are implementing telemedicine to provide health care facility to remote area where health care facilities are deficient. Bangladesh is not an exception to this either. In this paper we mention the reasons why Bangladesh has to move for telemedicine. We also present the past and on-going telemedicine activities and projects in Bangladesh. Analyzing these projects we have found out some factors which should be assessed carefully for successful implementation of telemedicine application. Finally we propose a prototype telemedicine network for Banglad...

  7. Parole in Jeans: poetry and telematics

    Directory of Open Access Journals (Sweden)

    Paola Barisone

    1998-01-01

    Full Text Available Presentation of project "Parole in Jeans" focuses on poetry and telematics under more 'general education reading in a multimedia context. The theme concerns "the culture of the various Italian regions" created through a collaborative implemented electronically between Genoa Middle School, Udine and Padua. The main aim 'to promote reading, comprehension and production of poetic texts in an interdisciplinary context and key media.

  8. Monitoring Progress and Adherence with Positive Airway Pressure Therapy for Obstructive Sleep Apnea: The Roles of Telemedicine and Mobile Health Applications.

    Science.gov (United States)

    Hwang, Dennis

    2016-06-01

    Technology is changing the way health care is delivered and how patients are approaching their own health. Given the challenge within sleep medicine of optimizing adherence to continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea (OSA), implementation of telemedicine-based mechanisms is a critical component toward developing a comprehensive and cost-effective solution for OSA management. Key elements include the use of electronic messaging, remote monitoring, automated care mechanisms, and patient self-management platforms. Current practical sleep-related telemedicine platforms include Web-based educational programs, automated CPAP follow-up platforms that promote self-management, and peer-based patient-driven Internet support forums.

  9. Development of health inter-professional telemedicine practice through simulation scenario training with students of physiotherapy-, occupational therapy-, medical laboratory technology, and nursing education

    DEFF Research Database (Denmark)

    Nortvig, Anne-Mette; Vestergaard, Kitt

    . Aims: The purpose of the project was • to develop practice oriented competences related to telemedicine in an inter-professional and a cross-sectoral context among health professional students of physiotherapy-, occupational therapy-, medical laboratory technology-, and nursing education. • to motivate...... and retain male students by the use of simulation training that involves technology. Methodology: The project was settled as a cross-professional telemedicine course on health educations. Nursing students (N=20) and physiotherapy students (N=34) participated actively and the scenarios were filmed and enacted...... and qualitative interviews. Recordings, field notes, memos and observations of students and lecturers were used as empirical material for follow-up research. Data were analyzed in order to categorize the theoretical perspectives relating to learning and motivation. Results: Evaluations and follow-up research...

  10. Young people's views on the potential use of telemedicine consultations for sexual health: results of a national survey

    Directory of Open Access Journals (Sweden)

    Fairley Christopher K

    2011-10-01

    Full Text Available Abstract Background Young people are disproportionately affected by sexually transmissible infections in Australia but face barriers to accessing sexual health services, including concerns over confidentiality and, for some, geographic remoteness. A possible innovation to increase access to services is the use of telemedicine. Methods Young people's (aged 16-24 pre-use views on telephone and webcam consultations for sexual health were investigated through a widely-advertised national online survey in Australia. Descriptive statistics were used to describe the study sample and chi-square, Mann-Whitney U test, or t-tests were used to assess associations. Multinomial logistic regression was used to explore the association between the three-level outcome variable (first preference in person, telephone or webcam, and demographic and behavioural variables; odds ratios and 95%CI were calculated using in person as the reference category. Free text responses were analysed thematically. Results A total of 662 people completed the questionnaire. Overall, 85% of the sample indicated they would be willing to have an in-person consultation with a doctor, 63% a telephone consultation, and 29% a webcam consultation. Men, respondents with same-sex partners, and respondents reporting three or more partners in the previous year were more willing to have a webcam consultation. Imagining they lived 20 minutes from a doctor, 83% of respondents reported that their first preference would be an in-person consultation with a doctor; if imagining they lived two hours from a doctor, 51% preferred a telephone consultation. The main objections to webcam consultations in the free text responses were privacy and security concerns relating to the possibility of the webcam consultation being recorded, saved, and potentially searchable and retrievable online. Conclusions This study is the first we are aware of that seeks the views of young people on telemedicine and access to

  11. 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

  12. Telemedicine in Greenland

    DEFF Research Database (Denmark)

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

    2017-01-01

    . 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. CONCLUSION: Greenlandic citizens are positive toward telemedicine and regard telemedicine......BACKGROUND: Telemedicine may have the possibility to provide better access to healthcare delivery for the citizens. Telemedicine in arctic remote areas must be tailored according to the needs of the local population. Therefore, we need more knowledge about their needs and their view of telemedicine....... OBJECTIVE: The aim of this study has been to explore how citizens living in the Greenlandic settlements experience the possibilities and challenges of telemedicine when receiving healthcare delivery in everyday life. MATERIALS AND METHODS: Case study design was chosen as the overall research design...

  13. 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…

  14. NASA's telemedicine testbeds: Commercial benefit

    Science.gov (United States)

    Doarn, Charles R.; Whitten, Raymond

    1998-01-01

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

  15. American Telemedicine Association: Federal Telemedicine Policy Summit

    Directory of Open Access Journals (Sweden)

    Benjamin Forstag

    2013-06-01

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

  16. Condition-Based Maintenance using Sensor Arrays and Telematics

    CERN Document Server

    Palem, Gopalakrishna

    2013-01-01

    Emergence of uniquely addressable embeddable devices has raised the bar on Telematics capabilities. Though the technology itself is not new, its application has been quite limited until now. Sensor based telematics technologies generate volumes of data that are orders of magnitude larger than what operators have dealt with previously. Real-time big data computation capabilities have opened the flood gates for creating new predictive analytics capabilities into an otherwise simple data log systems, enabling real-time control and monitoring to take preventive action in case of any anomalies. Condition-based-maintenance, usage-based-insurance, smart metering and demand-based load generation etc. are some of the predictive analytics use cases for Telematics. This paper presents the approach of condition-based maintenance using real-time sensor monitoring, Telematics and predictive data analytics.

  17. Customer service factors of a Telematic Learning BBA degree ...

    African Journals Online (AJOL)

    Customer service factors of a Telematic Learning BBA degree. ... accessibility of quality tertiary education via distance learning programmes of foreign institutions. ... Continuous client satisfaction research is conducted and this article reports ...

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

    Science.gov (United States)

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

    2016-12-01

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

  19. 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.

  20. Development of health inter-professional telemedicine practice through simulation scenario training with students of physiotherapy-, occupational therapy-, medical laboratory technology-, and nursing education

    DEFF Research Database (Denmark)

    Nortvig, Anne-Mette; Vestergaard*, Kitt

    2014-01-01

    must take place in an inter-professional context. Aims: The purpose of the project was •to develop practice oriented competences related to telemedicine in an inter-professional and a cross-sectoral context among health professional students of physiotherapy-, occupational therapy-, medical laboratory...... and motivation. Results: Evaluations and follow-up research showed that students developed competences equivalent to novice level through simulation training (3). The project gave rise to wide project on Occupational Therapy education and medical laboratory technology education too. Follow-up research concludes...

  1. Is there a contradiction between telemedicine and business?

    Science.gov (United States)

    Lievens, Frank; Jordanova, Malina

    2004-01-01

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

  2. Implementation of Remote Health Monitoring in Medical Rural Clinics for Web Telemedicine System

    OpenAIRE

    2014-01-01

    The problem with limited numbers of physicians, nurses, and other healthcare providers is expected to exacerbate. Health care must be as efficient as possible. This situation provides an opportunity for the application of telehealth clinics. It is time for organizations providing health care to objectively consider telehealth clinics. Information and communication technologies (ICTs) have great potential to address some of the challenges faced by both developed and developing countries in pro...

  3. Implementation of Remote Health Monitoring in Medical Rural Clinics for Web Telemedicine System

    Directory of Open Access Journals (Sweden)

    Hafez Fouad

    2014-11-01

    Full Text Available The problem with limited numbers of physicians, nurses, and other healthcare providers is expected to exacerbate. Health care must be as efficient as possible. This situation provides an opportunity for the application of telehealth clinics. It is time for organizations providing health care to objectively consider telehealth clinics. Information and communication technologies (ICTs have great potential to address some of the challenges faced by both developed and developing countries in providing accessible, cost-effective, high-quality health care services. Telemedical clinics use ICTs to overcome geographical barriers, and increase access to healthcare services. This is particularly beneficial for rural and underserved communities in developing countries – groups that traditionally suffer from lack of access to health care. In this work we propose an equipped system with new technology to provide wide range of services in Telemedical clinics which facilitates the provision of medical aids from a distance. It is an effective solution for providing specialty healthcare in the form of improved access and reduced cost to the rural patients and the reduced professional isolation of the rural doctors. Telemedical clinics can enable ordinary doctors to perform extra-ordinary tasks.

  4. 远程医疗对基层官兵医疗卫生保障的作用%Analysis on the role of telemedicine in health service to ordinary armed officers and soldiers

    Institute of Scientific and Technical Information of China (English)

    邢守志

    2013-01-01

    According to various advantages of telemedicine, its applications expanded. In the information age background, the telemedicine is gradually applied in the ordinary armed officers and soldiers in medical and health care, and has played a more and more important role. This article briefly described the overview of the development of telemedicine, analyzed the telemedicine necessity of health insurance and elaborates the role of telemedicine in health service to the ordinary armed officers and soldiers. The prospects and expectations of telemedicine systems are also given.%随着远程医疗的各种优势不断展现,其应用领域逐渐扩展。在目前信息时代的条件下,基层官兵的医疗卫生保障不断步入信息化管理,远程医疗逐渐应用到基层官兵的医疗卫生保障之中,并起到了越来越重要的作用。通过阐述远程医疗发展的概况,对远程医疗在基层官兵医疗卫生保障中的作用进行分析,进而对远程医疗有了更充分的认识,远程医疗在基层官兵医疗卫生保障中具有广阔的应用前景。

  5. 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.

  6. Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers.

    Science.gov (United States)

    Weinstein, Ronald S; Lopez, Ana Maria; Joseph, Bellal A; Erps, Kristine A; Holcomb, Michael; Barker, Gail P; Krupinski, Elizabeth A

    2014-03-01

    There has been a spike in interest and use of telehealth, catalyzed recently by the anticipated implementation of the Affordable Care Act, which rewards efficiency in healthcare delivery. Advances in telehealth services are in many areas, including gap service coverage (eg, night-time radiology coverage), urgent services (eg, telestroke services and teleburn services), mandated services (eg, the delivery of health care services to prison inmates), and the proliferation of video-enabled multisite group chart rounds (eg, Extension for Community Healthcare Outcomes programs). Progress has been made in confronting traditional barriers to the proliferation of telehealth. Reimbursement by third-party payers has been addressed in 19 states that passed parity legislation to guarantee payment for telehealth services. Medicare lags behind Medicaid, in some states, in reimbursement. Interstate medical licensure rules remain problematic. Mobile health is currently undergoing explosive growth and could be a disruptive innovation that will change the face of healthcare in the future.

  7. 社区糖尿病远程健康服务平台的构想%Scheme of the Diabetes Telemedicine Health Service Platform

    Institute of Scientific and Technical Information of China (English)

    胡景胜; 张梅奎

    2012-01-01

    Objective: Discuss how to apply the technology of internet and telemedicine to solve the problem of diabetes breaking out and over control. We are looking forward to design a telemedicine platform which could monitor and analyze automatically based on rich data and information of diabetics. Methods: analyze the purpose, necessary & feasibility of building telemedicine service platform of diabetes and suggest essential factor and basic concept. Results: The platform consists of five parts, and based this structure it could monitor & evaluate patient's condition and conduct treatment. Conclusions: We believe the platform could promote health level for individuals with diabetes in our country in the future elder society through continuous improvement, also telemedicine technology will become to the most important method in control the epidemic of diabetes.%目的:探讨如何应用信息化手段解决当今我国糖尿病的爆发及控制不力的实际问题.希望设计一个以远程医疗平台为基础,包含丰富的糖尿病患者数据资料的自动监测、分析平台.方法:分析构建糖尿病远程健康服务平台的目的、必要性和可行性,提出建设社区糖尿病远程健康服务平台的要件和基本思路.结果:该平台由五部分组成,在该框架下可进行糖尿病患者多种病情资料的监测、评估和治疗指导.结论:不断完善的糖尿病信息化远程健康平台可以有效提高我国未来老龄化社会糖尿病人群的整体健康水平,并且远程医疗技术也将成为解决当今糖尿病爆发流行的重要手段.

  8. Successful Adoption of a School-Based Telemedicine System

    Science.gov (United States)

    Mackert, Michael; Whitten, Pamela

    2007-01-01

    Background: Telemedicine, the provision of healthcare at a distance via telecommunication technology, has been used to address a wide range of health concerns in a variety of settings. Given the challenges schools face in keeping students healthy, telemedicine could be viewed as a mechanism to provide healthcare services directly to students in…

  9. Telemedicine and advances in urban and rural healthcare delivery in Africa.

    Science.gov (United States)

    Mars, Maurice

    2013-01-01

    Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine.

  10. Development of health inter-professional telemedicine practice through simulation scenario training with students of physiotherapy-, occupational therapy-, medical laboratory technology-, and nursing education

    DEFF Research Database (Denmark)

    Nortvig, Anne-Mette; Vestergaard*, Kitt

    2014-01-01

    actively and the scenarios were filmed and enacted via Adobe Connect. Students were divided into groups, and some students acted health professionals, while others acted patients. Excerpts of the recordings were analyzed and discussed with a focus on successful telemedical care and treatments well...... as challenges and they were followed by evaluation and qualitative interviews. Recordings, field notes, memos and observations of students and lecturers were used as empirical material for follow-up research. Data were analyzed in order to categorize the theoretical perspectives relating to learning......Background: Welfare technology is considered to be cost effective and to promote consistent quality in health care (1, 2). Due to the pervasive deployment of telemedicine and the political focus thereon, it is very important that health professional students gain an understanding of its benefits...

  11. Telemedicine: medical, legal and ethical perspectives.

    Science.gov (United States)

    Clark, Peter A; Capuzzi, Kevin; Harrison, Joseph

    2010-12-01

    Technological innovations in medical care have led to the development of telemedicine programs in both rural and urban environments. The necessity for telemedicine has increased immensely as more cost-effective treatment options have become available for both patients and physicians through the addition of telecommunication technologies to medical practice. The development of telemedicine systems began as a means of providing access to health care resources for individuals living in isolated rural areas, grew into advanced medical intervention techniques for soldiers on the battlefield, and have become prevalent in urban medical centers both as a resource to the underserved populations and as a platform for physicians off-site to conduct patient consults remotely. Urban telemedicine systems, as monitored in the Mercy Health System (Philadelphia, Pennsylvania) and AtlantiCare Regional Medical Center (Atlantic City, New Jersey), display the enormous benefits of telemedicine as a form of preliminary analysis of patients for the treatment of various medical conditions including chronic disease, mental health disorders and stroke. However, the initiation of telemedicine programs requires new protocols and safeguards to be initiated to protect patient confidentiality/privacy, ensure the appropriate licensure of physicians practicing across state borders, and educate patients on the use of new technological systems. Telemedicine represents the progression of medicine in the presence of improving communication technologies and should be instituted in all urban medical centers. This conclusion is based upon the ethical responsibility to treat all persons with dignity and respect, which in this case, mandates the provision of the most cost-effective, beneficial medical care for all populations.

  12. Dificultades para incorporar la telemedicina en las organizaciones sanitarias: perspectivas analíticas Difficulties of incorporating telemedicine in health organizations: analytical perspectives

    Directory of Open Access Journals (Sweden)

    Francesc Roig

    2009-04-01

    communication technologies to health care systems, which has been called «e-Health», has created enormous expectations in this context. Telemedicine has been one of pioneer experiences. Despite the early beginnings of telemedicine and the efforts invested, more widespread use of this technology remains difficult and controversial. Most projects last just the feasibility phase and are then forgotten. The traditional model of medical technologies assessment explains this phenomenon, based on the difficulty of obtaining the empirical evidence needed to support widespread adoption of telemedicine, as a consequence of the problems of conducting traditional studies of clinical efficacy and cost-effectiveness. In the last few years, a different analytical approach has emerged. This perspective indicates that the consolidation (or otherwise of telemedicine projects will depend on the results of interaction between technology and the context where it is applied and not only on clinical results. Better and deeper empirical knowledge of these interaction processes is needed to increase the spread of telemedicine.

  13. 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...

  14. Toward personal eHealth in cardiology. Results from the EPI-MEDICS telemedicine project.

    Science.gov (United States)

    Rubel, Paul; Fayn, Jocelyne; Nollo, Giandomenico; Assanelli, Deodato; Li, Bo; Restier, Lioara; Adami, Stefano; Arod, Sébastien; Atoui, Hussein; Ohlsson, Mattias; Simon-Chautemps, Lucas; Télisson, David; Malossi, Cesare; Ziliani, Gian-Luca; Galassi, Alfredo; Edenbrandt, Lars; Chevalier, Philippe

    2005-10-01

    Despite many attempts to improve the management of acute myocardial infarction, only small trends to shorter time intervals before treatment have been reported. The self-care solution developed by the European EPI-MEDICS project (2001-2004) is a novel, very affordable, easy-to-use, portable, and intelligent Personal ECG Monitor (PEM) for the early detection of cardiac ischemia and arrhythmia that is able to record a professional-quality, 3-lead electrocardiogram (ECG) based on leads I, II, and V2; derive the missing leads of the standard 12-lead ECG (thanks to either a generic or a patient-specific transform), compare each ECG with a reference ECG by means of advanced neural network-based decision-making methods taking into account the serial ECG measurements and the patient risk factors and clinical data; and generate different levels of alarms and forward the alarm messages with the recorded ECGs and the patient's Personal electronic Health Record (PHR) to the relevant health care providers by means of a standard Bluetooth-enabled, GSM/GPRS-compatible mobile phone. The ECG records are SCP-ECG encoded and stored with the PHR on a secure personal SD Card embedded in the PEM device. The alarm messages and the PHR are XML encoded. Major alarm messages are automatically transmitted to the nearest emergency call center. Medium or minor alarms are sent on demand to a central PEM Alarm Web Server. Health professionals are informed by a Short Message Service. The PEM embeds itself a Web server to facilitate the reviewing and/or update of the PHR during a routine visit at the office of the general physician or cardiologist. Eighty PEM prototypes have been finalized and tested for several weeks on 697 citizens/patients in different clinical and self-care situations involving end users (188 patients), general physicians (10), and cardiologists (9). The clinical evaluation indicates that the EPI-MEDICS concept may save lives and is very valuable for prehospitalization triage.

  15. Telemedicine: Experience at SGPGIMS, Lucknow

    Directory of Open Access Journals (Sweden)

    Kapoor L

    2005-01-01

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

  16. Communicating with residential electrical devices via a vehicle telematics unit

    Science.gov (United States)

    Roth, Rebecca C.; Pebbles, Paul H.

    2016-11-15

    A method of communicating with residential electrical devices using a vehicle telematics unit includes receiving information identifying a residential electrical device to control; displaying in a vehicle one or more controlled features of the identified residential electrical device; receiving from a vehicle occupant a selection of the displayed controlled features of the residential electrical device; sending an instruction from the vehicle telematics unit to the residential electrical device via a wireless carrier system in response to the received selection; and controlling the residential electrical device using the sent instruction.

  17. Research funding for telemedicine: an Australian perspective.

    Science.gov (United States)

    Barnett, Adrian G; Campbell, Megan J; Burns, Clare L

    2016-04-01

    Winning research funding is one of the most difficult challenges faced by researchers, especially with falling success rates and shrinking budgets. Telemedicine researchers can find it especially hard to win funding as they are often researching small changes to the health system that whilst important for patient care are often not as competitive as proposals that promise to cure diseases. In a climate of both tight health funding and tight research funding, telemedicine researchers should emphasise the potential for their research to add value and lower costs in order to increase their chances of winning funding.

  18. Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced?

    Directory of Open Access Journals (Sweden)

    Cynthia LeRouge

    2013-11-01

    Full Text Available Barriers have challenged widespread telemedicine adoption by health care organizations for 40 years. These barriers have been technological, financial, and legal and have also involved business strategy and human resources. The article canvasses recent trends—events and activities in each of these areas as well as US health reform activities that might help to break down these barriers. The key to telemedicine success in the future is to view it as an integral part of health care services and not as a stand-alone project. Telemedicine must move from experimental and separate to integrated and equivalent to other health services within health care organizations. Furthermore, telemedicine serves as vital connective tissue for expanding health care organization networks.

  19. 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.

  20. Institutionalizing telemedicine applications: the challenge of legitimizing decision-making.

    Science.gov (United States)

    Zanaboni, Paolo; Lettieri, Emanuele

    2011-09-28

    During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements--rationality, fairness, and efficiency--that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications--benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators' perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.

  1. Careful telemedicine planning limits costly liability exposure.

    Science.gov (United States)

    Edelstein, S A

    1999-12-01

    Recent Federal and state legislation and new payment opportunities from Medicare, Medicaid, and private payers may make it possible to offer telemedicine as a viable, cost-effective alternative to traditional care delivery in communities where access to health care is limited. Originally, nonexistent payment and expensive technology held back telemedicine but, these barriers are giving way to specific applications that can yield dramatic cost savings for group practices in the delivery of medical care while adding features and benefits not typically available in traditional delivery settings. Before joining a telemedicine network, group practices need to negotiate a variety of legal issues related to the corporate practice of medicine, patient confidentiality and privacy, malpractice, informed consent, licensure and credentialing, intellectual property, Medicare and Medicaid payment, fraud and abuse, medical device regulation, and antitrust.

  2. The Ontario Telemedicine Network: a case report.

    Science.gov (United States)

    Brown, Edward M

    2013-05-01

    This article describes the evolution, current status, and future prospects of the Ontario Telemedicine Network (OTN). Started in the late 1990s (and formally established in 2006), OTN is a not-for-profit corporation primarily funded by the Government of Ontario, Canada, that aims to improve access to and quality of care throughout the Province. It covers a land mass larger than France and serves a population of just over 13 million, the vast majority of which live in a narrow strip close to the U.S. border. Telemedicine has been effective in reducing travel to usual sources of care, reducing hospital admissions, and improving efficiency and prompt access to care. The diffusion of telemedicine is accelerating in Ontario, and it is becoming an integral part of the health system.

  3. Bringing the artificial pancreas home: telemedicine aspects.

    Science.gov (United States)

    Lanzola, Giordano; Capozzi, Davide; Serina, Nadia; Magni, Lalo; Bellazzi, Riccardo

    2011-11-01

    The design and implementation of telemedicine systems able to support the artificial pancreas need careful choices to cope with technological requirements while preserving performance and decision support capabilities. This article addresses the issue of designing a general architecture for the telemedicine components of an artificial pancreas and illustrates a viable solution that is able to deal with different use cases and is amenable to support mobile-health implementations. The goal is to enforce interoperability among the components of the architecture and guarantee maximum flexibility for the ensuing implementations. Thus, the design stresses modularity and separation of concerns along with adoption of clearly defined protocols for interconnecting the necessary components. This accounts for the implementation of integrated telemedicine systems suitable as short-term monitoring devices for supporting validation of closed-loop algorithms as well as devices meant to provide a lifelong tighter control on the patient state once the artificial pancreas has become the preferred treatment for patients with diabetes.

  4. Narrative review of telemedicine consultation in medical practice

    Science.gov (United States)

    Di Cerbo, Alessandro; Morales-Medina, Julio Cesar; Palmieri, Beniamino; Iannitti, Tommaso

    2015-01-01

    Background The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”. Objective This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care. Methods A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty). Results Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions. Conclusion Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. PMID:25609928

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

    African Journals Online (AJOL)

    2013-11-02

    Nov 2, 2013 ... professionals working in the private and public sectors in Durban, ... hospitals and occupational health clinics, while doctors were recruited at continuing .... In Canada and Australia, certain forms of telemedicine are becoming.

  6. The potential of telemedicine in South Sudan

    African Journals Online (AJOL)

    While the use of new technologies for the delivery of healthcare at a ... number of health challenges. The rationale for ... and infectious diseases notably malaria, tuberculosis and. HIV. [5]. ... Services showed that cost-effective telemedicine initiatives .... Smartphones loaded with point-of-care tools are effectively utilized by.

  7. [Telematics in geriatrics--potentials, problems and application experiences].

    Science.gov (United States)

    Mix, S; Borchelt, M; Nieczaj, R; Trilhof, G; Steinhagen-Thiessen, E

    2000-06-01

    Modern telecommunication technology (telematics) has the potential to improve the quality of life for elders with physical and mental impairments as well as for their care giving relatives. Videophones, internet resources, and multimedia computers can be used for networking them together with social workers, nurse practitioners, physicians and therapeutic staff in service-centers. This can be viewed as a unique opportunity to establish and maintain instant and personalized access to various medical services in a situation where increasing needs are opposed to decreasing resources. However, it is not yet clear whether telematics is adequate, efficient, and effective in supporting care for geriatric patients. Some studies already showed its applicability and feasibility, but there are still no larger trials showing that maintenance or enhancement of autonomy can be achieved effectively by using new technologies. This article reviews the literature on telematics in geriatrics and presents data of a tele-rehabilitation project ("TeleReha", conducted at the Berlin Geriatric Center) which comprised mobility-impaired patients (N = 13, mean age 72 yrs), care giving relatives (N = 8), and geriatric professionals. Networking was established using ISDN technology with videophones or PC-based videoconferencing systems. Results showed that participants regard telecommunication devices as a valuable resource for their informational and communicational needs. Use of telecommunication systems was inversely related to physical mobility. Having access to professional service and counselling was rated highly important but also the opportunity to establish reliable contacts with non-professionals (relatives, other participants). Despite experienced technical problems, use of telecommunication systems was evaluated more positively in the post-test as compared to the pre-test. In summary, current experience suggests that telematics can be used efficiently by geriatric patients and by

  8. Relief for maritime medical emergencies through telematics.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S; Pomportsis, A

    1998-12-01

    MERMAID is a European Union (EU)-financed maritime telemedicine project with global reach and 24-h multilingual capability, so as to serve multinational crews working in the isolation of the world's oceans. It provides a model for the provision of healthcare services based on the electronic transmission of medical information via ISDN-based video conferencing. This model is not limited to medical diagnostics, but it encompasses all cases in which the actual delivery of healthcare services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an extensive telecommunications infrastructure that includes both satellite transmission for ship to shore communication and an extensive ground-based network for summoning expert medical help from around the world so as to meet the project's multilinguality requirements and, therefore, the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low-, medium-, and high-bandwidth data requirements) are considered, while the full range of network choices (digital land lines, cellular/wireless, satellite, and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their lifecycle. Finally, out of that, MERMAID utilizes advanced land-based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  9. Critical to quality in telemedicine service management: application of DFSS (Design for Six Sigma) and SERVQUAL).

    Science.gov (United States)

    Yun, Eun Kyoung; Chun, Kee Moon

    2008-01-01

    Telemedicine generally refers to the use of communications and information technologies for the delivery of health care. owever, telemedicine is not merely a simple combination of health care and technology. The researchers propose a systematic approach for assessing needs of telemedicine customers, called critical-to-quality (CTQ) in Six Sigma, with a purpose of continuous quality improvement. The combination approach using DFSS (Design for Six Sigma) and SERVQUAL (Service Quality Framework) was applied to define the critical quality attributes of telemedicine service management and to match them with the current telemedicine process. With a step-by-step procedure, telemedicine service process was reviewed and all the important CTQ candidates identified via a case study. The findings suggest that nurses need further understanding and research methods that will improve and manage the quality of health care service in various medical fields.

  10. A telemedicine system for remote cooperative medical imaging diagnosis.

    Science.gov (United States)

    Gómez, E J; del Pozo, F; Quiles, J A; Arredondo, M T; Rahms, H; Sanz, M; Cano, P

    1996-01-01

    Telemedicine is changing the classical form of health care delivery, by providing efficient solutions to an increasing number of new situations: here we consider those which require some type of computer-supported cooperative work (CSCW) between health care professionals located in different clinical sites. This paper presents the design and development of a telemedicine system for remote computer-supported cooperative medical imaging diagnosis. The main and novel component of our system is a new CSCW distributed architecture, comprised by a collaborative toolkit to add audioconferencing, telepointing, window sharing, user's coordination and application synchronization facilities, either to existing or new medical imaging diagnosis applications. In comparison with existing CSCW products, mainly based on centralized architectures, our distributed toolkit is specially designed for telemedicine applications: to allow different levels of sharing between participants, to improve user feedback in highly interactive user interfaces, and to optimize the required communication bandwidth in order to implement a telemedicine CSCW application on almost any telecommunication network. This telemedicine CSCW system has been applied to build a cooperative medical imaging diagnosis application, in which two doctors, located in different hospitals, need to achieve a cooperative diagnosis on haemodynamic studies using cardiac angiography images. The design of the graphical user interface for this kind of telemedicine CSCW systems, a critical component which conforms any telemedicine application, is also addressed with a new methodological approach, to assure the system usability and final user acceptance. The telemedicine cardiac angiography pilot has been implemented, tested and evaluated within the Research Project 'FEST-Framework for European Services in Telemedicine' funded by EU AIM Programme.

  11. Practising cloud-based telemedicine in developing countries.

    Science.gov (United States)

    Puustjärvi, Juha; Puustjärvi, Leena

    2013-01-01

    In industrialised countries, telemedicine has proven to be a valuable tool for enabling access to knowledge and allowing information exchange, and showing that it is possible to provide good quality of healthcare to isolated communities. However, there are many barriers to the widespread implementation of telemedicine in rural areas of developing countries. These include deficient internet connectivity and sophisticated peripheral medical devices. Furthermore, developing countries have very high patients-per-doctor ratios. In this paper, we report our work on developing a cloud-based health information system, which promotes telemedicine and patient-centred healthcare by exploiting modern information and communication technologies such as OWL-ontologies and SQL-triggers. The reason for using cloud technology is twofold. First, cloud service models are easily adaptable for sharing patients health information, which is of prime importance in patient-centred healthcare as well as in telemedicine. Second, the cloud and the consulting physicians may locate anywhere in the internet.

  12. Clinical aspects of telemedicine

    Science.gov (United States)

    Merrell, Ronald C.

    1991-01-01

    Communication among physicians is an essential in order to combine our experiences for the elucidation and application of new knowledge and for the accurate and uniform application of established medical practice. This communication requires an adequate understanding of the culture of the patient and the social context of disease and indeed the culture of the physician. Malnutrition in Bangladesh means caloric insufficiency, and a program to lower cholesterol would be impertinent, while a program to enhance the nutrition of patients in Texas by an international effort to import more grain would be ludicrous. In the same vein a public health effort to combat alcoholic cirrhosis in Mecca would be as silly as a program to increase fiber in the diet of the Bantu. Clinical communication must acknowledge the culture of the issue at hand and the differences in the experiential base of the physicians. Not only do geography and culture affect the potential differences in the experiential bases, but the world utilizes very different traditions of education and science in training physicians. We are influenced by the diseases we treat, and learn to look for the expected at least as much as we are attentive to the unexpected. A physician in Siberia would be much more likely to recognize frostbite than one from Buenos Aires, and the Argentine doctor would much more likely consider Chaga's Disease to explain abdominal pain than a colleague in Zurich. Beyond these obvious issues in communication among physicians we must deal with the many languages and idioms used in the world. An overview of using Telemedicine SpaceBridge after the earthquake in the Republic of Armenia in 1988 is presented.

  13. Telemedicine and telepresence for trauma and emergency care management.

    Science.gov (United States)

    Latifi, R; Weinstein, R S; Porter, J M; Ziemba, M; Judkins, D; Ridings, D; Nassi, R; Valenzuela, T; Holcomb, M; Leyva, F

    2007-01-01

    The use of telemedicine is long-standing, but only in recent years has it been applied to the specialities of trauma, emergency care, and surgery. Despite being relatively new, the concept of teletrauma, telepresence, and telesurgery is evolving and is being integrated into modern care of trauma and surgical patients. This paper will address the current applications of telemedicine and telepresence to trauma and emergency care as the new frontiers of telemedicine application. The University Medical Center and the Arizona Telemedicine Program (ATP) in Tucson, Arizona have two functional teletrauma and emergency telemedicine programs and one ad-hoc program, the mobile telemedicine program. The Southern Arizona Telemedicine and Telepresence (SATT) program is an inter-hospital telemedicine program, while the Tucson ER-link is a link between prehospital and emergency room system, and both are built upon a successful existing award winning ATP and the technical infrastructure of the city of Tucson. These two programs represent examples of integrated and collaborative community approaches to solving the lack of trauma and emergency care issue in the region. These networks will not only be used by trauma, but also by all other medical disciplines, and as such have become an example of innovation and dedication to trauma care. The first case of trauma managed over the telemedicine trauma program or "teletrauma" was that of an 18-month-old girl who was the only survival of a car crash with three fatalities. The success of this case and the pilot project of SATT that ensued led to the development of a regional teletrauma program serving close to 1.5 million people. The telepresence of the trauma surgeon, through teletrauma, has infused confidence among local doctors and communities and is being used to identify knowledge gaps of rural health care providers and the needs for instituting new outreach educational programs.

  14. Use of telemedicine in disaster and remote places

    OpenAIRE

    Ajami, Sima; Lamoochi, Parisa

    2014-01-01

    One of the methods, especially those living in remote areas or have crashed and does not have access to specialists is telemedicine. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status and care. Travel and wait times between the initial consultations with the patient's own general practitioner and referral to specialist can be reduced and specialists have successfully provided remote triage a...

  15. Narrative review of telemedicine consultation in medical practice

    Directory of Open Access Journals (Sweden)

    Di Cerbo A

    2015-01-01

    Full Text Available Alessandro Di Cerbo,1,2 Julio Cesar Morales-Medina,3 Beniamino Palmieri,1,2 Tommaso Iannitti4 1Poliambulatorio del Secondo Parere, 2Department of General Surgery and Surgical Specialties, Surgical Clinic, University of Modena and Reggio Emilia Medical School, Modena, Italy; 3Centro de Investigación en Reproducción Animal, CINVESTAV, Universidad Autónoma de Tlaxcala, Tlaxcala de Xicohténcatl, Mexico; 4Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN, University of Sheffield, Sheffield, UK Background: The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”.Objective: This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care.Methods: A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-­medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty.Results: Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions.Conclusion: Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. Keywords: telemedicine, health care, patient

  16. Applications of telemedicine in dentistry. Review of literature

    OpenAIRE

    Elmokadem, Mohamed Said Elsayed

    2013-01-01

    The aim of this study was to review the different papers and articles that discuss applications of telemedicine in the dental field. This study is qualitative narrative review of literature Research of teledentistry literature was conducted in order to identify the relevant articles. The research focused on the electronic database of US National library of medicine .National institute of health (Pubmed.gov) and Journal of telemedicine and telecare. Specific keywords that were used in the rese...

  17. Telematic Requirements for a Mobile and Wireless Healthcare System derived from Enterprise Models

    NARCIS (Netherlands)

    Widya, I.; Halteren, van A.; Jones, V.; Bults, R.; Konstantas, D.; Vierhout, P.A.M.; Peuscher, J.; Jevtic, D.; Mikuc, M.

    2003-01-01

    A challenge of current innovation in healthcare processes is to improve the time to treatment. This paper addresses the benefits of telematic services and mobile & wireless devices such as vital sign sensors and head mounted cameras for healthcare processes. It explores the telematic requirements fo

  18. HIN3/396: Experience of Creation of the National (Regional) Telematics Medical Corporate Network in Ukraine

    Science.gov (United States)

    Mayorov, O; Ponomarenko, V; Kalnish, V

    1999-01-01

    Introduction Ukraine has an extensive experience on creating and maintaining National Medical Networks. A variety of examples include: The National Register of the persons suffered from the Chernobyl disaster: Net of the Sanitary and Epidemiological Service of the Ministry of Health. The National Medical Network for monitoring oncology patients: this links Regional Oncology Dispensaries with Institute of Oncology. Ukraine has a membership to "EuroTransplant" and National Medical Network in this effort has linked Regional Centres with the National Informational Centre on Transplantation. Regional databases from Regional Venereologic Dispensaries, used for monitoring diseases, have been extended to include cases of AIDS. The Telemedical Cardiology Centre in Kharkiv, with trans-telephone ECG. All equipment, including portable ECG amplifiers and modems, is developed in the Ukraine. Teleconsulting Medical Centres, in Kiev, for the analysis of MRI images. The centre "Patholog", in which oncologists - cytologists carry out work. The Ukrainian Association of Computer Medicine (UACM) has created (http: //www.uacm.cit-a.net) WWW- server , which has become a nucleus of the Corporate medical network permitting to exchange the information to 78 institutional members and over 900 individual members. The UACM has created affiliate Web - EHTO-UKRAINE server on national language (http://www.ehto-ukr.cit-ua.net). Ukraine took part in the "Telemedecine Medical Care Networks within the Baltic Region" programme. Also, Ukraine started the Ukrainian- American project on the monitoring of birth defects. Methods The National Telematics Medical Corporate Network 'UkrMedNet' is under construction on the basis of existing the HealthNet and some other autonomous medical networks, with the newest of telecommunication technologies, used in Internet. This project also envisages the integration of all existing separate medical nets, universities and R&D institutes into one 'UkrMedNet', as well as

  19. ICT BASED TELEMEDICINE FOR THE EGYPTIAN SOCIETY

    Directory of Open Access Journals (Sweden)

    Hafez A. Fouad

    2013-12-01

    Full Text Available The One of the most challenging problems that encounter the Egyptian society is the lack of significant health care in the rural areas. This problem leads to more severe problems that face the society; the patients from the different rural areas needs to travel to the Egyptian capital where the most experienced physicians are available. This will make overhead not only on the patient budget but on the country budget since the focus on the capital makes a severe traffic problem which threaten most of the economic sectors. The telemedicine is considered one of the most important solutions that could mitigate the accumulated problems of lack of experienced physicians in the Egyptian rural areas. The application of the telemedicine encounters several challenges in Egypt; the lack in the experience in dealing with the telemedicine in these areas and the problem of insufficient medical experts that could fulfil the gab. In this paper, a new ICT-based telemedicine system is proposed to serve the Egyptian society. The portal is already released and snapshots are included

  20. Telemedicine systems and telecommunications.

    Science.gov (United States)

    Harnett, Brett

    2006-01-01

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

  1. The human-computer interaction design of self-operated mobile telemedicine devices

    OpenAIRE

    Zheng, Shaoqing

    2015-01-01

    Human-computer interaction (HCI) is an important issue in the area of medicine, for example, the operation of surgical simulators, virtual rehabilitation systems, telemedicine treatments, and so on. In this thesis, the human-computer interaction of a self-operated mobile telemedicine device is designed. The mobile telemedicine device (i.e. intelligent Medication Box or iMedBox) is used for remotely monitoring patient health and activity information such as ECG (electrocardiogram) signals, hom...

  2. 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

  3. Telemedicine: challenges to dissemination in Brazil

    Directory of Open Access Journals (Sweden)

    Jose Manuel Santos de Varge Maldonado

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

  4. Telematics-based online client-server/client collaborative environment for radiotherapy planning simulations.

    Science.gov (United States)

    Kum, Oyeon

    2007-11-01

    Customized cancer radiation treatment planning for each patient is very useful for both a patient and a doctor because it provides the ability to deliver higher doses to a more accurately defined tumor and at the same time lower doses to organs at risk and normal tissues. This can be realized by building an accurate planning simulation system to provide better treatment strategies based on each patient's tomographic data such as CT, MRI, PET, or SPECT. In this study, we develop a real-time online client-server/client collaborative environment between the client (health care professionals or hospitals) and the server/client under a secure network using telematics (the integrated use of telecommunications and medical informatics). The implementation is based on a point-to-point communication scheme between client and server/client following the WYSIWIS (what you see is what I see) paradigm. After uploading the patient tomographic data, the client is able to collaborate with the server/client for treatment planning. Consequently, the level of health care services can be improved, specifically for small radiotherapy clinics in rural/remote-country areas that do not possess much experience or equipment such as a treatment planning simulator. The telematics service of the system can also be used to provide continued medical education in radiotherapy. Moreover, the system is easy to use. A client can use the system if s/he is familiar with the Windows(TM) operating system because it is designed and built based on a user-friendly concept. This system does not require the client to continue hardware and software maintenance and updates. These are performed automatically by the server.

  5. Integrated Solution Research of Military Health Consultation Aiding Xinjiang and Local Telemedicine Platform%军队卫生援疆与地方远程医疗平台整合方案研究

    Institute of Scientific and Technical Information of China (English)

    王武化; 高山

    2016-01-01

    Objective: Integrate military and local telemedicine resources to design a normal operation and management platform for military and local hospitals. Method: On the basis of analyzing the military and locality telemedicine resources, this paper proposes remote medical management platform architecture of normalization operations, extend the function of existing locality telemedicine platform. Result: Design a telemedicine consultation system sharing for military hospital and 86 county hospitals in Xinjiang. Conclusion: Achieve the design and application of Military health consultation aiding Xinjiang platform, discuss the related issue.%目的:整合军地远程医疗资源,设计一套军民融合的远程医疗常态化运营管理平台。方法:在分析军地医疗机构远程医疗资源特点的基础上,提出了常态化运营的远程医疗管理平台架构,利用地方现有远程医疗平台进行功能扩展。结果:设计开发出军民共用部队医院卫生援疆86所县医院远程医疗会诊系统。结论:实现了军队医院开展卫生援疆远程医疗管理平台的设计应用,探讨了军民融合下军队医院对地方医疗机构开展医疗远程会诊的相关问题。

  6. An Overview of Potential Factors for Effective Telemedicine Transfer to Sub-Saharan Africa.

    Science.gov (United States)

    Meso, Peter; Mbarika, Victor W A; Sood, Sanjay Prakash

    2009-09-01

    This paper gives an overview of core factors mitigating effective transfer of TeleMedicine to Sub-Saharan Africa (SSA) as a capability for improving the extremely poor state of healthcare delivery systems in that region of the world. Using specific examples of TeleMedicine applications, such as in TeleRadiology and health education, the paper highlights the importance of TeleMedicine in SSA. It then presents the salient factors that influence TeleMedicine technology transfer in the form of a conceptual framework. In explaining the framework, the paper offers opinions and supportive arguments on the importance and significance of the identified factors in effective TeleMedicine "uptake" within the SSA. We believe the framework provides a grounded theoretical basis that information and communications technologies (ICT) or technology transfer researchers can use for empirical investigation in order to understand the efficacy of TeleMedicine adoption within developing countries at large.

  7. 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

  8. Telemedicine implementation and benefits for quality and patient safety in Pakistan

    Directory of Open Access Journals (Sweden)

    Ijaz A. Qureshi

    2015-09-01

    Full Text Available Telemedicine is becoming an important aspect in developing countries to provide better health facilities. Rural areas in developing countries suffer due to lack of health facilities and face difficulties like time to reach health facilities at the faraway places, cost of reaching at a health care facility, and transportation needed to move around for the treatment/consulting purpose. Telemedicine could be used for safe and quality health by specialists at low cost in rural areas in Pakistan. Telemedicine services could be provided through video sharing, image sharing, mobile services or by e-mail. A research study was conducted to analyze the implementation and to explore the benefits of telemedicine in Pakistan. We distributed 150 questionnaires among teaching hospital doctors in city of Lahore, out of which we received 147 completed questionnaires. Three of the questionnaires were rejected due to incomplete information. The questionnaires were given to participants in the scheduled classes and collected at the end of class. Instructors were requested to allow students to complete questionnaires. The results showed 66.32% doctors of teaching hospital agreed to implement telemedicine for rural areas in Pakistan. 78.9% doctors agreed that telemedicine will save travelling time and money for availing expert opinion. However, 30.6% doctors agreed that Telemedicine will be beneficial for urban community – obtained the lowest score. The enhanced link between doctors and telemedicine can contribute to provide better health facilities in rural areas.

  9. Neurosurgery and Telemedicine in the United States: Assessment of the Risks and Opportunities.

    Science.gov (United States)

    Kahn, Elyne N; La Marca, Frank; Mazzola, Catherine A

    2016-05-01

    Telemedicine has seen substantial growth in the past 20 years, related to technologic advancements and evolving reimbursement policies. The risks and opportunities of neurosurgical telemedicine are nuanced. We reviewed general and peer-reviewed literature as it relates to telemedicine and neurosurgery, with particular attention to best practices, relevant state and federal policy conditions, economic evaluations, and prospective clinical studies. Despite technologic development, growing interest, and increasing reimbursement opportunities, telemedicine's utilization remains limited because of concerns regarding an apparent lack of need for telemedicine services, lack of widespread reimbursement, lack of interstate licensure reciprocity, lack of universal access to necessary technology, concerns about maintaining patient confidentiality, and concerns and limited precedent regarding liability issues. The Veterans Health Administration, a component of the U.S. Department of Veterans Affairs, represents a setting in which these concerns can be largely obviated and is a model for telemedicine best practices. Results from the VA demonstrate substantial cost savings and patient satisfaction with remote care for chronic neurologic conditions. Overall, the economic and clinical benefits of telemedicine will likely come from 1) diminished travel times and lost work time for patients; 2) remote consultation of subspecialty experts, such as neurosurgeons; and 3) remote consultation to assist with triage and care in time-sensitive scenarios, including acute stroke care and "teletrauma." Telemedicine is effective in many health care scenarios and will become more relevant to neurosurgical patient care. We favor proceeding with legislation to reduce barriers to telemedicine's growth. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Sygeplejerskers arbejde med telemedicin i en tværsektoriel kontekst / Nurses working with Telemedicine in a cross-sectional setting

    DEFF Research Database (Denmark)

    Lunde, Anita; Drachmann, Astrid Lykke; Christiansen, Karin

    2017-01-01

    the primary and secondary sectors, working with telemedicine in a project entitled, Hor-sens på forkant med sundhed (Horsens on the frontiers of Health). The analysis is da-ta-driven and reveals that cultivation of competences is closely associated to structural conditions. Nurses emphasize that telemedicine......The introduction of telemedicine will transform the health care sector and bring changes to the role and function of nurses. In this inquiry we ask, what competences are required in the ‘doing’ of telemedicine? The project is based on interviews with two focus groups involving nurses from...... has to be meaningful and a flexible and technically reliable solution. The possession of technical skills and a personal in-terest in telemedicine are advantageous. More important, however, are high clinical skills and competences in caring relationships. Nurses from diverse clinical settings report...

  11. 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.

  12. Scaling up Telemedicine

    DEFF Research Database (Denmark)

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

    Although the processes of innovation have attracted attention of an increasing number of scholars, its political dynamics remains underexplored. Against this backdrop, this paper examines political behavior as critical aspects of the process of scaling up innovations. We revisit the concepts...... 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...... 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...

  13. 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.

  14. Telemedicine in neurosciences.

    Science.gov (United States)

    Ganapathy, K; Ravindra, Aditi

    2008-01-01

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

  15. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    Science.gov (United States)

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network.

  16. Telemedicine: socio-ethical considerations in the Indian milieu.

    Science.gov (United States)

    Sharma, Luv K; Rajput, Meena

    2009-01-01

    Telemedicine is the rapidly developing application of clinical medicine by telephone, the internet or other networks for the purpose of consulting, and on occasions carrying out examinations or medical procedures. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries. Telemedicine offers real benefits in a country as vast as India where the majority of the population lives in remote areas with no access to even the most basic healthcare. As the practice of telemedicine spreads, maintaining standards, security and privacy, will be a challenge especially with regard to legal and regulatory measures and who will be held responsible if telemedicine-assisted surgery fails due to failure in connectivity? Is it the surgeon, the satellite provider or the software/hardware engineer? What is the legal status of telemedicine-based diagnosis and treatment? Other legal issues involve conflicting national laws and information piracy, the dangers of prescription drugs that are banned in one country but not in another and quacks who offer medical advice and prescribe drugs over the internet. This paper discusses some of the legal, ethical and social considerations in the Indian context.

  17. 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.

  18. Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment.

    Science.gov (United States)

    Amadi-Obi, Ahjoku; Gilligan, Peadar; Owens, Niall; O'Donnell, Cathal

    2014-01-01

    The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality research, should be developed. Telemedicine is well suited to extending the reach of specialist services particularly in the pre-hospital care of acute emergencies where treatment delays may affect clinical outcome. The exponential growth in research and development in telemedicine has led to improvements in clinical outcomes in emergency medical care. This review is part of the LiveCity project to examine the history and existing applications of telemedicine in the pre-hospital environment. A search of electronic databases including Medline, Excerpta Medica Database (EMBASE), Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant papers was performed. All studies addressing the use of telemedicine in emergency medical or pre-hospital care setting were included. Out of a total of 1,279 articles reviewed, 39 met the inclusion criteria and were critically analysed. A majority of the studies were on stroke management. The studies suggested that overall, telemedicine had a positive impact on emergency medical care. It improved the pre-hospital diagnosis of stroke and myocardial infarction and enhanced the supervision of delivery of tissue thromboplasminogen activator in acute ischaemic stroke. Telemedicine presents an opportunity to enhance patient management. There are as yet few definitive studies that have demonstrated whether it had an effect on clinical outcome.

  19. The research agenda in ICU telemedicine: a statement from the Critical Care Societies Collaborative.

    Science.gov (United States)

    Kahn, Jeremy M; 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

    2011-07-01

    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.

  20. A Correlational Study of the Technology Acceptance Model and Georgia Behavioral Healthcare Provider Telemedicine Adoption

    Science.gov (United States)

    Yallah, Ali

    2014-01-01

    The implementation of Telemedicine in behavioral health centers can be expensive if proactive steps were not taken to minimize user perceptions towards the new technology. Despite the significant capital investments on new Telemedicine, no consensus identified and explained what factors determined the acceptance, or rejection, of the technology.…

  1. A Correlational Study of the Technology Acceptance Model and Georgia Behavioral Healthcare Provider Telemedicine Adoption

    Science.gov (United States)

    Yallah, Ali

    2014-01-01

    The implementation of Telemedicine in behavioral health centers can be expensive if proactive steps were not taken to minimize user perceptions towards the new technology. Despite the significant capital investments on new Telemedicine, no consensus identified and explained what factors determined the acceptance, or rejection, of the technology.…

  2. 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.

  3. Usability Problems in a Home Telemedicine System

    DEFF Research Database (Denmark)

    Bruun, Anders; Stage, Jan

    2010-01-01

    Home telemedicine systems have the potential to reduce health care costs and improve the quality of life for many patients, including those suffering from chronic illness. This requires that the systems have functionality that fulfils relevant needs. Yet it also requires that the systems have...... 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....

  4. Use of telemedicine in disaster and remote places.

    Science.gov (United States)

    Ajami, Sima; Lamoochi, Parisa

    2014-01-01

    One of the methods, especially those living in remote areas or have crashed and does not have access to specialists is telemedicine. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients' health status and care. Travel and wait times between the initial consultations with the patient's own general practitioner and referral to specialist can be reduced and specialists have successfully provided remote triage and treatment consults of victims via the robot. The robot proved to be a useful means to extend resources and provide expert consulting if specialists were unable to physically be at the site. In fact, the telemedicine system is providing health care services for individuals who are not available because of geographical and environmental conditions. The aim of this study was to identify telemedicine applications in disaster, and proposed use of this technology in areas where the shortage of specialists in remote areas in disasters. This study was un-systematic (narrative) review. The literature was searched for using of telemedicine in disaster and remote places with the help of libraries, conference proceedings, data bank, and also search engines available at Google, Google scholar. In our searches, we employed the following keywords and their combinations: telemedicine, remote place, earthquake, disaster, war, and telecommunication in the searching areas of title, keyword, abstract, and full text. In this study, more than 85 articles and reports were collected and 26 of them were selected based on their relevancy. This literature review helps define the concept of "components and usages of the Telemedicine in disaster" as the new technology in the present age.

  5. Telemedicine for Gestational Diabetes Mellitus (TeleGDM): A Mixed-Method Study Protocol of Effects of a Web-Based GDM Support System on Health Service Utilization, Maternal and Fetal Outcomes, Costs, and User Experience.

    Science.gov (United States)

    Rasekaba, Tshepo Mokuedi; Lim, Kwang; Blackberry, Irene; Gray, Kathleen; Furler, John

    2016-08-09

    Women with insulin-treated gestational diabetes mellitus (GDM) require close monitoring and support to manage their diabetes. Recent changes to the diagnostic criteria have implications for service provision stemming from increased prevalence, suggesting an increased burden on health services in the future. Telemedicine may augment usual care and mitigate service burdens without compromising clinical outcomes but evidence in GDM is limited. The Telemedicine for Gestational Diabetes Mellitus (TeleGDM) trial aims to explore the use of telemedicine in supporting care and management of women with GDM treated with insulin. The TeleGDM is a mixed-methods study comprising an exploratory randomized controlled trial (RCT) and a qualitative evaluation using semistructured interviews. It involves women with insulin-treated GDM who are up to 35 weeks gestation. Participating patients (n=100) are recruited face-to-face in outpatient GDM clinics at an outer metropolitan tertiary hospital with a culturally diverse catchment and a regional tertiary hospital. The second group of participants (n=8) comprises Credentialed Diabetes Educator Registered Nurses involved in routine care of the women with GDM at the participating clinics. The RCT involves use of a Web-based patient-controlled personal health record for GDM data sharing between patients and clinicians compared to usual care. Outcomes include service utilization, maternal and fetal outcomes (eg, glycemic control, 2nd and 3rd trimester fetal size, type of delivery, baby birth weight), diabetes self-efficacy, satisfaction, and costs. Semistructured interviews will be used to examine user experiences and acceptability of telemedicine. The trial recruitment is currently underway. Results are expected by the end of 2016 and will be reported in a follow-up paper. Innovative use of technology in supporting usual care delivery in women with GDM may facilitate timely access to GDM monitoring data and mitigate care burdens without

  6. Telemedicine for Gestational Diabetes Mellitus (TeleGDM): A Mixed-Method Study Protocol of Effects of a Web-Based GDM Support System on Health Service Utilization, Maternal and Fetal Outcomes, Costs, and User Experience

    Science.gov (United States)

    Lim, Kwang; Blackberry, Irene; Gray, Kathleen; Furler, John

    2016-01-01

    Background Women with insulin-treated gestational diabetes mellitus (GDM) require close monitoring and support to manage their diabetes. Recent changes to the diagnostic criteria have implications for service provision stemming from increased prevalence, suggesting an increased burden on health services in the future. Telemedicine may augment usual care and mitigate service burdens without compromising clinical outcomes but evidence in GDM is limited. Objective The Telemedicine for Gestational Diabetes Mellitus (TeleGDM) trial aims to explore the use of telemedicine in supporting care and management of women with GDM treated with insulin. Methods The TeleGDM is a mixed-methods study comprising an exploratory randomized controlled trial (RCT) and a qualitative evaluation using semistructured interviews. It involves women with insulin-treated GDM who are up to 35 weeks gestation. Participating patients (n=100) are recruited face-to-face in outpatient GDM clinics at an outer metropolitan tertiary hospital with a culturally diverse catchment and a regional tertiary hospital. The second group of participants (n=8) comprises Credentialed Diabetes Educator Registered Nurses involved in routine care of the women with GDM at the participating clinics. The RCT involves use of a Web-based patient-controlled personal health record for GDM data sharing between patients and clinicians compared to usual care. Outcomes include service utilization, maternal and fetal outcomes (eg, glycemic control, 2nd and 3rd trimester fetal size, type of delivery, baby birth weight), diabetes self-efficacy, satisfaction, and costs. Semistructured interviews will be used to examine user experiences and acceptability of telemedicine. Results The trial recruitment is currently underway. Results are expected by the end of 2016 and will be reported in a follow-up paper. Conclusions Innovative use of technology in supporting usual care delivery in women with GDM may facilitate timely access to GDM

  7. ESTABLISHMENT OF A NEW TYPE OF URBAN HEALTH CARE SERVICE SYSTEM BASE ON TELEMEDICINE%基于远程医学构建新型城市医疗卫生服务体系的探讨

    Institute of Scientific and Technical Information of China (English)

    陈超; 许统亮; 张永; 胡桂周

    2014-01-01

    This paper explores the establishment of a new type of urban health care service system base on telemedi-cine.Firstly, the background and patterns of the system are presented.Secondly, the development status of telemedicine and the existing problems of community health service are analyzed.Thirdly, the idea is proposed to establish a new type of urban health care service system base on telemedicine.Finally, analyzed the necessity and feasibility of implementing this new measure, the author proposed the appropriate ways to carry on this new measure.%通过介绍新型城市医疗卫生服务体系构建的背景、模式,分析远程医学发展的现状,结合社区卫生服务发展存在的问题,提出利用远程医学构建新型城市医疗卫生服务体系的观点,并对实施的必要性和可行性进行分析,提出相应的措施。

  8. Florida TeleHealth Summit: “Telemedicine –It’s Here, It’s Now”

    Directory of Open Access Journals (Sweden)

    Samantha Wainright Haas

    2015-07-01

    Full Text Available The Southeastern Telehealth Resource Center, Florida State University College of Medicine, and the Florida Partnership for TeleHealth invites participation in the 2nd Annual Florida TeleHealth Summit. The Summit will be held December 3-4, 2015 at the Alfond Inn, Winter Park, Florida. For further information about the Southeastern Telehealth Resource Center and the Summit, visit: http://www.setrc.us/

  9. Hybrid ecologies: interactions between artificial and natural organisms in telematic environments

    OpenAIRE

    Guto Nóbrega

    2011-01-01

    This paper reports and analyses two projects in telematic art realized in 2011 that had the participation of NANO – Nucleus of Art and New Organisms - School of Fine Arts - UFRJ, research laboratory coordinated by Dr. Carlos (Guto) Nobrega and Dr. Maria Luisa Fragoso, as part of the Post Graduate Program in Visual Arts. Both projects involved the creation of artificial systems for interactivity in telematic environments. The text will present relevant points of the two projects, their relatio...

  10. Determinants of telemedicine acceptance in selected public hospitals in Malaysia: clinical perspective.

    Science.gov (United States)

    Zailani, Suhaiza; Gilani, Mina Sayyah; Nikbin, Davoud; Iranmanesh, Mohammad

    2014-09-01

    The purpose of this study is to explore the determinants of telemedicine acceptance in selected public hospitals in Malaysia and to investigate the effect of health culture on the relationship between these determinants and telemedicine acceptance. Data were gathered by means of a survey of physicians and nurses as the main group of users of telemedicine technology from hospitals that are currently using telemedicine technology. The results indicated that government policies, top management support, perception of usefulness and computer self-efficiency have a positive and significant impact on telemedicine acceptance by public hospitals in Malaysia. The results also confirmed the moderating role of health culture on the relationship between government policies as well as perceived usefulness on telemedicine acceptance by Malaysian hospitals. The results are useful for decision-makers as well as managers to recognize the potential role of telemedicine and assist in the process of implementation, adoption and utilization, and, therefore, spread the usage of telemedicine technology in more hospitals in the country.

  11. [Telemedicine in your suitcase: useful tools for the traveler].

    Science.gov (United States)

    Geissbuhler, A

    2014-05-07

    In our digital age, telemedicine becomes, under various forms, a useful companion for the traveler, providing access to up-to-date information about health and security risks, remote consultation of specialists to ascertain a diagnosis of select an appropriate treatment, connection to similar patients in order to obtain contextualized advice, biomedical sensors and other monitoring and diagnostic portable tools, as well as transportable electronic health records enabling continuity of care and mobility. Commercial telemedicine services are being developed specifically for travelers, most of which are using mobile phones as the main device, which thus becomes a real telestethoscope.

  12. MEDNET: Telemedicine via Satellite Combining Improved Access to Health-Care Services with Enhanced Social Cohesion in Rural Peru

    Science.gov (United States)

    Panopoulos, Dimitrios; Sachpazidis, Ilias; Rizou, Despoina; Menary, Wayne; Cardenas, Jose; Psarras, John

    Peru, officially classified as a middle-income country, has benefited from sustained economic growth in recent years. However, the benefits have not been seen by the vast majority of the population, particularly Peru's rural population. Virtually all of the nation's rural health-care centres are cut off from the rest of the country, so access to care for most people is not only difficult but also costly. MEDNET attempts to redress this issue by developing a medical health network with the help of the collaboration medical application based on TeleConsult & @HOME medical database for vital signs. The expected benefits include improved support for medics in the field, reduction of patient referrals, reduction in number of emergency interventions and improved times for medical diagnosis. An important caveat is the emphasis on exploiting the proposed infrastructure for education and social enterprise initiatives. The project has the full support of regional political and health authorities and, importantly, full local community support.

  13. 浅谈基于区域卫生信息平台的远程医疗系统建设及应用%DISCUSSION ON THE CONSTRUCTION AND APPLICATION OF TELEMEDICINE SYSTEM BASED ON REGIONAL HEALTH INFORMATION PLATFORM

    Institute of Scientific and Technical Information of China (English)

    高昭昇; 陆均暐; 李翠华; 徐静

    2015-01-01

    This paper mainly introduces the construction objective , technical framework and main functions of Guangzhou telemedicine system and probes into telemedicine service model by making two successful examples of Guangdou First Peoples'Hospital and Huashan Hospital.Through the application of telemedicine remote consultation, construction of remote diagnosis, remote educa-tion, two-way referral and remote reservation, the quality resources of the comprehensive hospital can be shared so as to deal with the problems from unbalanced displaying of medical health resources and speed up the resolution of the difficulties in visiting a doctor and the problem of high medical expenses"so as to improve the level of medical service and improve the primary hospital severe problems the level of treatment.%介绍广州市基于区域卫生信息平台的远程医疗系统建设目标、技术架构及主要功能,并结合广州市第一人民医院以及花山医院试点建设成效,探讨远程医疗服务应用模式。通过建设远程会诊、远程诊断、远程教育、双向转诊和远程预约等多元化的远程医疗应用,促进大型医院优质资源共享共用,缓解医疗卫生资源分布不均衡、促进解决群众“看病难、看病贵”等问题,从而提高基层医院医疗服务水平及提高疑难重症救治水平。

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

    Science.gov (United States)

    2010-09-01

    other than nurses (social workers, health aids or pharmacists ) can function as care mangers. Other research areas of importance were identified as...healthcare team that includes MDs, NPs, educators, sub-specialists, nutritionists, and behavioral clinicians . The CDMP is designed to be

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

    Science.gov (United States)

    2007-04-01

    AD_________________ Award Number: W81XWH-06-2-0031 TITLE: Diabetes Care and Treatment Project: A... Diabetes Institute of the Walter Reed Health Care System and Joslin Telemedicie PRINCIPAL INVESTIGATOR: Robert A. Vigersky, COL MC...COVERED (From - To) 10 Mar 2006 – 9 Mar 2007 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Diabetes Care and Treatment Project: A Diabetes Institute

  16. Social Networking of Instrumentation - a Case Study in Telematics

    Directory of Open Access Journals (Sweden)

    ROBU, D.

    2014-05-01

    Full Text Available The research work contributes to the design and implementation of the communication part for integrating remote instruments and drives via social networks (SN into instrumentation communities. It is used the virtual instrumentation (VI to manage objects that tweet on popular SN platforms applying the concept of the Internet of Things (IoT. Local and remote resource aggregation is based on National Instruments (NI data acquisition and distribution hardware in a NI software environment. NI LabVIEW-for-Twitter solutions (starting with simple authentication are extended, integrated with various third party services and validated in a complete remote monitoring proof-of-concept workbench with a closed loop for alarming-compensation. Solutions are extendible to Machine-to-Machine communication (M2M IoT scenarios for telematics, monitoring or control, and can be connected to intelligent systems based on powerful servers for cloud computing.

  17. Model for the Adoption of Telemedicine in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Dayani Jayasinghe

    2016-09-01

    Full Text Available We report the results of the study that explored the factors characterizing the introduction of telemedicine to the rural areas of Sri Lanka. A model was developed from the analysis of the literature, expert review, and a field study conducted in three districts of Sri Lanka, which involved clinicians, hospital staff, and the general public from both rural and urban areas. Health ministry officials, medical directors, and consultants from urban areas were also consulted. Quantitative data from the questionnaires, and qualitative data from the interviews, were analyzed to investigate the impact on culture, technology, and infrastructure when adopting a telemedicine system in rural areas of Sri Lanka. The TeleMedicine in Sri Lanka (TMSL model is presented, which expresses the factors that hinder the acceptance of telemedicine in Sri Lanka. The key findings are that an understanding of the culture of Sri Lanka and additional computing skills are essential when implementing a telemedicine system in the rural areas of the country.

  18. Telemedicine in neurology: underutilized potential.

    Science.gov (United States)

    Misra, U K; Kalita, J; Mishra, S K; Yadav, R K

    2005-03-01

    Advances in telecommunication which started with telephone lines, FAX, integrated service digital network (ISDN) lines and now internet have provided an unprecedented opportunity for transfer of knowledge and sharing of information. The information can be used for overlapping applications in patient care, teaching and research. In medicine there is increasing utilization of telemedicine; radiology and pathology being regarded as mature specialties and emergency medicine as maturing specialties compared to other evolving specialties which include psychiatry, dermatology, cardiology and ophthalmology. Of the emergencies, status epilepticus and stroke have high potential for improving patient management. Administration of tPA was more frequent when carried out under telemedicine guidance. Telemedicine has great potential for medical education. The principles of education are in congruence with those of telemedicine and can be closely integrated in the existing medical education system. Our experience of telemedicine as a medical education tool is based on video conferencing with SCB Medical College, Cuttack. We had 30 sessions during 2001 to 2004 in which 2-3 cases were discussed in each session. The patients' details, radiological and neurophysiological findings could be successfully transmitted. These conferences improved the knowledge of participants, provided an opportunity for a second opinion as well as modified the treatment decisions in some cases. The advances in telemedicine should be utilized more extensively in neurology, especially in emergency management, epilepsy and stroke patients as well, as it may have a role in neurophysiology and movement disorders.

  19. Telemedicine in neurology: Underutilized potential

    Directory of Open Access Journals (Sweden)

    Misra U

    2005-01-01

    Full Text Available Advances in telecommunication which started with telephone lines, FAX, integrated service digital network (ISDN lines and now internet have provided an unprecedented opportunity for transfer of knowledge and sharing of information. The information can be used for overlapping applications in patient care, teaching and research. In medicine there is increasing utilization of telemedicine; radiology and pathology being regarded as mature specialties and emergency medicine as maturing specialties compared to other evolving specialties which include psychiatry, dermatology, cardiology and ophthalmology. Of the emergencies, status epilepticus and stroke have high potential for improving patient management. Administration of tPA was more frequent when carried out under telemedicine guidance. Telemedicine has great potential for medical education. The principles of education are in congruence with those of telemedicine and can be closely integrated in the existing medical education system. Our experience of telemedicine as a medical education tool is based on video conferencing with SCB Medical College, Cuttack. We had 30 sessions during 2001 to 2004 in which 2-3 cases were discussed in each session. The patients′ details, radiological and neurophysiological findings could be successfully transmitted. These conferences improved the knowledge of participants, provided an opportunity for a second opinion as well as modified the treatment decisions in some cases. The advances in telemedicine should be utilized more extensively in neurology, especially in emergency management, epilepsy and stroke patients as well, as it may have a role in neurophysiology and movement disorders.

  20. American Telemedicine Association: 18th Annual International Meeting & Tradeshow

    Directory of Open Access Journals (Sweden)

    Benjamin Forstag

    2012-12-01

    Full Text Available For 18 years, the American Telemedicine Association (ATA Annual International Meeting & Exposition has been the premier forum for professionals in the telemedicine, telehealth and mHealth space -- one of the fastest growing meetings in the country. ATA 2013 is on course to be the largest ATA meeting ever, with over 6,000 projected attendees.  The program will include 500 educational sessions and posters, highlighting the latest innovations, applications and research in telemedicine. The 2013 exhibit hall will feature nearly 300 of the leading vendors in remote healthcare technologies. With over 6000 projected attendees, from all around the world, there's no better place to meet and network with your peers and thought leaders in the field. Detailed program information--including courses, sessions and CME information--will be available January 2013 at:http://www.americantelemed.org.

  1. [Effectiveness and economic impact of a program of integrated care with telemedicine support on insulin-treated type 2 diabetic patients (Study GITDIABE)].

    Science.gov (United States)

    Inoriza, Jose M; Ibañez, Annabel; Pérez-Berruezo, Xavier; Inoriza-Nadal, Cristina; Coderch, Jordi

    2017-03-01

    To evaluate if insulin-treated type 2 diabetic patients with blood glucose self-monitoring (DIA), included in a program of integrated management of diabetes mellitus (DM), achieve a better level of metabolic control with telemedicine support than with conventional support, after 12 months follow-up. The impact on the use and cost of healthcare services, pharmaceutical expenditure, and consumption of test strips for blood glucose, was also assessed. A prospective parallel cohorts study. Four basic health areas of an integrated healthcare organisation. The study included 126 DIA patients aged 15 or more years, treated with rapid or intermediate Insulin and blood glucose self-monitoring, grouped into 42 cases and 84 controls, matched according to age, sex, level of metabolic control, and morbidity profile. Telematics physician-patient communication and download of blood glucose self-monitoring data through the Emminens eConecta(®) platform; test strips home delivered according to consumption. Hidden controls with usual follow-up. Glycosylated haemoglobin (%HbA1c); perception of quality of life (EuroQol-5 and EsDQOL); cardiovascular risk; use of healthcare resources; consumption of test strips; pharmaceutical and healthcare expenditure. Reduction of 0.38% in HbA1c in the cases (95% CI:-0.89% to 0.12%). No significant differences with regard to any of the activities registered, or any significant change in the quality of life. The results obtained are similar to other equivalent studies. The profile of the patient is elderly and with multiple morbidities, who still have technological limitations. To surpass these barriers, it would be necessary to devote more time to the training and to the resolution of possible technological problems. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. The costs and potential savings of telemedicine for acute care neonatal consultation: preliminary findings.

    Science.gov (United States)

    Armfield, Nigel R; Donovan, Tim; Bensink, Mark E; Smith, Anthony C

    2012-12-01

    Telemedicine was used as a substitute for the telephone (usual care) for some acute care consultations from nurseries at four peripheral hospitals in Queensland. Over a 12-month study period, there were 19 cases of neonatal teleconsultation. Five (26%) cases of avoided infant transport were confirmed by independent assessment, four of which were avoided helicopter retrievals. We conducted two analyses. In the first, the actual costs of providing telemedicine at the study sites were compared with the actual savings associated with confirmed avoided infant transport and nursery costs. There was a net saving to the health system of 54,400 Australian Dollars (AUD) associated with the use of telemedicine over the 12-month period. In the second analysis, we estimated the potential savings that might have been achieved if telemedicine had been used for all retrieval consultations from the study sites. The total projected costs were AUD 64,969 while the projected savings were AUD 271,042, i.e. a projected net saving to the health system of AUD 206,073 through the use of telemedicine. A sensitivity analysis suggested that the threshold proportion of retrievals needed to generate telemedicine-related savings under the study conditions was 5%. The findings suggest that from the health-service perspective, the use of telemedicine for acute care neonatal consultation has substantial economic benefits.

  3. Distributed Collaborative Learning in a Telematic Context: Telematic Learning Support and its Potential for Collaborative Learning with New Paradigms and Conceptual Mapping Tools

    NARCIS (Netherlands)

    Kommers, Petrus A.M.; van der Veer, Gerrit C.; Lenting, Bert

    1998-01-01

    CSCL (Computer Supported Co‐operative Learning), better called TSCL, Telematic (and IT) Supported Co‐operative Learning, seems to be driven by both social dynamics (like the tendency to reduce the formal training component in industrial settings, and have it replaced by training on the job, handling

  4. 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…

  5. 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…

  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. Using the cloud to provide telemedicine services in a developing country

    Directory of Open Access Journals (Sweden)

    Liezel Cilliers

    2014-03-01

    Full Text Available Background: According to the World Health Organisation (WHO ‘Telemedicine is the use of medical information exchanged from one site to another via communications to improve a patient’s health’. Despite the documented advantages of telemedicine, especially in developing countries, the implementation of this technology has been slow, with most projects not succeeding past the pilot phase.Objectives: The aim of the article is to provide critical success factors (CSF that will enable the deployment of telemedicine in the cloud in order to improve health care services in developing countries.Methods: A thorough literature review was performed of peer reviewed articles in order to identify possible barriers for telemedicine to be deployed in the cloud. Furthermore, the Technology Organization Environmental Model was used in order to group the barriers according to the various factors and, from this process, critical success factors were formulated for consideration.Conclusion: Five critical success factors were formulated in order to implement telemedicine making use of the cloud in developing countries. These include having a national integrated plan for telemedicine; promoting best practices within a legislation framework; involving the end user; providing education to improve levels of telemedicine awareness amongst staff and patients, and addressing technological issues.

  8. Telemedicine-supported transition of stable coronary artery disease patients from tertiary to primary health care facilities: protocol for a randomized non-inferiority trial.

    Science.gov (United States)

    Batista, Joanna d'Arc Lyra; Furtado, Mariana Vargas; Katz, Natan; Agostinho, Milena Rodrigues; Neto, Brasil Silva; Harzheim, Erno; Polanczyk, Carisi Anne

    2016-07-07

    Many Brazilian patients with complex diseases who are treated in tertiary referral clinics have been stable for long periods. The main needs of these patients involve monitoring of risk factors and review of drug prescriptions, which could be satisfactorily done in primary care facilities. The goal of this protocol is to evaluate the safety and effectiveness of telemedicine services to support the transition of patients with stable chronic coronary artery disease from the tertiary to the primary level of care. We designed a randomized non-inferiority protocol that will include 280 patients with stable coronary artery disease (for at least 12 months). Patients will be selected from the Ischemic Heart Disease Clinic in a tertiary care hospital in southern Brazil. Enrolled participants will be randomized into one of two groups: 12 months of follow-up at the same clinic; or 12 months of follow-up at a primary care facility with clinical support from a telemedicine platform including a toll-free line for physicians (intervention group). In the intervention group, decisions to refer patients to tertiary care during follow-up will be made jointly by primary physicians and medical teleconsultants. The groups will be compared in terms of the primary outcome-maintenance of baseline functional class 1 or 2 after 12 months. Secondary outcomes include control of risk factors and instability of the disease. We intend to determine the effectiveness of using telemedicine to qualify the transition of patients with chronic coronary disease from the tertiary to the primary level of care. This should facilitate the access of patients to the healthcare system, since care will be provided closer to their homes, and provide more opportunities for treatment of severe cases at tertiary care hospitals that are often overcrowded. ClinicalTrials.gov # NCT02489565 - trial registration date May 13, 2015.

  9. Toward an information society for all: challenges in health telematics.

    Science.gov (United States)

    Emiliani, P L

    2000-01-01

    In the emerging information society each hospital is supposed to become a node of a complex networked information system that has to be accessible to a variety of users. These include doctors, nurses, administrators and the patients themselves, whose role is briefly described. This asks for a new approach to the implementation of the interfaces of the information system, which are used to carry out different tasks by people with different interests and computer literacy. A new approach to the implementation of such interfaces, based on the concepts of User interfaces for All, is briefly outlined, describing the scientific and technical achievements in some projects partially funded by the European Commission and the activities of the International Scientific Forum "Towards an Information Society for All" set-up to discuss and promote the relevant scientific concepts and technical issues.

  10. 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.

  11. 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

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

    Science.gov (United States)

    Kim, Paul T; Falcone, Richard A

    2017-02-01

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

  13. Rural telemedicine networks using store-and-forward Voice-over-IP.

    Science.gov (United States)

    Scholl, Jeremiah; Lambrinos, Lambros; Lindgren, Anders

    2009-01-01

    Store and forward Voice-over-IP is a suggested solution for supporting Telemedicine at rural health clinics in developing countries. Solutions described to date are designed to support communication by establishing point-to-point connectivity between two sites. In this paper we present an approach for creating scalable Telemedicine networks based on Delay Tolerant Networking. This holds potential for allowing Telemedicine networks to be created that can enable sharing of Teleconsultation and other medical information among a large number of locations in areas that cannot be served by existing solutions.

  14. The application of a telemedicine management system: the case of a Moroccan hospital unit.

    Science.gov (United States)

    Bennani Othmani, M; Diouny, S; Boumalif, O

    2012-01-01

    This study is a contribution to the ongoing debate on the application of informatics in medicine. It attempts to outline a theoretical framework supported by a software application of a telemedicine management system. The proposed model is based on a detailed benchmarking of Telecom environments, hardware environments, and content management systems. This approach, which uses open source technologies, helps to create an interface with two entities: web and medical care USB. In sum, for the proposed telemedicine model to be successful, health professionals, telecom operators and research medical informatics laboratories must play an active role in the conception and implementation of telemedicine applications.

  15. Discussion on the Development of Wearable Mobile Health Technology Application Research in Telemedicine%穿戴式移动医疗技术在远程医疗中的应用研究进展综述

    Institute of Scientific and Technical Information of China (English)

    闫军玲; 李楠; 杜小加; 桑发文

    2013-01-01

    It outlined the research and application of the key techniques in wearable m-health at home and aboard,which can provide guidance for the application of wearable mobile medical technology in telemedicine system of PLA.%  介绍穿戴式医疗仪器、生物医学传感器、电子织物、躯域传感网等几项穿戴式移动医疗中的关键技术在国内外远程医疗中的研究和应用情况,为穿戴式移动医疗技术在我军远程医学系统建设中的应用构想提供借鉴。

  16. 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.

  17. Hybrid ecologies: interactions between artificial and natural organisms in telematic environments

    Directory of Open Access Journals (Sweden)

    Guto Nóbrega

    2011-12-01

    Full Text Available This paper reports and analyses two projects in telematic art realized in 2011 that had the participation of NANO – Nucleus of Art and New Organisms - School of Fine Arts - UFRJ, research laboratory coordinated by Dr. Carlos (Guto Nobrega and Dr. Maria Luisa Fragoso, as part of the Post Graduate Program in Visual Arts. Both projects involved the creation of artificial systems for interactivity in telematic environments. The text will present relevant points of the two projects, their relations, resonances and unfoldings. The focus of our analysis is the process of invention of artificial interfaces, their hybridizations, complexity and modes of interaction and presence in the context of works of telematic art.

  18. A Computational framework for telemedicine.

    Energy Technology Data Exchange (ETDEWEB)

    Foster, I.; von Laszewski, G.; Thiruvathukal, G. K.; Toonen, B.; Mathematics and Computer Science

    1998-07-01

    Emerging telemedicine applications require the ability to exploit diverse and geographically distributed resources. Highspeed networks are used to integrate advanced visualization devices, sophisticated instruments, large databases, archival storage devices, PCs, workstations, and supercomputers. This form of telemedical environment is similar to networked virtual supercomputers, also known as metacomputers. Metacomputers are already being used in many scientific application areas. In this article, we analyze requirements necessary for a telemedical computing infrastructure and compare them with requirements found in a typical metacomputing environment. We will show that metacomputing environments can be used to enable a more powerful and unified computational infrastructure for telemedicine. The Globus metacomputing toolkit can provide the necessary low level mechanisms to enable a large scale telemedical infrastructure. The Globus toolkit components are designed in a modular fashion and can be extended to support the specific requirements for telemedicine.

  19. System of Systems - A Holistic Approach for Telemedicine

    Directory of Open Access Journals (Sweden)

    Adrian Petrescu

    2011-01-01

    Full Text Available New pressure factors are threatening the sustainability of the modern health systems. According to theEuropean Commission assessments [1], the demographic changes, are changing the diseases patternsand, along with the bioterrorism and the major physical and biological hazards induced by thetechnological and economic growth is causing new transmissible disease patterns. A second majoraspect is the population ageing – a phenomena which is affecting the developed countries. All thoseissues, catalyzed by the rapid development of new technologies into the fields of communication, microand nano technologies, powerful computing capabilities at affordable prices etc. are revolutionizing theway of predict, prevent and treat illness and have triggered a major development of the telemedicine. Thispaper presents the developments on the telemedicine technology undertaken by UTI Group in partnershipwith the Faculty of Automatics and Computer Science from the “Politehnica” University of Bucharest,Romania. The partnership aim is to develop solutions to improve the access, efficiency, effectiveness, andquality of clinical and business processes utilized by healthcare and social care organizations,practitioners, patients, and consumers in an effort to improve the health status of patients. This paper isfocused on the distributed system architecture, telemedicine system of system (SoS emergent behaviorand describes the main aspects of the distributed telemedicine systems efficiency evaluation.

  20. Telemedicine Supported Chronic Wound Tissue Prediction Using Classification Approaches.

    Science.gov (United States)

    Chakraborty, Chinmay; Gupta, Bharat; Ghosh, Soumya K; Das, Dev K; Chakraborty, Chandan

    2016-03-01

    Telemedicine helps to deliver health services electronically to patients with the advancement of communication systems and health informatics. Chronic wound (CW) detection and its healing rate assessment at remote distance is very much difficult due to unavailability of expert doctors. This problem generally affects older ageing people. So there is a need of better assessment facility to the remote people in telemedicine framework. Here we have proposed a CW tissue prediction and diagnosis under telemedicine framework to classify the tissue types using linear discriminant analysis (LDA). The proposed telemedicine based wound tissue prediction (TWTP) model is able to identify wound tissue and correctly predict the wound status with a good degree of accuracy. The overall performance of the proposed wound tissue prediction methodology has been measured based on ground truth images. The proposed methodology will assist the clinicians to take better decision towards diagnosis of CW in terms of quantitative information of three types of tissue composition at low-resource set-up.

  1. Secure mobile agent for telemedicine based on P2P networks.

    Science.gov (United States)

    Hsu, Wen-Shin; Pan, Jiann-I

    2013-06-01

    Exploring intelligent mobile agent (MA) technology for assisting medical services or transmitting personal patient-health information in telemedicine applications has been widely investigated. Conversely, peer-to-peer (P2P) networking has become one of the most popular applications used in the Internet because of its benefits for easy-to-manage resources and because it balances workloads. Therefore, constructing an agent-based telemedicine platform based on P2P networking architecture is necessary. The main purpose of this paper is to construct a safe agent-based telemedicine that based on P2P networking architecture. Two themes are addressed in this paper: (a) the P2P network architecture for an agent-based telemedicine service, and (b) the security mechanisms for the proposed telemedicine networking architecture. When an MA contains patient information and migrates from one host to another through the Internet, it can be attacked by other software agents or agent platforms that can illegally access patient information. The proposed P2P network architecture is based on the JXTA protocol and provides two types of telemedicine service models: the predictable service model and unpredictable service model. This architecture employs a two-layer safety mechanism for MAs (i.e., time-limited black boxes and RSA undetachable signature technologies), to provide a secure solution for agent-based telemedicine services.

  2. 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 Filho, Carlos Alberto Cordeiro; Andrade, Ana Helena Vicente; Terra, Jose Claudio Cyrineu; Teixeira Junior, José Carlos; Kanamura, Alberto Hideki

    2015-01-01

    To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. 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. 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. 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.

  3. Medication Abortion Through Telemedicine: Implications of a Ruling by the Iowa Supreme Court.

    Science.gov (United States)

    Yang, Y Tony; Kozhimannil, Katy B

    2016-02-01

    In summer 2015, the Iowa Supreme Court unanimously struck down a restriction that would have prevented physicians from administering a medication abortion remotely through video teleconferencing. In its ruling, the Iowa Supreme Court stated that the restriction would have placed an undue burden on a woman's right to access abortion services. It is crucially important for clinicians--especially primary care clinicians, obstetrician-gynecologists (ob-gyns), and all health care providers of telemedicine services--to understand the implications of this recent ruling, especially in rural settings. The Court's decision has potential ramifications across the country, for both women's access to abortion and the field of telemedicine. Today telemedicine abortion is available only in Iowa and Minnesota; 18 states have adopted bans on it. If telemedicine abortions are indeed being unconstitutionally restricted as the Iowa Supreme Court determined, court decisions reversing these bans could improve access to abortion services for the 21 million reproductive-age women living in these 18 states, which have a limited supply of ob-gyns, mostly concentrated in urban, metropolitan areas. Beyond the potential effects on abortion access, we argue that the Court's decision also has broader implications for telemedicine, by limiting the role of state boards of medicine regarding the restriction of politically controversial medical services when provided through telemedicine. The interplay between telemedicine policy, abortion politics, and the science of medicine is at the heart of the Court's decision and has meaning beyond Iowa's borders for reproductive-age women across the United States.

  4. Secure Mobile Agent for Telemedicine Based on P2P Networks

    OpenAIRE

    Hsu, Wen-Shin; Pan, Jiann-I

    2013-01-01

    Exploring intelligent mobile agent (MA) technology for assisting medical services or transmitting personal patient-health information in telemedicine applications has been widely investigated. Conversely, peer-to-peer (P2P) networking has become one of the most popular applications used in the Internet because of its benefits for easy-to-manage resources and because it balances workloads. Therefore, constructing an agent-based telemedicine platform based on P2P networking architecture is nece...

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

    Science.gov (United States)

    Rufo, Rebecca Zapatochny

    2012-01-01

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

  6. 基于广州市区域卫生信息平台的远程医疗应用服务实践%The Telemedicine Application Services Practice Based on Guangzhou Regional Health Information Platform

    Institute of Scientific and Technical Information of China (English)

    高昭昇; 冯东雷; 徐静; 李雪婉

    2015-01-01

    主要介绍基于区域卫生信息平台的远程医疗应用中专家会诊事务管理系统的流程、模式和结构。通过远程医疗应用服务实践在医学专家和病人之间建立起全新的联系,通过信息化技术缩短不同地域医疗水平差距,使病人在原地、原医院即可接受异地专家的会诊及在其指导下的治疗与护理,提高基层医院医疗服务能力,提高疑难重症救治水平,减少就医成本,缓解群众看病难问题。%This paper mainly introduces the process,the pattern and the structure of expert consultation transaction management system on the application of telemedicine in the regional health information platform. Through telemedicine application service, established a new contact between medical experts and patients in different medical institutions. Shorten the gap between different regional medical levels from information technology. Expert consultation transaction management system has which made the patient in the same place and the same hospital, who can accept consultation from the experts in other places and accept treatment or nursing under the guidance. To improve the medical service capabilities of primary hospital, to improve the treatment level of dubious and acute diseases and to relief the problems for the crowd to see a doctor.

  7. QoS considerations in wireless sensor networks for telemedicine

    Science.gov (United States)

    Hu, Fei; Kumar, Sunil

    2003-11-01

    The integration of telemedicine with medical micro sensor technology (Mobile Sensor Networks for Telemedicine applications -- MSNT) provides a promising approach to improve the quality of people's lives. This type of network can truly implement the goal of providing health-care services anytime and anywhere. Our research in this field generates the following outcomes that are reported in this paper: (1) We propose a mobile sensor network infrastructure to support the third-generation telemedicine applications; (2) An energy-efficient query resolution mechanism in large-scale mobile sensor networks is used for critical medical data collections; (3) To provide the guaranteed mobile QoS for arriving multimedia calls, a new multi-class call admission control mechanism is proposed which is based on dynamically forming a reservation pool for handoff requests. We used discrete-event-based simulation model using OPNET to verify our scheme. The simulation results show that our system can satisfy the adaptive QoS requirements in large-scale telemedicine sensor networks.

  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.

  9. 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...

  10. Making medical treatments resilient to technological disruptions in telemedicine systems

    NARCIS (Netherlands)

    Larburu, Nekane; Widya, Ing; Bults, Richard G.A.; Hermens, Hermie J.

    2014-01-01

    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

  11. 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

  12. Using case methods to study cultural diversity within the development of telematic systems

    DEFF Research Database (Denmark)

    Nøhr, Christian; Bertelsen, Pernille Scholdan; Brender, Jytte

    The report " Using case methods to study cultural diversity within the development of telematic systems" discusses a case study method which is an extension of work orginallly done in Babel, a 5th framework EU project. The report contributes to the discussion identifying operational cultural...

  13. Broadening industry perspectives of vehicle telematics application through virtual learning environments

    NARCIS (Netherlands)

    Bull, K.; Hull, N.; Peck, D.P.

    2009-01-01

    EADIS is a two year international initiative funded by Leonardo Da Vinci UK. It involves five European design-related educational institutions who have developed a Vehicle Telematics Road Map. The map acts as the basis for an internationally available online training programme that shares knowledge

  14. Using case methods to study cultural diversity within the development of telematic systems

    DEFF Research Database (Denmark)

    Nøhr, Christian; Bertelsen, Pernille Scholdan; Brender, Jytte

    The report " Using case methods to study cultural diversity within the development of telematic systems" discusses a case study method which is an extension of work orginallly done in Babel, a 5th framework EU project. The report contributes to the discussion identifying operational cultural...

  15. Willingness to Adopt Telemedicine in Major Iraqi Hospitals: A Pilot Study

    Science.gov (United States)

    Abd Ghani, Mohd Khanapi; Jaber, Mustafa Musa

    2015-01-01

    The Iraqi healthcare services are struggling to regain their lost momentum. Many physicians and nurses left Iraq because of the current situation in the country. Despite plans of calling back the skilled health workforce, they are still worried by the disadvantages of their return. Hence, technology plays a central role in taking advantage of their profession through the use of telemedicine. Studying the factors that affect the implementation of telemedicine is necessary. Telemedicine covers network services, policy makers, and patient understanding. A framework that includes the influencing factors in adopting telemedicine in Iraq was developed in this study. A questionnaire was distributed among physicians in Baghdad Medical City to examine the hypothesis on each factor. The Statistical Package for the Social Sciences was utilized to verify the reliability of the questionnaire and Cronbach's alpha test shows that the factors have values more than 0.7, which are standard. PMID:26557848

  16. Willingness to Adopt Telemedicine in Major Iraqi Hospitals: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Mohd Khanapi Abd Ghani

    2015-01-01

    Full Text Available The Iraqi healthcare services are struggling to regain their lost momentum. Many physicians and nurses left Iraq because of the current situation in the country. Despite plans of calling back the skilled health workforce, they are still worried by the disadvantages of their return. Hence, technology plays a central role in taking advantage of their profession through the use of telemedicine. Studying the factors that affect the implementation of telemedicine is necessary. Telemedicine covers network services, policy makers, and patient understanding. A framework that includes the influencing factors in adopting telemedicine in Iraq was developed in this study. A questionnaire was distributed among physicians in Baghdad Medical City to examine the hypothesis on each factor. The Statistical Package for the Social Sciences was utilized to verify the reliability of the questionnaire and Cronbach’s alpha test shows that the factors have values more than 0.7, which are standard.

  17. Using telemedicine in the care of newborn infants after discharge from a neonatal intensive care unit reduced the need of hospital visits.

    Science.gov (United States)

    Robinson, Charlotta; Gund, Anna; Sjöqvist, Bengt-Arne; Bry, Kristina

    2016-08-01

    This study examined the use of telemedicine as a means to follow up infants discharged from a Swedish neonatal intensive care unit to home health care. Families were randomised to either a control group receiving standard home health care (n = 42 families) or a telemedicine group receiving home health care with telemedicine support (n = 47 families) after discharge from the hospital. Both groups had follow-up hospital appointments with the neonatal nurse. In the telemedicine group, appointments were supplemented by the use of a specially designed web page and video calls. The use of the web page and video calls decreased the number of emergency visits to the hospital (p = 0.047). In the telemedicine group, 26% of the families felt they had more scheduled appointments than necessary, whereas only 6% of the families in the control group thought so (p = 0.037). The parents were highly satisfied with the use of telemedicine. Although the nurses were favourable to using telemedicine, the rigid organisation of the home healthcare programme and the nurses' schedules and work routines prevented its optimal use. The use of telemedicine decreased the need of hospital visits. Organisational adaptations would be necessary to make the best use of telemedicine. ©2016 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  18. 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.

  19. 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.

  20. Using cable television networks for interactive home telemedicine services.

    Science.gov (United States)

    Valero, M A; Arredondo, M T; del Nogal, F; Rodríguez, J M; Torres, D

    1999-01-01

    Most recent cable television network infrastructures can be used to deliver broadband interactive telemedicine services to the home. These facilities allow the provision of social and health services like medical televisiting for elderly, disabled and chronically ill patients; health tele-education; and teleconsultation on demand. Large numbers of patients could benefit from these services. There is also the increasing European tendency to offer customized home-care services. These applications are being developed and validated by a pilot project in Madrid as part of the ATTRACT project of the European Commission. The long-term aim is to develop broadband applications on a large scale to support low-cost interactive home telemedicine services for both patients and institutions.

  1. Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people

    Directory of Open Access Journals (Sweden)

    Vanessa Hiratsuka

    2013-08-01

    Full Text Available Background . Among indigenous populations in remote locations who are at increased risk for chronic diseases such as diabetes, telemedicine has the potential to improve access to health care services and thus may reduce adverse health outcomes. Yet few studies are available on how best to use telemedicine technology in reducing ethnic and racial health care disparities. Objective . We examined perspectives of patients and providers in 2 indigenous populations in Alaska and Hawai'i about the use of telemedicine in primary care chronic disease management. Design . Six focus groups with patients and providers at 2 sites (3 in Alaska and 3 in Hawai'i. Results . Three broad themes were common to both sites: (a benefits and barriers of using telemedicine; (b building patient–provider relationships; and (c elements of an acceptable telemedicine primary care encounter. Two key elements were endorsed by both patients and providers as important for an effective telemedicine encounter: (a the initial patient–provider interaction should be face-to-face; and (b patients must see the same provider on follow-up visits. Conclusion . The use of telemedicine in chronic disease management has potential to improve patient care in remote indigenous populations and may supplement patient–provider relationships.

  2. A suggestion for future research on interface design of an Internet-based telemedicine system for the elderly.

    Science.gov (United States)

    Chuna, Young J; Patterson, Patrick E

    2012-01-01

    Telemedicine has emerged as an effective tool for providing high quality healthcare service and health-related information, especially in rural areas. Rural areas often have a larger elderly population with greater rates of preventable disease. These areas also have fewer medical resources and specialists, and have limited access to health services, all of which can influence overall health. An Internet-based telemedicine system can be one solution to provide the rural elderly with the proper health information when needed. The elderly obviously have limited capabilities compared with younger adults in the use of internet technology. However, the interfaces of the currently existing Internet-based telemedicine systems are not specifically developed for elderly users. This paper suggests future interface design research for an Internet-based telemedicine system specifically for the elderly.

  3. [Telemedicine, cementing the nursing team].

    Science.gov (United States)

    Canipel, Lydie

    2016-11-01

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

  4. Telemedicine in neurology: Underutilized potential

    OpenAIRE

    Misra U; Kalita J; Mishra S; Yadav R

    2005-01-01

    Advances in telecommunication which started with telephone lines, FAX, integrated service digital network (ISDN) lines and now internet have provided an unprecedented opportunity for transfer of knowledge and sharing of information. The information can be used for overlapping applications in patient care, teaching and research. In medicine there is increasing utilization of telemedicine; radiology and pathology being regarded as mature specialties and emergency medicine as maturing specialtie...

  5. A strategic vision for telemedicine and medical informatics in space flight

    Science.gov (United States)

    Williams, D. R.; Bashshur, R. L.; Pool, S. L.; Doarn, C. R.; Merrell, R. C.; Logan, J. S.

    2000-01-01

    This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

  6. A strategic vision for telemedicine and medical informatics in space flight.

    Science.gov (United States)

    Williams, D R; Bashshur, R L; Pool, S L; Doarn, C R; Merrell, R C; Logan, J S

    2000-01-01

    This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

  7. 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.

  8. Telemedicine interventions for gestational diabetes mellitus: A systematic review and meta-analysis.

    Science.gov (United States)

    Rasekaba, Tshepo M; Furler, John; Blackberry, Irene; Tacey, Mark; Gray, Kathleen; Lim, Kwang

    2015-10-01

    To evaluate the effect of telemedicine on GDM service and maternal, and foetal outcomes. A systematic review and meta-analysis of randomised controlled trials (RCT) of telemedicine interventions for GDM was conducted. We searched English publications from 01/01/1990 to 31/08/2013, with further new publication tracking to June 2015 on MEDLINE, EMBASE, PUBMED, CINAHL, the Cochrane Central Register of Controlled Trials and the World Health Organization International Clinical Trials Registry electronic databases. Findings are presented as standardised mean difference (SMD) and odds ratios (OR) or narrative and quantitative description of findings where meta-analysis was not possible. Our search yielded 721 abstracts. Four met the inclusion criteria; two publications arose from the same study, resulting in three studies for review. All studies compared telemedicine to usual care. Telemedicine was associated with significantly fewer unscheduled GDM clinic visits, SMD. Quality of life, glycaemic control (HbA1c, pre and postprandial blood glucose level (BGL)), and caesarean section rate were similar between the telemedicine and usual care groups. None of the studies evaluated costs. Telemedicine has the potential to streamline GDM service utilisation without compromising maternal and foetal outcomes. Its advantage may lie in the convenience of reducing face-to-face and unscheduled consultations. Studies are limited and more trials that include cost evaluation are required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Treurnicht, Maria J.

    2014-05-01

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

  11. Telemedicine for Epilepsy Support in Resource-poor Settings

    Directory of Open Access Journals (Sweden)

    Victor ePatterson

    2014-08-01

    Full Text Available The ProblemEpilepsy is a common disease worldwide causing significant physical and social. disability. It is one of the most treatable neurological diseases. Yet in rural, poorer countries like much of India and Nepal most people with epilepsy are not on any treatment often because they cannot access doctors. Conventional ApproachesIt is being appreciated that perhaps doctors are not the solution and that enabling health workers to treat epilepsy may be better. Few details however have been put forward about how that might be achieved.Thinking differentlyUntreated epilepsy should be considered a public health problem like HIV/AIDS, the various steps needed for treatment identified and solutions found. Telemedicine ApproachesTelemedicine might contribute to two steps - diagnosis and review. A tool which enables non-doctors to diagnose episodes as epileptic has been developed as a mobile phone app and has good applicability, sensitivity and specificity for the diagnosis. There are a number of ways in which the use of phone review or SMS can improve management.ConclusionsTelemedicine, as part of a public health program, can potentially help the millions of people in the resource-poor world with untreated epilepsy.

  12. Telemedicine in plastic surgery: E-consult the attending surgeon.

    Science.gov (United States)

    Pap, Stephen A; Lach, Elliot; Upton, Joseph

    2002-08-01

    Telemedicine has evolved into a valuable but underused resource for the delivery of health care to patients at a distance, particularly where patient transport is impractical, expensive, complicated, and/or urgent. Today, over 250,000 telemedicine consults are generated annually, involving various specialties in both military and civilian health delivery systems. The ability to evaluate and triage plastic surgery patients through the use of telemedicine has not been widely explored. We have designed, developed, and tested a "store-and-forward" solution at UMass Memorial Hospital and Beth Israel Deaconess Hospital whereby the plastic surgery residents who responded to a consult request transmitted digital photographs by means of the Internet to the attending physician on call. The customary telephone call between resident and attending physician benefited from the additional photographic data, and patient management resulted in a clear, concise, and unambiguous treatment plan. The initial management suggested by the resident was modified on some occasions, particularly with complex problems. The use of digital images was especially helpful for evaluation of radiographs and complex wounds of the hand and face. The solution proved to be very valuable for both attending physicians and residents in plastic surgery. The photographs provide rich detail and resolution comparable to high-quality prints. The mechanics of obtaining images and the process of sending them electronically was readily mastered. Images reached their destination in only a few minutes over standard telephone lines. No problems were encountered while sending or viewing images on Macintosh or Windows platforms. Determining course of action with a complete clinical history now includes a level of visual detail previously not available. As this application expands into wider use, data integrity and safety will have to be more formally secured and monitored. Our model of telemedicine has broad

  13. Communication and interoperability for serial comparison in continuous health care--the new challenges.

    Science.gov (United States)

    Zywietz, Christoph

    2004-01-01

    The evolution of information technology and of telematics and increasing efforts to establish an electronic health record stimulate the development and introduction of new concepts in health care. However, compared to other application areas, e.g., tourism, banking, commerce etc. the use of information technology in health care is still of limited success. In hospitals as well in ambulatory medicine (General Practitioner systems) computers are often only used for administrative purposes. Fully operational Hospital Information Systems (HIS) are rare and often island solutions. The situation is somewhat better for department systems (DIS), e.g., where image analysis, processing of biochemical data or of biosignals is in the clinical focus. Even before we have solved the various problems in health care data processing and management within the "conventional" care institutions new challenges are coming up with concepts of telemedicine for assisted and non-assisted home care for patients with chronic diseases or people at high risk. The major challenges for provision of tele-monitoring and alarming services are improvement of communication and interoperability of devices and care providers. A major obstacle in achieving such goals are lack of standards for devices as well for procedures and a lack of databases with information on "normal" variability of many medical parameters to be monitored by serial comparison in continuous medical care. Some of these aspects will be discussed in more detail.

  14. The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.).

    Science.gov (United States)

    Di Lenarda, Andrea; Casolo, Giancarlo; Gulizia, Michele Massimo; Aspromonte, Nadia; Scalvini, Simonetta; Mortara, Andrea; Alunni, Gianfranco; Ricci, Renato Pietro; Mantovan, Roberto; Russo, Giancarmine; Gensini, Gian Franco; Romeo, Francesco

    2017-05-01

    Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30-35% reduction in mortality and 15-20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional 'chronic care model'. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation.

  15. The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.)

    Science.gov (United States)

    Casolo, Giancarlo; Gulizia, Michele Massimo; Aspromonte, Nadia; Scalvini, Simonetta; Mortara, Andrea; Alunni, Gianfranco; Ricci, Renato Pietro; Mantovan, Roberto; Russo, Giancarmine; Gensini, Gian Franco; Romeo, Francesco

    2017-01-01

    Abstract Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient’s prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30–35% reduction in mortality and 15–20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional ‘chronic care model’. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation PMID:28751839

  16. Engaging elderly people in telemedicine through gamification

    NARCIS (Netherlands)

    Vette, de Frederiek; 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

  17. 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

  18. Unassisted Assessment of Stroke Severity Using Telemedicine

    NARCIS (Netherlands)

    Van Hooff, Robbert-Jan; De Smedt, Ann; De Raedt, Sylvie; Moens, Maarten; Marien, Peter; Paquier, Philippe; De Keyser, Jacques; Brouns, Raf

    Background and Purpose-Quantification of stroke severity through telemedicine consultation is challenging and relies on professional support at the patient's bedside. We aimed to develop a novel scale for assessing stroke severity through telemedicine without assistance from a third party

  19. Unassisted Assessment of Stroke Severity Using Telemedicine

    NARCIS (Netherlands)

    Van Hooff, Robbert-Jan; De Smedt, Ann; De Raedt, Sylvie; Moens, Maarten; Marien, Peter; Paquier, Philippe; De Keyser, Jacques; Brouns, Raf

    2013-01-01

    Background and Purpose-Quantification of stroke severity through telemedicine consultation is challenging and relies on professional support at the patient's bedside. We aimed to develop a novel scale for assessing stroke severity through telemedicine without assistance from a third party (Unassiste

  20. The effectiveness of telemedicine in the management of chronic heart disease – a systematic review

    Science.gov (United States)

    Soma, Mounica; Pulluri, Deepthi; Nemali, Naga T; Brooks, Matthew

    2017-01-01

    Objective The primary objective of this systematic review is to assess the effectiveness of telemedicine in managing chronic heart disease patients concerning improvement in varied health attributes. Design This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. Setting We adopted a logical search process used in two main research databases, the Cumulative Index to Nursing and Allied Health Literature and PubMed (MEDLINE). Four reviewers meticulously screened 151 abstracts to determine relevancy and significance to our research objectives. The final sample in the literature review consisted of 20 articles. Main outcome measures We looked for improved medical outcomes as the main outcome measure. Results Our results indicated that telemedicine is highly associated with the reduction in hospitalisations and readmissions (9 of 20 articles, 45%). The other significant attributes most commonly encountered were improved mortality and cost-effectiveness (both 40%) and improved health outcomes (35%). Patient satisfaction occurred the least in the literature, mentioned in only 2 of 20 articles (10%). There was no significant mention of an increase in patient satisfaction because of telemedicine. Conclusions We concluded that telemedicine is considered to be effective in quality measures such as readmissions, moderately effective in health outcomes, only marginally effective in customer satisfaction. Telemedicine shows promise on an alternative modality of care for cardiovascular disease, but additional exploration should continue to quantify the quality measures. PMID:28321319

  1. [Telemedicine for patients with chronic intestinal failure].

    Science.gov (United States)

    Nauta, Sjoukje; Feibig, Doreen; Wanten, Geert

    2014-01-01

    Telemedicine is a valuable extension of the ways in which patients with chronic diseases can be contacted. Patients can easily contact their caregivers within the safe environment of the digital waiting room. Telemedicine especially offers an advantage for those forms of care where the visual aspect is important. Care should be taken with respect to its implementation into the disease management process with careful synchronisation between all involved parties, e.g. patient, caregiver, and organisation. The effectiveness of telemedicine and the savings that can be achieved should be properly established in order to justify the funding of a telemedicine project. Rather than focusing on the possible drawbacks of telemedicine, e.g. safety concerns and the user-friendliness of the system, we should highlight the possibilities that information technology offers.

  2. Hearing rehabilitation through telemedicine to enhance public policies in Brazil

    Directory of Open Access Journals (Sweden)

    Silvio Pires Penteado

    2011-03-01

    Full Text Available Since 2004, the Brazilian government has run one of the most all-inclusive hearing rehabilitation program based on hearing aids worldwide. In 2007 this investment in hearing aids topped U$ 68 million, apart from covering the cost of physicians and audiologists. Nearly 140 centers are certified by the government to dispense fitted hearing aids, figures which are still low when one considers the size of the country. Telemedicine can represent a field of knowledge which broadens hearing rehabilitations services in Brazil, for it may help increase the number of hearing rehabilitation centers, enable remote training and provide for an “online second opinion”. As far as public administration is concerned, it may enable process standardization and the very control over this hugely complex operation. The present article aimed to consider Telemedicine a powerful ally to improve hearing health care policies in Brazil.

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

    Directory of Open Access Journals (Sweden)

    A. A. Baranov

    2013-01-01

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

  4. Distributing medical expertise: the evolution and impact of telemedicine in arkansas.

    Science.gov (United States)

    Lowery, Curtis L; Bronstein, Janet M; Benton, Tina L; Fletcher, David A

    2014-02-01

    Arkansas's telemedicine system has evolved since 2003 from a support mechanism for high-risk pregnancy consultations to an initiative that spans medical specialties, including asthma care, pediatric cardiology, gynecology, and mental health. The system has also expanded care to diverse populations, including incarcerated women and people with HIV/AIDS. This article describes the system's evolution, organization, and diverse activities. It also shows how telemedicine can have a positive impact on a rural state and how such a state can become an engine for change regionally. The Arkansas telemedicine system faced classic challenges to uptake and function, in building and sustaining funding, in obtaining insurance reimbursement for services, and in educating patients and providers. The system's impacts on health outcomes and medical practice culture have also reached beyond patient care and provider support. The existing yet continually evolving telemedicine infrastructure and partnerships in Arkansas will respond to the state's inevitable health care reform adaptations from the Affordable Care Act and could provide direction for other states seeking to adopt or expand their telemedicine efforts.

  5. Telemedicine vs in-person cancer genetic counseling: measuring satisfaction and conducting economic analysis

    Directory of Open Access Journals (Sweden)

    Datta SK

    2011-05-01

    Full Text Available Santanu K Datta1,2, Adam H Buchanan3, Gail P Hollowell4, Henry F Beresford5, Paul K Marcom1,3, Martha B Adams1,61Department of Medicine, Duke University; 2Center for Health Services Research in Primary Care, Durham VA Medical Center; 3Duke Cancer Institute, Duke University; 4Department of Biology, North Carolina Central University; 5School of Nursing, Duke University; 6Department of Community and Family Medicine, Duke University, Durham, NC, USAAbstract: Cancer genetic counseling (CGC provides benefits and is the standard of care for individuals at increased risk of having a hereditary cancer syndrome. CGC services are typically centered in urban medical centers, leading to limited access to counseling in rural communities. Telemedicine has the potential to improve access to CGC, increase efficient use of genetic counselors, and improve patient care in rural communities. For telemedicine CGC to gain wide acceptance and implementation it needs to be shown that individuals who receive telemedicine CGC have high satisfaction levels and that CGC is cost-effective; however little research has been conducted to measure the impact of telemedicine CGC. This paper describes the design and methodology of a randomized controlled trial comparing telemedicine with in-person CGC. Measurement of patient satisfaction and effectiveness outcomes are described, as is measurement of costs that are included in an economic analysis. Study design and methodologies used are presented as a contribution to future comparative effectiveness investigations in the telemedicine genetic counseling field.Keywords: cancer genetics, genetic counseling, rural health services, telemedicine, satisfaction, cost

  6. Telemedicine Workplace Environments: Designing for Success

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Krupinski

    2014-02-01

    Full Text Available 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 consultant is. On the patient side, the first thing to realize is that most telemedicine clinics are not going to be newly designed and built. In all likelihood they will be existing rooms converted to telemedicine clinic rooms. Quite often the former room will not even have been used for clinical purposes, but may have simply been a storage area cleared out for telemedicine use. Therefore, design is often a challenge but there are a few basic principles that can be followed to create a workable clinical space. This paper will review some of the basic human factors principles to take into account when designing a working telemedicine environment.

  7. 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.

  8. Fast resuscitation and care of the burn patients by telemedicine: A review

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2014-01-01

    Full Text Available Background: In Iran, burns are the second most common cause of death, after traffic accidents in individuals under the age of 15 years. Many burned patients die or suffer injury due to lack of immediate care, so we need to use an alternative resuscitations to cure them immediately. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients′ health status and care. The aim of this study was to express the advantages of Telemedicine to resuscitate and care burn patients. Materials and Methods: This study was a narrative review. The literature was searched on fast resuscitation and care of the patients′ burn by telemedicine with the help of libraries, databases, and also searches engines available at Google, Google scholar, books and conference proceedings. In our searches, we employed the following keywords and their combinations: Telemedicine, Telecare, Burn, Burn patient, Air transport, Triage and Health Information Management in the searching areas of titles, keywords, abstracts and full texts. Results: In this study, more than 78 articles and reports were collected and 30 of them were selected based on their relevancy. Conclusion: Acute evaluation of burn patients can be performed by the telemedicine and it plays an important role in improving access to the required expertise, and raises physician confidence in treating burn patients. This can reduce under-triage or over-triage for air transport and finally lead to saving time and cost.

  9. 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

  10. 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...

  11. Telemedicine for urban uninsured: a pilot framework for specialty care planning for sustainability.

    Science.gov (United States)

    Maffei, Roxana; Hudson, Yelena; Dunn, Kim

    2008-11-01

    A national approach to medical care for the uninsured is for the provision of primary and preventive care through Community Health Centers. Access to specialty care for both Medicaid and uninsured patients is in decline even though specialty care has been shown to be cost-effective and improve outcomes. The consequences could result in further deterioration of the health of the uninsured and underinsured populations and increasing costs born by the insured and safety net providers. Telemedicine can provide specialty services efficiently if planned with a business model to sustain the program. This paper outlines a pilot framework to plan and cost-justify telemedicine specialty care for the uninsured and marginally insured. This potential framework is supported by data from an urban community with the highest concentration of uninsured in the country: Houston, Texas. Further study and evaluation will be needed once the framework and tools are implemented to empirically prove the sustainability of telemedicine specialty care for the urban uninsured.

  12. Telemedicine: challenges to dissemination in Brazil.

    Science.gov (United States)

    Maldonado, Jose Manuel Santos de Varge; Marques, Alexandre Barbosa; Cruz, Antonio

    2016-11-03

    Telemedicine has been seen as an important tool for facing the challenges of universal health systems. The goal of this article is to discuss the main challenges to its full dissemination in Brazil. Being a somewhat new area, there are not many scientific papers that systematize it. This article is an exploratory paper, as it aims to provide an overall perspective on the subject. From an economic point of view, telemedicine is a strategic area due to its an intrinsic potential of being a source for generating innovation, for requiring and incorporating technological breakthroughs from other areas, and for its interdisciplinary nature and dynamic inter-relations that drive different industries. From the social perspective, it has the potential to make access to health services democratic, by connecting remote regions with health services located in hospitals and centers of reference for prevention, diagnosis and treatment. Resumo: A telemedicina está sendo vista como uma ferramenta importante para enfrentar os desafios dos sistemas de saúde universais. O objetivo deste artigo foi discutir os principais desafios para a sua plena disseminação no Brasil. Em função do caráter relativamente emergente desta área, existe uma escassez relativa de trabalhos científicos que a sistematizem. Por isso, este artigo se enquadra na categoria de trabalho exploratório, já que tem por objetivo proporcionar uma visão geral sobre o tema. Destaca-se, que do ponto de vista econômico, a telemedicina se constitui em uma área estratégica por seu potencial intrínseco de ser fonte geradora de inovações, por demandar e incorporar avanços tecnológicos oriundos de outras áreas e, em função da sua natureza interdisciplinar e de suas inter-relações dinâmicas, pela possibilidade de impulsionar diferentes indústrias. Do ponto de vista social, tem o potencial de democratizar o acesso aos serviços de saúde, integrando regiões remotas com serviços de saúde localizados em

  13. Telemedicina y Cirugía Plástica Telemedicine and Plastic Surgery

    Directory of Open Access Journals (Sweden)

    E. Cabrera Sánchez

    2010-09-01

    Full Text Available La Telemedicina es aplicable a todos los campos médicos, incluyendo la Cirugía. Poca atención se ha prestado a sus aplicaciones diagnósticas, de las que sin embargo, nuestra especialidad, en la que es perfectamente aplicable el antiguo proverbio chino "una imagen vale mil palabras", podría salir muy beneficiada. Esto permitiría una mayor reducción de costes con contundentes mejoras en eficiencia y calidad. Presentamos un modelo de Telemedicina tipo envío y almacenaje (store and forward desarrollado y aplicado en un hospital británico del sureste de Inglaterra desde hace 7 años. Comentamos las ventajas e inconvenientes del sistema y sus posibles aplicaciones en nuestro medio. Es un hecho claro que estas tecnologías van a producir un gran cambio en la sociedad y en el quehacer diario del médico durante la próxima década. Lo que hoy conocemos como Telemedicina, en breve perderá el prefijo "tele" porque la población entenderá este tipo de Medicina y de aplicaciones telemáticas como algo habitual. Sin duda, nuestra especialidad será una de las grandes beneficiadas de la aplicación de estas tecnologías.Telemedicine is available in any medical fields, including Surgery. Poor attention has been showed to diagnosis application. Nevertheless, Plastic Surgery, is a practice in which the application of the old chinese proverb: "A picture is better than thousand words", would be very benefited, reducing costs and improving efficiency and quality. We present a Telemedicine store and forward model developed and worked in a Plastic Surgery Unit of southern England for 7 years. We show system advantages and disvantages and its potential applications in our country. It's clear that this technology will be able to produce a great change in our society and in our daily medical activity in the next years. What today we knows as Telemedicine, in a few time will lose "tele" prefix, because people will understand as usual this kind of Medicine and

  14. Telemedicine diabetes consultations are cost-effective, and effects on essential diabetes treatment parameters are similar to conventional treatment

    DEFF Research Database (Denmark)

    Levin, Klaus; Madsen, Jette R; Petersen, Inge

    2013-01-01

    in transportation time (7 h). Reductions in traveling costs and saved working days were the most important factors in making the telemedicine set-up economically efficient. CONCLUSION: Telemedicine consultation for remote outpatient diabetes control is feasible, and the interdisciplinary interventions achieved high......BACKGROUND: The increasing number of patients with diabetes poses a major challenge for the health care system. One instrument to meet these challenges could be the use of telemedicine, which, at the same time, may reduce treatment costs. Since 2005, diabetes patients on the island of Aeroe have...... were at least 6 months of telemedicine diabetes control with a minimum of two visits and two hemoglobin A1c (HbA1c) values. Results were compared with data from the Danish National Diabetes Registry (DVDD). Data are given in medians. In total, 23 type 1 diabetes mellitus (T1DM) patients, aged 65 (56...

  15. A usability gap between older adults and younger adults on interface design of an Internet-based telemedicine system.

    Science.gov (United States)

    Chun, Young J; Patterson, Patrick E

    2012-01-01

    Internet-based telemedicine is becoming an effective tool to deliver home-healthcare services and health information on demand, especially in rural areas, where there is often a large elderly population with greater rates of preventable chronic diseases. However, the designs of current interfaces for these internet-based telemedicine systems do not take elderly user characteristics into consideration. This study conducted usability testing on the interface of an internet-based telemedicine system using two different age groups, young adults and older adults. Differences in overall performance and satisfaction between the two groups were identified. Based on these results, a future direction is suggested for the interfaces of Internet-based telemedicine systems.

  16. Satisfaction with rural rheumatology telemedicine service.

    Science.gov (United States)

    Poulsen, Katherine A; Millen, Catherine M; Lakshman, Umayal I; Buttner, Petra G; Roberts, Lynden J

    2015-03-01

    To assess patient satisfaction with the rheumatology telemedicine service provided to a rural town in northern Australia. A prospective, questionnaire-based exploratory study of patients seen at the Mount Isa (rural town) rheumatology telemedicine clinics during 2012 was undertaken. Control groups included patients travelling over 3 h to be seen face-to-face in Townsville (tertiary referral centre), and patients seen at the infrequent face-to-face clinic in Mount Isa. A 5-point Likert scale was used to explore themes of communication, confidentiality, physical examination, rapport, medication safety and access. This study evaluated 107 rheumatology outpatients (49 telemedicine, 46 face-to-face Townsville, 12 face-to-face Mount Isa). Patients seen in Mount Isa travelled a median of rheumatology telemedicine service, and may prefer this to extensive travelling. Evaluation in other settings is recommended before generalizing this finding. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  17. Towards grid-enabled telemedicine in Africa

    CERN Document Server

    Jacq, F; Meda, N; Donnarieix, D; Salzemann, J; Vayssiere, V; Jacq, N; Renaud, M; Traore, F; Meda, G; Nikiema, R; Breton, V

    2006-01-01

    Telemedicine services are very relevant tools to train local physicians and to improve diagnosis by exchanging medical data. Telemedicine networks allow these exchanges but the set-up of multipoint dynamic telemedicine requires moving towards GRID technologies. A healthgrid is an environment where data of medical interest can be stored and is easily available between the different actors of healthcare. Two telemedicine applications were developed to link physicians from Burkina Faso and France with the perspective of setting up a grid infrastructure between the participating medical sites. A web site to exchange diagnosis on diabetic retinopathy was developed in PHP and another application using web services was developed to exchange patient information between two databases.

  18. 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.

  19. Web-based Internet telemedicine management of patients with heart failure.

    Science.gov (United States)

    Kashem, Abul; Droogan, Marie T; Santamore, William P; Wald, Joyce W; Marble, Judith F; Cross, Robert C; Bove, Alfred A

    2006-08-01

    An Internet-based store-and-retrieval telemedicine system to communicate between patients and their healthcare provider was tested. The system requires no specialized equipment, is Web-based, and allows frequent surveillance of the health status of the patients with heart failure (HF). Thirty six patients were recruited to evaluate a Web-based telemedicine system for reducing care encounters. Eighteen patients were randomized to the telemedicine arm (group T), and 18 were given usual clinical care (group C) in our HF center. Patients in group T reported three times weekly via a secure Internet site for telemedicine intervention. We studied patients with HF with New York Heart Association (NYHA) class 2 to 4 with hospitalization within past 6 months. Mean age was 56.1 +/- 12.6 years (66.7% male; 66.7% Caucasian, 27.8% African American, and 5.6% Hispanic). Mean ejection fraction (EF) was 23.9% +/- 17.6% in group T and 26.6% +/- 16.4% in group C. Over an 8-month period, unscheduled (group T-3; group C-5), and scheduled clinic visits (group T-11, group C-7) were similar (p = NS); one group T patient was transplanted, one group C patient died. Total hospital days were lower with group T (44 days) compared to group C (133 days), p HF. Surveillance through Internet-based telemedicine resulted in less hospitalization compared to control patients. This system may be helpful in reducing the cost of HF patient care.

  20. Telemedical Education: Training Digital Natives in Telemedicine.

    Science.gov (United States)

    Pathipati, Akhilesh S; Azad, Tej D; Jethwani, Kamal

    2016-01-01

    Telemedicine plays an important role in the delivery of medical care, and will become increasingly prominent going forward. Current medical students are among the first generation of "digital natives" who are well versed in the incorporation of technology into social interaction. These students are well positioned to apply advances in communications to patient care. Even so, providers require training to effectively leverage these opportunities. Therefore, we recommend introducing telemedicine training into medical school curricula and propose a model for incorporation.

  1. Applying Telemedicine to Outpatient Physical Therapy

    OpenAIRE

    Jacobs, Joshua L.; Davis, Daniel C.

    2002-01-01

    Few studies have specifically addressed telemedicine applied to physical rehabilitation. This ongoing pilot study examines the role of Internet-based, World Wide Web electronic communication, including textual, audio, and video, over a HIPAA-compliant network configuration, to enhance patient care in an outpatient physical therapy rehabilitation setting. Areas that can benefit from telemedicine are targeted, and include communication between physical therapist and specialty therapist, between...

  2. The Empirical Evidence for Telemedicine Interventions in Mental Disorders.

    Science.gov (United States)

    Bashshur, Rashid L; Shannon, Gary W; Bashshur, Noura; Yellowlees, Peter M

    2015-12-01

    This research derives from the confluence of several factors, namely, the prevalence of a complex array of mental health issues across age, social, ethnic, and economic groups, an increasingly critical shortage of mental health professionals and the associated disability and productivity loss in the population, and the potential of telemental health (TMH) to ameliorate these problems. Definitive information regarding the true merit of telemedicine applications and intervention is now of paramount importance among policymakers, providers of care, researchers, payers, program developers, and the public at large. This is necessary for rational policymaking, prudent resource allocation decisions, and informed strategic planning. This article is aimed at assessing the state of scientific knowledge regarding the merit of telemedicine interventions in the treatment of mental disorders (TMH) in terms of feasibility/acceptance, effects on medication compliance, health outcomes, and cost. We started by casting a wide net to identify the relevant studies and to examine in detail the content of studies that met the eligibility criteria for inclusion. Only studies that met rigorous methodological criteria were included. Necessary details include the specific nature and content of the intervention, the research methodology, clinical focus, technological configuration, and the modality of the intervention. The published scientific literature on TMH reveals strong and consistent evidence of the feasibility of this modality of care and its acceptance by its intended users, as well as uniform indication of improvement in symptomology and quality of life among patients across a broad range of demographic and diagnostic groups. Similarly, positive trends are shown in terms of cost savings. There is substantial empirical evidence for supporting the use of telemedicine interventions in patients with mental disorders.

  3. 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 CO2, 50 metric tons of CO, 3.7 metric tons of NOx, 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.

  4. Evolving medical service in the information age: a legal analysis of applying telemedicine programs in Taiwan.

    Science.gov (United States)

    Wu, Hsing-Hao

    2008-12-01

    In the face of the information age, Internet and telecommunication technologies have been widely applied in various settings. These innovational technologies have been used in the areas of e-commerce, long distance learning programs, entertainment, e-government, and so on. In recent years, the evolution of Internet technology is also pervading the health care industry. This dramatic trend may significantly alter traditional medical practice as well as the means of delivery of health care. The idea of telemedicine is to use modern information technology as a means or platform to deliver health care service in remote areas and to manage medical information in digitalized forms. The progress of developing telemedicine, however, is rather slow. The main reason for this slow progress is not technological but rather legal. Health care providers are reluctant to promote this innovation in medical service mainly due to uncertain legal consequences and ethical concerns. Although there are many legal challenges surrounding telemedicine, this note will examine major legal issues including licensure, malpractice liability, and privacy protection. Furthermore, I will discuss the potential of applying telemedicine programs in Taiwan's National Health Insurance Program (hereinafter referred to as NHI).

  5. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... 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...

  6. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... 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...... with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. CONCLUSIONS: Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when...

  7. 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....

  8. Collaborative efforts are needed to ensure proper knowledge dissemination of telemedicine projects

    DEFF Research Database (Denmark)

    Jakobsen, Neel Kolthoff; Jensen, Lena Sundby; Kayser, Lars

    2014-01-01

    documented and disseminated. MATERIAL AND METHODS: Public and private funds were contacted for information about telemedicine studies focusing on people residing in their homes. After an initial screening of titles and abstracts, 19 projects were identified. The managers of the projects were contacted......INTRODUCTION: Telemedicine is often seen as the solution to the challenge of providing health care for an increasing number of people with chronic conditions. Projects are often organised locally and based on the involvement of stakeholders with a wide range of backgrounds. It can be challenging...... to ensure that projects are based on previous experience and that they do not repeat previous studies. To better understand these challenges and current practice, we examined telemedicine projects funded in the 2008-2010 period to explore where, how and to what extent results from the projects were...

  9. Effectiveness of Telemedicine for Controlling Asthma Symptoms: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Zhao, Jie; Zhai, Yun-Kai; Zhu, Wei-Jun; Sun, Dong-Xu

    2015-06-01

    The effectiveness of telemedicine for the management of chronic diseases is unclear. This study examined the effectiveness of telemedicine in relieving asthma symptoms. A systematic review of the Medline, Cochrane, EMBASE, and Google Scholar databases was conducted until December 31, 2013 using the following key words: "asthma," "telemedicine," "telehealth," "e-health," "mobile health," "Internet," "telecommunication," "telemanagement," "remote," and "short message service." Inclusion criteria were randomized controlled trial, a diagnosis of asthma, the majority of the patients were ≥18 years of age, and intervention involved any format of telemedicine. A meta-analysis of eligible studies was conducted with the primary outcome being change of asthma symptoms. Of 813 articles identified, 11 were included in the qualitative synthesis, and 6 were included in the meta-analysis. Among the 11 studies, there were 1,460 patients in the intervention groups and 1,349 in the control groups, and the total numbers of participants ranged from 12 to 481 in the intervention groups and from 12 to 487 in the control groups. The mean age of patients ranged in the intervention groups from 34.4 to 54.6 years and in the control groups from 30.7 to 56.4 years. The treatment duration ranged from 0.5 to 12 months. The meta-analysis of six eligible studies revealed no significant difference in asthma symptom score change between the telemedicine and control groups (pooled Hedges's g=0.34, 95% confidence interval=-0.05 to 0.74, Z=1.69, p=0.090). Telemedicine interventions do not appear to improve asthma function scores, but other benefits may be present.

  10. [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.

  11. Strategic Analysis and Plan for Implementing Telemedicine at Fort Greely

    Science.gov (United States)

    2003-03-01

    the equipment would need addressing. Telemedicine Use Examples: Diabetes Management Management of diabetic patients requires an ongoing commitment from...both the patients and their providers. Telemedicine enabled management of diabetic patients appears valuable to both the patients and the

  12. Telemedicine's Potential to Support Good Dying in Nigeria: A Qualitative Study

    NARCIS (Netherlands)

    Gurp, J.L.P. van; Soyannwo, O.; Odebunmi, K.; Dania, S.; Selm, M. van; Leeuwen, E. van; Vissers, K.; Hasselaar, J.G.J.

    2015-01-01

    OBJECTIVES: This qualitative study explores Nigerian health care professionals' concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice. MATERIALS AND METHODS: Supported by the Centre for Palliative Care Nigeria (CPCN

  13. Organizational and economical aspects of telemedicine training in the Archangelsk region

    Science.gov (United States)

    Pankratov, Alexey N.; Rogalev, Konstantin K.

    2008-06-01

    An opportunity of distance education and elevation of specialist's qualification, using telemedicine technologies, has an important role in the improvement of the medical aids quality. This article reflects the formation stages of distance training system for the specialists of Archangelsk region health care. Here there are some results of this system activity in the region.

  14. [Current capabilities of telemedicine in anaesthesiology].

    Science.gov (United States)

    Czaplik, M; Brokmann, J; Hochhausen, N; Beckers, S K; Rossaint, R

    2015-03-01

    Because of an ageing population and a relative lack of professionals, the German health system is under great pressure. In rural regions in particular, anesthesiology is also affected - nursing staff, anesthetists, intensive care physicians, and emergency physicians often have to be supported by freelancers from other regions and from abroad - at least periodically. In addition to the increasing number of treatments, the potential quality of therapy is also increasing owing to progress in medical research. Against this background the need for resources is increasing to ensure the optimal quality of treatment. This applies to all clinical disciplines, including all sections of anesthesiology - especially in economically underdeveloped regions where highly qualified experts are lacking. In various cases it is not the physical attendance or manual skills of experts that is primarily requested on-site, but rather their medical expertise and experience. Therefore, telemedicine systems are suitable for closing these gaps very effectively and efficiently. In the various anesthesiological sub-sections the number of scientific papers published to date varies. For anesthesia and pain therapy only a few telemedical applications or concepts have been reported in the literature. However, in tele-intensive care medicine and tele-emergency medicine several national and international research projects have successfully been carried out, leading to established routine systems in some cases.

  15. 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.

  16. CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial.

    Science.gov (United States)

    Mendelson, Monique; Vivodtzev, Isabelle; Tamisier, Renaud; Laplaud, David; Dias-Domingos, Sonia; Baguet, Jean-Philippe; Moreau, Laurent; Koltes, Christian; Chavez, Léonidas; De Lamberterie, Gilles; Herengt, Frédéric; Levy, Patrick; Flore, Patrice; Pépin, Jean-Louis

    2014-11-01

    Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients. A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention. Sleep clinics in France. 107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention). Patients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages. The main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life. Self-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention. CPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients. ClinicalTrials.gov identifier: NCT01226641.

  17. Transaction costs economics as a conceptual framework for the analysis of barriers to the diffusion of telemedicine.

    Science.gov (United States)

    Pelletier-Fleury, N; Fargeon, V; Lanoé, J L; Fardeau, M

    1997-10-01

    Telemedecine has been talked about for more than 20 years, without it entering daily use with any success. Based on transaction costs economics, the present analysis of the exchange relationships between health care producers highlights certain characteristics of the current technical and legislative context, which leads to transaction costs. It also demonstrates that the introduction of telemedicine shifts the costs associated with agents' opportunism from patients to health-care producers themselves. All these costs may be considered nowadays to thwart the use of telemedicine. It is argued here that the Public Authorities and professionals of health care could act upon telemedicine in two fields: (1) intervention in the institutional environment aims notably at better defining the property rights of telemedicine, and so constitutes an unavoidable means of encouraging health-care producers to invest in new technology; and (2) implementation of organisational forms and mechanisms susceptible to regulating such telemedical relationships between health care producers-given the present institutional environment-constitutes an essential means for overcoming the immediate barriers blocking the diffusion of telemedicine.

  18. Safety effects of in-car telematics : a checklist : determining possible abverse effects of telematic systems on the driving task. On behalf of the Dutch Ministry of Transport, Public Works and Water Management, Transport Research Centre AVV.

    NARCIS (Netherlands)

    Heijer, T.

    1997-01-01

    This report is part of a project aimed at investigating the road safety effects of various telematics applications intended to support the driver. An attempt is made: (1) to reorder a checklist according to the aspects of visual, mental and physical task load; and (2) to assemble basic material nece

  19. 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.

  20. Strategic Procedures and Revisions for implementing Telemedicine and Telecare in Greece.

    Science.gov (United States)

    Tsirintani, M

    2012-01-01

    The development of telemedicine and telecare has been changed all over the world the recent decades as practitioners and health care managers reached better understanding of the use of information and communication technologies to offer urgent and qualified medical services at a distance. Governments and health care providers have shown a large initial interest in the benefits of telemedicine services to reduce costs mostly for patient's transfer to tertiary hospitals or for educational purposes but have been slow to provide strategic plans and procedures in order to proceed the projects into practice. The paper identifies the involvement of governments, healthcare management, healthcare professionals and IT suppliers in telemedicine policy development and reviews the experience of Greece in the specific field which seems that despite the enormous scientific interest for both medicine and health informatics, the practice until now has not gained the expected results. Furthermore, the analysis concerns the critical success factors that have to be revised simultaneously with the main managerial principles for the design and implementation of quality telemedicine and telecare services.

  1. The Practical Design of In-vehicle Telematics Device with GPS and MEMS Accelerometers

    Directory of Open Access Journals (Sweden)

    D. M. Dramićanin

    2012-11-01

    Full Text Available The latest generation of vehicle tracking devices relies not only on Global Positioning System (GPS but also uses low-cost Micro-Electro-Mechanical Systems (MEMS accelerometers. This combination supports new services such as driving style characterization and Automatic Crash Notification (ACN. Our focus will be on practical considerations of such a telematics unit. The paper will consider the boundaries of allowed errors and minimal requirements for sensors and mounting requirements. Sensor range for crash detection and impact angle estimation was tested on field trials with two units containing accelerometers range of 18g and 2g. The kinematic orientation of vehicle is evaluated in a series of field trials with a resulting standard deviation of estimation of 1.67°. The second run of experiments considers the dynamic range and sampling rate of sensors during collision. A sensor range of 8g (typical for present-day telematics devices can be used to detect crash without accurate knowledge of impact angle.

  2. Telemedicine: creating the value-added paradigm for medical video conferencing.

    Science.gov (United States)

    LeRouge, Cynthia; Lerouge, Cynthia; Tulu, Bengisu

    2008-11-06

    Transferring concepts of value for many health information technologies (HIT) into strategic, sustainable programs for health care organizations can be a challenge. The objective of this study is to explore organizational strategy for deploying HIT programs to provide a foundation for strategic guidelines and archetype models in the health care domain. Telemedicine (medical video conferencing) serves as our instantiation of an HIT. We use a multi-case study approach that employs quantitative and qualitative methods.

  3. 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.

  4. Is there a role for telemedicine in adult allergy services?

    Science.gov (United States)

    Krishna, M T; Knibb, R C; Huissoon, A P

    2016-05-01

    Telemedicine refers to the application of telecommunication and information technology (IT) in the delivery of health and clinical care at a distance or remotely and can be broadly considered in two modalities: store-and-forward and real-time interactive services. Preliminary studies have shown promising results in radiology, dermatology, intensive care, diabetes, rheumatology and primary care. However, the evidence is limited and hampered by small sample sizes, paucity of randomized control studies and lack of data relating to cost-effectiveness, health-related quality of life and patient and clinician satisfaction. This review appraises the evidence from studies that have employed telemedicine tools in other disciplines and makes suggestions for its potential applications in specific clinical scenarios in adult allergy services. Possible examples include: triaging patients to determine the need for allergy tests; pre-assessment for specialized treatments such as allergen immunotherapy, follow-up to assess treatment response and side effects; and education in self-management plan including training updates for self-injectable adrenaline and nasal spray use. This approach might improve access for those with limited mobility or living far away from regional centres, as well as bringing convenience and cost savings for the patient and service provider. These potential benefits need to be carefully weighed against evidence of service safety and quality. Keys to success include delineation of appropriate clinical scenarios, patient selection, training, IT support and robust information governance framework. Well-designed prospective studies are needed to evaluate its role.

  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. Quality of life in patients receiving telemedicine enhanced chronic heart failure disease management: A meta-analysis.

    Science.gov (United States)

    Knox, Liam; Rahman, Rachel J; Beedie, Chris

    2017-08-01

    Background Previous reviews have investigated the effectiveness of telemedicine in the treatment of heart failure (HF). Dependent variables have included hospitalisations, mortality rates, disease knowledge and health costs. Few reviews, however, have examined the variable of health-related quality of life (QoL). Methods Randomised controlled trials comparing the delivery methods of any form of telemedicine with usual care for the provision of HF disease-management were identified via searches of all relevant databases and reference lists. Studies had to report a quantitative measure for mental, physical or overall QoL in order to be included. Results A total of 33 studies were identified. However, poor reporting of data resulted in the exclusion of seven, leaving 26 studies with 7066 participants. Three separate, random effects meta-analyses were conducted for mental, physical and overall QoL. Telemedicine was not significantly more effective than usual care on mental and physical QoL (standardised mean difference (SMD) 0.03, (95% confidence interval (CI) -0.05-0.12), p = 0.45 and SMD 0.24, (95% CI -0.08-0.56), p = 0.14, respectively). However, when compared to usual care, telemedicine was associated with a small significant increase in overall QoL (SMD 0.23, (95% CI 0.09-0.37), p = 0.001). Moderator analyses indicated that telemedicine delivered over a long-duration (≥52 weeks) and via telemonitoring was most beneficial. Conclusion Compared to usual care, telemedicine significantly increases overall QoL in patients receiving HF disease management. Statistically non-significant but nonetheless positive trends were also observed for physical QoL. These findings provide preliminary support for the use of telemedicine in the management of heart failure without jeopardising patient well-being.

  7. American Telemedicine Association 2012 Fall Forum

    Directory of Open Access Journals (Sweden)

    Benjamin Forstag

    2012-06-01

    Full Text Available The ATA 2012 Fall Forum will follow a similar format to our highly-rated 2011 program, which was filled with unique ideas in an innovative format. We are looking for short talks, two-person dialogues, and demonstrations or other inventive presentation formats on a wide range of telemedicine subject areas. Topics might include: a unique approach to delivering telehealth services; a new and better device; a successful way of introducing telemedicine to providers or consumers; a novel way to organize and fund a program; or a fresh look at overcoming a barrier.

  8. 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.

  9. The slow pace of interactive video telemedicine adoption: the perspective of telemedicine program administrators on physician participation.

    Science.gov (United States)

    Grigsby, Bill; Brega, Angela G; Bennett, Rachael E; Devore, Patricia A; Paulich, Marsha J; Talkington, Sylvia G; Floersch, Natasha R; Barton, Phoebe L; Neal, Susannah; Araya, Tesfa M; Loker, Jeff L; Krohn, Neil; Grigsby, Jim

    2007-12-01

    We conducted semistructured interviews with telemedicine program administrators as part of a national survey of physicians and managers regarding attitudes toward, and knowledge of, telemedicine. Telemedicine administrators were interviewed regarding factors affecting physician adoption of interactive video (IAV) telemedicine. The seven networks with which these managers were affiliated represented "traditional" telemedicine programs, primarily providing specialty teleconsultation via IAV. These programs were located in different geographic regions, and included both consulting and referring sites. We include data only for well-established networks for which multiple administrators responded. Data were analyzed using standard qualitative research methods. We conclude that reimbursement issues are important determinants of the rate of adoption, but that by themselves they do not fully account for the slow diffusion of IAV telemedicine. Likewise, appeals to physicians as rational decision-makers are necessary but insufficient means of increasing the volume of telemedicine within a network. Telemedicine networks and administrators that have been effective in persuading physicians to practice telemedicine or to refer patients demonstrate an emphasis on aggressive recruitment of physicians who will be involved actively in one or the other role. Most efforts to encourage physicians to adopt telemedicine, however, have focused on the supply of specialists, rather than stimulating demand among primary care providers who have patients to refer. Habit was identified as an important, albeit overlooked, factor explaining physician adoption of telemedicine.

  10. A literature review of email-based telemedicine.

    Science.gov (United States)

    Caffery, Liam J; Smith, Anthony C

    2010-01-01

    A structured analysis of peer-reviewed literature about the delivery of health services by email was undertaken for this review. A total of 185 articles were included in the analysis. These articles were thematically categorised for medical specialty, participants, sub-topic, study design and service-delivery application. It was shown that email-based telemedicine can be practiced in a large number of medical specialties and has application in primary consultation, second opinion consultation, telediagnosis and administrative roles (e.g. e-referral). Email has niche applications in low-bandwidth, image-based specialties (e.g. dermatology, pathology, wound care and ophthalmology) where attached digital camera images were used for telediagnosis. Diagnostic accuracy of these images was the predominant topic of research and results show email as a valid means of delivering these medical services. Email is also often used in general practice as an adjunct for face-to-face consultation. Further, a number of organisations have significantly improved the efficiency of their outpatient services when using email as a triage or e-referral system. Email-based telemedicine provides specialist medical opinion in the majority of reviewed services and is most likely to be instigated by the patient's primary care giver. However, email-consultations between patient and primary care and patient and secondary care are not uncommon. Most email services are implemented using ordinary email. However, a number of organisations have developed purpose-written email applications to support their telemedicine service due to impediments of using ordinary email. These impediments include lack of management tools for: the allocation and auditing of cases for a timely response and the co-ordination of effort in a multi-clinician, multi-disciplinary service. The ability to encrypt ordinary email thereby securing patient confidentiality is also regarded as difficult when using ordinary email. Hence

  11. Telemedicine in pre-hospital care: a review of telemedicine applications in pre-hospital environment.

    OpenAIRE

    Amadi-Obi, Ahjoku; Gilligan, Peadar; Owens, Niall; O'Donnell, Cathal

    2014-01-01

    The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality resear...

  12. Legal Status of Telemedicine in the Internal Market.

    Science.gov (United States)

    Glanowski, Grzegorz

    2016-06-01

    Health services enjoy freedom of movement within the European Union (EU). This freedom also applies to information society services (ISS). This article presents a legal framework within which it is possible to provide qualifying health services with the help of information and telecommunications technology (ICT) as iss. Due to the ambiguity of EU regulation, the problem regarding how to determine whether a particular medical service corresponds to favourable structural iss conditions is considered. Since telemedicine makes a wide application of electronic devices possible, a new element appears in the relationship between physicians and their patients. Therefore, using electronic devices may cause numerous doubts regarding the normative status of these devices, since they modify the physician's responsibility and affect the scope of his duty with regard to information. At the same time, the complexity of functional elements (actions) necessary to provide health services using ICT can, in some cases, prevent them from being recognised as ISS.

  13. 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

  14. Telemedicine and security. Confidentiality, integrity, and availability: a Canadian perspective.

    Science.gov (United States)

    Jennett, P; Watanabe, M; Igras, E; Premkumar, K; Hall, W

    1996-01-01

    The health care system is undergoing major reform, characterized by organized delivery systems (regionalization, decentralization, devolution, etc); shifts in care delivery sites; changing health provider roles; increasing consumer responsibilities; and accountability. Rapid advances in information technology and telecommunications have led to a new type of information infrastructure which can play a major role in this reform. Compatible health information systems are now being integrated and connected across institutional, regional, and sectorial boundaries. In the near future, these information systems will readily be accessed and shared by health providers, researchers, policy makers, health consumers, and the public. SECURITY is a critical characteristic of any health information system. This paper will address three fields associated with SECURITY: confidentiality, integrity, and availability. These will be defined and examined as they relate to specific aspects of Telemedicine, such as electronic integrated records and clinical databases; electronic transfer of documents; as well as data storage and disposal. The guiding principles, standards, and safeguards being considered and put in place to ensure that telemedicine information intrastructures can protect and benefit all stakeholders' rights and needs in both primary and secondary uses of information will be reviewed. Implemented, proposed, and tested institutional, System, and Network solutions will be discussed; for example, encryption-decryption methods; data transfer standards; individual and terminal access and entry I.D. and password levels; smart card access and PIN number control; data loss prevention strategies; interference alerts; information access keys; algorithm safeguards; and active marketing to users of standards and principles. Issues such as policy, implementation, and ownership will be addressed.

  15. 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

  16. Professional opinions of the use of telemedicine in child & adolescent psychiatry.

    Science.gov (United States)

    Mitchell, Sarah A; MacLaren, Andrew T; Morton, Michael; Carachi, Robert

    2009-08-01

    The Telemedicine project at Yorkhill Hospital, Glasgow was set up in 2004 to aid in the rapid diagnosis of children at a distant location. The Child and Adolescent Mental Health Services (CAMHS) are now the largest users. CAMHS use this service for clinical work, service development and to aid research. Twenty four CAMHS professionals with experience of the telemedicine facility were asked to complete questionnaires outlining their opinions on the strengths and weaknesses of the facility; 19 responded. The results showed a wide variety of professionals use the facility and that clinical work makes up the majority of the use. An advantage to rural populations in Scotland was considered the most important benefit. Saving time and an improved method of communication were also highlighted as important. Failure of technology and problems with sound quality were highlighted as drawbacks. Seventy nine percent of subjects stated that they preferred Telemedicine to Telephone conferencing. The results show the Telemedicine facility is perceived as a positive addition to CAMHS in Scotland. Therefore, its use should be encouraged in other areas of medicine and surgery.

  17. [Direct communication on the Internet. Uninet: the university link for Integrate Telematic Services].

    Science.gov (United States)

    Coma del Corral, M J; Martín-Alganza, A; Hawa-Attourah, M

    1998-06-01

    The importance of Internet as a communication medium is clear due to the amount of information it distributes and the high number of potential recipients it has. The appearance of virtual user communities (CMV) focuses to information classification within subjects of interest for certain groups of people in order to facilitate its search and use. The UniNet project of Integrated Telematic Services for CMV through, as well as other subprojects, the 'propuesta RedUni' encourages the creation of CMV by mean of integration of various computer and Internet resources, such as distribution mailing list, web pages, Internet Relay Chat (IRC), etc. The current state of IRC in such context is presented and the utilities of the known as Scientific-IRC as a professional real time communication tool are discussed.

  18. Telemedicine: The legal framework (or the lack of it in Europe

    Directory of Open Access Journals (Sweden)

    Raposo, Vera Lúcia

    2016-08-01

    Full Text Available In the framework of European law telemedicine is, simultaneously, a health service and an information service, therefore, both regulations apply. In what concerns healthcare and the practice of medicine there are no uniform regulations at the European level. Concerning health services the most relevant achievement to regulate this domain is Directive 2011/24/EU. In what regards information and telecommunications we must have in consideration Directive 95/46/EU, Directive 2000/31/EC and Directive 2002/58/EC. However, many issues still lack uniform regulation, mainly the domain of medical liability and of medical . Probably such standardization will never take place, since the European Union does not have, until now, a common set of norms regarding tort and criminal liability, much less specific legal norms on medical liability. These gaps may jeopardize a truly European internal market in health services and hamper the development of telemedicine in the European zone.

  19. Telemedicine: The legal framework (or the lack of it) in Europe

    Science.gov (United States)

    Raposo, Vera Lúcia

    2016-01-01

    In the framework of European law telemedicine is, simultaneously, a health service and an information service, therefore, both regulations apply. In what concerns healthcare and the practice of medicine there are no uniform regulations at the European level. Concerning health services the most relevant achievement to regulate this domain is Directive 2011/24/EU. In what regards information and telecommunications we must have in consideration Directive 95/46/EU, Directive 2000/31/EC and Directive 2002/58/EC. However, many issues still lack uniform regulation, mainly the domain of medical liability and of medical leges artis. Probably such standardization will never take place, since the European Union does not have, until now, a common set of norms regarding tort and criminal liability, much less specific legal norms on medical liability. These gaps may jeopardize a truly European internal market in health services and hamper the development of telemedicine in the European zone. PMID:27579146

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

    Science.gov (United States)

    1991-01-01

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

  1. [Barriers 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.

  2. 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.

  3. Monte Carlo Simulation Modeling of a Regional Stroke Team’s Use of Telemedicine

    Science.gov (United States)

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

    2015-01-01

    incentives between those who would have to fund the up-front technology investments and those who will benefit over time from reduced ongoing health care expenses will be necessary to fully realize the benefits of telemedicine for stroke care. PMID:26720746

  4. 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 up-front technology investments and those who will benefit over time from reduced ongoing health care expenses will be necessary to fully realize the benefits of telemedicine for stroke care. © 2015 by the Society for Academic Emergency Medicine.

  5. Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing

    Directory of Open Access Journals (Sweden)

    Bruno Monteiro Tavares Pereira

    Full Text Available CONTEXT AND OBJECTIVE: Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. DESIGN AND SETTING: Retrospective study at Universidade Estadual de Campinas. METHODS: Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. RESULTS: A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3 teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7, or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. CONCLUSION: Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country, and to other reference centers abroad. This virtual proximity has enabled discussion of international training with students and residents, to increase their overall knowledge and improve their education within this institution.

  6. Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing.

    Science.gov (United States)

    Pereira, Bruno Monteiro Tavares; Calderan, Thiago Rodrigues Araújo; Silva, Marcos Tadeu Nolasco da; Silva, Antonio Carlos da; Marttos, Antonio Carlos; Fraga, Gustavo Pereira

    2012-01-01

    Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. Retrospective study at Universidade Estadual de Campinas. Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3) teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7), or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country, and to other reference centers abroad. This virtual proximity has enabled discussion of international training with students and residents, to increase their overall knowledge and improve their education within this institution.

  7. Home Monitoring and Personal Health Management Services in a Regional Health Telematics Network

    Science.gov (United States)

    2007-11-02

    status; (d) continuous integration of planning and follow-up for risk factor management; and (e) provision of continuous feedback and positive...ATTRACT Project, Deliverable 6.2: Results from Demonstration Phase (http://www.tid.es/ trabajo /attract) [10] G.M. McFaddin, “Changing the Paradigm: The

  8. Telemedicine and diabetes: achievements and prospects.

    Science.gov (United States)

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

    2011-12-01

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

  9. Design and Implementation of Telemedicine based on Java Media Framework

    Science.gov (United States)

    Xiong, Fengguang; Jia, Zhiyan

    According to analyze the importance and problem of telemedicine in this paper, a telemedicine system based on JMF is proposed to design and implement capturing, compression, storage, transmission, reception and play of a medical audio and video. The telemedicine system can solve existing problems that medical information is not shared, platform-dependent is high, software is incompatibilities and so on. Experimental data prove that the system has low hardware cost, and is easy to transmission and storage, and is portable and powerful.

  10. Telemedicine diabetes consultations are cost-effective, and effects on essential diabetes treatment parameters are similar to conventional treatment

    DEFF Research Database (Denmark)

    Levin, Klaus; Madsen, Jette R; Petersen, Inge

    2013-01-01

    been offered expert diabetes care using teleconsultations. This article describes the impact of the telemedicine solution on essential diabetes treatment parameters, patient satisfaction, and cost-effectiveness. METHODS: Telemedicine consultations were conducted with the patient and nurse specialist......BACKGROUND: The increasing number of patients with diabetes poses a major challenge for the health care system. One instrument to meet these challenges could be the use of telemedicine, which, at the same time, may reduce treatment costs. Since 2005, diabetes patients on the island of Aeroe have...... placed in a consultation room of Aeroe Hospital in audiovisual contact with the physician situated at the hospital on the mainland. Consultations were supported by an electronic patient record and a Web-based quality-monitoring diabetes database. RESULTS: Inclusion criteria in this retrospective study...

  11. Telemedicine Based on Mobile Devices and Mobile Cloud Computing

    Directory of Open Access Journals (Sweden)

    Lidong Wang

    2014-04-01

    Full Text Available Mobile devices such as smartphones and tablets support kinds of mobile computing and services. They can access to the cloud or offload the computation-intensive part to the cloud computing resources. Mobile cloud computing (MCC integrates the cloud computing into the mobile environment, which extends mobile devices’ battery lifetime, improves their data storage capacity and processing power, and improves their reliability and information security. In this paper, the applications of smartphones in telemedicine and MCC-based telemedicine were presented. Issues on the information security of smartphones and tablets, challenges of smartphones in telemedicine and challenges of MCC-based telemedicine were also introduced.

  12. The Role of Telematic Practices in Computer Engineering: A Low-cost Remote Power Control in a Network Lab

    Directory of Open Access Journals (Sweden)

    Tomas Mateo Sanguino

    2012-05-01

    Full Text Available The present paper describes a practical solution of e-learning laboratory devoted to the study of computer networks. This laboratory has been proven with two groups of students from the University of Huelva (Spain during two academic years. In order to achieve this objective, it has been necessary to create an entire network infrastructure that includes both the telematic access to the laboratory equipment and the remote power control. The interest of this work lies in an economical and simple system of remote control and telematic access with a twofold objective. On the one hand, to develop distance practices with attendance appearance by means of real hardware systems, not simulated. On the other hand, to reduce the power consumption regarding other proposals of remote labs with permanent power connection, providing herein an on demand connection only when required. As a result, a versatile and flexible laboratory has been put into practice whose basic network topology allows transferring traditional practices to telematic practices in a natural way and without harsh changes

  13. Telemedicine and medical informatics in the multimedia super corridor: the Malaysian vision.

    Science.gov (United States)

    Abidi, S S; Goh, A; Yusoff, Z

    1998-01-01

    The practice of medicine, with its wide range of environmental conditions and complex dependencies, has long been used as a test bed for various advanced technologies. Telemedicine, as conceptualised within the Multimedia Super Corridor (MSC) context, is seen as the application of several relatively mature technologiesartificial intelligence (AI), multimedia communication and information systems (IS) amongst othersso as to benefit a large cross-section of the Malaysian population. We will discuss in general terms the Malaysian vision on the comprehensive MSC telemedicine solution, its functionality and associated operational conditions. In particular, this paper focuses on the conceptualisation of one key telemedical component i.e. the Lifetime Health Plan (LHP) system, which is eventually intended to be a distributed multi-module application for the periodic monitoring and generation of health-care advisories for upwards of 20 million Malaysians.

  14. 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...

  15. Changes in the workplace with telemedicine.

    Science.gov (United States)

    Tachakra, S; El Habashy, A; Dawood, M

    2001-01-01

    The opinions of 110 emergency nurse practitioners (ENPs) practising telemedicine in 11 British minor injury units were sought using a questionnaire. There were 90 respondents (82%). The respondents thought that, since telemedicine had been introduced, they had become more open to change (96%) and more ready to grasp opportunities (93%). They considered that they were more keen to learn new things (99%) and were better disposed to teaching others (90%). They adopted a more advisory and supportive role (80%), found the work environment more varied (83%) and were well disposed to teamwork (64%). The power balance with doctors had changed (86%) and doctors indulged in dialogue rather than direction (69%). The results suggest that although changes have started in the workplace, they have not been as dramatic as a previous study of patients had predicted.

  16. Record media used by primary care providers in medically underserved regions of upstate New York was not pivotal to clinical result in the Informatics for Diabetes Education and Telemedicine (IDEATel project

    Directory of Open Access Journals (Sweden)

    Philip Morin

    2009-06-01

    Conclusions Our findings suggest an effective and complementary element of national health information technology (HIT strategy, telemedicine, can be implemented by PCPs with success despite the lack of a concurrent EMR for efficient data exchange.

  17. 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.

  18. 构建远程医疗省级平台的探讨%Discuss on Founding the Province-level Platform for Telemedicine System

    Institute of Scientific and Technical Information of China (English)

    任宇飞; 张晓祥; 汪火明

    2012-01-01

    推进深化医改,国家“3521”工程计划构建系统整合、信息共享的国家、省、地市(区域)三级卫生信息服务平台.目前,远程医疗系统的建设多以各自的中心医院为主导,不同远程医疗系统之间相互隔离.远程医疗项目亟需在省级建设层面上有所突破,建立远程医疗省级平台,在省级平台的支持下,开展远程专家会诊、远程医学影像诊断等医疗服务,实现省内各级医院之间的互联互通和远程医疗数据共享,并在各省远程医疗省级平台的建设基础上,构建全国互联的远程医疗服务体系.%To promote the medical reform, we plan to build the "3521" project which needs several integrating and information-sharing system composed by country-level, province-level and city-level health information platform. At present, the telemedicine system was built individually which results in information isolation between different telemedicine systems. The telemedicine project needs support of province-level telemedicine platform, which will make a breakthrough at the construction of province-level telemedicine system. With province-level platform support, we can provide medical services including remote expert consultation, remote medical imaging and others among all level hospitals and promote telemedicine data sharing. Then a nationwide interconnected telemedicine service system will be constructed on the basis of the province-level telemedicine platform.

  19. 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.

  20. A Shared Decision-Making Approach to Telemedicine: Engaging Rural Patients in Glycemic Management.

    Science.gov (United States)

    Griffith, Michelle L; Siminerio, Linda; Payne, Tammie; Krall, Jodi

    2016-11-17

    Telemedicine can connect specialist health care providers with patients in remote and underserved areas. It is especially relevant in diabetes care, where a proliferation of treatment options has added further complexity to the care of an already complex, highly prevalent disease. Recent developments in health reform encourage delivery systems to use team-based models and engage patients in shared decision-making (SDM), where patients and providers together make health care decisions that are tailored to the specific characteristics and values of the patient. The goal of this project was to design, integrate, and evaluate a team-based, SDM approach delivered to patients with diabetes in a rural community, building upon the previously established telemedicine for reach, education, access, and treatment (TREAT) model. Patients in this feasibility study demonstrated improvement in hemoglobin A1c values, and reported better understanding of diabetes. Providers reported the SDM aids increased cohesion among team members (including patients) and facilitated patient education and behavioral goal setting. This project demonstrated that SDM could be integrated into the workflow of a telemedicine team visit with good provider and patient satisfaction.

  1. A Shared Decision-Making Approach to Telemedicine: Engaging Rural Patients in Glycemic Management

    Directory of Open Access Journals (Sweden)

    Michelle L. Griffith

    2016-11-01

    Full Text Available Telemedicine can connect specialist health care providers with patients in remote and underserved areas. It is especially relevant in diabetes care, where a proliferation of treatment options has added further complexity to the care of an already complex, highly prevalent disease. Recent developments in health reform encourage delivery systems to use team-based models and engage patients in shared decision-making (SDM, where patients and providers together make health care decisions that are tailored to the specific characteristics and values of the patient. The goal of this project was to design, integrate, and evaluate a team-based, SDM approach delivered to patients with diabetes in a rural community, building upon the previously established telemedicine for reach, education, access, and treatment (TREAT model. Patients in this feasibility study demonstrated improvement in hemoglobin A1c values, and reported better understanding of diabetes. Providers reported the SDM aids increased cohesion among team members (including patients and facilitated patient education and behavioral goal setting. This project demonstrated that SDM could be integrated into the workflow of a telemedicine team visit with good provider and patient satisfaction.

  2. International Journal of Health Research

    African Journals Online (AJOL)

    Erah

    Knowledge and Perceptions of E-Health and Telemedicine. Int J Health ... engineering fields). ... forum for the communication and evaluation of data, methods and findings in health sciences and related ..... them had a formal computer training.

  3. Telemedicine and E-Learning in a Primary Care Setting in Sudan: The Experience of the Gezira Family Medicine Project.

    Science.gov (United States)

    Mohamed, K G; Hunskaar, S; Abdelrahman, S H; Malik, E M

    2015-01-01

    Information and communication technology (ICT) is progressively used in the health sector (e-health), to provide health care in a distance (telemedicine), facilitate medical education (e-learning), and manage patients' information (electronic medical records, EMRs). Gezira Family Medicine Project (GFMP) in Sudan provides a 2-year master's degree in family medicine, with ICT fully integrated in the project. This cross-sectional study describes ICT implementation and utilization at the GFMP for the years 2011-2012. Administrative data was used to describe ICT implementation, while questionnaire-based data was used to assess candidates' perceptions and satisfaction. In the period from April 2011 to December 2012, 3808 telemedicine online consultations were recorded and over 165000 new patients' EMRs were established by the study subjects (125 candidates enrolled in the program). Almost all respondents confirmed the importance of telemedicine. The majority appreciated also the importance of using EMRs. Online lectures were highly rated by candidates in spite of the few challenges encountered by combining service provision with learning activity. Physicians highlighted some patients' concerns about the use of telemedicine and EMRs during clinical consultations. Results from this study confirmed the suitability of ICT use in postgraduate training in family medicine and in service provision.

  4. Telemedicine Use in Rural Native American Communities in the Era of the ACA: a Systematic Literature Review.

    Science.gov (United States)

    Kruse, Clemens Scott; Bouffard, Shelby; Dougherty, Michael; Parro, Jenna Stewart

    2016-06-01

    Native American communities face serious health disparities and, living in rural areas, often lack regular access to healthcare services as compared to other Americans. Since the early 1970's, telecommunication technology has been explored as a means to address the cost and quality of, as well as access to, healthcare on rural reservations. This systematic review seeks to explore the use of telemedicine in rural Native American communities using the framework of cost, quality, and access as promulgated by the Affordable Care Act of 2010 and urge additional legislation to increase its use in this vulnerable population. As a systematic literature review, this study analyzes 15 peer-reviewed articles from four databases using the themes of cost, quality, and access. The theme of access was referenced most frequently in the reviewed literature, indicating that access to healthcare may be the biggest obstacle facing widespread adoption of telemedicine programs on rural Native American reservations. The use of telemedicine mitigates the costs of healthcare, which impede access to high-quality care delivery and, in some cases, deters prospective patients from accessing healthcare at all. Telemedicine offers rural Native American communities a means of accessing healthcare without incurring high costs. With attention to reimbursement policies, educational services, technological infrastructure, and culturally competent care, telemedicine has the potential to decrease costs, increase quality, and increase access to healthcare for rural Native American patients. While challenges facing the implementation of telemedicine programs exist, there is great potential for it to improve healthcare delivery in rural Native American communities. Public policy that increases funding for programs that help to expand access to healthcare for Native Americans will improve outcomes because of the increase in access.

  5. Quality of data computational models and telemedicine treatment effects

    NARCIS (Netherlands)

    Larburu, Nekane; Bults, Richard G.A.; Widya, Ing; Hermens, Hermie 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 d

  6. Usability in telemedicine systems—a literature survey

    NARCIS (Netherlands)

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

    2016-01-01

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

  7. Usability in telemedicine systems—a literature survey

    NARCIS (Netherlands)

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

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

  8. Determinants of successful telemedicine implementations: a literature study

    NARCIS (Netherlands)

    Broens, Tom H.F.; Huis in 't Veld, Rianne M.H.A.; Vollenbroek-Hutten, Miriam M.R.; Hermens, Hermie J.; Halteren, van Aart; Nieuwenhuis, Lambert J.M.

    2007-01-01

    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 infl

  9. Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S; Pomportsis, A; Bountzioukas, S; Beltrame, F; Orsi, G

    1998-01-01

    MERMAID is an EU financed telemedicine project with global reach and 24-h, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (digital land lines, cellular/wireless, satellite and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  10. 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

  11. [Chances and Risks of Telemedicine in Orthopaedics and Trauma Surgery].

    Science.gov (United States)

    Holderried, Martin; Schlipf, Madeleine; Höper, Ansgar; Meier, Reinhard; Stöckle, Ulrich; Kraus, Tobias Maximilian

    2017-08-24

    Background The use of information technology (IT) in health care has continuously increased. This includes software solutions for digitalisation, data storage and innovative approaches in diagnostics. The facilitation of the access to specific information, even by the patient, has changed daily clinical work. Patients inform themselves about symptoms, diagnostic methods and treatment options. This urge for information and the wish for the best treatment is summarised in the expression "patient empowerment". In some countries, the gap between do-it-yourself diagnosis and telemedicine via the telephone has already been closed. A sophisticated telemedical hotline may help to improve consultation and treatment of patients living in remote regions or rural communities. Traumatology telemedicine may also be used in trauma environments, such as disasters or mass casualties. Therefore, the purpose of this study was to assess the demand for e-health solutions among patients seeking the help of the emergency department in a trauma hospital. Methods A total of 255 patients (age range 18 - 75 years) were included in the study and were surveyed with the use of a questionnaire. As regards personal data, the questionnaire asked the patient about their Internet habits and about interesting topics they had researched in the world wide web. However, the questionnaire was specifically designed to ask for potential benefits and the patient's expectations for e-health solutions. Expected weaknesses and procedures for telemedical services were also included in a subsection. Results 43.5% of the patient cohort were woman and 56.5% men. The average distance to the hospital was 39.86 km. 223 patients were insured by the governmental health service providers and 32 had private insurance coverage. Aside from online shopping and online banking, the search for health topics was most frequent. The greatest fear was the lack of personal contact to the doctor (71.2%). Patients were also

  12. Medical Tourism and Telemedicine: A New Frontier of an Old Business.

    Science.gov (United States)

    Hong, Yan Alicia

    2016-05-23

    In October 2015, the "Chinese American Physicians E-Hospital" celebrated its "grand opening" online. All physicians affiliated with this E-Hospital are bilingual Chinese American physicians, who provide services ranging from initial teleconsulting to international transfer and treatment in the United States. Such telemedicine platform for medical tourism not only saves the patients from the hassles of identifying and connecting with an appropriate health service provider but also minimizes the language and cultural barriers. As a growing number of patients from middle- and low-income countries travel to the United States (US) for medical care, we face promising opportunities as well as mounting challenges. The Centers for Disease Control (CDC) in the US has guidance for Americans seeking care overseas, but is not available for international patients seeking care in US. This article opens a dialogue on the challenges associated with flourishing medical tourism and telemedicine, including quality assessment, risk communication, ethical guidelines, and legal concerns.

  13. Patient and provider satisfaction with the use of telemedicine: Overview and rationale for cautious enthusiasm

    Directory of Open Access Journals (Sweden)

    Whitten P

    2005-01-01

    Full Text Available Telemedicine research addressing user satisfaction abounds in academic literature. Results from patient satisfaction studies indicate exceptionally high levels of perceived satisfaction, often above the rates of expected satisfaction for traditional forms of health delivery. Results from provider satisfaction studies are also generally quite positive; however, data from providers point to higher concerns with delivery barriers and challenges. Even though data from patient and provider satisfaction research suggests overwhelming optimism for this delivery modality, this paper urges cautious embracement of these results for several reasons. First, many of the studies exhibit serious methodological weaknesses related to design and data collection instruments. In addition, the construct of satisfaction is largely undefined and is not clear. Even recognizing these caveats, the results of the study do offer some evidence that patient satisfaction will not impede the deployment of telemedicine, but provider satisfaction merits additional study.

  14. Effects of telemedicine in the treatment of patients with type 2 diabetes – a study protocol

    DEFF Research Database (Denmark)

    Hansen, Caroline Raun; Perrild, Hans; Koefoed, Birgitte Gade

    2013-01-01

    INTRODUCTION: Despite rehabilitation programmes offered to all patients with newly diagnosed type 2 diabetes in Denmark, a number of patients either never accomplish good diabetes regulation or the regulation deteriorates with time. Therefore, new approaches are needed. The aim of the present study...... is to examine whether telemedicine conferences with a nurse can contribute to achieving good diabetes control among patients with poorly regulated type 2 diabetes. MATERIAL AND METHODS: A total of 165 patients with type 2 diabetes who have formerly undergone a rehabilitation programme are randomized to either...... telemedicine intervention or usual care. The intervention lasts for 32 weeks and consists of monthly videoconferences with a nurse from a health-care centre as an add-on to usual care. Blood sugar, blood pressure and weight are regularly self-monitored and measurements are automatically transferred...

  15. Effects of telemedicine in the treatment of patients with type 2 diabetes--a study protocol

    DEFF Research Database (Denmark)

    Hansen, Caroline Raun; Perrild, Hans; Koefoed, Birgitte Gade

    2013-01-01

    INTRODUCTION: Despite rehabilitation programmes offered to all patients with newly diagnosed type 2 diabetes in Denmark, a number of patients either never accomplish good diabetes regulation or the regulation deteriorates with time. Therefore, new approaches are needed. The aim of the present study...... is to examine whether telemedicine conferences with a nurse can contribute to achieving good diabetes control among patients with poorly regulated type 2 diabetes. MATERIAL AND METHODS: A total of 165 patients with type 2 diabetes who have formerly undergone a rehabilitation programme are randomized to either...... telemedicine intervention or usual care. The intervention lasts for 32 weeks and consists of monthly videoconferences with a nurse from a health-care centre as an add-on to usual care. Blood sugar, blood pressure and weight are regularly self-monitored and measurements are automatically transferred...

  16. Minimizing Interference in Wireless Mesh Networks Based Telemedicine System

    Directory of Open Access Journals (Sweden)

    Kamalrulnizam Abu Bakar

    2012-01-01

    Full Text Available Problem statement: It has been always a challenging task for the researchers to incorporate information technology advancements in the medical profession. In order to guarantee a reliable network infrastructure that supports the employment of wireless technology and mobile devices, a hybrid infrastructure that integrates wireless networks with the traditional wired Local Area Networks (LANs is needed. The wired network will provide the stability to the network, improve the overall performance of the hybrid network and provide an alternative to the mobile routes, hence increasing the degree of redundancy and reliability. In recent years, Wireless Mesh Networks (WMN have become more popular than ever. WMN has advantage of robust fault tolerance. Even if some of the mesh nodes are incapable, there exist many other alternative nodes to serve relay. In addition, multi-hop of WMN can not only spread coverage but also save both cabling cost and human resource. Health care can drastically benefit by incorporating technological advancements, particularly wireless mesh technology. In this study we have presented a telemedicine system for rural and urban scenario based on WMN so that the medical community gets benefited by state of art broadband connectivity. Also in this study we have addressed a critical issue of performance degradation in WMN due to interference and varying load. Approach: For this we have proposed a routing protocol AODV LBIARM. We have incorporated our routing metric Load Balancing Interference Aware Routing Metric (LBIARM in AODV protocol to minimize the interference and cater for varying traffic load in multi hop WMN based telemedicine system, thereby maximizing network throughput. Results and Conclusion: This protocol is evaluated by simulating in Opnet Modeler 16.1 PL1. We have found that our proposed protocol performs better than AODV WCETT and AODV HOP-COUNT.

  17. 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

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

    Directory of Open Access Journals (Sweden)

    Chanda Rupa

    2011-05-01

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

  19. Assessment of long-term outcomes for the STRokE DOC telemedicine trial.

    Science.gov (United States)

    Meyer, Brett C; Raman, Rema; Ernstrom, Karin; Tafreshi, Gilda M; Huisa, Branko; Stemer, Andrew B; Hemmen, Thomas M

    2012-05-01

    Telemedicine can provide stroke evaluations in locations with limited available expertise. The reliability of telestroke has been established. Decision making efficacy has been shown in the National Institutes of Health's STRokE DOC trial. No prospective trial has assessed long-term telestroke outcomes, however. In an institutional review board-approved trial (NCT00936455), we contacted patients originally enrolled in the STRokE DOC trial. A telephone script was used to verify consent. Patients were asked standardized questions regarding disposition, modified Rankin Scale (mRS) score, mortality, and recurrent stroke for 2 retrospective time points (6 and 12 months postevent) and one current time point. Blind was maintained. Primary outcome measures of mortality and percent mRS score of 0-1 [%mRS(0-1)] at 6 months are reported. Wilcoxon's rank-sum test was used for continuous variables, and Fisher's exact was used for categorical variables. Of the original 222 participants, 75 patients or surrogates could be contacted. Mean time from enrollment was 3.96 ± 1.0 years (range, 2.33-5.45 years). Mean National Institutes of Health Stroke Scale (NIHSS) score was 8 ± 7 (5 ± 8 for telephone; 12 ± 8 for telemedicine; P = .002). The rate of intravenous recombinant tissue plasminogen activator (rt-PA) use was 31%. Six-month %mRS(0-1) outcome was not different, at 42%. Mortality after imputation to the entire study sample also was not different, at 18%. There was no difference in the rate of recurrent stroke (P = .61). Some 85% of patients were home at 6 months. This study reports a good 6-month outcome for stroke patients evaluated by telemedicine or telephone. This design is limited by the time since original enrollment and resultant inability to contact participants. Although these findings can add to the limited data on telemedicine outcomes, a prospective trial is needed.

  20. Telematics System and it's Application to Bus / Coach of Golden Dragon%Telematics系统及其在金旅客车上的应用

    Institute of Scientific and Technical Information of China (English)

    赖志艺

    2012-01-01

    Telematics作为计算机和无线通信技术的融合体,可提供一种高效率的信息传递渠道,以达到满足各种商业功能和政府相关公众服务的目的。本文介绍国内外Telematics的发展情况,以及金旅客车在Telematics项目上的研究成果。%Telematics is the blending of computers and wireless telecommunications technologies. It can provide an efficient conveying way for information in order to meet the needs of a variety of business functions or govern- ment-related public services. The author discusses the Telematics development in domestic and foreign, and its research achievements in Golden Dragon Bus Co.,Ltd

  1. Implementation of Self Organizing Map (SOM) as decision support: Indonesian telematics services MSMEs empowerment

    Science.gov (United States)

    Tosida, E. T.; Maryana, S.; Thaheer, H.; Hardiani

    2017-01-01

    Information technology and communication (telematics) is one of the most rapidly developing business sectors in Indonesia. It has strategic position in its contribution towards planning and implementation of developmental, economics, social, politics and defence strategies in business, communication and education. Aid absorption for the national telecommunication SMEs is relatively low; therefore, improvement is needed using analysis on business support cluster of which basis is types of business. In the study, the business support cluster analysis is specifically implemented for Indonesian telecommunication service. The data for the business are obtained from the National Census of Economic (Susenas 2006). The method used to develop cluster model is an Artificial Neural Network (ANN) system called Self-Organizing Maps (SOM) algorithm. Based on Index of Davies Bouldin (IDB), the accuracy level of the cluster model is 0.37 or can be categorized as good. The cluster model is developed to find out telecommunication business clusters that has influence towards the national economy so that it is easier for the government to supervise telecommunication business.

  2. Exposure as Duration and Distance in Telematics Motor Insurance Using Generalized Additive Models

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Boucher

    2017-09-01

    Full Text Available In Pay-As-You-Drive (PAYD automobile insurance, the premium is fixed based on the distance traveled, while in usage-based insurance (UBI the driving patterns of the policyholder are also considered. In those schemes, drivers who drive more pay a higher premium compared to those with the same characteristics who drive only occasionally, because the former are more exposed to the risk of accident. In this paper, we analyze the simultaneous effect of the distance traveled and exposure time on the risk of accident by using Generalized Additive Models (GAM. We carry out an empirical application and show that the expected number of claims (1 stabilizes once a certain number of accumulated distance-driven is reached and (2 it is not proportional to the duration of the contract, which is in contradiction to insurance practice. Finally, we propose to use a rating system that takes into account simultaneously exposure time and distance traveled in the premium calculation. We think that this is the trend the automobile insurance market is going to follow with the eruption of telematics data.

  3. Telemedicine in Egypt: SWOT analysis and future trends [Telemedizin in Ägypten: SWOT-Analyse und Zukunftstrends

    Directory of Open Access Journals (Sweden)

    Khalifa, Aly

    2012-06-01

    Full Text Available [english] Today, many countries have succeeded in integrating telemedicine and advanced technologies into a broad-range of healthcare processes including diagnosis, treatment, disease prevention, and health education & research. Nevertheless, many developing countries are still unable to sustain meaningful telemedicine projects. Egypt has achieved significant progress in building the Information Society (IS, by providing an enabling legal and regulatory framework, and an adequate Information and Communications Technology (ICT infrastructure. However, telemedicine projects in Egypt still face common problems and challenges that hinder the wide-scale adoption of eHealth systems. This study provides a comprehensive Strengths, Weaknesses, Opportunities, and Threats (SWOT analysis of the current telemedicine applications in Egypt. Based on that, four future trends in Telemedicine in Egypt 2020 have been identified from governmental, financial, technological, and medical perspectives. Consequently, these future trends were aligned to the global trends in telemedicine. The main output of this study is that telemedicine should be part of a National eHealth Initiative.[german] Bis heute konnten in vielen Ländern erfolgreich Telemedizin und moderne Informationstechnik in vielen medizinischen Prozessen von der Diagnostik über Therapie und Vorsorge bis hin zur Medizinischen Ausbildung und Forschung integriert werden. Aber gerade in Entwicklungsländern ist es oft nicht gelungen, nützliche Telemedizin-Lösungen dauerhaft zu etablieren. Ägypten hat bereits erhebliche Fortschritte dabei gemacht, sich zu einer Informationsgesellschaft zu entwickeln. Es wurden rechtliche und regulatorische Rahmenbedingungen geschaffen, in deren Rahmen eine leistungsfähige Infrastruktur für Informations- und Kommunikationstechnik aufgebaut werden konnte. Dennoch sehen sich ägyptische Telemedizinprojekte immer noch mit erheblichen Problemen und Herausforderungen

  4. 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.

  5. Innovation Network Development Model in Telemedicine: A Change in Participation.

    Science.gov (United States)

    Goodarzi, Maryam; Torabi, Mashallah; Safdari, Reza; Dargahi, Hossein; Naeimi, Sara

    2015-10-01

    This paper introduces a telemedicine innovation network and reports its implementation in Tehran University of Medical Sciences. The required conditions for the development of future projects in the field of telemedicine are also discussed; such projects should be based on the common needs and opportunities in the areas of healthcare, education, and technology. The development of the telemedicine innovation network in Tehran University of Medical Sciences was carried out in two phases: identifying the beneficiaries of telemedicine, and codification of the innovation network memorandum; and brainstorming of three workgroup members, and completion and clustering ideas. The present study employed a qualitative survey by using brain storming method. Thus, the ideas of the innovation network members were gathered, and by using Freeplane software, all of them were clustered and innovation projects were defined. In the services workgroup, 87 and 25 ideas were confirmed in phase 1 and phase 2, respectively. In the education workgroup, 8 new programs in the areas of telemedicine, tele-education and teleconsultation were codified. In the technology workgroup, 101 and 11 ideas were registered in phase 1 and phase 2, respectively. Today, innovation is considered a major infrastructural element of any change or progress. Thus, the successful implementation of a telemedicine project not only needs funding, human resources, and full equipment. It also requires the use of innovation models to cover several different aspects of change and progress. The results of the study can provide a basis for the implementation of future telemedicine projects using new participatory, creative, and innovative models.

  6. 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.

  7. Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology.

    Science.gov (United States)

    Wechsler, Lawrence R; Tsao, Jack W; Levine, Steven R; Swain-Eng, Rebecca J; Adams, Robert J; Demaerschalk, Bart M; Hess, David C; Moro, Elena; Schwamm, Lee H; Steffensen, Steve; Stern, Barney J; Zuckerman, Steven J; Bhattacharya, Pratik; Davis, Larry E; Yurkiewicz, Ilana R; Alphonso, Aimee L

    2013-02-12

    To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice, military medicine, and current federal policy. Review of practice models and published literature on primary studies of the efficacy of neurology telemedicine. Teleneurology is of greatest benefit to populations with restricted access to general and subspecialty neurologic care in rural areas, those with limited mobility, and those deployed by the military. Through the use of real-time audio-visual interaction, imaging, and store-and-forward systems, a greater proportion of neurologists are able to meet the demand for specialty care in underserved communities, decrease the response time for acute stroke assessment, and expand the collaboration between primary care physicians, neurologists, and other disciplines. The American Stroke Association has developed a defined policy on teleneurology, and the American Academy of Neurology and federal health care policy are beginning to follow suit. Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into further areas of neurology.

  8. A multicenter study of ICU telemedicine reengineering of adult critical care.

    Science.gov (United States)

    Lilly, Craig M; McLaughlin, John M; Zhao, Huifang; Baker, Stephen P; Cody, Shawn; Irwin, Richard S

    2014-03-01

    Few studies have evaluated both the overall effect of ICU telemedicine programs and the effect of individual components of the intervention on clinical outcomes. The effects of nonrandomized ICU telemedicine interventions on crude and adjusted mortality and length of stay (LOS) were measured. Additionally, individual intervention components related to process and setting of care were evaluated for their association with mortality and LOS. Overall, 118,990 adult patients (11,558 control subjects, 107,432 intervention group patients) from 56 ICUs in 32 hospitals from 19 US health-care systems were included. After statistical adjustment, hospital (hazard ratio [HR]=0.84; 95% CI, 0.78-0.89; PHR=0.74; 95% CI, 0.68-0.79; Pbest practices, and (4) quicker alert response times. ICU telemedicine interventions, specifically interventions that increase early intensivist case involvement, improve adherence to ICU best practices, reduce response times to alarms, and encourage the use of performance data, were associated with lower mortality and LOS.

  9. Facilitating telemedicine project sustainability in medically underserved areas: a healthcare provider participant perspective.

    Science.gov (United States)

    Paul, David L; McDaniel, Reuben R

    2016-04-26

    Very few telemedicine projects in medically underserved areas have been sustained over time. This research furthers understanding of telemedicine service sustainability by examining teleconsultation projects from the perspective of healthcare providers. Drivers influencing healthcare providers' continued participation in teleconsultation projects and how projects can be designed to effectively and efficiently address these drivers is examined. Case studies of fourteen teleconsultation projects that were part of two health sciences center (HSC) based telemedicine networks was utilized. Semi-structured interviews of 60 key informants (clinicians, administrators, and IT professionals) involved in teleconsultation projects were the primary data collection method. Two key drivers influenced providers' continued participation. First was severe time constraints. Second was remote site healthcare providers' (RSHCPs) sense of professional isolation. Two design steps to address these were identified. One involved implementing relatively simple technology and process solutions to make participation convenient. The more critical and difficult design step focused on designing teleconsultation projects for collaborative, active learning. This learning empowered participating RSHCPs by leveraging HSC specialists' expertise. In order to increase sustainability the fundamental purpose of teleconsultation projects needs to be re-conceptualized. Doing so requires HSC specialists and RSHCPs to assume new roles and highlights the importance of trust. By implementing these design steps, healthcare delivery in medically underserved areas can be positively impacted.

  10. Patient perceptions of a comprehensive telemedicine intervention to address persistent poorly controlled diabetes

    Directory of Open Access Journals (Sweden)

    Andrews SM

    2017-03-01

    Full Text Available Sara M Andrews,1 Nina R Sperber,1,2 Jennifer M Gierisch,1,2 Susanne Danus,1 Stephanie L Macy,1 Hayden B Bosworth,1,2 David Edelman,1,2 Matthew J Crowley1,3 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 2Division of General Internal Medicine, Department of Medicine, 3Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Duke University, Durham, NC, USA Objective: We studied a telemedicine intervention for persistent poorly controlled diabetes mellitus (PPDM that combined telemonitoring, self-management support, and medication management. The intervention was designed for practical delivery using existing Veterans Affairs (VA telemedicine infrastructure. To refine the intervention and inform the delivery of the intervention in other settings, we examined participants’ experiences. Methods: We conducted semistructured interviews with 18 Veterans who completed the intervention. We analyzed interview text using directed content analysis and categorized themes by hemoglobin A1c (HbA1c improvement (<1% or ≥1%. Results: Participants generally reported greater awareness of their blood glucose levels; however, they described dissatisfaction with the telemonitoring interface and competing demands during the intervention. Participants with <1% HbA1c improvement reported that these challenges interfered with their engagement. Participants with ≥1% HbA1c improvement reported new self-management routines despite challenges. Conclusion: Despite competing demands and frustration with the telemonitoring interface, many participants demonstrated intervention engagement and substantial improvement in HbA1c (≥1%. Differences in engagement may reflect differing capacity to manage treatment burden. Because it relies on existing infrastructure, this intervention is a promising model for addressing PPDM within VA. Future work should focus on optimizing systems’ telemedicine infrastructure

  11. New hospital telemedicine services: potential market for a nighttime telehospitalist service.

    Science.gov (United States)

    Sanders, Richard B; Simpson, Kit N; Kazley, Abby S; Giarrizzi, Dana P

    2014-10-01

    A critical shortage in the supply of physicians in the United States has necessitated innovative approaches to physician service delivery. Telemedicine is a viable service delivery model for a variety of physician and health services. Telemedicine is most effective when applied where physician resources are scarce, patient care is time sensitive, and service volume may be distributed across a network. Shortages in critical care and neurology specialists have led to the use of tele-intensive care unit and telestroke services in hospital settings. These hospital-based telemedicine services have gained acceptance and recommendation. Hospitalist staffing shortages may provide an opportunity to apply similar telemedicine models to hospitalist medicine. This study assesses the potential market for a nighttime telehospitalist service. An analysis of the Florida state hospital discharge dataset investigated the potential market for a new nighttime telehospitalist service. Admissions were filtered and stratified for common hospitalist metrics, time of day, and age of patients. Admissions were further expressed by hour of day and location. Nineteen percent of common hospitalist admissions occurred between 7:00 p.m. and 7:00 a.m., with a range of 17%-27% or 0.23-10.09 admissions per night per facility. Eighty percent of admissions occurred prior to midnight. Nonrural facilities averaged 6.69 hospitalist admissions per night, whereas rural facilities averaged 1.35 admissions per night. The low volume of nighttime admissions indicates an opportunity to leverage a telehospitalist physician service to deliver inpatient medical admission services across a network. Lower volumes of nighttime admissions in rural facilities may indicate a market for telehospitalist solutions to address the dilemma of hospitalist staffing shortages.

  12. Telemedicine deployments within NATO military forces: a data analysis of current and projected capabilities.

    Science.gov (United States)

    Lam, David M; Poropatich, Ronald K

    2008-11-01

    Since the creation of the NATO Telemedicine Expert Panel (now renamed the TMED Expert Team) in 2000, when few nations had deployed telemedicine systems to support military field operations, this group has been encouraging the nations to deploy telemedicine (TMED) in support of their forces, and to write the use of TMED into NATO doctrine. This has been a relatively successful effort, and TMED is increasingly being used within the military medical structures of some NATO and Partnership for Peace nations to provide medical care to deployed military personnel. We report the results of a multinational survey of current and projected availability of various telemedicine modalities within the NATO medical services that are participating in the work of the TMED expert team (ET). Though only a "snapshot in time," and not representing all NATO nations, this is the first attempt to identify both current and planned TMED utilization within the multinational military medical community. Participating nations report that communication systems now in place at the lowest levels of medical support increasingly enable the routine use of Web-based teleconsultation modalities. Teleradiology is now being seen as the de facto standard for imaging support. While a number of nations report they have deployed capabilities for obtaining clinical consultations at a distance, most responding nations do not have a formal organizational structure to control and manage remote consultation and rely on informal clinical relationships (e.g., requesting consults from the deployed clinician's home hospital or from friends). Military electronic health records are in use by only a minority of nations and fewer still are capable of civilian interface. Less common TMED capabilities (e.g., tele-microbiology, tele-pathology, tele-medical maintenance) are being increasingly used, but are still rarely deployed. As a result of the findings of this survey, specific recommendations for expanding the use of

  13. Telemedicine compared with standard care in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rasmussen, Ole W.; Lauszus, F. F.; Loekke, M.

    2016-01-01

    INTRODUCTION: Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared...... telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. METHODS: Forty patients with type 2 diabetes mellitus allocated from October 2011-July 2012 were randomized to either treatment at home...

  14. Telemedicine is cost effective compared with standard care. A randomized controlled project in Type 2 diabetes mellitus in an outpatient clinic

    DEFF Research Database (Denmark)

    Rasmussen, Ole Winther; Lauszus, Finn Friis; Løkke, Mette Marie

    2017-01-01

    Background: New approaches on outpatient control are required and need testing to motivate and give feedback to the patients at home. Telemedicine has the capacity to achieve this, optimizing care through motivation and direct feedback adapted to milieu of the patient and at the same time to keep...... the total cost at a reasonable level. Objectives: We evaluated the economic and short-time health effect of two different ways of outpatient treatment in patients with type 2 diabetes (T2DM). A health economist calculated the total cost of replacing the standard care with telemedicine. Methods: Forty......, cholesterol levels and albuminuria were measured. The telephone company, TDC, Denmark delivered and serviced a TandBerg E20 video telephone to the patients in the telemedicine group. The economic analysis was performed with a Danish hospital payer’s cost perspective. Cost data were based on the measured time...

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

    Directory of Open Access Journals (Sweden)

    Bossen AL

    2015-03-01

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

  16. Estimating travel reduction associated with the use of telemedicine by patients and healthcare professionals: proposal for quantitative synthesis in a systematic review

    Directory of Open Access Journals (Sweden)

    Bahaadinbeigy Kambiz

    2011-08-01

    Full Text Available Abstract Background A major benefit offered by telemedicine is the avoidance of travel, by patients, their carers and health care professionals. Unfortunately, there is very little published information about the extent of avoided travel. We propose to undertake a systematic review of literature which reports credible data on the reductions in travel associated with the use of telemedicine. Method The conventional approach to quantitative synthesis of the results from multiple studies is to conduct a meta analysis. However, too much heterogeneity exists between available studies to allow a meaningful meta analysis of the avoided travel when telemedicine is used across all possible settings. We propose instead to consider all credible evidence on avoided travel through telemedicine by fitting a linear model which takes into account the relevant factors in the circumstances of the studies performed. We propose the use of stepwise multiple regression to identify which factors are significant. Discussion Our proposed approach is illustrated by the example of teledermatology. In a preliminary review of the literature we found 20 studies in which the percentage of avoided travel through telemedicine could be inferred (a total of 5199 patients. The mean percentage avoided travel reported in the 12 store-and-forward studies was 43%. In the 7 real-time studies and in a single study with a hybrid technique, 70% of the patients avoided travel. A simplified model based on the modality of telemedicine employed (i.e. real-time or store and forward explained 29% of the variance. The use of store and forward teledermatology alone was associated with 43% of avoided travel. The increase in the proportion of patients who avoided travel (25% when real-time telemedicine was employed was significant (P = 0.014. Service planners can use this information to weigh up the costs and benefits of the two approaches.

  17. Design and application of the telemedicine system%远程医疗系统的设计与应用

    Institute of Scientific and Technical Information of China (English)

    胡磊; 罗天友; 王友俊; 曾勇明; 陈亮

    2014-01-01

    目的:响应国家新医改中关于首诊下沉的要求。探讨以医院为中心,辐射周边,建立远程医疗系统。方法通过“TOGAF”法对系统进行科学的需求分析和体系架构设计。结果建立集远程会诊、远程诊断、远程教育于一体的远程医疗系统。结论系统的设计、建设与应用有积极的示范作用和意义。%Objective In response to the requirements of the new nation health care reform for the first diagnosis sinking .To in‐vestigate hospital as the center ,radiation surrounding ,we build the telemedicine system .Methods We analyzed the requirement ,de‐sign the architecture of the system through the way of "TOGAF" .Results The telemedicine system including telemedicine ,remote diagnosis and distance education was built .Conclusion The design ,establishment and application of the telemedicine system has an important influence and meaning .

  18. 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...

  19. Telemedicine in the Federated States of Micronesia.

    Science.gov (United States)

    Rutstein, D

    2000-09-01

    Telemedicine (other than costly long distance telephone and facsimile messages) in the Federated States of Micronesia (FSM) started approximately 4 years ago with the establishment of Internet access in the State of Yap. A local access, for medical use only, via already established trunk lines maintained by Continental Airlines was established. It provided a connection to CompuServe at a baud rate of 300 bps. FSM TeleCom provided this free service. While this connection was slow, it allowed medical staff at Yap State Hospital to send and receive text based e-mail regarding patient management. By its use interest was generated in both medical and non-medical individuals to develop a commercial full scale Internet service. In March 1996, TeleCom became a full scale commercial Internet Service Provider in Yap. Rates were reasonable and the CompuServe access was phased out. The full scale internet allowed medical personnel to engage in telemedicine activities, including email; email attachments; the search and retrieval of medical literature; transmission to medical specialists of X-rays, ECG's and other images; and real-time teleconferencing over the Internet with both audio and video. In addition, to the improvement of medical care, this allowed for greater efficiency in arranging referral of patients for medical treatment outside of the FSM.

  20. 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.

  1. The internet as a chance for marketable telematic solutions; Das Internet als Chance fuer marktfaehige Telematikloesungen

    Energy Technology Data Exchange (ETDEWEB)

    Feldmann, R.; Heidemann, U. [ESC GmbH Co. KG, Grosswallstadt (Germany)

    2003-07-01

    The internet as a worldwide communication network with protocol standards provides new perspectives of success for in-vehicle telematic solutions. The internet is already part of the daily life. The question is not, whether vehicles will be connected to the internet but when and how the internet will be used inside the vehicle. Services for logistics, telemetry and tele diagnosis will be based on the same technology. For the in-vehicle services, safety and quality aspects must be considered. Ease of use is essential for safety, acceptance and market success. A new info-automatic mode combined with speech output offers new possibilities. A business model with shared risk takes care on solid portal financing. The traveltainer {sup registered}, an information, travel and entertainment magazine is one of the first products where this should be put into practice. (orig.) [German] Das Intenet, als weltweites Kommunikationsnetz mit Protokollstandards, bietet neue Chancen fuer die Telematik. Wenn auch nicht immer wahrnehmbar, das Internet gehoert laengst zum festen Bestandteil unseres Lebens. Die Frage ist deshalb nicht, ob Fahrzeuge internetfaehig werden, sondern wann und wie das Internet im Fahrzeug genutzt wird. Auf gleicher Basis werden auch Loesungen fuer Logistik, Telemetrie und Ferndiagnose realisiert werden. Fuer die Verwendung von Diensten im Fahrzeug muessen besondere Sicherheitsaspekte und Qualitaetsrichtlinien beruecksichtigt werden. Einfache Bedienbarkeit ist entscheidend fuer Fahrsicherheit, Akzeptanz und den Markterfolg. Eine Info-Automatik, kombiniert mit einer Sprachausgabe, eroeffnet vollkommen neue Moeglichkeiten. Die Portalfinanzierung soll ueber ein Businessmodell mit geteiltem Risiko erfolgen. Erstmals soll dieses im traveltainer {sup registered}, einem individuellen Reise-, Informations- und Unterhaltungsmagazin, umgesetzt werden. (orig.)

  2. 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.

  3. The use of telemedicine in primary care for women with cervical cytological abnormalities.

    Science.gov (United States)

    Etherington, lan J; Watts, Anne D; Hughes, Elisabeth; Lester, Helen E

    2002-01-01

    Telemedicine can be used in two different ways in the context of the National Health Service Cervical Screening Programme. The first method allows primary health-care providers to offer direct online booking of clinic appointments according to predefined algorithms based on the woman's cytological abnormality. The second method is telecolposcopy, which is designed to be used by nurses in primary care. Preliminary data confirm that such a system can be used reliably to make diagnoses. The technology is easily adaptable for realtime teleconsultation.

  4. [Tele-cooperation for innovative care using the example of the University Hospital Aachen. Telematics in intensive care medicine, emergency medicine, and telemedical intersectoral rehabilitation planning in geriatric trauma].

    Science.gov (United States)

    Marx, Gernot; Beckers, Rainer; Brokmann, Jörg Christian; Deisz, Robert; Pape, Hans-Christoph

    2015-10-01

    The demographic challenge of the ageing society is associated with increasing comorbidity. On the other hand, there will be an ageing workforce in medicine, resulting in an imbalance between the demand and supply of medical care in the near future. In rural areas in particular, this imbalance is already present today. Based on three best practice projects carried out by our telemedical center in Aachen, including emergency medicine, intensive care medicine, and the rehabilitation planning of geriatric trauma care, some experience and the potential of the intersectoral provision of care, supported by telemedicine, are demonstrated. Telemedicine is the provision of medical services over a geographical distance by using tele-communication and data transfer. It has been proven to ensure a constant quality of health care. Telemedical support enables shared expertise independent of time and space, and allows efficient allocation of resources. A review of international experience supports this notion.

  5. Early phase telemedicine requirements elicitation in collaboration with medical practitioners

    NARCIS (Netherlands)

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

    2013-01-01

    Ubiquity of Information and Communication Technology enables innovative telemedicine treatment applications for disease management of ambulant patients. Development of new treatment applications must comply with medical protocols and ‘way of working’ to obtain safety and efficacy evidence before

  6. Challenges for user-interface designers of telemedicine systems.

    Science.gov (United States)

    Salvemini, A V

    1999-01-01

    Problems associated with telemedicine systems include high telecommunications costs, lack of physician interest, and failure to build evaluation into the design process from the onset of the telemedicine project. An overview of the human-factors engineering approach to systems design and how it can be applied to the development of telemedicine systems is described. Design of an interface is based on an analysis of user capabilities, tasks, and work environment. Task analyses are performed to understand and document the interaction between a user's work activities and a system. Two characteristics of a human factors approach that are important for telemedicine are: (1) defining and measuring user performance, and (2) involving users in the design and testing of a system. Usability goals are operationally defined and tracked to quantify performance. Having users participate in the design, testing, and critique of a system also increases the likelihood that the system will be accepted and used after it is released.

  7. 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.

  8. Determinants of successful telemedicine implementations: a literature study.

    Science.gov (United States)

    Broens, Tom H F; Huis in't Veld, Rianne M H A; Vollenbroek-Hutten, Miriam M R; Hermens, Hermie J; van Halteren, Aart T; Nieuwenhuis, Lambert J M

    2007-01-01

    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 influenced their implementation. The identified determinants, which would influence the future implementation of telemedicine interventions, can be classified into five major categories: (1) Technology, (2) Acceptance, (3) Financing, (4) Organization and (5) Policy and Legislation. Each category contains determinants that are relevant to different stakeholders in different domains. We propose a layered implementation model in which the primary focus on individual determinants changes throughout the development life cycle of the telemedicine implementation. For success, a visionary approach is required from the multidisciplinary stakeholders, which goes beyond tackling specific issues in a particular development phase. Thus the right philosophy is: 'start small, think big'.

  9. Telemedicine technology and applications for home hemodialysis.

    Science.gov (United States)

    Agroyannis, B; Fourtounas, C; Romagnoli, G; Skiadas, M; Tsavdaris, C; Chassomeris, C; Tzanatos, H; Kopelias, I; Lymberopoulos, D; Psarras, J

    1999-10-01

    Home hemodialysis (HD) for the treatment of patients with end-stage renal disease (ESRD) was first put into practice about 30 years ago. In this paper we describe the application of telematics monitoring services (TMS) for supporting patients who need home or satellite HD (SHD). For the clinical trials two modified HD machines were located in the renal unit and a central control station (UNIX workstation with multimedia PC-terminal) was located in another room of the hospital. Bi-directional communication between modified HD machines and central control station was managed via ISDN (Integrated Services Digital Network) links. Using these HD-machines 150 HD sessions were performed in nine patients over a period of five months. This system enabled on-line remote supervision of the HD machine-related functions (air in the blood, leak of blood, low conductivity etc.) and the clinical condition of patients through measurement of blood pressure (BP), pulse rate, PO2 (pulse oxymetry) and electrocardiogram (ECG) from the central control station (CCS). The user checked the type of alarm/warning, its appearance on HD machines and multimedia terminal units (MTU), the action of the protective system and the appearance of consultative messages from CCS on the remote terminal unit RTU. According to the data collected, the disturbances of HD machine function were visible and audible in the CCS and the user messages were always observed on the RTU. No unusual dialysis-associated complications were observed, all data and alarms/warnings were transmitted correctly and patients had adequate HD treatment.

  10. Telemedicine: opportunities and risks; Telemedizin: Chancen und Risiken

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, R. [IT-Abteilung, Tiroler Landeskrankenanstalten GmbH, Innsbruck (Austria)

    2002-05-01

    Problem. Due to the rapid progress in the fields of information technology and data networks, telemedicine applications are growing in number. Besides curative telemedicine, the electronic exchange of medical data and the integration of health information systems between health care providers is gaining importance. Through the improved accessibility of electronic patient record information, considerable risks arise.Methods. A project for the interconnection of medical picture archiving and communication systems (PACS) between several hospitals is presented and the possibilities for further developing such networking systems utilizing new software technologies for transparent data access between different locations (GRID) and for decision support (software agents) are considered.Results. The availability of the electronic patient record via the data network and the perspective of semi intelligent software systems automatically preparing the data bears great potential for a boost in treatment quality and efficiency. Systems for unique electronic patient identification and for secure digital signature are a prerequisite, but per se not enough to ensure the protection of data against illegitimate access.Conclusion. Despite quality and efficiency benefits, challenges in the protection of sensible data and in the change of the physicians role result. (orig.) [German] Fragestellung. Durch die rasante Entwicklung der Informationstechnologie und der Datennetzwerke werden auch telemedizinische Applikationen immer zahlreicher eingesetzt. Neben der kurativen Telemedizin, die medienwirksame Erfolge verbuchen kann, gewinnen der elektronische Datenaustausch und die Gesundheitseinrichtungen uebergreifende Informationssystemintegration wachsende Bedeutung. Aus der besseren Zugaenglichkeit der elektronischen Krankengeschichtsinformation ergeben sich neben Chancen auch Risiken.Methodik. Ein Beispielprojekt fuer die Vernetzung von medizinischen Bildarchivierungssystemen (PACS

  11. ZigBee wireless communication system for telemedicine

    OpenAIRE

    2014-01-01

    The authors of the paper presented the circuit design of electronic circuit of transmitting and receiving information for solving the problems of telemedicine. For simulation and configuration, Smart RF software environment was used. The simulation was carried out, and 3D visualization of system elements in the PROTEUS software was developed. The features of using telecommunication technologies of the IEE 802.15.4 standard in telemedicine infrastructure were considered. The basic requirements...

  12. 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.

  13. ANMCO/SIT Consensus Document: telemedicine for cardiovascular emergency networks.

    Science.gov (United States)

    Caldarola, Pasquale; Gulizia, Michele Massimo; Gabrielli, Domenico; Sicuro, Marco; De Gennaro, Luisa; Giammaria, Massimo; Grieco, Niccolò Brenno; Grosseto, Daniele; Mantovan, Roberto; Mazzanti, Marco; Menotti, Alberto; Brunetti, Natale Daniele; Severi, Silva; Russo, Giancarmine; Gensini, Gian Franco

    2017-05-01

    Telemedicine has deeply innovated the field of emergency cardiology, particularly the treatment of acute myocardial infarction. The ability to record an ECG in the early prehospital phase, thus avoiding any delay in diagnosing myocardial infarction with direct transfer to the cath-lab for primary angioplasty, has proven to significantly reduce treatment times and mortality. This consensus document aims to analyse the available evidence and organizational models based on a support by telemedicine, focusing on technical requirements, education, and legal aspects.

  14. Telemedicine – a scientometric and density equalizing analysis

    OpenAIRE

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

    2015-01-01

    Background 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. Methods 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. Results During the period from 1900 to 2006 a number of...

  15. The Implementation of Telemedicine within a Community Cancer Network

    OpenAIRE

    London, Jack W; Morton, Daniel E.; Marinucci, Donna; Catalano, Robert; Comis, Robert L.

    1997-01-01

    Telemedicine is being used by physicians at the member hospitals of the Jefferson Cancer Network (JCN) for consultations regarding the diagnosis and management of cancer patients. The technology employed for this telemedicine system was chosen to meet three related specifications: low capital and operating cost, internal maintainability by community hospital data processing staffs, and compatibility with the existing technologic infrastructure. The solution selected is the u...

  16. 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

  17. Research on the Telemedicine System and Application%远程医疗系统及其应用研究

    Institute of Scientific and Technical Information of China (English)

    孙正收

    2015-01-01

    随着我国医疗保障制度改革的深入,远程医疗作为解决老百姓“看病难、看病贵”问题的重要途径之一,正逐渐在各大城市开展,成为加强医疗资源共享、提高医疗资源配置效率的新型医疗形式。通过调研远程医疗系统的应用现状,分析了远程医疗系统的建设需求和原则,重点讨论了远程心电医疗产品的建设规范、常见系统架构和工作模式,并列举了数个应用实例。以上述调研结果为基础,总结了远程医疗系统的新特点,并探讨了未来的发展趋势。%With the development of national health insurance system reformation, telemedicine has become a significant method to solve the problems of expensive and difcult medical treatment for the common people. Telemedicine systems are widely promoted in many cities and identified as new medical forms to share the premium medical resources and improve al ocation efciency. Based on the research of application status, the requirements and protocols of telemedicine construction were analyzed. The building standards, system architecture and normal operating mode of telemedicine electrocardiogram systems were mainly discussed. After several typical applications were il ustrated, the new characteristics of telemedicine systems were summarized and the development trends were explored.

  18. Telemedicine in pre-hospital care: a review of telemedicine applications in the pre-hospital environment

    OpenAIRE

    Amadi-Obi, Ahjoku; Gilligan, Peadar; Owens, Niall; O’Donnell, Cathal

    2014-01-01

    The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality resear...

  19. 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.

  20. Telemedicine's Potential to Support Good Dying in Nigeria: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Jelle van Gurp

    Full Text Available This qualitative study explores Nigerian health care professionals' concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice.Supported by the Centre for Palliative Care Nigeria (CPCN and the University College Hospital (UCH in Ibadan, Nigeria, the authors organized three focus groups with Nigerian health care professionals interested in palliative care, unstructured interviews with key role players for palliative care and representatives of telecom companies, and field visits to primary, secondary and tertiary healthcare clinics that provided palliative care. Data analysis consisted of open coding, constant comparison, diagramming of categorizations and relations, and extensive member checks.The focus group participants classified good dying into 2 domains: a feeling of completion of the individual life and dying within the community. Reported barriers to palliative care provision were socio-economic consequences of being seriously ill, taboos on dying and being ill, restricted access to adequate medical-technical care, equation of religion with medicine, and the faulty implementation of palliative care policy by government. The addition of telemedicine to Nigeria's palliative care practice appears problematic, due to irregular bandwidth, poor network coverage, and unstable power supply obstructing interactivity and access to information. However, a tele-education 'lite' scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication.Nigerian health care professionals' concepts on good dying/a good death and barriers and opportunities for palliative care provision were, for the greater part, similar to prior findings from other studies in Africa. Information for and education of patient, family, and community are essential to further improve palliative care in Africa. Telemedicine can only help

  1. Quantitative 3-D imaging topogrammetry for telemedicine applications

    Science.gov (United States)

    Altschuler, Bruce R.

    1994-01-01

    The technology to reliably transmit high-resolution visual imagery over short to medium distances in real time has led to the serious considerations of the use of telemedicine, telepresence, and telerobotics in the delivery of health care. These concepts may involve, and evolve toward: consultation from remote expert teaching centers; diagnosis; triage; real-time remote advice to the surgeon; and real-time remote surgical instrument manipulation (telerobotics with virtual reality). Further extrapolation leads to teledesign and telereplication of spare surgical parts through quantitative teleimaging of 3-D surfaces tied to CAD/CAM devices and an artificially intelligent archival data base of 'normal' shapes. The ability to generate 'topogrames' or 3-D surface numerical tables of coordinate values capable of creating computer-generated virtual holographic-like displays, machine part replication, and statistical diagnostic shape assessment is critical to the progression of telemedicine. Any virtual reality simulation will remain in 'video-game' realm until realistic dimensional and spatial relational inputs from real measurements in vivo during surgeries are added to an ever-growing statistical data archive. The challenges of managing and interpreting this 3-D data base, which would include radiographic and surface quantitative data, are considerable. As technology drives toward dynamic and continuous 3-D surface measurements, presenting millions of X, Y, Z data points per second of flexing, stretching, moving human organs, the knowledge base and interpretive capabilities of 'brilliant robots' to work as a surgeon's tireless assistants becomes imaginable. The brilliant robot would 'see' what the surgeon sees--and more, for the robot could quantify its 3-D sensing and would 'see' in a wider spectral range than humans, and could zoom its 'eyes' from the macro world to long-distance microscopy. Unerring robot hands could rapidly perform machine-aided suturing with

  2. Mobile health systems: a brief overview

    Science.gov (United States)

    Voskarides, S.; Pattichis, Constantinos S.; Habib Istepanian, Robert S.; Kyriacou, E.; Pattichis, Marios S.; Schizas, C. N.

    2002-06-01

    Rapid advances in information technology and telecommunications, and more specifically wireless and mobile communications, and their convergence (telematics) are leading to the emergence of a new type of information infrastructure that has the potential of supporting an array of advanced services for healthcare. The objective of this paper is to provide a snapshot of the applications of mobile technology in healthcare. A brief review of the spectrum of these applications and the potential benefits of these efforts will be presented, followed by success case studies in electronic patient record, emergency telemedicine, teleradiology, and home monitoring. It is anticipated that the progress carried out in these efforts, and the potential benefits of emerging mobile technologies will trigger the development of more applications, thus enabling the offering of a better service to the citizen.

  3. The management and policy challenges of the globalisation effect of informatics and telemedicine.

    Science.gov (United States)

    Rigby, M

    1999-01-01

    Managers and policy makers face new and as yet unrecognised challenges--particularly loss of control--through the application of new information technologies in healthcare. Whilst informatics and telemedicine are important developments, the potential for adverse organisational and societal effects should be recognised and anticipated. Health organisations are frequently seen as circumscribed networks, and these in turn form local alliances with related organisations. Information technologies are frequently construed as relating to operational systems within organisations, not least electronic patient record systems and diagnostic systems. These can then be linked to new generation health business systems, to provide accurate management information at low additional cost. However, this pair of assumptions is now seriously flawed, due to the effects of the latest developments in health informatics and telemedicine. In particular, telecommunications and Internet technologies render ineffectual previous external barriers of distance and national boundaries, whilst within the organisation the combination of knowledge bases with information technologies creates tendencies towards internal autonomy. Organisational and national policy control of health care face direct and radical challenges through perverse effects of otherwise beneficial developments, and early action is needed.

  4. 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.)

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

    OpenAIRE

    Soo-kyung Park

    2013-01-01

    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....

  6. Implementing Rede Universitaria de Telemedicina Usability-the Brazilian Telemedicine University Network

    Directory of Open Access Journals (Sweden)

    Wilson Coury

    2011-01-01

    Full Text Available Problem statement: Remote and underserved regions in Brazil have a lack of specialized doctors for health assistance and education. Approach: The Brazilian Telehealth initiative enables videoconferencing, diagnosis and formative second opinion, continuous and permanent education and web conferencing, by linking university and teaching hospitals via RNP (Rede Nacional de Ensino e Pesquisa, Brazil’s national research and education R and E network. Results: It operates two significant national projects: The Telemedicine University Network, RUTE (Rede Universitaria de TElemedicina www.rute.rnp.br, (Pesquisas e Ações em Saúde nos Institutos de Pesquisa do Ministério da Ciência e Tecnologia, N.1, 2010 and the National Telehealth Primary Care Program, Brazil Telehealth (www.telessaudebrasil.org.br; respectively from the Science and Technology Ministry MCT and Health Ministry MS. The municipal, state, national and international health institutions coordinate collaborative projects in research, innovation, development, management, education and assistance. Conclusion: At the moment 48 University and Teaching Hospitals operate their Telemedicine Nuclei and also a network of more than 200 institutions and their specialists participating in 40 Special Interest Groups, with ca. 2-3 sessions every day.

  7. Rural telemedicine infrastructure and services in the Department of Cauca, Colombia.

    Science.gov (United States)

    Rendón, Alvaro; Martínez, Andrés; Dulcey, María F; Seoane, Joaquín; Shoemaker, Richard G; Villarroel, Valentín; López, Diego M; Simó, Javier

    2005-08-01

    The development of telemedicine programs for the public health network of the Department of Cauca, Colombia, (Department is the major political and territorial division of the country. The Department of Cauca is located on the Pacific coast in the southwest of the country.) would make it possible to satisfy many identified needs such as medical coordination, continuing education, epidemiologic surveillance, patient referral and counterreferral, and an end to the feeling of isolation among professionals who work in rural health centers. Nevertheless, geographic, economic, and social difficulties, and the lack of a telecommunication infrastructure in areas with these characteristics present a challenge of such magnitude that the majority of existing telemedicine projects in Colombia have been centered in urban or other areas which present fewer difficulties. In the municipality of Silvia, the University of Cauca has established a prototype network using the "Hispano-American Health Link" (EHAS in Spanish) program technologies, which uses very high frequency (VHF) and wireless fidelity, (WiFi, a set of standards for wireless local area networks) radio systems for the deployment of low-cost voice and data networks. Over this network information access and exchange services have been developed, in order to meet the needs identified above. The objectives were to obtain information about the development of the project's activities and their possible impact. Project telecommunication network and information services are described, and the results and conclusions of the first evaluation are presented.

  8. 新疆区域性远程医学体系构建与应用%The Construction and Application of Xinjiang Regional Telemedicine System

    Institute of Scientific and Technical Information of China (English)

    温浩; 李勇; 孙亮; 张玺; 韩月珍

    2013-01-01

    目的构建基于远程医学的区域医疗合作共同体,探索远程医学在区域医疗协作网络体系中的价值和作用。方法本文从我院远程医学在学科帮扶、基层人才培养、新技术、新业务的传播、医疗适宜技术的推广应用等方面的实践应用入手,分析远程医学在区域医疗协作卫生惠民体系中的作用。结果远程医学在新疆区域医疗协同发展方面已凸显成效,并已形成独具特色的区域医疗协作文化品牌。结论发展远程医学,促进边疆卫生惠民事业。%Objective From construct a regional medical cooperation community based on telemedicine, to explore the values and functions of telemedicine in regional medical collaboration system . Methods In this paper, we mainly introduced the practice and application of telemedicine in our hospital,such as disciplines helping ,grassroots personnel training, new technologies communication, appropriate technology promotion and other aspects. From these, to analyze the values and functions of telemedicine in regional medical collaboration system. Results Telemedicine has highlighted the effectiveness in Xinjiang regional medical collaboration system, and has formed an unique culture brand of regional medical collaboration. Conclusion To develop the telemedicine, to promote the health career of borderland.

  9. THE APPLICATION OF TELEMATIC TECHNOLOGIES IN SLOVAKIA – THE POSSIBILITY OF IMPROVING ROAD SAFETY IN THE SLOVAK REPUBLIC

    Directory of Open Access Journals (Sweden)

    Ľubomír ČERNICKÝ

    2015-03-01

    Full Text Available Life on the road with all its aftermath and consequences works as a big triangle: driver-road-car. The main cause of road accidents is driver who can´t cope with increase of traffic density and with more and more powerful cars. Increasing number of new vehicles on our roads shows certain economic power of Slovakia and improving standard of living. The annual growth of more than seventy thousand new cars has as a result overcrowded Slovakian road network. Because of this, there is a special attention given to road traffic safety and its various factor at the present not only in our country, but also in the European Union. By joining the European Union we are committed to achieve standards in all areas that are comparable with European developed countries. In our paper we would analyze accident rate of traffic in recent years in Slovakia and design telematic measures to reduce it.

  10. TELEMEDICINE ACCEPTABILITY IN SOUTH WESTERN NIGERIA: ITS PROSPECTS AND CHALLENGES

    Directory of Open Access Journals (Sweden)

    Ajala F. A.

    2015-11-01

    Full Text Available  The use of advanced technology to deliver healthcare services at a distance has proven to be one of the defining medical revolutions of the 21st century. With the unwieldy healthcare system under scrutiny, telemedicine can be one of the answers for increasing access and at the same time decreasing the cost of healthcare service delivery. Nevertheless, employing the services of telemedicine comes with a cost though its benefits transcend any cost that may be accrued. This paper presents a report of an evaluation carried out in the south western states of Nigeria, the report reveals the extent to which medical facilities in south western Nigeria has embraced telemedicine, its prospect and challenges. Structured questionnaires and interviews were used to elicit information from medical professionals who were recruited into the study using a convenience sampling method. Results obtained after analyzing the evaluation results showed that despite the awareness of telemedicine by medical practitioners in south western Nigeria, only few medical facilities have integrated telemedicine into their services.

  11. Challenges in managing telemedicine centers in remote tribal hilly areas of Uttarakhand

    Directory of Open Access Journals (Sweden)

    S Suresh

    2013-12-01

    Full Text Available Background: Healthcare Information Technology advances in the Information, Communication and Telecommunication (ICT sector have made telemedicine a common and alternate medical service delivery in remote areas. Indian Space and Research Organization (ISRO established village resource centers managed by Non-government Organizations (NGO’s all over the country in 2010. While ISRO provided satellite connectivity and required equipment for communication, tele-education, and telemedicine in Uttarakhand, Himalayan Institute Hospital Trust provided primary health care through tele-consultation to remote tribal hilly areas through village resource centers. This paper features the technical and financial challenges faced in providing tele-consultation. Methods: A cross-sectional study of 115 clients, 4 health supervisors and co-ordinating doctor from three districts was done using semi-structured questionnaires for interview. Parameters at both doctor’s and patients’ end for communication, costs involved, quality of doctor-patient interaction and patient satisfaction from Tele-consultation sessions were assessed. Results: Video quality was more satisfactory than audio. The physical presence of a doctor was felt necessary only in 33/115 (30% of the time. The average cost for telemedicine consultation works out to just Rs. 15 per patient. Around 48.7% of the queries were processed in less than 10 minutes of satellite time. Around 67% of the beneficiaries felt that their privacy was not maintained as per their expectations.  The request to extend the timing of the session was made by 85% of the clients. Conclusions: Long periods of non- connectivity due to satellite failure, lack of technical staff, lack of patient’s privacy during sessions, lack of income generation for self-sustainability, were the major challenges faced. However many patients benefitted, did not have to travel long distances for medical advice and easy follow ups were

  12. 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

  13. 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.

  14. Critical issues in medical education and the implications for telemedicine technology.

    Science.gov (United States)

    Mahapatra, Ashok Kumar; Mishra, Saroj Kanta; Kapoor, Lily; Singh, Indra Pratap

    2009-01-01

    Ensuring quality medical education in all the medical colleges across India based on uniform curriculum prescribed by a regulatory body and maintaining a uniform standard are dependent on availability of an excellent infrastructure. Such infrastructure includes qualified teachers, knowledge resources, learning materials, and advanced education technology, which is a challenge in developing countries due to financial and logistic constraints. Advancement in telecommunication, information science, and technology provides an opportunity to exchange knowledge and skill across geographically dispersed organizations by networking academic medical centers of excellence with medical colleges and institutes to practice distance learning using information and communication technology (ICT)-based tools. These may be as basic as commonly used Web-based tools or may be as advanced as virtual reality, simulation, and telepresence-based collaborative learning environment. The scenario in India is no different from any developing country, but there is considerable progress due to technical advancement in these sectors. Telemedicine and tele-education in health science, is gradually getting adopted into the Indian Health System after decade-long pilot studies across the country. A recent recommendation of the National Knowledge Commission, once implemented, would ensure a gigabyte network across all the educational institutions of the country including medical colleges. Availability of indigenous satellite communication technology and the government policy of free bandwidth provision for societal development sector have added strength to set up infrastructure to pilot several telemedicine educational projects across the country.

  15. Telemedicine: what framework, what levels of proof, implementation rules.

    Science.gov (United States)

    Zannad, Faiez; Maugendre, Philippe; Audry, Antoine; Avril, Carole; Blaise, Lucile; Blin, Olivier; Burnel, Philippe; Falise-Mirat, Béatrice; Girault, Danièle; Giri, Isabelle; Goehrs, Jean-Marie; Lassale, Catherine; Le Meur, Roland; Leurent, Pierre; Ratignier-Carbonneil, Christelle; Rossignol, Patrick; Satonnet, Evelyne; Simon, Pierre; Treluyer, Laurent

    2014-01-01

    The concept of telemedicine was formalised in France in the 2009 "Hospital, patients, health territories" (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation. With this background, the round table wanted to produce recommendations on different areas of medical telemonitoring (the role of telemonitoring, the regulatory system, the principles for assessment, methods of use and conditions for sustained and seamless deployment). Whilst many studies carried out on new medical telemonitoring approaches have led to the postulate that it offers benefit, both clinically and in terms of patient quality of life, more information is needed to demonstrate its impact on the organisation of healthcare and the associated medico-economic benefit (criteria, methods, resources). Similarly, contractual frameworks for deployment of telemonitoring do exist, although they are complicated and involve many different stakeholders (Director General fo the Care Offering [Direction générale de l'offre de soins, DGOS], ARS, HAS, Agency for Shared Health Information Systems [Agence des systèmes d'information partagés de santé, ASIP], French National Data Protection Commission [Commission nationale informatique et libertés, CNIL], French National Medical Council [Conseil national de l'Ordre des médecins, CNOM], etc.) that would benefit from a shared approach and seamless exchange between the partners involved. The current challenge is also to define the conditions required to validate a stable economic model in order to promote organisational change. One topical issue is placing the emphasis on its evaluation and

  16. INTEGRATING ARTIFICIAL NEURAL NETWORKS FOR DEVELOPING TELEMEDICINE SOLUTION

    Directory of Open Access Journals (Sweden)

    Mihaela GHEORGHE

    2015-06-01

    Full Text Available Artificial intelligence is assuming an increasing important role in the telemedicine field, especially neural networks with their ability to achieve meaning from large sets of data characterized by lacking exactness and accuracy. These can be used for assisting physicians or other clinical staff in the process of taking decisions under uncertainty. Thus, machine learning methods which are specific to this technology are offering an approach for prediction based on pattern classification. This paper aims to present the importance of neural networks in detecting trends and extracting patterns which can be used within telemedicine domains, particularly for taking medical diagnosis decisions.

  17. Technical Developments and Clinical Use of Telemedicine in Sleep Medicine

    Directory of Open Access Journals (Sweden)

    Marie Bruyneel

    2016-12-01

    Full Text Available The use of assistive technology and telemedicine is likely to continue to shape our medical practice in the future, notably in the field of sleep medicine, especially within developed countries. Currently, the number of people suffering from obstructive sleep apnea syndrome (OSAS is increasing. Telemedicine (TM can be used in a variety of ways in sleep medicine: telediagnostics, teleconsultation, teletherapy and telemonitoring of patients being treated with positive pressure devices. In this review, we aim to summarize the recent scientific progresses of these techniques and their potential clinical applications and give consideration to the remaining problems related to TM application.

  18. Telematics support to electric car sharing%车联网对电动汽车共享服务的支持

    Institute of Scientific and Technical Information of China (English)

    左静

    2016-01-01

    At present, automobile emissions caused by traffic pollution is becoming increasingly serious in China, and the emissions also cause energy shortages, traffic congestion and other problems. Electric car sharing service can effectively reduce vehicle emissions and traffic congestion. The development of telematics can facilitate the promotion of electric car sharing.Through the research of telematics and electric car sharing, this paper gets the conclusion about the telematics support to the electric car sharing.%目前,我国汽车排放引起的交通污染日益严重,并且伴随能源紧缺,交通拥堵等问题。电动汽车共享服务能有效的减少汽车尾气排放,减缓交通拥堵。车联网技术的发展能够促进电动汽车共享的推广。文章通过研究车联网技术,电动汽车共享服务模式,得出车联网技术在电动汽车共享服务中的支持。

  19. The Emerging Role of Telemedicine in Managing Glycemic Control and Psychobehavioral Aspects of Pregnancy Complicated by Diabetes

    Directory of Open Access Journals (Sweden)

    Nino Cristiano Chilelli

    2014-01-01

    Full Text Available There is a gradual decline in concern of specialists who follow up the care of pregnant women with diabetes. In addition, due to the dwindling economic resources allocated to health services, access to specialized healthcare facilities is becoming more difficult. Telemedicine, or medicine practiced at a distance, is inserted in this context with applications differing for type of interaction (real-time or deferred, i.e., videoconferencing versus store-and-forward data transmission, type of monitoring (automatic versus requesting cooperation from the patient, and type of devices used (web connections and use of mobile phones or smartphones. Telemedicine can cope with the current lack of ability to ensure these patients frequent direct contact with their caregivers. This approach may have an impact not only on the classical maternal-fetal outcome, but also on some underestimated aspects of patients with diabetes in pregnancy, in this case their quality of life, the perception of “diabetes self-efficacy,” and the glycemic variability. In this paper, we will analyze the current evidence regarding the use of telemedicine in pregnancies complicated by diabetes, trying to highlight the main limitations of these studies and possible strategies to overcome them in order to improve the effectiveness of future clinical interventions with these medical applications.

  20. Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

    Directory of Open Access Journals (Sweden)

    Ken Russell Coelho

    2011-01-01

    Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

  1. 远程医疗在老年人群中的应用%Application of telemedicine in elderly population

    Institute of Scientific and Technical Information of China (English)

    谢海雁; 张雪晗; 倪雪峰; 姜鸿; 李冬晶

    2016-01-01

    随着信息化与老龄化社会的到来,远程医疗逐渐成为新兴的医疗模式。远程医疗可以用于对老年人的健康监测、疾病诊断、咨询、教育和慢性病管理、长期照护等,尤其有利于慢性心力衰竭、糖尿病等慢性疾病的管理及实现转诊医疗、保持医疗的连续性。在老年人群中开展远程医疗有不同于其他专科疾病管理的特殊性,其推广有利于打破处所的局限性,使老年专科医生及辅助医疗团队的价值得到最大程度的体现。国外远程医疗的研究与发展对我国有很高的借鉴意义。%With the emerging of aging society and advances of information sciences, telemedicine has gradually become a new medical model.Telemedicine can be used in health monitoring, disease diagnosis, counseling, education, chronic disease management and long-term care in elderly population;particularly in management of chronic heart failure, diabetes and other chronic diseases, as well as in referral and continuous medical care.To promote telemedicine in the elderly population can break the physical limitations of different health care settings, so that geriatrician and the allied team members are enable to maximize their values in providing corresponding health services.This article reviews the progress of telemedicine in foreign countries, which would be of reference value for development of telemedicine for elderly people in China.

  2. 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

  3. Telemedicine: An Overview with Implications for Military Use

    Science.gov (United States)

    2007-11-02

    medical fields in which telemedicine is already being used includes radiology, ophthalmology, cardiology , pathology, and dermatology. For example...capabilities. The special forces medic’s training transcends the combat medic’s training in the areas surgery, anesthesia, dentistry, veterinary medicine

  4. Web-based home telemedicine system for orthopedics

    Science.gov (United States)

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

    2001-05-01

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

  5. Making the business case for telemedicine: an interactive spreadsheet.

    Science.gov (United States)

    McCue, Michael J; Palsbo, Susan E

    2006-04-01

    The objective of this study was to demonstrate the business case for telemedicine in nonrural areas. We developed an interactive spreadsheet to conduct multiple financial analyses under different capital investment, revenue, and expense scenarios. We applied the spreadsheet to the specific case of poststroke rehabilitation in urban settings. The setting involved outpatient clinics associated with a freestanding rehabilitation hospital in Oklahoma. Our baseline scenario used historical financial data from face-to-face encounters as the baseline for payer and volume mix. We assumed a cost of capital of 10% to finance the project. The outcome measures were financial breakeven points and internal rate of return. A total of 340 telemedicine visits will generate a positive net cash flow each year. The project is expected to recoup the initial investment by the fourth year, produce a positive present value dollar return of more than $2,000, and earn rate of return of 20%, which exceeds the hospital's cost of capital. The business case is demonstrated for this scenario. Urban telemedicine programs can be financially self-sustaining without accounting for reductions in travel time by providers or patients. Urban telemedicine programs can be a sound business investment and not depend on grants or subsidies for start-up funding. There are several key decision points that affect breakeven points and return on investment. The best business strategy is to approach the decision as whether or not to build a new clinic.

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

    NARCIS (Netherlands)

    Fung, N.L.S.; Jones, V.M.; Hermens, H.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 MobiGu

  7. A systematic review of technical evaluation in telemedicine systems.

    Science.gov (United States)

    Thiyagarajan, C A; Clarke, M

    2006-01-01

    We conducted a systematic review of the literature to critically analyse the evaluation and assessment frameworks that have been applied to telemedicine systems. Subjective methods were predominantly used for technical evaluation (59 %), e.g. Likert scale. Those including objective measurements (41%) were restricted to simple metrics such as network time delays. Only three papers included a rigorous standards based objective approach. Our investigation has been unable to determine a definitive standards-based telemedicine evaluation framework that exists in the literature that may be applied systematically to assess and compare telemedicine systems. We conclude that work needs to be done to address this deficiency. We have therefore developed a framework that has been used to evaluate videoconferencing systems telemedicine applications. Our method seeks to be simple to allow relatively inexperienced users to make measurements, is objective and repeatable, is standards based, is inexpensive and requires little specialist equipment. We use the EIA 1956 broadcast test card to assess resolution, grey scale and for astigmatism. Colour discrimination is assessed with the TE 106 and Ishihara 24 colour scale chart. Network protocol analysis software is used to assess network performance (throughput, delay, jitter, packet loss).

  8. A generic task-driven multi-agent telemedicine system.

    Science.gov (United States)

    Nageba, Ebrahim; Fayn, Jocelyne; Rubel, Paul

    2007-01-01

    Pervasive Telemedicine is an emerging research discipline, which focuses on the development and the application of ubiquitous computing technology for healthcare purposes. However, the current telemedicine systems lack to be self adaptable to handle different types of data such as vital biosignals, images, video and textual data. In addition, they do not use the full capabilities of the computing devices on which they run. Unfortunately, the existing telemedicine systems do not pay enough attention to the quality level of their offered services nor offer adequate resources management for meeting bandwidth and end-to-end communication delays. In this paper we propose an information and communication architecture of a generic telemedicine system based on a knowledge base and intelligent agents interacting each with the other in a synergetic way to perform several medical tasks for a high level of quality of service (QoS). The medical assistance to skiers and high mountains resorts residents will be used in particular as an example of applicability scenario and models personalization.

  9. Telemedicine compared with standard care in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rasmussen, O. W.

    2015-01-01

    Objectives: For patients with T2DM does telemedicine, compared with standard care, provide equivalent clinical outcomes? Methods: Forty patients with type 2 diabetes mellitus allocated from October 2011 until July 2012 randomized to either treatment at home by video conferences only or the standard...

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

    NARCIS (Netherlands)

    Liu, Chanjuan

    2014-01-01

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

  11. STARPAHC space-oriented medical evaluation. [telemedicine system

    Science.gov (United States)

    1979-01-01

    Development of the STARPAHC telemedicine system is documented. Using STARPAHC assessment results and monitoring experience, on board and ground based flight medical system monitoring requirements and operational procedures were developed for use with the Space Transportation System during OFT and mature operation phases of the shuttle.

  12. Quality-of-data management for telemedicine systems

    NARCIS (Netherlands)

    Larburu, Nekane; Bults, Richard; Sinderen, van Marten; Hermens, Hermie

    2015-01-01

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

  13. Supporting the developers of context-aware mobile telemedicine applications

    NARCIS (Netherlands)

    Broens, T.H.F.

    2005-01-01

    Telemedicine, which is defined as providing healthcare and sharing of medical knowledge over distance using telecommunication means, is a promising approach to improve and enhance the healthcare provisioning process. However, only recently, technology has evolved (i.e. miniaturization of high power

  14. The past, present, and future of telemedicine for Parkinson's disease

    NARCIS (Netherlands)

    Achey, M.; Aldred, J.L.; Aljehani, N.; Bloem, B.R.; Biglan, K.M.; Chan, P.; Cubo, E.; Dorsey, E. Ray; Goetz, C.G.; Guttman, M.; Hassan, A.; Khandhar, S.M.; Mari, Z.; Spindler, M.; Tanner, C.M.; Haak, P. van den; Walker, R.; Wilkinson, J.R.

    2014-01-01

    Travel distance, growing disability, and uneven distribution of doctors limit access to care for most Parkinson's disease (PD) patients worldwide. Telemedicine, the use of telecommunications technology to deliver care at a distance, can help overcome these barriers. In this report, we describe the

  15. The added value of thorough economic evaluation of telemedicine networks.

    Science.gov (United States)

    Le Goff-Pronost, Myriam; Sicotte, Claude

    2010-02-01

    This paper proposes a thorough framework for the economic evaluation of telemedicine networks. A standard cost analysis methodology was used as the initial base, similar to the evaluation method currently being applied to telemedicine, and to which we suggest adding subsequent stages that enhance the scope and sophistication of the analytical methodology. We completed the methodology with a longitudinal and stakeholder analysis, followed by the calculation of a break-even threshold, a calculation of the economic outcome based on net present value (NPV), an estimate of the social gain through external effects, and an assessment of the probability of social benefits. In order to illustrate the advantages, constraints and limitations of the proposed framework, we tested it in a paediatric cardiology tele-expertise network. The results demonstrate that the project threshold was not reached after the 4 years of the study. Also, the calculation of the project's NPV remained negative. However, the additional analytical steps of the proposed framework allowed us to highlight alternatives that can make this service economically viable. These included: use over an extended period of time, extending the network to other telemedicine specialties, or including it in the services offered by other community hospitals. In sum, the results presented here demonstrate the usefulness of an economic evaluation framework as a way of offering decision makers the tools they need to make comprehensive evaluations of telemedicine networks.

  16. Utilização da telemedicina como estratégia de promoção de saúde em comunidades ribeirinhas da Amazônia: experiência de trabalho interdisciplinar, integrando as diretrizes do SUS Use of telemedicine technology as a strategy to promote health care of riverside communities in the Amazon: experience with interdisciplinary work, integrating NHS guidelines

    Directory of Open Access Journals (Sweden)

    Felipe Salles Neves Machado

    2010-01-01

    Full Text Available Este artigo apresenta uma experiência de formação educacional e de assistência médica, utilizando a telemedicina como recurso tecnológico para a promoção e prevenção em saúde, além da capacitação profissional de populações ribeirinhas do baixo Madeira, no Estado de Rondônia. A atuação contou com a constituição de um pequeno pólo de telemedicina na comunidade de Santa Catarina, localizada no rio Madeira, há duzentos quilômetros do município de Porto Velho. A experiência no campo foi realizada entre 17 e 31 de julho de 2006, promovendo a inclusão de moradores de nove comunidades ribeirinhas. O sistema permitiu a troca simultânea de vídeo e áudio em tempo real, possibilitando acesso à informação, assistência médica e palestras sobre prevenção em saúde básica à população em geral. A realização deste projeto mostrou que a implantação da telemedicina é uma alternativa para a melhor distribuição dos serviços de saúde. Além de levar o atendimento a populações menos favorecidas, permite a reintegração social de pessoas preteridas pelo isolamento geográfico, auxilia na difusão de informação, proporciona capacitação aos moradores e futuros usuários do sistema, promove a prevenção em saúde, desenvolvendo a responsabilidade da população para uma melhor da qualidade de vida da região.This article aims at presenting an experience of professional and medical assistance education using telemedicine as a technology for the promotion and prevention in health care as well as professional qualification of the riverside population living in the margins of Madeira river, in the State of Rondônia. This project comprised a small pole of the telemedicine in the community of Santa Catarina, located by Madeira river, 200 km from the city of Porto Velho, Rondônia State. Field experience was performed between July 17 and 31, 2006, promoting the inclusion of inhabitants of nine riverside communities. The

  17. Medical Optimization Network for Space Telemedicine Resources

    Science.gov (United States)

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

    2017-01-01

    INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system. Beyond the traditional limitations in mass, power, and volume, consideration must be given to other factors such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. As NASA develops the medical system for an exploration mission, it must have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources (MONSTR) was developed over the past year for this reason, and is now a system for managing data pertaining to medical resources and their relative importance when addressing medical conditions. METHODS: The MONSTR web application with a Microsoft SQL database backend was developed and made accessible to Tableau v9.3 for analysis and visualization. The database was initially populated with a list of medical conditions of concern for an exploration mission taken from the Integrated Medical Model (IMM), a probabilistic model designed to quantify in-flight medical risk. A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program compiled a list diagnostic and treatment medical resources required to address best- and worst-case scenarios of each medical condition using a terrestrial standard of care and entered this data into the system. This list included both tangible resources (e.g. medical equipment, medications) and intangible resources (e.g. clinical skills required to perform a procedure). The physician team then assigned criticality values to each instance of a resource, representing the importance of that resource to diagnosing or treating its associated condition(s). Medical condition probabilities of occurrence during a Mars mission were pulled from the IMM and imported into the MONSTR database for use within a resource criticality-weighting algorithm. DISCUSSION

  18. 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

  19. 77 FR 43773 - Wireline Competition Bureau Seeks Further Comment on Issues in the Rural Health Care Reform...

    Science.gov (United States)

    2012-07-26

    ... DA 12-1166 and may be filed using the Commission's Electronic Comment Filing System (ECFS). See... providers on their networks, using telemedicine and other telehealth applications to improve the quality and... rural health care, telemedicine, and Health IT. Based on what we have learned from the Pilot...

  20. Telehealth and Mobile Health

    OpenAIRE

    Ward, Tomas

    2015-01-01

    The E-Medicine, E-Health, M-Health, Telemedicine, and Telehealth Handbook provides extensive coverage of modern telecommunication in the medical industry, from sensors on and within the body to electronic medical records and beyond. Telehealth and Mobile Health is the second volume of this handbook. Featuring chapters written by leading experts and researchers in their respective fields.

  1. Predictive factors of telemedicine service acceptance and behavioral intention of physicians.

    Science.gov (United States)

    Rho, Mi Jung; Choi, In Young; Lee, Jaebeom

    2014-08-01

    Despite the proliferation of telemedicine technology, telemedicine service acceptance has been slow in actual healthcare settings. The purpose of this research is to develop a theoretical model for explaining the predictive factors influencing physicians' willingness to use telemedicine technology to provide healthcare services. We developed the Telemedicine Service Acceptance model based on the technology acceptance model (TAM) with the inclusion of three predictive constructs from the previously published telemedicine literature: (1) accessibility of medical records and of patients as clinical factors, (2) self-efficacy as an individual factor and (3) perceived incentives as regulatory factors. A survey was conducted, and structural equation modeling was applied to evaluate the empirical validity of the model and causal relationships within the model using the data collected from 183 physicians. Our results confirmed the validity of the original TAM constructs: the perceived usefulness of telemedicine directly impacted the behavioral intention to use it, and the perceived ease of use directly impacted both the perceived usefulness and the behavioral intention to use it. In addition, new predictive constructs were found to have ramifications on TAM variables: the accessibility of medical records and of patients directly impacted the perceived usefulness of telemedicine, self-efficacy had a significant positive effect on both the perceived ease of use and the perceived usefulness of telemedicine, and perceived incentives were found to be important with respect to the intention to use telemedicine technology. This study demonstrated that the Telemedicine Service Acceptance model was feasible and could explain the acceptance of telemedicine services by physicians. These results identified important factors for increasing the involvement of physicians in telemedicine practice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-05-01

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

  3. TELEMEDICINE NETWORK BASED ON CODE-DIVISION MULTIPLE ACCESS WIRELESS TECHNOLOGY

    Institute of Scientific and Technical Information of China (English)

    同鸣; 卞正中; 张亮

    2003-01-01

    Objective To satisfy the need of reliable and efficient telemedicine in many mobile and ambulance situations. Methods A practical telemedicine system bases on code-division multiple access (CDMA) wireless communication technology has been developed, which has never been mentioned before. The design scheme for the proposed system is described and detailed analysis of the network protocol stacks and the data flow is presented. Results Experiments on real time transmission of medical images using developed system have demonstrated that the system performance is satisfactory and acceptable. Conclusion The telemedicine system based on CDMA is easy to implement and has high quality of transmitted images. It would be a prospective solution to mobile telemedicine.

  4. New trends in diabetes management: mobile telemedicine closed-loop system.

    Science.gov (United States)

    Hernando, M Elena; Gómez, Enrique J; Gili, Antonio; Gómez, Mónica; García, Gema; del Pozo, Francisco

    2004-01-01

    The rapid growth and development of information technologies over recent years, in the areas of mobile and wireless technologies is shaping a new technological scenario of telemedicine in diabetes. This telemedicine scenario can play an important role for further acceptance by diabetic patients of the existing continuous glucose monitoring systems and insulin pumps with the final goal of improving current therapeutic procedures. This paper describes a Personal Smart Assistant integrated in a multi-access telemedicine architecture for the implementation of a mobile telemedicine closed-loop system for diabetes management. The system is being evaluated within the European Union project named INCA ("Intelligent Control Assistant for Diabetes").

  5. Transeuropean network for the provision of added-VAlue Services in Telemedicine--(VAST-Net).

    Science.gov (United States)

    Anogianakis, G; Maglavera, S

    1997-01-01

    Populations most likely to use telemedicine are usually located far away from ISDN networks in contrast to providers of telemedical services who normally dwell in urban centers. VAST-Net is a consortium that aspires to reach such populations by introducing added-value ISDN-based telemedical services across Europe, through networking a small number of selected, strategically distributed, points-of-care and by focusing on a series of well defined health care provision scenaria. This will be achieved by relying on: (1) the Euro-ISDN infrastructure, (2) satellite based ISDN medical networks (e.g. the INMARSAT/VSAT based MERMAID network), (3) private ISDN networks. The VAST-Net telemedical network will be initially operated on a small but transnational scale in order to assess: (1) the acceptance of telemedical services by end users, (2) the economic viability of the telemedical sector, especially in an international context (3) the legal implications of telemedical practice (4) the regulatory framework within which telemedicine will be developed in the E.U. Based on this assessment the VAST-Net Consortium will proceed to develop appropriate business plans that will allow PTTs and other Telecom operators, medical groups, insurance companies and public health authorities to offer transnationally ISDN-based telemedical services. Potential forms of cooperation may include: (1) "Framework agreements" between PTTs, telemedical service providers (e.g. doctors, hospitals etc.) and "bulk users" (insurance companies, public health authorities), (2) PTT provision of "telecommunications backbones" over which competing telemedical networks can be organised, (3) organisation of a European Economic Interest Group (EEIG), modeled upon international companies such as INMARSAT, that will undertake the operation of VAST-Net.

  6. Socio-technical and organizational challenges to wider e-Health implementation.

    Science.gov (United States)

    Vitacca, M; Mazzù, M; Scalvini, S

    2009-01-01

    Recent advances in information communication technology allow contact with patients at home through e-Health services (telemedicine, in particular). We provide insights on the state of the art of e-Health and telemedicine for possible wider future clinical use. Telemedicine opportunities are summarized as i) home telenursing, ii) electronic transfer to specialists and hospitals, iii) teleconsulting between general practitioners and specialists and iv) call centres activities and online health. At present, a priority action of the EU is the Initiative on TM for chronic disease management as home health monitoring and the future Vision for Europe 2020 is based on development of Integrated Telemedicine Services. There are pros and cons in e-Health and telemedicine. Benefits can be classified as benefits for i) citizens, patients and caregivers and ii) health care provider organizations. Institutions and individuals that play key roles in the future of e-Health are doctors, patients and hospitals, while the whole system should be improved at three crucial levels: 1) organizational, 2) regulatory and 3) technological. Quality, access and efficiency are the general key issues for the success of e-Health and telemedicine implementation. The real technology is the human resource available into the organizations. For e-Health and telemedicine to grow, it will be necessary to investigate their long-term efficacy, cost effectiveness, possible improvement in quality of life and impact on public health burden.

  7. Use of telemedicine-based care for the aging and elderly: promises and pitfalls

    Directory of Open Access Journals (Sweden)

    Bujnowska-Fedak MM

    2015-05-01

    Full Text Available Maria Magdalena Bujnowska-Fedak, Urszula Grata-Borkowska Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland Abstract: Telemedicine-based care provides remote health and social care to maintain people's autonomy and increase their quality of life. The rapidly aging population has come with a significant increase in the prevalence of chronic diseases and their effects, and thus the need for increased care and welfare. The elderly have become one of the main target groups for telecare technologies. Smart home systems allow older adults to live in the environment of their choice and protect them against institutionalization or placement in a nursing home. It gives the elderly person a feeling of reassurance and safety, and appears to be one of the most promising approaches to facilitate independent living in a community-dwelling situation. Telecare solutions give a new opportunity for diagnosis, treatment, education, and rehabilitation, and make it possible to monitor patients with a number of chronic diseases. It also reduces socioeconomic disparity with regard to access to care and gives equal chances to patients from urban and rural areas. However, although telecare has undisputed benefits, it also has some limitations. Older people are often resistant to use of new technology, in particular acquiring the knowledge and skills necessary for use of electronic devices and computer systems. Further, privacy and security are important elements when building confidence in telemedicine systems. Leaking of sensitive information, such as health or test results, may have a negative and far-reaching impact on the personal and professional life of the patient. Telemedicine-based care should now be personalized for the needs, capabilities, and preferences of the elderly, with adaptation over time as care needs evolve. If technologies are introduced that are familiar, usable, desirable, and cost-effective, and able to be adapted to

  8. 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.

  9. Tele-education service using telemedicine network in healthcare industry.

    Science.gov (United States)

    Mahadevan, S; Muralidhar, Kanchi; Shetty, Devi

    2012-11-01

    We have used a telemedicine facility to conduct academic teaching/training sessions. The objective of this study was to examine the feasibility, advantages, and disadvantages of this method of e-learning sessions. The teaching/learning sessions were organized twice a week between the two teaching hospitals. The success of each academic session was analyzed in terms of satisfaction of the participating candidates, infrastructure difficulties (if any), and the overall outcome of the program. In total, 293 academic sessions were held from 2008 to 2010. Each session's presentation was 45 min long and was made using Microsoft(®) (Redmond, WA) PowerPoint. We have found that telemedicine proved to be effective in establishing communication not only between the patient and the physician, but also between the teacher and the student. Several candidates benefited from the application of this technology. Candidates expressed satisfaction and were content with the teaching methods adapted.

  10. ROI-based DICOM image compression for telemedicine

    Indian Academy of Sciences (India)

    Vinayak K Bairagi; Ashok M Sapkal

    2013-02-01

    Many classes of images contain spatial regions which are more important than other regions. Compression methods capable of delivering higher reconstruction quality for important parts are attractive in this situation. For medical images, only a small portion of the image might be diagnostically useful, but the cost of a wrong interpretation is high. Hence, Region Based Coding (RBC) technique is significant for medical image compression and transmission. Lossless compression schemes with secure transmission play a key role in telemedicine applications that help in accurate diagnosis and research. In this paper, we propose lossless scalable RBC for Digital Imaging and Communications in Medicine (DICOM) images based on Integer Wavelet Transform (IWT) and with distortion limiting compression technique for other regions in image. The main objective of this work is to reject the noisy background and reconstruct the image portions losslessly. The compressed image can be accessed and sent over telemedicine network using personal digital assistance (PDA) like mobile.

  11. The Collaborative Coordination of Special Interest Groups on the Telemedicine University Network (RUTE) in Brazil.

    Science.gov (United States)

    de Lima Verde Brito, Thiago Delevidove; Baptista, Roberto Silva; de Lima Lopes, Paulo Roberto; Haddad, Ana Estela; Messina, Luiz Ary; Torres Pisa, Ivan

    2015-01-01

    In Brazil the Telemedicine University Network (Rede Universitária de Telemedicina RUTE) is an initiative that among others promotes collaboration between university hospitals, universities, and health professionals through information technology infrastructure and special interest groups (SIGs) support. This paper presents results of analyses on collaboration during implementation and coordination activities of RUTE SIGs. This study is based on descriptive statistics and data visualization previously collected by RUTE national coordination relative to the status in July 2014. The analysis through collaboration graph identified the strongest collaboration RUTE units. The graph also highlights the collaborative relationship of RUTE units in form of communities, the most collaborative with each other in a communion in the same SIGs, and the less the collaborative units in the network. It should be stated that the most active units are also the oldest in the community.

  12. Compression and Encryption of ECG Signal Using Wavelet and Chaotically Huffman Code in Telemedicine Application.

    Science.gov (United States)

    Raeiatibanadkooki, Mahsa; Quchani, Saeed Rahati; KhalilZade, MohammadMahdi; Bahaadinbeigy, Kambiz

    2016-03-01

    In mobile health care monitoring, compression is an essential tool for solving storage and transmission problems. The important issue is able to recover the original signal from the compressed signal. The main purpose of this paper is compressing the ECG signal with no loss of essential data and also encrypting the signal to keep it confidential from everyone, except for physicians. In this paper, mobile processors are used and there is no need for any computers to serve this purpose. After initial preprocessing such as removal of the baseline noise, Gaussian noise, peak detection and determination of heart rate, the ECG signal is compressed. In compression stage, after 3 steps of wavelet transform (db04), thresholding techniques are used. Then, Huffman coding with chaos for compression and encryption of the ECG signal are used. The compression rates of proposed algorithm is 97.72 %. Then, the ECG signals are sent to a telemedicine center to acquire specialist diagnosis by TCP/IP protocol.

  13. [Telecommunications, health and radiology: potential synergies for the new millennium].

    Science.gov (United States)

    Lagalla, R

    2001-01-01

    Healthcare telematics, or telemedicine, is a new methodology that applies the potentialities of telecommunications technologies to the needs of medicine, thereby greatly contributing to improving the management of clinical data and medical information for the benefit of the individual patient and the community at large. The fields of application of Telemedicine are becoming increasingly vast, and this gives rise to technical problems (interconnections) as well as professional, ethical, medico-legal and legal problems. The dissemination of Telemedicine will require changes to be made to the organisation and delivery of the medical/administrative services connected to the management of patient data, the remote provision of care, and the impact of Telemedicine itself (e.g. need to standardise the nomenclature for telemedicine services). In addition, it will also call for a careful analysis of costs and benefits for both healthcare providers and patients. One of the most interesting experiences in terms of impact is Teleradiology. This is neither a new discipline nor a (sub)specialty: the practice of Teleradiology must comply with the rules regulating any radiological medical act, the primary aim of which is to contribute to establishing - rapidly and accurately - a diagnosis that will affect treatment strategies. It may be anticipated that in some situations Teleradiology will significantly change the working practices of Radiology Specialists and Radiology Technicians. Because it is better to anticipate problems rather than wait for them to arise, our Scientific Society, which is always sensitive to emerging issues, intends to propose the following recommendations/guidelines for the use of Teleradiology in the common interest of the community and healthcare workers. The invitation to take part in the initiative proposed by the Italian Society of Medical Radiology (SIRM), the Italian Association of Nuclear Medicine (AIMN) and the Italian Association of Neuroradiology

  14. Information Retrieval in Telemedicine: a Comparative Study on Bibliographic Databases

    Science.gov (United States)

    Ahmadi, Maryam; Sarabi, Roghayeh Ershad; Orak, Roohangiz Jamshidi; Bahaadinbeigy, Kambiz

    2015-01-01

    Background and Aims: The first step in each systematic review is selection of the most valid database that can provide the highest number of relevant references. This study was carried out to determine the most suitable database for information retrieval in telemedicine field. Methods: Cinhal, PubMed, Web of Science and Scopus databases were searched for telemedicine matched with Education, cost benefit and patient satisfaction. After analysis of the obtained results, the accuracy coefficient, sensitivity, uniqueness and overlap of databases were calculated. Results: The studied databases differed in the number of retrieved articles. PubMed was identified as the most suitable database for retrieving information on the selected topics with the accuracy and sensitivity ratios of 50.7% and 61.4% respectively. The uniqueness percent of retrieved articles ranged from 38% for Pubmed to 3.0% for Cinhal. The highest overlap rate (18.6%) was found between PubMed and Web of Science. Less than 1% of articles have been indexed in all searched databases. Conclusion: PubMed is suggested as the most suitable database for starting search in telemedicine and after PubMed, Scopus and Web of Science can retrieve about 90% of the relevant articles. PMID:26236086

  15. Telemedicine to Promote Patient Safety: Use of Phone-Based Interactive Voice-Response System to Reduce Adverse Safety Events in Pre-dialysis CKD.

    Science.gov (United States)

    Weiner, Shoshana; Fink, Jeffery C

    2017-01-01

    CKD patients have several features conferring on them a high risk of adverse safety events, which are defined as incidents with unintended harm related to processes of care or medications. These characteristics include impaired kidney function, polypharmacy, and frequent health system encounters. The consequences of such events in CKD can include new or prolonged hospitalization, accelerated kidney function loss, acute kidney injury, ESRD, and death. Health information technology administered via telemedicine presents opportunities for CKD patients to remotely communicate safety-related findings to providers for the purpose of improving their care. However, many CKD patients have limitations that hinder their use of telemedicine and access to the broad capabilities of health information technology. In this review, we summarize previous assessments of the pre-dialysis CKD populations' proficiency in using telemedicine modalities and describe the use of interactive voice-response system to gauge the safety phenotype of the CKD patient. We discuss the potential for expanded interactive voice-response system use in CKD to address the safety threats inherent to this population.

  16. Telemedicine: history, uses and new learning tools

    OpenAIRE

    2011-01-01

    Introduction: Currently, health care interventions either diagnostic or therapeutic, are not distributed evenly across the globe, therefore ensuring the provision of health services represents a constant challenge for many health care programs in different countries, however, thanks to the advances in telecommunication and imaging processing, it is now possible to offer a variety of health care services to a greater number of people at a distance with a good level of quality, this concept is ...

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

    Science.gov (United States)

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

    2012-06-01

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

  18. The International Telematic University UNINETTUNO A Model of Cooperative & Work-Integrated Education through the New Technologies

    Directory of Open Access Journals (Sweden)

    Maria Amata Garito

    2013-11-01

    Full Text Available Internet has completely changed the ways of producing and communicating knowledge. Today it is possible to attend University without any space or time limitation. The International Telematic University UNINETTUNO (UTIU has been developing an organizational and psycho-pedagogical model and a technological structure, which, thanks to Internet, give everyone the possibility to attend the University anywhere in the world. Thanks to this model, UTIU has been committed in supporting the national socio-economic environment, through bilateral agreements and joint projects with trade unions and companies, in order to update and upgrade workersཿ competences and to help them entering into the global markets. It is shown here the results of the outcomes deriving from an agreement signed with the Italian biggest telecommunication company: Telecom Italia. This agreement, which offers to Telecom Italiaཿs employees the opportunity to enrol at UTIU degree programmes with the economic support of their employer, represents an innovative example of collaboration among a Company, a University and the Trade Unions, with the purpose of fostering human resourcesཿ training and professionalization. The agreement derives from Telecom Italiaཿs need for training its personnel. Thus, with the aim of improving their competences, Telecom Italia has counted on the innovative technologies provided by distance learning, acknowledging UTIUཿs psycho-pedagogical model as the best solution available. As an innovative element, for the first time in the negotiation history the Trade Unions and a Company has agreed on the possibility for the employees to enrol for a degree programme, thus improving their social and cultural status.

  19. 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,

  20. Specialist physicians' knowledge and beliefs about telemedicine: a comparison of users and nonusers of the technology.

    Science.gov (United States)

    Barton, Phoebe Lindsey; Brega, Angela G; Devore, Patricia A; Mueller, Keith; Paulich, Marsha J; Floersch, Natasha R; Goodrich, Glenn K; Talkington, Sylvia G; Bontrager, Jeff; Grigsby, Bill; Hrincevich, Carol; Neal, Susannah; Loker, Jeff L; Araya, Tesfa M; Bennett, Rachael E; Krohn, Neil; Grigsby, Jim

    2007-10-01

    Telemedicine as a technology has been available for nearly 50 years, but its diffusion has been slower than many had anticipated. Even efforts to reimburse providers for interactive video (IAV) telemedicine services have had a limited effect on rates of participation. The resulting low volume of services provided (and consequent paucity of research subjects) makes the phenomenon difficult to study. This paper, part of a larger study that also explores telemedicine utilization from the perspectives of referring primary care physicians and telemedicine system administrators, reports the results of a survey of specialist and subspecialist physicians who are users and nonusers of telemedicine. The survey examined self-assessed knowledge and beliefs about telemedicine among users and nonusers, examining also the demographic characteristics of both groups. Statistically significant differences were found in attitudes toward telemedicine between users and nonusers, but in many respects the views of the two groups were rather similar. Physicians who used telemedicine were aware of the limitations of the technology, but also recognized its potential as a means of providing consultation. Demographic differences did not explain the differences in the knowledge and beliefs of user and nonuser consultant physicians, although some of the differences may be explained by other aspects of the professional environment.

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

    NARCIS (Netherlands)

    Larburu, N.; Bults, R.G.A.; Sinderen, van M.; Widya, I.; Hermens, H.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, t

  2. 7 CFR 1700.31 - Distance Learning and Telemedicine Loan and Grant Program.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.31 Section 1700.31 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.31 Distance Learning and Telemedicine...

  3. 7 CFR 1700.57 - Distance Learning and Telemedicine Loan and Grant Program.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section 1700.57 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE GENERAL INFORMATION Loan and Grant Approval Authorities § 1700.57 Distance Learning and Telemedicin...

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

    Science.gov (United States)

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

    2017-01-01

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

  5. La telemedicina: ¿ciencia o ficción? Telemedicine: science or fiction?

    Directory of Open Access Journals (Sweden)

    J. L. Monteagudo

    2005-12-01

    , the need for new health services based on telemedicine. This article offers an up-to-date view of the state of the art of telemedicine but without entering into an in-depth evaluation and description of the technology and its applications. On the contrary, our aim is to make it known to users and to the different health organisations, including their managers, that the conditions for its development are now available. Thus the success or failure of its implantation is a task for all of the actors involved. What is certain is that in the light of the experience and results of its application during the last decade, both in our surrounding geographical milieu and in the United States, there are unmistakable signs that telemedicine is here to stay.

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

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2015-01-01

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

  7. 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.

  8. A Vertical Handover Management for Mobile Telemedicine System using Heterogeneous Wireless Networks

    Directory of Open Access Journals (Sweden)

    Hoe-Tung Yew

    2016-07-01

    Full Text Available Application of existing mobile telemedicine system is restricted by the imperfection of network coverage, network capacity, and mobility. In this paper, a novel telemedicine based handover decision making (THODM algorithm is proposed for mobile telemedicine system using heterogeneous wireless networks. The proposed algorithm select the best network based on the services requirement to ensure the connected or targeted network candidate has sufficient capacity for supporting the telemedicine services. The simulation results show that the proposed algorithm minimizes the number of unnecessary handover to WLAN in high speed environment. The throughput achieved by the proposed algorithm is up to 75% and 205% higher than Cellular and RSS based schemes, respectively. Moreover, the average data transmission cost of THODM algorithm is 24% and 69.2% lower than the Cellular and RSS schemes. The proposed algorithm minimizes the average transmission cost while maintaining the telemedicine service quality at the highest level in high speed environment.

  9. Using TV white space spectrum to practise telemedicine: A promising technology to enhance broadband internet connectivity within healthcare facilities in rural regions of developing countries.

    Science.gov (United States)

    Chavez, Afton; Littman-Quinn, Ryan; Ndlovu, Kagiso; Kovarik, Carrie L

    2016-06-01

    The following correspondence provides an overview of TV White Space (TVWS) technology, regulations, and potential applications to the health care sector. This report also introduces "Project Kgolagano," a Botswana-based initiative representing the first endeavour to utilize TVWS internet connection for practising telemedicine. TV "white space" refers to the previously unused, wasted spectrum within TV radiofrequency channels that can now be leveraged to obtain broadband internet access. TVWS represents a less costly, faster, and farther-reaching internet connection that is a promising option for connecting the previously unconnected populations of remote and underserved areas. The Botswana-University of Pennsylvania Partnership, Microsoft, Botswana Innovation Hub, Vista Life Sciences, and Global Broadband Solutions have partnered together to bring TVWS wireless broadband access to healthcare facilities in poorly connected regions of Botswana (Lobatse, Francistown, Maun, Gaborone) in order to improve healthcare delivery and facilitate telemedicine in dermatology, cervical cancer screening, and family medicine (HIV/AIDS, TB, general adult and pediatric medicine).

  10. 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.

  11. A Mobile-Phone Tele-Medicine System That Promotes SelfManagement of Blood Pressure among Hypertensive Patients in Kirinyaga Sub County

    Directory of Open Access Journals (Sweden)

    James W. Mugoh

    2015-04-01

    Full Text Available The current practice adopted by hypertensive patients in managing hypertension is making frequent visits to a health center as recommended by medical specialists. However, very few patients adhere to this practice as it is time consuming and tiresome especially if they have to travel for long distances to have their BP checked. This practice is also not practical for critically-ill patients. Consequently, most patients neglect BP check-ups and therefore focus on medication alone. This puts the patients’ at risk as uncontrolled BP can lead to fatal complications. The overall objective of this research was to design, develop and pilot-test a mobile telemedicine system that helps patients’ to self-manage their BP condition from the comfort of their homes. Participatory action research design was used in this study. Testing for performance, usability and utilityof the tele-medicine system was conducted.

  12. African Regional Symposium on Telematics for Development. Report and Recommendations = Colloque regional africain la telematique au service du developpement. Rapport et recommandations (Addis Ababa, Ethiopia, April 3-7, 1995).

    Science.gov (United States)

    International Telecommunication Union, Geneva (Switzerland).

    The African Regional Symposium on Telematics for Development was organized in view of the special educational and communication needs of Africa in a time of accelerating change and development of information technologies. The symposium brought together more than 150 African specialists, and over 40 participants from other regions and development…

  13. 贵州省远程医疗系统建设和实现%Construction and Realization of Telemedicine System in Guizhou Province

    Institute of Scientific and Technical Information of China (English)

    严刚; 吴雪梅; 陈茂华; 李立盛; 沈剑峰

    2012-01-01

    针对目前贵州省基层卫生医疗的现状,介绍远程医疗系统在贵州省建设的目标和具体内容。通过远程医疗系统的建设和运行,提高了贵州省卫生行业乃至全省信息化技术的推广和应用水平,对我国欠发达地区远程医疗系统建设具有借鉴意义。%Aiming at the current status of primary health care in Guizhou province,the paper introduces the target and concrete contents of telemedicine system construction in Guizhou province.Through the construction and operation of telemedicine system,the health industry and even the information technology promotion and application level in Guizhou province could be improved.It could provide references for telemedicine system constrution in undeveloped areas in China.

  14. Distribution of neurologists and neurosurgeons in India and its relevance to the adoption of telemedicine

    Directory of Open Access Journals (Sweden)

    Krishnan Ganapathy

    2015-01-01

    Full Text Available Majority of Indians have no access to centres of neurological excellence in the country. A detailed analysis of 3666 members of the Neurological Society of India and the Indian Academy of Neurology revealed that not a single member lived in a geographical area covering 934.8 million people. 30.09% live in the four major metropolitan cities, 29.54% in the state capitals, 30.58% in Tier 2 cities, 7.12% in tier 3 cities and 2.67% in rural areas covering a population of 84.59 million. Building additional neurological centres cannot be the only answer, given the acute shortage of funds and trained personnel. In 1999, the author among others, foresaw that it could be possible, to extend the reach of urban specialists to suburban and rural India, by virtual means. The neurological community has been slow to use Information and Communication Technology (ICT as an integral part of their health care delivery system. This article analyses the distribution of neurologists and neurosurgeons in India and suggests that providing additional virtual neurological care can be the only answer to offset the lop sided distribution of clinical care givers in neurosciences. In this article, the authors′ considerable experience in introducing and developing telehealth in India over the last 15 years is being shared with specific emphasis on its relevance to neurosciences. A review of the global literature on telemedicine and neurosciences will substantiate the plea that telemedicine must be deployed by neurologists and neurosurgeons in India to extend their reach to patients particularly those residing in rural areas.

  15. Telemedicine for disaster management: can it transform chaos into an organized, structured care from the distance?

    Science.gov (United States)

    Latifi, Rifat; Tilley, Elizabeth H

    2014-01-01

    Telemedicine and advanced technologies that ensure telepresence have become common practice and are an effective way of providing healthcare services. The authors conducted a traditional narrative review of English literature through search engines (Medline, Pub Med, Embase, and Science Direct) using mesh terms "telemedicine," "telepresence," "earthquake," "disaster," "natural disaster," and "man-made disaster" published between January 1, 1980 and September 30, 2013. For our analysis, only published studies were selected when telemedicine or telepresence was reported for disaster management, both in real life and in mock and simulation situations. Original articles, clinical trials, case presentations, and review articles were considered. Books and book chapters were used as well. Data from the International Disaster Database were included in the review to provide a sense of worldwide disaster occurrence. Symposia and other meetings were searched and used when available. Between January 1980 and September 2013, 17,565 disasters recorded. During this study period, 878 articles, chapters, books, and presentations were reported. Of these, only 88 articles and books fulfilled our selection criteria. Six articles described the effectiveness of telemedicine in mock simulations and disaster drills, and 63 presented the need and discussed how telemedicine would be beneficial in disaster response. Only 19 articles provided examples of effective use of telemedicine in disaster response. However, these studies demonstrated telemedicine as a valuable tool for communication between front-line humanitarian aid workers and expert physicians at remote locations. Telemedicine has not been used thus in the management of disasters, despite its great potential. There is an acute need for establishing telemedicine programs in high risk areas for disasters, so that when these disasters strike, existing telemedicine networks can be used, rather than attempting to bring solutions into a

  16. Nucleating the development of telemedicine to support healthcare workers in resource-limited settings: a new approach.

    Science.gov (United States)

    Wootton, Richard; Wu, Wei-I; Bonnardot, Laurent

    2013-10-01

    Collegium Telemedicus (CT) offers a new approach to the problem of starting a store-and-forward telemedicine network for use in low resource settings. The CT organization provides a no-cost template to allow groups to start a network without delay, together with a peer-support environment for those operating the networks. A new group needs only to supply a Guarantor (who accepts responsibility for the work of the network) and a Coordinator (who operates the telemedicine network, allocating cases and ensuring that they are responded to). Communication takes place via secure messaging, which has several advantages over plain email, e.g. all the data are stored centrally, which means that they can be read from a hand-held device such as a smart phone, but do not need to be stored on that device. Users can access the system with a standard web browser. In the first three months, seven networks were established on the CT system by university groups in the US, the UK, Australia and New Zealand, and by a large, multinational humanitarian organisation. In the most active network, there were 86 telemedicine cases in the first three months, i.e. an average submission rate of 7 cases/week. The CT system appears to fulfil its aim of assisting doctors who wish to help colleagues in other countries by improving their access to specialist opinions, while allowing them to maintain control over the new network's use and development. The long term aim of the CT organization is to provide a means of improving the quality of health care at the point of delivery in low resource settings.

  17. The RAFT Telemedicine Network in Low and Middle Income Countries: Educational and Clinical Services, Lessons Learnt and Perspectives

    Directory of Open Access Journals (Sweden)

    Georges eBediang

    2014-10-01

    Full Text Available Background: The objectives of this paper are to: i provide an overview of the educational and clinical experiences of the RAFT network, ii analyse key challenges and lessons learnt throughout a decade of activity and, iii draw a vision and perspectives of its sustainability.Methods: The study was carried out following three main stages: i a literature review, ii the analysis of key documents and iii discussions with key collaborators of the RAFT.Results: RAFT has been offering an important quantity of educational, clinical and public health activities during the last decade. The educational activities include: the weekly delivery of video-lectures for continuing and postgraduate medical education, the use of virtual patients for training in clinical decision making, research training activities using ICTs and other e-learning activities. The clinical and public health activities include: tele-expertise to support health professionals in the management of difficult clinical cases, the implementation of clinical information systems in African hospitals, the deployment of mHealth projects, etc. Since 2010, the RAFT has been extended to the Altiplano in Bolivia and Nepal (in progress. Lessons learnt and perspectives: Important lessons have been learnt from the accumulated experiences throughout these years. These lessons concern: social and organization, human resources, technologies and data security, policy and legislation, and economy and financing. Also, given the increase of the activities and the integration of eHealth and telemedicine in the health system of most of the countries, the RAFT network faces many other challenges and perspectives such as: learning throughout life, recognition and valorisation of teaching or learning activities, the impact evaluation of interventions, and the scaling up and transferability out of Africa of RAFT activities. Based on the RAFT experience, effective integration and optimum use of eHealth and

  18. Trends in the growth of literature of telemedicine: A bibliometric analysis.

    Science.gov (United States)

    Yang, Ya-Ting; Iqbal, Usman; Ching, Jack Horn-Yu; Ting, Jonathan Bee-Shen; Chiu, Hsien-Tsai; Tamashiro, Hiko; Hsu, Yi-Hsin Elsa

    2015-12-01

    Over the past two decades, the use of telemedicine as a way to provide medical services has grown as communication technologies advance and patients seek more convenient ways to receive care. Because developments within this field are still rapidly evolving, identifying trends within telemedicine literature is an important task to help delineate future directions of telemedicine research. In this study, we analyzed 7960 telemedicine-related publication records found in the Science Citations Index - Expanded database between 1993 and 2012. Bibliometric analyses revealed that while the total growth in telemedicine literature has been significant in the last twenty years, the publication activity per country and over time has been variable. While the United States led the world in the cumulative number of telemedicine publications, Norway ranked highest when we ordered countries by publications per capita. We also saw that the growth in the number of publications per year has been inconsistent over the past two decades. Our results identified that neuroscience neurology and nursing as two fields of research in telemedicine that have seen considerable growth in interest in this field, and are poised to be the focus of research activity in the near future.

  19. Feasibility of epilepsy follow-up care through telemedicine: a pilot study on the patient's perspective.

    Science.gov (United States)

    Ahmed, Syed Nizamuddin; Mann, Carly; Sinclair, D Barry; Heino, Angela; Iskiw, Blayne; Quigley, Daphne; Ohinmaa, Arto

    2008-04-01

    Cost analysis and patient satisfaction with telemedicine in epilepsy care. This controlled study included out-of-town epilepsy patients coming to follow-up at the University of Alberta hospital epilepsy clinic. After an informed consent, patients were randomized to either conventional (n = 18) or telemedicine (n = 23) clinics. Patients or caregivers filled patient satisfaction and travel cost questionnaires in both alternatives. Cost per visit analysis included costs of traveling, lodging, and lost productivity. Average age of the population was 41 years (range 19-73; 45% women). Eighty-three percent of patients preferred their next visit through telemedicine. About 90% of patients indicated a need for companion travel (mainly by car) to conventional clinic. For the conventional group patients the value of lost productivity was CAD $201, hotel cost CAD $8.50, and the value of car mileage CAD $256.50, totaling about CAD $466.00. Patient costs for telemedicine were CAD $35.85. Telemedicine production costs are similar to the patients' savings in traveling and lost productivity. About 90% of patients in both groups were satisfied with the quality of the service. Telemedicine can play a role in follow-up care of epilepsy patients, reduce patient costs, and improve patient satisfaction. This is the first full-time epilepsy telemedicine clinic in Western Canada.

  20. The telematic network of referee hospital "V. Monaldi" in Naples: state of the art and perspectives.

    Science.gov (United States)

    Pepino, A; Colasanate, A; Rossi, A

    2001-01-01

    The new advances in I.T. both in Hardware (wideband network) and in Software are rapidly changing the Health Information Systems scenario. In many hospitals of Campania Region this leads in many case to rebuild, starting from zero, both infrastructure and applications. Ericsson Enterprise has recently developed for the A.O. Monaldi and Integrated information System which consists of an advanced LAN (Local Area Network), a number of software infrastructures and some application systems as WEB site, Dicom PACS, E-mail server, Streaming Video from Operating Theatres, Internal TV Network. This integrated system represents the starting point for modern health information systems, which is compliant with new standards. The start-up of such systems represents always a problem for the organization and management point of view, therefore a number of problems concerning: training, education, security, privacy, operative procedures, co-ordination with existing applications, system management at the start-up and after. This paper deals with the technical aspects of this information system and discusses the problem met in introducing these IT products in a big and important hospital of Campania Region in Italy, in order to suggest a model, useful for other similar experiences.

  1. The System Project and the policy of Telemedicine%远程医学系统工程与政策建议

    Institute of Scientific and Technical Information of China (English)

    翟新海; 郝姜菲; 董纪平; 吴豪

    2013-01-01

    远程医学是一项逐渐被大众接受的新型医疗服务模式。当前远程医学需要统一规划、系统设计,区别应用、分类管理。在发展中面临收费不规范、综合成本高、产业发展乏力、运营模式不成熟等诸多问题,需要出台相关政策,规范和促进远程医学健康发展。%Telemedicine is one of the new health service model, accepted by the public gradually. Currently, telemedicine requires unified planning, system design, differences application and classification management. In developing, there are many problems, such as nonstandard charge, comprehensive high cost, weak industrial development and immature operating mode. We need to publish relevant policies to regulate and promote the healthy development of telemedicine.

  2. 移动远程医疗系统的设计与应用%Design and Application of Mobile Telemedicine System

    Institute of Scientific and Technical Information of China (English)

    张伟娜; 吴美娟; 王修来

    2012-01-01

    随着社会对用科技进步改善医疗服务水平的需求日益增加,将无线移动通信技术应用到远程医疗系统成为了发展方向.通过对移动远程医疗系统的目标、关键技术、总体结构、功能模块等设计,以及在心脑血管疾病远程监护和急救中的应用,满足了家庭监护和应急场合对远程医疗服务的需求,为服务公众健康、提高医疗质量提供了有效支持.%Along with the increasing demands of improving medical service level by technology advancement, the introduction of wireless mobile communication technologies to the mobile telemedicine system is becoming the development direction. By design on the goal, key techniques, whole structure, and function modules of mobile telemedicine system, and application to ECG monitoring and first aid, requirements of family monitor and emergency circumstance to telemedicine are satisfied, which not only gives service to public health, but also provides foundation to improve medical treatment quality.

  3. [Telemedicine stroke department network. Introduction of a telemedicine pilot project for integrated stroke management in South Bavaria and analysis of its efficiency].

    Science.gov (United States)

    Audebert, H J; Wimmer, M L J; Schenkel, J; Ulm, K; Kolominsky-Rabas, P L; Bogdahn, U; Horn, M; Haberl, R L

    2004-02-01

    More than 100 stroke units have been established in Germany. In rural areas, however, acute stroke care needs to be improved. In order to advance clinical stroke therapy, two specialized stroke centers founded a telemedicine network (TEMPiS) among 12 community hospitals in eastern Bavaria. Each network hospital established specialized stroke wards where qualified teams manage acute stroke patients. Twenty-four hours daily, physicians in local hospitals are able to contact the stroke centers via videoconferencing including transmission of digital DICOM data. To study the efficacy of this network, a controlled trial will be performed. Five TEMPiS-network hospitals will be matched with five other hospitals equal in size, catchment area, and diagnostic techniques. For about 1 year, all consecutive stroke cases in the matched study hospitals will be prospectively recorded in a database. Neurological deficits will be quantified on the National Institute of Health Stroke Scale within 24 h after stroke onset. Mortality and institutional care as a combined primary endpoint will be assessed after 3 and 12 months. Furthermore, functional outcome according to the modified Rankin scale, Barthel score, and quality of life will be assessed using a standard telephone interview. Data acquisition started in July 2003, and final results are expected in 2005.

  4. [Interventional decentralized telemonitoring: possible indications and perspectives of a new method in telemedicine].

    Science.gov (United States)

    Neumann, Claas Lennart; Schulz, Egbert Godehard

    2014-04-23

    Telemedicine comprises different concepts aiming to close a spatial distance between practitioner, medical staff and patient. Its functionality can include mere data transmission but extend as well to triggering alarms or enable consultation and therapy suggestions. A special form of telemedicinal application is interventional decentralized telemonitoring. Here practitioner-patient communication is characterized by telemedicinal data collection driven therapy-control and -optimization. To identify feasible indications for the employment of telemonitoring a detailed definition of communicated parameters, alarm rules and algorithms of intervention are required as well as a benefit-cost analysis. The quality of the telemedical application is determined by the medical quality of the resulting actions.

  5. Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

    Science.gov (United States)

    Eszes, Dóra J.; Szabó, Dóra J.; Russell, Greg; Kirby, Phil; Paulik, Edit; Nagymajtényi, László

    2016-01-01

    Introduction. Diabetic retinopathy (DR) is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients' satisfaction when using such tools (fundus camera examination) and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants' experience during fundus examination (comfort, reliability, and future interest in participation), as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software). Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening. PMID:28078306

  6. [Telemedicine in pacemaker therapy and follow-up].

    Science.gov (United States)

    Schuchert, A

    2009-12-01

    Present-day remote systems for cardiovascular implantable electronic devices (CIEDs) provide, in contrast to previous solutions, a broad range of data about the patient and the implanted device ("remote control"). Telemedicine includes remote monitoring as well as remote follow-up: Remote monitoring is the continual interrogation of the device to detect patient- or device-related adverse events earlier than with standard follow-up visits. Remote follow-up aims to replace scheduled and unscheduled face-to-face follow-up visits due to the interrogation of the automatic pacemaker functions. Currently available remote systems, such as Home Monitoring, CareLink, Merlin.net, and Latitude, have in common that they interrogate the device, send these data to a server, and provide the data to the physician on a secured web site. Automatic wireless interrogation of the device is the preferred solution; however, the devices must have been equipped with a micro-antenna, which is usually restricted to more recent pacemaker models. Knowledge about remote control in pacemaker patients is limited, because most remote applications were evaluated in ICD and CRT patients. While the most frequently reported clinical event in pacemaker patients is atrial fibrillation, the impact in routine clinical follow-up still has to be evaluated in detail. Device-related adverse events are rare. Large, long-term, randomized trials are comparing remote and conventional approaches with the aim of demonstrating the benefits of telemedicine in this patient group.

  7. Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

    Directory of Open Access Journals (Sweden)

    Dóra J. Eszes

    2016-01-01

    Full Text Available Introduction. Diabetic retinopathy (DR is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients’ satisfaction when using such tools (fundus camera examination and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants’ experience during fundus examination (comfort, reliability, and future interest in participation, as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software. Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening.

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

    Directory of Open Access Journals (Sweden)

    Jothydev Kesavadev

    2015-01-01

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

  9. Practical Considerations for Optic Nerve Estimation in Telemedicine

    Energy Technology Data Exchange (ETDEWEB)

    Karnowski, Thomas Paul [ORNL; Aykac, Deniz [ORNL; Chaum, Edward [ORNL; Giancardo, Luca [ORNL; Li, Yaquin [University of Tennessee, Knoxville (UTK); Tobin Jr, Kenneth William [ORNL

    2009-01-01

    The projected increase in diabetes in the United States and worldwide has created a need for broad-based, inexpensive screening for diabetic retinopathy (DR), an eye disease which can lead to vision impairment. A telemedicine network with retina cameras and automated quality control, physiological feature location, and lesion / anomaly detection is a low-cost way of achieving broad-based screening. In this work we report on the effect of quality estimation on an optic nerve (ON) detection method with a confidence metric. We report on an improvement of the fusion technique using a data set from an ophthalmologists practice then show the results of the method as a function of image quality on a set of images from an on-line telemedicine network collected in Spring 2009 and another broad-based screening program. We show that the fusion method, combined with quality estimation processing, can improve detection performance and also provide a method for utilizing a physician-in-the-loop for images that may exceed the capabilities of automated processing.

  10. 77 FR 27015 - Distance Learning and Telemedicine Grant Program

    Science.gov (United States)

    2012-05-08

    ...The Rural Utilities Service (RUS) is providing notice of Fiscal Year 2012 awards for its Distance Learning and Telemedicine (DLT) Grant Program. For Fiscal Year 2012, $15 million in grants will be awarded to the top scoring applications in rank order for the national competition announced in the Federal Register on February 24, 2011 (Vol. 76, No. 37). Therefore, applications for DLT grant funds will not be solicited in FY 2012. Many of the applications submitted under the aforementioned Notice, which have been evaluated and scored, represent exemplary projects in their use of telecommunications, computer networks, and related advanced technologies to encourage and improve telemedicine services and distance learning services in rural areas. Only a limited number of these projects, however, could be funded with appropriated FY 2011 funds. The $15 million appropriated in Fiscal Year 2012 will be awarded to fund the highest scoring of these remaining projects according to their ranking position in the 2011 competition. RUS will notify the public when it will be taking new applications

  11. The Implementation of Telemedicine within a Community Cancer Network

    Science.gov (United States)

    London, Jack W.; Morton, Daniel E.; Marinucci, Donna; Catalano, Robert; Comis, Robert L.

    1997-01-01

    Telemedicine is being used by physicians at the member hospitals of the Jefferson Cancer Network (JCN) for consultations regarding the diagnosis and management of cancer patients. The technology employed for this telemedicine system was chosen to meet three related specifications: low capital and operating cost, internal maintainability by community hospital data processing staffs, and compatibility with the existing technologic infrastructure. The solution selected is the ubiquitous desktop personal computer and associated software, and Integrated Services Digital Network (ISDN) communications links. The overall performance of this technology has been very satisfactory; ISDN communications has sufficient bandwidth for the transfer of patient data, including text reports, radiographs, and pathology slide images. The presence of the radiologist's interpretation along with the radiographic images allows the presentation of the images on these systems to be acceptable for review purposes. The video frame rates of these systems (12 to 15 frames per second) is adequate, particularly given the “talking heads” nature of the video presentations. Furthermore, the quality of the video image (resolution, size, frame rate) is secondary to the quality of the presentation of the medical information displayed and the capability for mutual annotation of the patient data during the consultation. PMID:8988470

  12. Timely implementation of a retinopathy of prematurity telemedicine system.

    Science.gov (United States)

    Quinn, Graham E; Ying, Gui-Shuang; Repka, Michael X; Siatkowski, R Michael; Hoffman, Robert; Mills, Monte D; Morrison, David; Daniel, Ebenezer; Baumritter, Agnieshka; Hildebrand, P Lloyd; Schron, Eleanor B; Ells, Anna L; Wade, Kelly; Kemper, Alex R

    2016-10-01

    To examine the feasibility of a retinopathy of prematurity (ROP) telemedicine evaluation system of providing timely feedback to a neonatal intensive care unit (NICU) with at-risk premature infants. This was a prospective observational study of premature infants with birth weights of return of the grading results to the clinical center was 10.1 ± 11.3 hours (standard deviation), with a median of 12.0 hours (1st quartile, 0.9 hours; 3rd quartile, 16 hours). Overall, 95.5% of gradings (95% CI, 93.9%-96.7%) were returned within 24 hours. Subgroup analyses found, for image sets submitted to the reading center before 2 p.m. Eastern Standard Time, median time to report was 1.7 hours (1st quartile, 0.7 hours; 3rd quartile, 15.5 hours) compared with those submitted after 2pm (median, 14.1 hours; 1st quartile, 11.2, hours; 3rd quartile, 16.3 hours). An ROP telemedicine approach can provide timely feedback to the NICU regarding the detection of potentially serious ROP and thus referral to an ophthalmologist for examination and consideration of treatment. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  13. SCALING UP A MOBILE TELEMEDICINE SOLUTION IN BOTSWANA: KEYS TO SUSTAINABILITY

    Directory of Open Access Journals (Sweden)

    Kagiso eNdlovu

    2014-12-01

    Full Text Available Effective health care delivery is significantly compromised in an environment where resources, both human and technical, are limited. Botswana’s health care system is one of the many in the African continent with few specialised medical doctors, thereby posing a barrier to patients’ access to health care services. In addition, the traditional landline and non-robust Information Technology (IT network infrastructure characterised by slow bandwidth still dominates the health care system in Botswana. Upgrading of the landline IT infrastructure to meet today’s health care demands is a tedious, long and expensive process. Despite these challenges, there still lies hope in health care delivery utilising wireless telecommunication services. Botswana has recently experienced a tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices. This growth inspired the Botswana-UPenn Partnership (BUP to collaborate with local partners to explore using mobile devices as tools to improve access to specialised health care delivery. Pilot studies were conducted across four medical specialties, including radiology, oral medicine, dermatology and cervical cancer screening. Findings from the studies became vital evidence in support of the first scale-up project of a mobile telemedicine solution in Botswana, also known as Kgonafalo. Some technical and social challenges were encountered during the initial studies, such as malfunctioning of mobile devices, accidental damage of devices and cultural misalignment between IT and healthcare providers. These challenges brought about lessons learnt, including a strong need for unwavering senior management support, establishment of solid local public-private partnerships, and efficient project sustainability plans. Sustainability milestones included the development and signing of a Memorandum of Understanding (MOU between the Botswana government and

  14. Telemedicine: The Practice of Medicine at a Distance. Resources in Technology.

    Science.gov (United States)

    Reed, Philip A.

    2003-01-01

    Reviews developments in telemedicine and a number of related areas (telecommunications, virtual presence, informatics, artificial intelligence, robotics, materials science, and perceptual psychology). Provides learning activities for technology education. (SK)

  15. Telemedicine for diabetes support in family doctors' practices: a pilot project.

    Science.gov (United States)

    Bujnowska-Fedak, Maria Magdalena; Puchała, Edward; Steciwko, Andrzej

    2006-01-01

    A telemedicine support system for diabetes management was compared with standard monitoring of patients with diabetes. The telemedicine system was composed of two modules: a Patient Unit and a Medical Unit connected by the telecommunication network. The study involved 60 patients of family doctors' practices in the Lower Silesia Region who were diagnosed with diabetes. There was no significant difference in haemoglobin A(1c) between telemonitoring and the traditional group of diabetic patients during the survey. The patients' quality of life slightly improved in the telemonitoring (mean score 3.4) and the traditionally monitored group (mean score 3.2), but there was no significant difference between them. Most of the telemonitoring patients (75%) expressed the desire to continue with telemedicine support and nearly 60% of patients monitored with traditional methods wanted to be included in the telemedicine group. The system seems to be reliable, simple to use and friendly for the patients.

  16. A convincing case for the provision of telemedicine services to ocean going vessels: the MERMAID paradigm.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S

    1998-01-01

    MERMAID is an EU financed telemedicine project with global reach and 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (Digital land lines, Cellular/Wireless, Satellite and Broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental state each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  17. 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.

  18. A platform to integrate climate information and rural telemedicine in Malawi

    Science.gov (United States)

    Lowe, R.; Chadza, T.; Chirombo, J.; Fonda, C.; Muyepa, A.; Nkoloma, M.; Pietrosemoli, E.; Radicella, S. M.; Tompkins, A. M.; Zennaro, M.

    2012-04-01

    It is commonly accepted that climate plays a role in the transmission of many infectious diseases, particularly those transmitted by mosquitoes such as malaria, which is one of the most important causes of mortality and morbidity in developing countries. Due to time lags involved in the climate-disease transmission system, lagged observed climate variables could provide some predictive lead for forecasting disease epidemics. This lead time could be extended by using forecasts of the climate in disease prediction models. This project aims to implement a platform for the dissemination of climate-driven disease risk forecasts, using a telemedicine approach. A pilot project has been established in Malawi, where a 162 km wireless link has been installed, spanning from Blantyre City to remote health facilities in the district of Mangochi in the Southern region, bordering Lake Malawi. This long Wi-Fi technology allows rural health facilities to upload real-time disease cases as they occur to an online health information system (DHIS2); a national medical database repository administered by the Ministry of Health. This technology provides a real-time data logging system for disease incidence monitoring and facilitates the flow of information between local and national levels. This platform allows statistical and dynamical disease prediction models to be rapidly updated with real-time climate and epidemiological information. This permits health authorities to target timely interventions ahead of an imminent increase in malaria incidence. By integrating meteorological and health information systems in a statistical-dynamical prediction model, we show that a long-distance Wi-Fi link is a practical and inexpensive means to enable the rapid analysis of real-time information in order to target disease prevention and control measures and mobilise resources at the local level.

  19. 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.

  20. Accuracy of blood pressure measurements transmitted through a telemedicine system in underserved populations.

    Science.gov (United States)

    Santamore, William P; Homko, Carol J; Kashem, Abul; McConnell, Timothy R; Menapace, Francis J; Bove, Alfred A

    2008-05-01

    In underserved populations, inadequate surveillance and treatment allows hypertension to persist until actual cardiovascular events occur. Thus, we developed an Internet-based telemedicine system to address the suboptimal control of hypertension and other modifiable risk factors. To minimize cost, the subjects used home monitors for blood pressure (BP) measurements and entered these values into the telemedicine system. We hypothesized that patients could accurately measure their BP and transmit these values via a telemedicine system. Inner city and rural subjects (N = 464; 42% African-American or Hispanic) with 10% or greater 10-year risk of cardiovascular disease and with treatable risk factors were randomized into two groups, control group (CG) and telemedicine group (TG). Each subject received a home sphygmomanometer with memory. The TG recorded and entered BP at least weekly. During office visits, the BP meters were downloaded and recorded BP compared to BP values transmitted via telemedicine. The telemedicine (T) BP values were similar to the meter recorded (R) values (T: systolic/diastolic BP 133.4 +/- 11.1/77.5 +/- 6.8 mm Hg, and R: systolic/diastolic BP 136.4 +/- 11.9.4/79.7 +/- 7.5 mm Hg). The percent error was telemedicine BP values were similar to the office (O) BP values for systolic and diastolic BP (T: systolic/diastolic BP 133.4 +/- 11.1/77.5 +/- 6.8 mm Hg, and O: systolic/diastolic BP 136.3 +/- 20.5/78.1 +/- 10.5 mm Hg). In underserved populations, this inexpensive approach of patients using a home monitor and entering these values into a telemedicine system provided accurate BP data.

  1. 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

  2. Assessment of Patients’ Perception of Telemedicine Services Using the Service User Technology Acceptability Questionnaire

    Directory of Open Access Journals (Sweden)

    Claudio Dario

    2016-06-01

    Full Text Available Introduction: The purpose of this paper is to assess if similar telemedicine services integrated in the management of different chronic diseases are acceptable and well perceived by patients or if there are any negative perceptions. Theory and methods: Participants suffering from different chronic diseases were enrolled in Veneto Region and gathered into clusters. Each cluster received a similar telemedicine service equipped with different disease-specific measuring devices. Participants were patients with diabetes (n = 163, chronic obstructive pulmonary disease (n = 180, congestive heart failure (n = 140 and Cardiac Implantable Electronic Devices (n = 1635. The Service User Technology Acceptability Questionnaire (SUTAQ was initially translated, culturally adapted and pretested and subsequently used to assess patients’ perception of telemedicine. Data were collected after 3 months and after 12 months from the beginning of the intervention. Data for patients with implantable devices was collected only at 12 months. Results: Results at 12 months for all clusters are similar and assessed a positive perception of telemedicine. The SUTAQ results for clusters 2 (diabetes, 5 (COPD and 7 (CHF after 3 months of intervention were confirmed after 12 months. Conclusions: Telemedicine was perceived as a viable addition to usual care. A positive perception for telemedicine services isn’t a transitory effect, but extends over the course of time.

  3. Mobile Telemedicine Implementation with WiMAX Technology: A Case Study of Ghana.

    Science.gov (United States)

    Tchao, Eric Tutu; Diawuo, Kwasi; Ofosu, Willie K

    2017-01-01

    Telemedicine has become an effective means of delivering quality healthcare in the world. Across the African continent, Telemedicine is increasingly being recognized as a way of improving access to quality healthcare. The use of technology to deliver quality healthcare has been demonstrated as an effective way of overcoming geographic barriers to healthcare in pilot Telemedicine projects in certain parts of Kumasi, Ghana. However because of poor network connectivity experienced in the pilot projects, the success of the pilot networks could not be extended to cover the whole city of Kumasi and other surrounding villages. Fortunately, recent deployment of WiMAX in Ghana has delivered higher data rates at longer distances with improved network connectivity. This paper examines the feasibility of using WiMAX in deploying a city wide Mobile Telemedicine solution. The network architecture and network parameter simulations of the proposed Mobile Telemedicine network using WiMAX are presented. Five WiMAX Base Stations have been suggested to give ubiquitous coverage to the proposed Mobile Telemedicine sites in the network using adaptive 4 × 4 MIMO antenna configurations.

  4. Telemedicine as a means of effective speech evaluation for patients with cleft palate.

    Science.gov (United States)

    Whitehead, Elizabeth; Dorfman, Valerie; Tremper, Glendora; Kramer, Amanda; Sigler, Alicia; Gosman, Amanda

    2012-04-01

    Providing long-term multidisciplinary care for cleft lip/palate is a challenge for international humanitarian organizations that perform surgery across borders. The use of telemedicine as a means of evaluating speech in patients with cleft lip/palate has not been studied previously. We looked at determining whether a speech evaluation performed by a speech-language pathologist (SLP) using telemedicine would be equivalent to a speech evaluation performed in-person, in an international setting between Tijuana, Mexico and San Diego, CA. Spanish-speaking SLPs developed an informal protocol to evaluate several speech characteristics. Patients were simultaneously evaluated by 2 SLPs, one in-person in Tijuana and the other over telemedicine videoconference from San Diego, CA. In addition, we obtained data regarding the parents experience with telemedicine through a satisfaction survey. Results showed no statistically significant differences between the 2 methods of speech evaluation, particularly in oral muscle tone, resonance, lingual lateralization, oral pressure, and dentition. The satisfaction survey showed family satisfaction with the speech evaluation performed using telemedicine. Thus, telemedicine represents an effective medium for conducting speech assessment in patients with cleft lip/palate, allowing for increased access to care for underserved populations.

  5. The Telemedicine benchmark--a general tool to measure and compare the performance of video conferencing equipment in the telemedicine area.

    Science.gov (United States)

    Klutke, P J; Mattioli, P; Baruffaldi, F; Toni, A; Englmeier, K H

    1999-09-01

    In this paper, we describe the 'Telemedicine Benchmark' (TMB), which is a set of standard procedures, protocols and measurements to test reliability and levels of performance of data exchange in a telemedicine session. We have put special emphasis on medical imaging, i.e. digital image transfer, joint viewing and editing and 3D manipulation. With the TMB, we can compare the aptitude of different video conferencing software systems for telemedicine issues and the effect of different network technologies (ISDN, xDSL, ATM, Ethernet). The evaluation criteria used are length of delays and functionality. For the application of the TMB, a data set containing radiological images and medical reports was set up. Considering the Benchmark protocol, this data set has to be exchanged between the partners of the session. The Benchmark covers file transfer, whiteboard usage, application sharing and volume data analysis and compression. The TMB has proven to be a useful tool in several evaluation issues.

  6. Telemedicine delivery of patient education in remote Ontario communities: feasibility of an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-led inflammatory arthritis education program

    Science.gov (United States)

    Warmington, Kelly; Flewelling, Carol; Kennedy, Carol A; Shupak, Rachel; Papachristos, Angelo; Jones, Caroline; Linton, Denise; Beaton, Dorcas E; Lineker, Sydney

    2017-01-01

    Objective Telemedicine-based approaches to health care service delivery improve access to care. It was recognized that adults with inflammatory arthritis (IA) living in remote areas had limited access to patient education and could benefit from the 1-day Prescription for Education (RxEd) program. The program was delivered by extended role practitioners with advanced training in arthritis care. Normally offered at one urban center, RxEd was adapted for videoconference delivery through two educator development workshops that addressed telemedicine and adult education best practices. This study explores the feasibility of and participant satisfaction with telemedicine delivery of the RxEd program in remote communities. Materials and methods Participants included adults with IA attending the RxEd program at one of six rural sites. They completed post-course program evaluations and follow-up interviews. Educators provided post-course feedback to identify program improvements that were later implemented. Results In total, 123 people (36 in-person and 87 remote, across 6 sites) participated, attending one of three RxEd sessions. Remote participants were satisfied with the quality of the video-conference (% agree/strongly agree): could hear the presenter (92.9%) and discussion between sites (82.4%); could see who was speaking at other remote sites (85.7%); could see the slides (95.3%); and interaction between sites adequately facilitated (94.0%). Educator and participant feedback were consistent. Suggested improvements included: use of two screens (speaker and slides); frontal camera angles; equal interaction with remote sites; and slide modifications to improve the readability on screen. Interview data included similar constructive feedback but highlighted the educational and social benefits of the program, which participants noted would have been inaccessible if not offered via telemedicine. Conclusion Study findings confirm the feasibility of delivering the RxEd program

  7. TELEFORMATION AND TELEMATIC SCIENTIFIC ADVISORY IN THE ENVIRONMENT OF UNIVERSITY EDUCATION / TELEFORMACIÓN Y TUTORÍA TELEMÁTICA EN EL ÁMBITO DE LA EDUCACIÓN UNIVERSITARIA

    Directory of Open Access Journals (Sweden)

    José Luís Ulizarna García

    2010-07-01

    Full Text Available The new technologies emerge as a suitable complement for coming social educators. For this case, the telematics nets and basic software are two complementary tools that allow the design and total or partial follow-up (telematic scientific advisory of the teaching of the subject: New technologies applied to Social Education. It is assured that in a ¨virtual classroom¨ well designed generates an adequate ¨learning environment¨. In the University of Century XXI, the mastery of the informatics resources is quite necessary for the teacher as well as for the learners. The formative contents situated in the net produce such a flexibility that makes singular changes in the quality of the teaching-learning process.

  8. Reversible and Embedded Watermarking of Medical Images for Telemedicine

    Directory of Open Access Journals (Sweden)

    Chung-Yen Su

    2015-08-01

    Full Text Available In this paper, we propose a new reversible watermarking of medical images for the applications in telemedicine. By using a bit-stream insertion scheme, the patient’s information can be treated as a watermark and can be embedded into the bit-stream of a cover image for remote transmission. The proposed method simplifies the design of traditional image coding after a reversible watermarking. Experimental results show that the compression ratio can be achieved up to 3.025. The watermarking capacity can be obtained over 0.75 bpp for some common images. In addition, the watermark can be extracted exactly and the cover image can be reconstructed either in a lossless way or a lossy way. The obtained results also show the improvement with respect to previous works.

  9. IMS: a new technology to develop a telemedicine system.

    Science.gov (United States)

    Uceda, J D; Elena, M; Blasco, S; Tarrida, C L; Quero, J M

    2008-01-01

    The emergent IMS (Internet Protocol Multimedia Subsystem) technology appears to improve the current communication technologies. Its characteristics, such as Quality of Service (QoS), make it an advantageous system for innovative applications. Providing integrated services to users is one of the main reasons for the existence of IMS. Operators provide the technology as an open source, to be able to use services developed by researchers. Combining and integrating them, users will receive completely new services. Our proposal of use for IMS is the development of a telemedicine platform, designed to support not only remote biological signal monitoring, but value-added services for diagnosis and medical care, both of these working in real time.

  10. 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.

  11. User reflection on actions in ambulance telemedicine systems

    DEFF Research Database (Denmark)

    Hansen, Magnus

    2010-01-01

    Much information is shared, interpreted and recreated between caller, emergency dispatch personnel and ambulance crew during an emergency call. This paper studies the use of reflection in the ambulance control center based on the information an ambulance crew produces during patient treatment in ...... to understand and use the feedback delivered through the system. The paper argues for broadening the scope of telemedicine use outside the boundaries of communication between ambulance and emergency department....... in the ambulance. The study is based on an ethnographical single case study of a Danish ambulance control center that uses a system called “amPHI” to monitor outgoing and homebound ambulance runs from scene of injury to arrival at the emergency department. The paper finds that the control center uses...

  12. Remote measurements of heart and respiration rates for telemedicine.

    Directory of Open Access Journals (Sweden)

    Fang Zhao

    Full Text Available Non-contact and low-cost measurements of heart and respiration rates are highly desirable for telemedicine. Here, we describe a novel technique to extract blood volume pulse and respiratory wave from a single channel images captured by a video camera for both day and night conditions. The principle of our technique is to uncover the temporal dynamics of heart beat and breathing rate through delay-coordinate transformation and independent component analysis-based deconstruction of the single channel images. Our method further achieves robust elimination of false positives via applying ratio-variation probability distributions filtering approaches. Moreover, it enables a much needed low-cost means for preventing sudden infant death syndrome in new born infants and detecting stroke and heart attack in elderly population in home environments. This noncontact-based method can also be applied to a variety of animal model organisms for biomedical research.

  13. Remote measurements of heart and respiration rates for telemedicine.

    Science.gov (United States)

    Zhao, Fang; Li, Meng; Qian, Yi; Tsien, Joe Z

    2013-01-01

    Non-contact and low-cost measurements of heart and respiration rates are highly desirable for telemedicine. Here, we describe a novel technique to extract blood volume pulse and respiratory wave from a single channel images captured by a video camera for both day and night conditions. The principle of our technique is to uncover the temporal dynamics of heart beat and breathing rate through delay-coordinate transformation and independent component analysis-based deconstruction of the single channel images. Our method further achieves robust elimination of false positives via applying ratio-variation probability distributions filtering approaches. Moreover, it enables a much needed low-cost means for preventing sudden infant death syndrome in new born infants and detecting stroke and heart attack in elderly population in home environments. This noncontact-based method can also be applied to a variety of animal model organisms for biomedical research.

  14. Experience in the application of Java Technologies in telemedicine.

    Science.gov (United States)

    Fedyukin, IV; Reviakin, YG; Orlov, OI; Doarn, CR; Harnett, BM; Merrell, RC

    2002-09-17

    Java language has been demonstrated to be an effective tool in supporting medical image viewing in Russia. This evaluation was completed by obtaining a maximum of 20 images, depending on the client's computer workstation from one patient using a commercially available computer tomography (CT) scanner. The images were compared against standard CT images that were viewed at the site of capture. There was no appreciable difference. The client side is a lightweight component that provides an intuitive interface for end users. Each image is loaded in its own thread and the user can begin work after the first image has been loaded. This feature is especially useful on slow connection speed, 9.6 Kbps for example. The server side, which is implemented by the Java Servlet Engine works more effective than common gateway interface (CGI) programs do. Advantages of the Java Technology place this program on the next level of application development. This paper presents a unique application of Java in telemedicine.

  15. 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.

  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. Driving Distance to Telemedicine Units in Northern Ontario as a Measure of Potential Access to Healthcare.

    Science.gov (United States)

    O'Gorman, Laurel D; Hogenbirk, John C

    2016-04-01

    The Ontario Telemedicine Network (OTN) uses technology to help make medical services more accessible to people in medically underserved rural and remote parts of Ontario, Canada. We examined access to OTN-enabled health and medical services in Northern Ontario, which has 775,000 people in communities scattered across an area of 803,000 km(2). We used ArcGIS Network Analyst (Esri, Redlands, CA) to conduct a service area analysis with travel time as a measure of potential access to care. We used road distance and speed limits to estimate travel time between Northern Ontario communities and the nearest OTN unit. In 2014 there were 2,331 OTN units, of which 552 (24%) were located in Northern Ontario. All seven communities in Northern Ontario with a population of 10,000 or greater had OTN units. Almost 97% of the 59 communities with 1,000-10,000 people were within 30 min of an OTN unit. The percentage of communities within 30 min steadily decreased with decreasing population size, to 58% for communities with fewer than 50 people. In total, 86% (690/802) of Northern Ontario communities were within an hour's drive of an OTN unit. This study showed that most Northern Ontario communities were within an hour's drive of an OTN unit. The current distribution of OTN units has the potential to increase access to medical services and to reduce the need for medically related travel for residents of these communities.

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

    Science.gov (United States)

    Eren, Ali; Subasi, Abdulhamit; Coskun, Osman

    2008-02-01

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

  19. Assessing the quality of teleconsultations in a store-and-forward telemedicine network

    Directory of Open Access Journals (Sweden)

    Richard eWootton

    2014-07-01

    Full Text Available Store and forward telemedicine in resource-limited settings is becoming a relatively mature activity. However, there are few published reports about quality measurement in telemedicine, except in image-based specialities, and they mainly relate to high- and middle-income countries. In 2010, Médecins Sans Frontières (MSF began to use a store-and-forward telemedicine network to assist its field staff in obtaining specialist advice. To date, more than 1000 cases have been managed with the support of telemedicine, from a total of 40 different countries. We propose a method for assessing the overall quality of the teleconsultations provided in a store-and-forward telemedicine network. The assessment is performed at regular intervals by a panel of observers, who -- independently -- respond to a questionnaire relating to a randomly-chosen past case. The answers to the questionnaire allow two different dimensions of quality to be assessed: the quality of the process itself and the outcome, defined as the value of the response to three of the four parties concerned, i.e. the patient, the referring doctor and the organisation. It is not practicable to estimate the value to society by this technique. The feasibility of the method was demonstrated by using it in the MSF telemedicine network, where process-quality scores, and user-value scores, appeared to be stable over a nine-month trial period. This was confirmed by plotting the cusum of a portmanteau statistic (the sum of the four scores over the study period. The proposed quality assessment method appears feasible in practice, and will form one element of a quality assurance programme for MSF's telemedicine network in future. The method is a generally applicable one, which can be used in many forms of medical interaction.

  20. A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists

    Directory of Open Access Journals (Sweden)

    Victor Patterson

    2013-09-01

    Full Text Available Background: One way to tackle health inequalities in resource-poor settings is to establish links between doctors and health professionals there and specialists elsewhere using web-based telemedicine. One such system run by the Swinfen Charitable Trust has been in existence for 13 years which is an unusually long time for such systems. Objective: We wanted to gain some insights into whether and how this system might be improved. Methods: We carried out a survey by questionnaire of referrers and specialists over a six months period. Results: During the study period, a total of 111 cases were referred from 35 different practitioners, of whom 24% were not doctors. Survey replies were received concerning 67 cases, a response rate of 61 per cent. Eighty-seven per cent of the responding referrers found the telemedicine advice useful, and 78% were able to follow the advice provided. As a result of the advice received, the diagnosis was changed in 22% of all cases and confirmed in a further 18 per cent. Patient management was changed in 33 per cent. There was no substantial difference between doctors and non-doctors. During the study period, the 111 cases were responded to by 148 specialists, from whom 108 replies to the questionnaire were received, a response rate of 73 per cent. About half of the specialists (47% felt that their advice had improved the management of the patients. There were 62 cases where it was possible to match up the opinions of the referrer and the consultants about the value of a specific teleconsultation. In 34 cases (55% the referrers and specialists agreed about the value. However, in 28 cases (45% they did not: specialists markedly underestimated the value of a consultation compared to referrers. Both referrers and specialist were extremely positive about the system which appears to be working well. Minor changes such as a clearer referral template and an improved web interface for specialists may improve it.

  1. Impact on Quality of Life of a Telemedicine System Supporting Head and Neck Cancer Patients: A Controlled Trial During the Postoperative Period at Home

    NARCIS (Netherlands)

    J.L. van den Brink (Jaap); P.W. Moorman (Peter); M.F. de Boer (Maarten); W.C.J. Hop (Wim); J.F.A. Pruyn (Jean); C.D.A. Verwoerd (Carel); J.H. van Bemmel (Jan)

    2007-01-01

    textabstractObjectives: Telemedicine applications carry the potential to enhance the quality of life of patients, but studies evaluating telemedicine applications are still scarce. The evidence regarding the effectiveness of telemedicine is limited and not yet conclusive. This study investigated whe

  2. Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability.

    Science.gov (United States)

    Ndlovu, Kagiso; Littman-Quinn, Ryan; Park, Elizabeth; Dikai, Zambo; Kovarik, Carrie L

    2014-01-01

    Effective health care delivery is significantly compromised in an environment where resources, both human and technical, are limited. Botswana's health care system is one of the many in the African continent with few specialized medical doctors, thereby posing a barrier to patients' access to health care services. In addition, the traditional landline and non-robust Information Technology (IT) network infrastructure characterized by slow bandwidth still dominates the health care system in Botswana. Upgrading of the landline IT infrastructure to meet today's health care demands is a tedious, long, and expensive process. Despite these challenges, there still lies hope in health care delivery utilizing wireless telecommunication services. Botswana has recently experienced tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices. This growth inspired the Botswana-UPenn Partnership (BUP) to collaborate with local partners to explore using mobile devices as tools to improve access to specialized health care delivery. Pilot studies were conducted across four medical specialties, including radiology, oral medicine, dermatology, and cervical cancer screening. Findings from the studies became vital evidence in support of the first scale-up project of a mobile telemedicine solution in Botswana, also known as "Kgonafalo." Some technical and social challenges were encountered during the initial studies, such as malfunctioning of mobile devices, accidental damage of devices, and cultural misalignment between IT and healthcare providers. These challenges brought about lessons learnt, including a strong need for unwavering senior management support, establishment of solid local public-private partnerships, and efficient project sustainability plans. Sustainability milestones included the development and signing of a Memorandum of Understanding (MOU) between the Botswana government and a private

  3. Construction and Application of Telemedicine in Xinjiang Regional Medical Cooperation System%远程医学在新疆区域医疗协作体系中的构建与应用

    Institute of Scientific and Technical Information of China (English)

    李勇; 姜小明; 张玺; 孙亮; 韩月珍

    2013-01-01

    Objective:To explore the value and role of telemedicine in health Huimin system of regional medical collaboration. To build a cultural brand of regional healthcare cooperation community. Methods: We start from the practical application to analyze the role of telemedicine in health Huimin system of regional healthcare collaboration. Results: Telemedicine has highlighted the effectiveness in Xinjiang regional healthcare collaborative development, and has formed a unique regional healthcare collaborative culture brand. Conclusion:To development of telemedicine, to promote career of Borderland Health Huimin.%目的:构建基于远程医学的区域医疗合作共同体,探索远程医学在区域医疗协作网络体系中的价值和作用。方法:从医院远程医学在学科帮扶、基层人才培养、新技术、新业务的传播、医疗适宜技术的推广应用等方面的实践应用入手,分析远程医学在区域医疗协作卫生惠民体系中的作用。结果:远程医学在新疆区域医疗协同发展方面已凸显成效,并已形成独具特色的区域医疗协作文化品牌。结论:发展远程医学,促进边疆卫生惠民事业。

  4. 终端虚拟化实现远程医疗的研究与应用%Research and application on telemedicine by terminal virtualization

    Institute of Scientific and Technical Information of China (English)

    殷一栋; 刘昱; 陆松筠; 吴斌

    2014-01-01

    通过对国内远程医疗发展现状进行分析,比较了目前实现远程医疗的两种方式:移动应用方式和终端虚拟化方式。根据自身医院的业务需求,采用终端虚拟化技术实现远程医疗,并阐述了项目实施后的评价。认为终端虚拟化技术在移动医疗领域的探索应用也将为今后区域卫生信息平台建设和医院与社区双向转诊、社区医生到居民家服务提供宝贵的实践经验,为通过技术手段全面提升医疗服务水平开辟新的通道。%By the analysis of status quo of the development of domestic telemedicine in China, mobile application and terminal virtualization telemedicine mode were compared. According to the needs of Ningbo the first hospital, it shows that terminal virtualization technology can help health information platform establishment, dual referral between hospital and community health center, integrated healthcare between community health center and patient’s home, which can full improve medical service by technology.

  5. Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits.

    Science.gov (United States)

    Kessler, Elizabeth A; Sherman, Ashley K; Becker, Mara L

    2016-09-20

    There is a critical shortage of pediatric rheumatologists in the US. Substantial travel to clinics can impose time and monetary burdens on families. The aim of this study was to evaluate the cost of in-person pediatric rheumatology visits for families and determine if telemedicine clinics resulted in time and cost savings. Factors associated with interest in telemedicine were also explored. Surveys were offered to parents and guardians of patients in Pediatric Rheumatology follow-up clinics in Kansas City, Missouri, the primary site of in-person care, and at a telemedicine outreach site 160 miles away, in Joplin, Missouri. Survey questions were asked about non-medical, out-of-pocket costs associated with the appointment and interest in a telemedicine clinic. At the primary Kansas City clinic, the median distance traveled one-way was 40 miles [IQR = 18-80]. In the Joplin sample, the median distance traveled to the telemedicine clinic was 60 miles [IQR = 20-85] compared to 175 miles [IQR = 160-200] for the same cohort of patients when seen in Kansas City (p < 0.001). When the Joplin cohort was seen via telemedicine they missed less time from work and school (p = 0.028, p = 0.003, respectively) and a smaller percentage spent money on food compared to when they had traveled to Kansas City (p < 0.001). There was no statistical difference between the Joplin cohort when they had traveled to Kansas City and the Kansas City cohort in terms of miles driven to clinic, time missed from work and school, and percentage of subjects who spent money on food. Traditional in-person visits can result in a financial toll on families, which can be ameliorated by the use of telemedicine. Telemedicine leveled the economic burden of clinic visits so that when the Joplin cohort was seen via telemedicine, they experienced costs similar to the Kansas City cohort.

  6. Connected health: emerging disruptive technologies

    National Research Council Canada - National Science Library

    Iglehart, John K

    2014-01-01

    ... the confusion over the definitions of telemedicine, telehealth, and mHealth. The importance of an array of emerging technologies and services is certain to grow as more people who reside in rural locales or areas of provider scarcity gain coverage and team-based care becomes a more prominent feature of the delivery landscape. In addition, as former Senate M...

  7. 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.

  8. The Debate over eHealth

    CERN Document Server

    Gaddi, Antonio Vittorino

    2014-01-01

    The future of eHealth and telemedicine has recently become a much debated and controversial subject. It is widely believed that eHealth will play an increasingly important role in shaping healthcare systems in the twenty-first century. The rising burden of chronic diseases and the potential of eHealth for cutting costs and improving quality and safety of health services make eHealth a great opportunity for providing more efficient health care.

  9. Effect Of A Large-Scale Social Franchising And Telemedicine Program On Childhood Diarrhea And Pneumonia Outcomes In India.

    Science.gov (United States)

    Mohanan, Manoj; Babiarz, Kimberly S; Goldhaber-Fiebert, Jeremy D; Miller, Grant; Vera-Hernández, Marcos

    2016-10-01

    Despite the rapid growth of social franchising, there is little evidence on its population impact in the health sector. Similar in many ways to private-sector commercial franchising, social franchising can be found in sectors with a social objective, such as health care. This article evaluates the World Health Partners (WHP) Sky program, a large-scale social franchising and telemedicine program in Bihar, India. We studied appropriate treatment for childhood diarrhea and pneumonia and associated health care outcomes. We used multivariate difference-in-differences models to analyze data on 67,950 children ages five and under in 2011 and 2014. We found that the WHP-Sky program did not improve rates of appropriate treatment or disease prevalence. Both provider participation and service use among target populations were low. Our results do not imply that social franchising cannot succeed; instead, they underscore the importance of understanding factors that explain variation in the performance of social franchises. Our findings also highlight, for donors and governments in particular, the importance of conducting rigorous impact evaluations of new and potentially innovative health care delivery programs before investing in scaling them up.

  10. PS3-28: Telemedicine Specialty Consultation in a Medically Underserved Community

    Science.gov (United States)

    Palen, Ted; Bodily, Mike

    2010-01-01

    Background and Aims: During the current national health care reform discussions, health information technologies (HIT) are receiving a lot of attention as means of lowering health care costs, improving access to health care, reducing errors during the delivery of healthcare, and improving health outcomes. Patients in rural or medically underserved areas find it difficult to obtain and maintain adequate access to health care. Telemedicine (TM) services can exchange video and audio information between healthcare providers and patients in different locations. For individuals in rural communities TM may improve access to care through the use of novel care delivery models. We are conducting a proof of concept (POC) study to evaluate the use of TM consultation between a primary care clinic in a medically underserved region of southern Colorado and a specialty care (endocrinology) clinic in Denver. Methods: This is a prospective health services POC study. We are taking advantage of a “natural experiment,” the expansion of primary care services into a medically underserved area of southern Colorado, to examine the requirements for establishing TM services between a rural primary care clinic and metropolitan based specialists. Results: Technical requirements included establishing network capabilities (512 kbps ISDN, H.320), 2 Mbps IP (H.323 or SIP), wirelss LAN connection, encryption embedded transmissions (H.235 and IEEE 802.1 x authentication); and remote monitoring equipment (exam camera, ENT/otoscope, electronic digital audio stethoscope (frequency: 40 Hz–2000 Hz, response: 45 Hz–1.6 KHz). Legal requirements involved the review of both federal and state statutes governing the use of TM for patient care and geographical/population requirements. Billing and regulatory requirements entail ensuring the use of the correct CPT and modifiers codes for TM and making sure these are operational within the medical record. Establishing criteria to ensure patients are

  11. Transmission of olfactory information for tele-medicine

    Energy Technology Data Exchange (ETDEWEB)

    Keller, P.E.; Kouzes, R.T.; Kangas, L.J.; Hashem, S.

    1995-01-01

    While the inclusion of visual, aural, and tactile senses into virtual reality systems is widespread, the sense of smell has been largely ignored. We have developed a chemical vapor sensing system for the automated identification of chemical vapors (smells). Our prototype chemical vapor sensing system is composed of an array of tin-oxide vapor sensors coupled to an artificial neural net-work. The artificial neural network is used in the recognition of different smells and is constructed as a standard multilayer feed-forward network trained with the backpropagation algorithm. When a chemical sensor array is combined with an automated pattern identifier, it is often referred to as an electronic or artificial nose. Applications of electronic noses include monitoring food and beverage odors, automated flavor control, analyzing fuel mixtures, and quantifying individual components in gas mixtures. Our prototype electronic nose has been used to identify odors from common household chemicals. An electronic nose will potentially be a key component in an olfactory input to a telepresent virtual reality system. The identified odor would be electronically transmitted from the electronic nose at one site to an odor generation system at another site. This combination would function as a mechanism for transmitting olfactory information for telepresence. This would have direct applicability in the area of telemedicine since the sense of smell is an important sense to the physician and surgeon. In this paper, our chemical sensing system (electronic nose) is presented along with a proposed method for regenerating the transmitted olfactory information.

  12. Secured telemedicine using region-based watermarking with tamper localization.

    Science.gov (United States)

    Al-Haj, Ali; Amer, Alaa'

    2014-12-01

    Medical images exchanged over public networks require a methodology to provide confidentiality for the image, authenticity of the image ownership and source of origin, and image integrity verification. To provide these three security requirements, we propose in this paper a region-based algorithm based on multiple watermarking in the frequency and spatial domains. Confidentiality and authenticity are provided by embedding robust watermarks in the region-of-non-interest (RONI) of the image using a blind scheme in the discrete wavelet transform and singular value decomposition domain (DWT-SVD). On the other hand, integrity is provided by embedding local fragile watermarks in the region-of-interest (ROI) of the image using a reversible scheme in the spatial domain. The integrity provided by the proposed algorithm is implemented on a block-level of the partitioned-image, thus enabling localized detection of tampered regions. The algorithm was evaluated with respect to imperceptibility, robustness, capacity, and tamper localization capability, using MRI, Ultrasound, and X-ray gray-scale medical images. Performance results demonstrate the effectiveness of the proposed algorithm in providing the required security services for telemedicine applications.

  13. Experience in the application of Java Technologies in telemedicine

    Science.gov (United States)

    Fedyukin, IV; Reviakin, YG; Orlov, OI; Doarn, CR; Harnett, BM; Merrell, RC

    2002-01-01

    Java language has been demonstrated to be an effective tool in supporting medical image viewing in Russia. This evaluation was completed by obtaining a maximum of 20 images, depending on the client's computer workstation from one patient using a commercially available computer tomography (CT) scanner. The images were compared against standard CT images that were viewed at the site of capture. There was no appreciable difference. The client side is a lightweight component that provides an intuitive interface for end users. Each image is loaded in its own thread and the user can begin work after the first image has been loaded. This feature is especially useful on slow connection speed, 9.6 Kbps for example. The server side, which is implemented by the Java Servlet Engine works more effective than common gateway interface (CGI) programs do. Advantages of the Java Technology place this program on the next level of application development. This paper presents a unique application of Java in telemedicine. PMID:12459045

  14. [Social networks for teaching and learning: the case of the telemedicine laboratory].

    Science.gov (United States)

    Saigí Rubió, Francesc

    2011-01-01

    This article analyzes the possibility of using social networks for teaching and learning telemedicine. The Telemedicine Laboratory is presented as a case study that offers a learning model supported by the development of a social network in a higher education environment. We performed a qualitative research study through an anonymous survey and participant observation. The results show that the Telemedicine Laboratory allows the generation of new knowledge from a holistic approach to reality, through communication and information technology, supported by the development of a social network. The presence of "invited experts" in the teaching and learning process and the linking of this process to problematic situations that members can "recognize" and perceive as true for their domain increase motivation and constitute success factors in the learning and teaching process.

  15. The Use of Telemedicine Access to Schools to Facilitate Expert Assessment of Children with Asthma

    Directory of Open Access Journals (Sweden)

    David A. Bergman

    2008-01-01

    Full Text Available Research has shown that access to an asthma specialist improves asthma outcomes. We hypothesized that we could improve access to expert asthma care through a telemedicine link between an asthma specialist and a school-based asthma program. We conducted a prospective cohort study in 3 urban schools to ascertain the feasibility of using an asthma-focused telemedicine solution. Each subject was seen by an asthma expert at 0, 8, and 32 weeks. The assessment and recommendations for care were sent to the primary care physician (PCP and parents were told to contact their physician for follow-up care. Eighty three subjects participated in the study. Subjects experienced improvement (P<.05 in family social activities and the number of asthma attacks. Ninety four percent of subjects rated the program as good or excellent. This study demonstrates the feasibility and acceptance of a school-based asthma program using a telemedicine link to an asthma specialist.

  16. 远程医学平台建设的研究和实践%General Planning and Implementation of Telemedicine Platform

    Institute of Scientific and Technical Information of China (English)

    周彬; 蔡敏芳; 吴檠

    2012-01-01

    Telemecine as a key project of the Medical reforms is fully considered by the government these years. As the only medical institution which take the responsibility of 2010 high-level and basic telemedicine programs simultaneously assigned by the Ministry of Health, Wuhan Union Hospital design the strategic planning and blueprint of the telemedicine platform with its regional healthcare project research specifically. Based on a borderless telemedical collaboration platform, establish an open telemedicine cloud infrastructure providing an interactive system for the whole nation.%远程医学作为国家医改工作重点之一受到广泛关注,同时,华中科技大学同济医学院附属协和医院(简称武汉协和医院)也是2010年卫生部远程项目中唯一同时承担高端和基层两个远程项目建设的单位.结合项目要求和医院自身区域医疗课题研究,对整个远程医学平台进行分阶段战略规划,远景是在以无边界远程协同系统的基础上构建开放式的远程医学平台,在未来3年的时间内,构建一个完善的医学服务云平台,为湖北省、华中地区乃至全国的病患及医护人员提供一套完善的交互式系统.

  17. Telematics and Gender Discrimination: Some Usage-Based Evidence on Whether Men’s Risk of Accidents Differs from Women’s

    Directory of Open Access Journals (Sweden)

    Mercedes Ayuso

    2016-04-01

    Full Text Available Pay-as-you-drive (PAYD, or usage-based automobile insurance (UBI, is a policy agreement tied to vehicle usage. In this paper we analyze the effect of the distance traveled on the risk of accidents among young drivers with a PAYD policy. We use regression models for survival data to estimate how long it takes them to have their first accident at fault during the coverage period. Our empirical application with real data is presented and shows that gender differences are mainly attributable to the intensity of use. Indeed, although gender has a significant effect in explaining the time to the first crash, this effect is no longer significant when the average distance traveled per day is introduced in the model. This suggests that gender differences in the risk of accidents are, to a large extent, attributable to the fact that men drive more often than women. Estimates of the time to the first accident for different driver risk types are presented. We conclude that no gender discrimination is necessary if telematics provides enough information on driving habits.

  18. 基于网络的导航信息服务系统研究%Study on network based navigation telematics service system

    Institute of Scientific and Technical Information of China (English)

    李锦辉; 徐敬海

    2009-01-01

    分析了车辆导航系统的历史和现状,提出下一代导航系统为基于网络的导航信息服务系统-Navigation Telematics System(NTS).定义NTS为一种通过无线网络为汽车和个人等,提供基于实时交通信息的动态车辆导航服务为主的信息服务系统.采用垂直方向上划分功能层,水平方向上划分功能模块的原则设计了NTS的系统结构,该结构具有独立干平台、可扩展等特点.分析了其中不同功能层的组成,详细论述了NTS的核心功能.

  19. [Telemedicine correlation in retinopathy of prematurity between experts and non-expert observers].

    Science.gov (United States)

    Ossandón, D; Zanolli, M; López, J P; Stevenson, R; Agurto, R; Cartes, C

    2015-01-01

    To study the correlation between expert and non-expert observers in the reporting images for the diagnosis of retinopathy of prematurity (ROP) in a telemedicine setting. A cross-sectional, multicenter study, consisting of 25 sets of images of patients screened for ROP. They were evaluated by two experts in ROP and 1 non-expert and classified according to telemedicine classification, zone, stage, plus disease and Ells referral criteria. The telemedicine classification was: no ROP, mild ROP, type 2 ROP, or ROP that requires treatment. Ells referral criteria is defined as the presence at least one of the following: ROP in zone I, Stage 3 in zone I or II, or plus+ For statistical analysis, SPSS 16.0 was used. For correlation, Kappa value was performed. There was a high correlation between observers for the assessment of ROP stage (0.75; 0.54-0.88) plus disease (0.85; 0.71-0.92), and Ells criteria (0.89; 0.83-1.0). However, inter-observer values were low for zone (0.41; 0.27-0.54) and telemedicine classification (0.43; 0.33-0.6). When evaluating telemedicine images by examiners with different levels of expertise in ROP, the Ells criteria gave the best correlation. In addition, stage of disease and plus disease have good correlation among observers. In contrast, the correlation between observers was low for zone and telemedicine classification. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Telemedicine for detecting diabetic retinopathy: a systematic review and meta-analysis.

    Science.gov (United States)

    Shi, Lili; Wu, Huiqun; Dong, Jiancheng; Jiang, Kui; Lu, Xiting; Shi, Jian

    2015-06-01

    To determine the diagnostic accuracy of telemedicine in various clinical levels of diabetic retinopathy (DR) and diabetic macular oedema (DME). PubMed, EMBASE and Cochrane databases were searched for telemedicine and DR. The methodological quality of included studies was evaluated using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2). Measures of sensitivity, specificity and other variables were pooled using a random effects model. Summary receiver operating characteristic curves were used to estimate overall test performance. Meta-regression and subgroup analyses were used to identify sources of heterogeneity. Publication bias was evaluated using Stata V.12.0. Twenty articles involving 1960 participants were included. Pooled sensitivity of telemedicine exceeded 80% in detecting the absence of DR, low- or high-risk proliferative diabetic retinopathy (PDR), it exceeded 70% in detecting mild or moderate non-proliferative diabetic retinopathy (NPDR), DME and clinically significant macular oedema (CSME) and was 53% (95% CI 45% to 62%) in detecting severe NPDR. Pooled specificity of telemedicine exceeded 90%, except in the detection of mild NPDR which reached 89% (95% CI 88% to 91%). Diagnostic accuracy was higher with digital images obtained through mydriasis than through non-mydriasis, and was highest when a wide angle (100-200°) was used compared with a narrower angle (45-60°, 30° or 35°) in detecting the absence of DR and the presence of mild NPDR. No potential publication bias was detected. The diagnostic accuracy of telemedicine using digital imaging in DR is overall high. It can be used widely for DR screening. Telemedicine based on the digital imaging technique that combines mydriasis with a wide angle field (100-200°) is the best choice in detecting the absence of DR and the presence of mild NPDR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.