MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Telemedicine and Telecare' source. Mon, 15 Mar 2010 14:44:46 +0100 http://www.medworm.com/index.php?rid=3304311&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F105%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304311 Wed, 24 Feb 2010 22:33:05 +0100 3304311 http://www.medworm.com/index.php?rid=3304310&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F100%3Frss%3D1 We investigated the validity and feasibility of online delivery of the Lee Silverman Voice Treatment (LSVT) for the treatment of the speech disorder of a patient with idiopathic Parkinson's disease. The treatment was delivered in 16 sessions to the participant's home, 90 km from the speech language pathologist. A PC-based videoconferencing system was used, operating at 128 kbit/s over the public telecommunications network. The patient achieved substantial improvements in vocal sound pressure levels during sustained vowel phonation (6.13 dB), reading (12.28 dB) and conversational monologue (11.32 dB). There were improvements in the duration of sustained vowel phonation (4 s). Improvements were also perceived in the degree of breathiness and roughness in the voice, and in overall speech inte... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304310 Wed, 24 Feb 2010 22:33:05 +0100 3304310 http://www.medworm.com/index.php?rid=3304309&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F95%3Frss%3D1 Only 42 of the 116 public hospitals in Queensland employ qualified pharmacists to staff their pharmacies. We undertook a feasibility study to determine if pharmaceutical reviews, undertaken face-to-face by a visiting pharmacist, could be replicated using telemedicine. The study was conducted in two phases, with the same pharmacist coordinating the project from the main hospital to two rural hospitals, which relied on supply nurses for all their pharmaceutical services. All inpatients admitted between October 2006 and May 2007 were included in the study. In Phase I the pharmacist made weekly visits to both facilities, to perform face-to-face pharmaceutical reviews of the current inpatients. In Phase 2, all pharmaceutical reviews were performed remotely by the pharmacist by telephone or vide... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304309 Wed, 24 Feb 2010 22:33:05 +0100 3304309 http://www.medworm.com/index.php?rid=3304308&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F89%3Frss%3D1 We assessed the cost and benefits of tele-endoscopy clinics in a remote location in Scotland. Before the introduction of a tele-endoscopy service, patients whose symptoms suggested possible cancer of the airways had to travel to the mainland (to Aberdeen) to receive an endoscopy. The costs of staff, capital, disposables and travel were estimated for the tele-endoscopy clinic and for the conventional, mainland clinic. The benefits of the two types of clinic were estimated from a sample of the general public using a survey method called the discrete choice experiment. The average cost per patient was lower for the tele-endoscopy clinic (£353) than for the mainland clinic (£381). This was true if more than 27 patients were seen per year. Assuming equal waiting times, individuals p... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304308 Wed, 24 Feb 2010 22:33:05 +0100 3304308 http://www.medworm.com/index.php?rid=3304307&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F83%3Frss%3D1 Patients with amyotrophic lateral sclerosis (ALS) need a care programme as the disease progresses. We used telemedicine-assisted integrated care (TAIC) in 40 patients with ALS, for a mean duration of 8.6 months (range 1–12). A nurse-tutor played the key role, supported by respiratory physicians, neurologists and psychologists. Each patient used a portable pulse oximeter during the daily telephone contacts to assess clinical/oxygen variations. Patients also completed a satisfaction questionnaire. During the study period, each patient used TAIC at least five times per month. There were 1907 scheduled telephone calls (86% of the total) and 317 unscheduled calls. Of the unscheduled calls, 84% were managed by the nurse-tutor and only 16% of them required specialist intervention. The most ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304307 Wed, 24 Feb 2010 22:33:05 +0100 3304307 http://www.medworm.com/index.php?rid=3304306&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F77%3Frss%3D1 Expert visual guidance (EVG) is computer assistance that displays to the examiner how the image plane moves towards (or away from) a desired anatomical location as the ultrasound probe is manipulated over the patient's body. We tested whether EVG by a remote expert could assist inexperienced examiners in acquiring abdominal ultrasound images. The inexperienced examiners were 20 medical students, who were randomly assigned to verbal instruction alone (Group 1) or to EVG (Group 2). The examiners were tested on their ability to visualize the abdominal aorta and the right kidney. Group 2 was more successful in identifying specified anatomy in longitudinal and cross-sectional views of the aorta (95 vs. 75%, P = 0.032) and kidney (98 vs. 88%, P = 0.09). The groups succeeded equally well in obtai... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304306 Wed, 24 Feb 2010 22:33:05 +0100 3304306 http://www.medworm.com/index.php?rid=3304305&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F68%3Frss%3D1 We conducted a systematic review of the literature about home telemonitoring compared with usual care. An electronic literature search was conducted to identify studies of home telemonitoring use in congestive heart failure (CHF) patients. Twenty-one original studies on home telemonitoring for patients with CHF were included (3082 patients). A random effects model was used to compute treatment efficacy to measure the average effect of the intervention across all studies where the quantitative pooling of results was appropriate. Home telemonitoring reduced mortality (risk ratio = 0.64; 95% CI: 0.48–0.85) compared with usual care. Several studies suggested that home telemonitoring also helped to lower the number of hospitalizations and the use of other health services. Patient quality ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304305 Wed, 24 Feb 2010 22:33:05 +0100 3304305 http://www.medworm.com/index.php?rid=3304304&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F63%3Frss%3D1 We evaluated two 12-week long community-based obesity control programmes in Korea. One was a visiting-type programme (V-type) (n = 515) administered by a public health centre and the other was a remote-type programme (R-type) (n = 410) utilizing an Internet website and mobile phones with a short message service. The total cost for the intention-to-treat subjects was US$116,993 in the V-type programme and $24,555 in the R-type programme. In the per-protocol subjects, 66% of V-type participants (n = 117) achieved the target bodyweight reduction (5%) and 13% of R-type participants (n = 15). In the per-protocol subjects, the cost per person was $227 (V-type) and $60 (R-type). The cost per person achieving the target weight reduction was $975 (V-type) and $1637 (R-type). The average amount that... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304304 Wed, 24 Feb 2010 22:33:05 +0100 3304304 http://www.medworm.com/index.php?rid=3304303&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F57%3Frss%3D1 An evaluation was undertaken on the effectiveness and efficiency of care coordination in delivering health services to Australian veterans with chronic or complex medical conditions requiring multidisciplinary care and who had moderate to high care needs. The veterans participated in a randomized controlled trial (RCT) supported by the Department of Veterans' Affairs. For evaluation of the RCT, information on cost of care and quality of life (QOL) was collected before the commencement of coordinated care and at follow-up after 12 months. Of 525 veterans who were recruited, 481 were surveyed at baseline (243 in the intervention group and 238 controls). At follow-up, 421 were surveyed (213 intervention and 208 controls). There were no significant differences between the coordinated care and ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304303 Wed, 24 Feb 2010 22:33:05 +0100 3304303 http://www.medworm.com/index.php?rid=3304302&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F53%3Frss%3D1 Hearing loss is the most prevalent chronic disability and a major contributor to the global burden of disease. Its effects are far-reaching and can lead to severely restricted developmental outcomes for children and limited vocational prospects for adults. The benefits of intervention are dramatic and can significantly improve developmental outcomes, especially in infants identified early. Hearing health-care services in developing regions such as sub-Saharan Africa are however severely limited, leaving affected individuals without access to secondary and tertiary intervention. Tele-audiology has potential for improved access to specialist hearing health services including identification, diagnosis and intervention. There has been limited experience so far with tele-audiology in industrial... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3304302 Wed, 24 Feb 2010 22:33:05 +0100 3304302 http://www.medworm.com/index.php?rid=3187122&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F48%3Frss%3D1 Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of arm-hand function in cervical spinal cord injury (SCI). Data collection comprised a telephone interview and a self-reported paper questionnaire. Of the patients who agreed to participate, 39 stroke patients (44%) and 38 patients with SCI (78%) returned a questionnaire. More than 75% of patients expressed a need for more information about the treatment of disease-related impairment. The DAs were highly appreciated by both patient groups. Nearly all patients expressed a positive attitude towards the u... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187122 Tue, 19 Jan 2010 23:38:36 +0100 3187122 http://www.medworm.com/index.php?rid=3187121&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F42%3Frss%3D1 We designed a broker platform for e-homecare services using web service technology. The broker allows efficient data communication and guarantees quality requirements such as security, availability and cost-efficiency by dynamic selection of services, minimizing user interactions and simplifying authentication through a single user sign-on. A prototype was implemented, with several e-homecare services (alarm, telemonitoring, audio diary and video-chat). It was evaluated by patients with diabetes and multiple sclerosis. The patients found that the start-up time and overhead imposed by the platform was satisfactory. Having all e-homecare services integrated into a single application, which required only one login, resulted in a high quality of experience for the patients. (Source: Journal of... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187121 Tue, 19 Jan 2010 23:38:36 +0100 3187121 http://www.medworm.com/index.php?rid=3187120&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F35%3Frss%3D1 In 2008 a prototype, web-based system was launched which provided information for different user groups interested in European public health topics. The EUPHIX system contained scientifically sound data, with presentations as well as textual information. The information was structured according to the European Community Health Indicators (ECHI) shortlist. The information included different types of data presentations (tables, interactive graphs and maps), explanatory texts and overviews of the data sources and the literature used. The content was produced by a network of European experts according to a structured, peer-reviewed editorial process. Thus EUPHIX provided an easily accessible, comprehensive, state-of-the-art information source. To ensure that it will continue, financial support... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187120 Tue, 19 Jan 2010 23:38:36 +0100 3187120 http://www.medworm.com/index.php?rid=3187119&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F30%3Frss%3D1 We studied the success and success factors of online support groups (OSGs) for patients, and the motives and goals of people who start such groups. We interviewed 23 webmasters of OSGs for patients with breast cancer, fibromyalgia and arthritis. The majority were women (n = 20) and most were patients (n = 21). Analysis of the interviews revealed that webmasters had altruistic and intrinsic motives for initiating an online support group. They defined success as the fulfilment of the goals they had in mind when they initiated their groups. To be able to make a group successful, decisions about its organization and management need to be coherent with these goals. Most webmasters stressed that promoting the group, keeping it alive and moderating the messages were vital success factors during t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187119 Tue, 19 Jan 2010 23:38:36 +0100 3187119 http://www.medworm.com/index.php?rid=3187118&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F25%3Frss%3D1 The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, Infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187118 Tue, 19 Jan 2010 23:38:36 +0100 3187118 http://www.medworm.com/index.php?rid=3187117&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F20%3Frss%3D1 We have developed an Internet training aid (MyMigraine) for migraine self-management derived from an evidence-based protocol for behavioural attack prevention. Its acceptance was tested in two studies concerning the opinions of new patients (n = 10), and the opinions of expert patients acquainted with the protocol (n = 6). The questionnaires employed 5-point scales. In study 1, all lessons were rated positively regarding clarity, instructiveness, importance and easy execution. After training, the patients were positive about user-friendliness and clarity (mean score 3.9), training content (3.5), satisfaction (3.6) and benefits (attack risk detection: 3.7; preventive coping: 3.9). In study 2, the expert patients provided positive ratings for the web application (mean score 4.1), digital sup... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187117 Tue, 19 Jan 2010 23:38:36 +0100 3187117 http://www.medworm.com/index.php?rid=3187116&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F15%3Frss%3D1 During a three-month study period, visitors to an online decision aid (DA) for attention deficit hyperactivity disorder (ADHD) were invited to complete an online questionnaire before and after working through the DA. Some 75,000 unique visitors found their way to the page on DAs, although fewer than 1 in 10 visited the DA for ADHD, staying there for about six minutes on average and using 8–9 clicks to navigate. A total of 195 people completed the first questionnaire (a response rate of about 3%). Only 12 of the respondents to the first questionnaire (6%) completed the second questionnaire. There was no significant effect of the DA as measured by three decisional outcome measures. Respondents moderately appreciated the information received. Even though the DA was constructed according... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187116 Tue, 19 Jan 2010 23:38:36 +0100 3187116 http://www.medworm.com/index.php?rid=3187115&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F12%3Frss%3D1 The University Medical Centre Utrecht (UMC Utrecht) has developed an eczema portal that combines e-consulting, monitoring and self-management training by a dermatology nurse online for patients and parents of young children with atopic dermatitis (AD). Patient satisfaction with the portal was high. It could be extended to become a Digital Eczema Centre for multidisciplinary collaboration between health-care providers from different locations and the patient. Before starting the construction of the Digital Eczema Centre, the feasibility was examined by carrying out a business case analysis. The purposes, strength and weaknesses showed that the Digital Eczema Centre offered opportunities to improve care for patients with AD. The financial analysis resulted in a medium/best case scenario with... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187115 Tue, 19 Jan 2010 23:38:36 +0100 3187115 http://www.medworm.com/index.php?rid=3187114&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F8%3Frss%3D1 We studied a web-based triage system which was accessible to the general public in the Netherlands. In a retrospective analysis we investigated the type of complaints that were submitted and the kind of advice provided. Over a period of 15 months, 13,133 different people began using the web-based triage system and 3812 patients went right through the triage process to the end. The most frequent complaints were common cold symptoms, such as cough and a sore throat (22%), itch problems (13%), urinary complaints (12%), diarrhoea (10%), headache (8%) and lower back pain (8%). Most commonly, the system generated the advice to contact a doctor (85%) and in 15% of the cases the system provided fully automated, problem-tailored, self-care advice. A total of 192 patients participated in a prospecti... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187114 Tue, 19 Jan 2010 23:38:36 +0100 3187114 http://www.medworm.com/index.php?rid=3187113&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F3%3Frss%3D1 We evaluated a web-based intervention, the Healthy Weight Assistant (HWA), which was designed to help people with a healthy bodyweight, or those who are slightly overweight, to achieve and maintain a healthy weight. Four evaluation methods were used: (1) pre- and post-test questionnaires; (2) real time usability-tests; (3) log-file analysis; (4) qualitative analysis of forum posts, email messages and free-text responses in the questionnaires. A total of 703 respondents received access to the HWA. Six weeks after receiving access, 431 respondents completed a second questionnaire. The enthusiastic responses showed that many people were interested in using an interactive online application to support achieving and maintaining a healthy weight. The preliminary results suggest that improvements... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187113 Tue, 19 Jan 2010 23:38:36 +0100 3187113 http://www.medworm.com/index.php?rid=3187112&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F2%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187112 Tue, 19 Jan 2010 23:38:36 +0100 3187112 http://www.medworm.com/index.php?rid=3187111&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F1%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3187111 Tue, 19 Jan 2010 23:38:36 +0100 3187111 http://www.medworm.com/index.php?rid=3037838&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F425%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037838 Mon, 30 Nov 2009 12:50:27 +0100 3037838 http://www.medworm.com/index.php?rid=3037837&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F424%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037837 Mon, 30 Nov 2009 12:50:27 +0100 3037837 http://www.medworm.com/index.php?rid=3037836&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F423%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037836 Mon, 30 Nov 2009 12:50:27 +0100 3037836 http://www.medworm.com/index.php?rid=3037835&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F421%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037835 Mon, 30 Nov 2009 12:50:27 +0100 3037835 http://www.medworm.com/index.php?rid=3037834&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F419%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037834 Mon, 30 Nov 2009 12:50:27 +0100 3037834 http://www.medworm.com/index.php?rid=3037833&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F414%3Frss%3D1 We developed a web-based, remote radiation treatment planning system which allowed staff at an affiliated hospital to obtain support from a fully staffed central institution. Network security was based on a firewall and a virtual private network (VPN). Client computers were installed at a cancer centre, at a university hospital and at a staff home. We remotely operated the treatment planning computer using the Remote Desktop function built in to the Windows operating system. Except for the initial setup of the VPN router, no special knowledge was needed to operate the remote radiation treatment planning system. There was a time lag that seemed to depend on the volume of data traffic on the Internet, but it did not affect smooth operation. The initial cost and running cost of the system wer... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037833 Mon, 30 Nov 2009 12:50:27 +0100 3037833 http://www.medworm.com/index.php?rid=3037832&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F409%3Frss%3D1 We have conducted a three-year prospective study of medical incidents on a commercial airline. A telemedicine service was available via an on-board satellite phone. During the study period there were 3364 medical incidents. The most common incident was collapse (n = 2310, 57%). Telemedicine was used in 323 of the cases (9%). Neurological patients, mostly stroke and seizures, excluding psychiatric diseases, were seen in 27% of the telemedicine cases (n = 83). Most of the cases involved middle-aged people, not the elderly. The group of patients that needed diversion (n = 27) was compared to the cases staying on board (n = 275). None of the patients in the non-diversion group deteriorated. All unstable patients forced a diversion. Doctors on board used the service in more severe cases, wherea... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037832 Mon, 30 Nov 2009 12:50:27 +0100 3037832 http://www.medworm.com/index.php?rid=3037831&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F404%3Frss%3D1 We developed a hands-free portable device which can provide two-way, real-time audio and video communication between hospital doctors and emergency medical technicians (EMTs) providing pre-hospital care. The device was based on an ultra mobile PC with a camera, a microphone/earphone set and a WIBRO modem for wireless Internet connection at an average data transmission rate of 1 Mbit/s. Feasibility tests were conducted in 55 real emergency situations over a period of three months at five different Rescue Centres in Seoul. Successful communication between an EMT and a doctor was achieved in 46 cases (84%). The device showed acceptable performance in terms of audio/video transmission time delays and maximum transmitted video frame rates, both outdoors, inside a building and in a moving vehicl... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037831 Mon, 30 Nov 2009 12:50:27 +0100 3037831 http://www.medworm.com/index.php?rid=3037830&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F397%3Frss%3D1 We evaluated the feasibility and quality of uncomplicated hypertension care based on telemedicine in a rural area of northern Sweden. The intervention subjects were 91 consecutive patients with primary hypertension. For comparison, 182 age- and sex-matched patients with hypertension were randomly selected from a similar health centre. The telemedicine equipment consisted of a video link between the physician and the patients, supported by a system for accessing medical data via the Internet. During a 21-month study period, telemedicine was used in 270 (91%) of the 297 consultations in the intervention group. All health personnel involved in the telemedicine treatment rated the method as feasible. Both systolic and diastolic blood pressure improved in the two groups during the study period.... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037830 Mon, 30 Nov 2009 12:50:27 +0100 3037830 http://www.medworm.com/index.php?rid=3037829&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F391%3Frss%3D1 In order to test a newly developed algorithm for detecting atrial fibrillation in clinical practice, we carried out parallel recordings using a conventional 24-h electrocardiogram (ECG) monitor and telemonitoring with an external loop recorder. Recordings were made in 24 patients with persistent atrial fibrillation and in another 24 patients with sinus rhythm. Atrial fibrillation was detected immediately in 23 of 24 patients with persistent atrial fibrillation and 20 min after fitting the single-channel loop recorder in the 24th patient (sensitivity 100%). On average, 3.1 false positives (i.e. detection of an episode, including the end or beginning of atrial fibrillation) were transmitted per patient. The sensitivity of the algorithms for automatically detecting bradycardiac and tachycardi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037829 Mon, 30 Nov 2009 12:50:27 +0100 3037829 http://www.medworm.com/index.php?rid=3037828&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F383%3Frss%3D1 We explored the perception and receptivity of elderly people regarding the introduction of an intelligent videomonitoring system (IVS) at home. Using a mixed methods design, 25 elderly people with a history of falls completed a structured interview (two questionnaires). In the year preceding the interview, 72% of the participants fell as many as seven times. Open-ended questions (qualitative data) were used to supplement the quantitative data. A content analysis (qualitative data) and a descriptive analysis (quantitative data) were carried out. The participants were 84% favourable or partially favourable to technologies which ensured home security and 96% favourable or partially favourable to the IVS. About half (48%) said that they would use it. The other participants did not wish to use ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037828 Mon, 30 Nov 2009 12:50:27 +0100 3037828 http://www.medworm.com/index.php?rid=3037827&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F8%2F377%3Frss%3D1 The Telesynergy workstation is a remote medical consultation system that provides medical staff with the means to collaborate with one another on cancer research and treatment. There are about 25 systems in use around the world. In order to share the equipment with five community hospital partners in Western Pennsylvania, we designed and implemented a transport system for the workstation. Small groups can be accommodated within the trailer and larger groups can participate inside a building when the system is offloaded at a suitable site. We designed special transport cases for the main components and chose a trailer suitable to move them by road. The transport cases were secured by inexpensive, ratchet style tiedown devices made of woven nylon webbing with steel end hooks. Calculations su... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3037827 Mon, 30 Nov 2009 12:50:27 +0100 3037827 http://www.medworm.com/index.php?rid=2873755&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F373%3Frss%3D1 Since 2004, educational videoconferences have been held in Brazil for paediatric radiologists in training. The RUTE network has been used, a high-speed national research and education network. Twelve videoconferences were recorded by the Health Channel and transformed into TV programmes, both for conventional broadcast and for access via the Internet. Between October 2007 and December 2009 the Health Channel website registered 2378 hits. Our experience suggests that for successful recording of multipoint videoconferences, four areas are important: (1) a pre-planned script is required, for both physicians and film-makers; (2) particular care is necessary when editing the audiovisual material; (3) the audio and video equipment requires careful adjustment to preserve clinical discussions and ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873755 Thu, 08 Oct 2009 23:27:04 +0100 2873755 http://www.medworm.com/index.php?rid=2873754&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F368%3Frss%3D1 Collaboration between nations and sectors is crucial to improve regional preparedness against pandemic influenza. In 2008, a Virtual Symposium was organized in the Asia-Pacific region by the Asia-Pacific Economic Cooperation Emerging Infections Network (APEC EINet) to discuss pandemic preparedness. The multipoint videoconference lasted approximately 4.5 hours and was attended by 16 APEC members who shared best practices in public-private partnerships for pandemic influenza preparedness planning. Twelve of the 16 APEC members who participated responded to a post-event survey. The overall experience of the event was rated highly. Partnering public health, technology and business communities to discuss best practices in preparedness using videoconferencing may be an effective way to improve r... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873754 Thu, 08 Oct 2009 23:27:04 +0100 2873754 http://www.medworm.com/index.php?rid=2873753&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F362%3Frss%3D1 We examined the feasibility of a commercial home telemonitoring system for monitoring adverse events related to vaccination and influenza-like illness (ILI) signs and outcomes in the primary care setting in the Netherlands. A prospective cohort of people eligible for influenza vaccination was monitored daily between mid-October 2007 and mid-March 2008. Adults from five primary care centres were invited to participate. A total of 245 people participated (response rate 75%). Their mean age was 61 years (SD = 15), 50% were female and 60% had a chronic disease. Most (73%) had no problems with installation of the system and 67% finished all sets of monitoring dialogues. The reported incidence of adverse events in the first week after vaccination was 8–38%. The reported incidence rates of ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873753 Thu, 08 Oct 2009 23:27:04 +0100 2873753 http://www.medworm.com/index.php?rid=2873752&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F356%3Frss%3D1 Nine counselling psychology students were enrolled in a 12-week pilot practicum (i.e. a work placement) for either one hour of course credit (six students) or three hours (three students). Group supervision was provided both in-person and by videoconferencing. Each trainee completed a measure evaluating their satisfaction with supervision (Supervisory Satisfaction Questionnaire, SSQ) and the supervisory relationship (Supervisory Working Alliance Inventory – Trainee Version, SWAI-T). The student's self-efficacy was also tracked during the semester (Counselling Self-Estimate Inventory, COSE). Trainees rated their satisfaction with videoconferencing similarly to the in-person format. The supervisory relationship also did not appear to be affected by the videoconferencing format. The COS... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873752 Thu, 08 Oct 2009 23:27:04 +0100 2873752 http://www.medworm.com/index.php?rid=2873751&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F351%3Frss%3D1 We studied the dialogue between telephone operators at medical emergency communication centres in Norway and parents of children later diagnosed with sudden infant death syndrome. The aim was to understand how the parents experienced the communication with the telephone operators. The qualitative method involved semi-structured interviews. We interviewed six respondents from urban areas and five from rural areas. An important finding was that all the parents were satisfied with the resuscitation instructions they received. It was also perceived as important that the emergency operators expressed empathy and care. We believe that it is not merely the quality of the resuscitation attempts that the operators' efforts should be measured against. It is also important that the operators provide ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873751 Thu, 08 Oct 2009 23:27:04 +0100 2873751 http://www.medworm.com/index.php?rid=2873750&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F344%3Frss%3D1 We compared the effects of evidence-based disease management guidelines delivered to patients with heart failure and diabetes using three different modalities: in-person visits alone (Control), in-person visits and a telephone intervention (Telephone), and in-person visits and telemonitoring (Telemonitoring). Patients were randomized to the three groups. There were 112 patients in the Control group, 93 in the Telephone group and 98 in the Telemonitoring group. During the first 60 days, 10% of the Control group were rehospitalized, 17% of the Telephone group and 16% of the Telemonitoring group. Having heart failure and receiving more in-person visits were significantly related to readmission and time to readmission. However, after adjusting for diagnosis and visits, the differences between ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873750 Thu, 08 Oct 2009 23:27:04 +0100 2873750 http://www.medworm.com/index.php?rid=2873749&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F339%3Frss%3D1 We investigated the use of camera phones for telehaematology. First, the minimum requirements for the camera phones to be used in telehaematology were investigated. A single image containing white cells, red cells and platelets was sent from a camera phone to 33 different camera phones. Nine of the camera phones were found to be unsuitable for telehaematology due to low display resolution or no zoom function of the image. Then we examined the agreement between a haematologist using a suitable camera phone for remote diagnosis and the blood film report made in the usual way. Blood samples were collected from nine patients who had conditions in which diagnostically important morphological abnormalities occurred. In seven of the nine cases, the telehaematology responses were similar to the do... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873749 Thu, 08 Oct 2009 23:27:03 +0100 2873749 http://www.medworm.com/index.php?rid=2873748&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F327%3Frss%3D1 A systematic review was conducted to investigate the use of technology in achieving behaviour change in chronic illness. The areas reviewed were: (1) methods employed to adapt traditional therapy from a face-to-face medium to a computer-assisted platform; (2) targets of behaviour change; and (3) level of human (e.g. therapist) involvement. The initial literature search produced 2032 articles. A total of 45 articles reporting 33 separate interventions met the inclusion/exclusion criteria and were reviewed in detail. The majority of interventions reported a theoretical basis, with many arising from a cognitive-behavioural framework. There was a wide range of therapy content. Therapist involvement was reported in 73% of the interventions. A common problem was high participant attrition, which... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873748 Thu, 08 Oct 2009 23:27:03 +0100 2873748 http://www.medworm.com/index.php?rid=2873747&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F7%2F323%3Frss%3D1 Three key areas in diagnostics will drive the convergence of diagnostic and communication technologies: point-of-care testing, micro-electromechanical systems and biomarker discovery. In addition, the communications revolution means that increasing numbers of people will be able to send data from their home to their doctor using the Internet. Also, the widespread availability of broadband opens up the possibly of realtime videoconferencing with clinicians. It is already possible for patients at home to monitor simple variables, such as heart rate and blood pressure, and send their results using communication technologies to their doctors, who can promptly review the information to diagnose problems. As diagnostic and communication technologies converge, it will be feasible for patients to ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2873747 Thu, 08 Oct 2009 23:27:03 +0100 2873747 http://www.medworm.com/index.php?rid=2749168&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F321%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749168 Sun, 30 Aug 2009 23:00:00 +0100 2749168 http://www.medworm.com/index.php?rid=2749167&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F317%3Frss%3D1 The U Special Kids Program (USK) at the University of Minnesota provides care coordination and case management services by telephone to children with special health-care needs. We measured the effect of the USK programme on hospital resource utilization using a retrospective record review. Information on hospitalizations was collected for children enrolled in the programme for at least two years and validated for accuracy against inpatient claims data. Hospitalizations were classified as planned, unplanned or due to lack of home care. A total of 43 children enrolled in the USK programme between July 1996 and December 2006 met the study criteria. The children had multiple, complex conditions. During the period of the study, there were 61 planned hospitalizations, 184 unplanned hospitalizati... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749167 Sun, 30 Aug 2009 23:00:00 +0100 2749167 http://www.medworm.com/index.php?rid=2749166&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F310%3Frss%3D1 We conducted a modified narrative review of the literature on telehealth applications used in speech-language pathology assessment and treatment. The following databases and information resources were used: MEDLINE, CINAHL, PSYCInfo, ERIC, Digital Dissertations, CSA Social Services Abstracts, CSA Sociological Abstracts, On-line ASHA publications and personal contacts. Sixty-two full-text documents were located. Twenty-eight provided sufficient detail to be reviewed using a checklist adapted from the Scottish Intercollegiate Guideline Network (SIGN) recommendations for level of evidence rankings and quality assessment ratings. Five of the 28 studies received a ranking indicating a high level of evidence (larger sample sizes, assessed outcomes with valid and reliable measures, performed stat... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749166 Sun, 30 Aug 2009 23:00:00 +0100 2749166 http://www.medworm.com/index.php?rid=2749165&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F302%3Frss%3D1 We developed a system consisting of both wearable and ambient technologies designed to monitor personal wellbeing for several months during daily life. The variables monitored included bodyweight, blood pressure, heart-rate variability and air temperature. Two different user groups were studied: there were 17 working-age subjects participating in a vocational rehabilitation programme and 19 elderly people living in an assisted living facility. The working-age subjects collected data for a total of 1406 days; the average participation period was 83 days (range 43–99). The elderly subjects collected data for a total of 1593 days; the average participation period was 84 days (range 19–107). Usage, technical feasibility and usability of the system were also studied. Some technical ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749165 Sun, 30 Aug 2009 23:00:00 +0100 2749165 http://www.medworm.com/index.php?rid=2749164&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F297%3Frss%3D1 We evaluated the feasibility of a home-based rehabilitation programme, which was designed to resemble an in-hospital rehabilitation programme. Patients who underwent cardiac surgery (EuroSCORE 0–10) followed a one-month home rehabilitation programme supervised by a nurse-tutor and a physiotherapist. Physiotherapy was performed at home with calisthenic exercises and bicycle-ergometer tests. Patients transmitted the recorded ECGs by telephone to a service centre. They also performed a 6-minute walking test and filled in a satisfaction questionnaire at the end of the programme. A total of 47 patients were enrolled in the study. There were 3050 telephone calls, of which 3012 (99%) were scheduled and 38 were unscheduled. No further action was required in 95% of calls. There were 809 sessi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749164 Sun, 30 Aug 2009 23:00:00 +0100 2749164 http://www.medworm.com/index.php?rid=2749163&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F290%3Frss%3D1 A telehealth network was established between seven health centres, the local university and the university hospital in the Oulu Arc Subregion in a rural area of northern Finland. During the period 2004–2007, the videophone network was used for different types of teleconsultation (orthopaedics, psychiatry, diabetes, rehabilitation), continuing education and various patient care and administrative meetings. Qualitative research with observation and interviews with 30 professionals (physicians, nurses, psychiatric nurses, physiotherapists) was carried out in early 2007 to find out health-care professionals' attitudes toward telehealth and to see how the attitudes were connected to telehealth usage. Overall, the attitudes were more positive than negative, ranging from negative to enthusi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749163 Sun, 30 Aug 2009 23:00:00 +0100 2749163 http://www.medworm.com/index.php?rid=2749162&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F286%3Frss%3D1 We reviewed the appointment data for a psychiatry service in California that provided consultations and also therapy through telepsychiatry. Over an 18-month period, there were 7523 telepsychiatry appointments and 115,148 conventional (face-to-face) appointments. A higher proportion of the telepsychiatry appointments was kept (92% telepsychiatry vs. 87% non-telepsychiatry). Also, telepsychiatry appointments were significantly less likely to be cancelled by patients (3.5% vs. 4.8%) and significantly less likely to be no-shows (4.2% vs. 7.8%). These findings were similar in three of the four counties where the service was delivered. However, one county was different, and further examination suggested that the morale of the staff and patients may have contributed to the unenthusiastic accepta... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749162 Sun, 30 Aug 2009 23:00:00 +0100 2749162 http://www.medworm.com/index.php?rid=2749161&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F281%3Frss%3D1 We examined the feasibility of using home blood pressure (BP) telemonitoring devices for managing patients with poor BP control. We enrolled 591 subjects with a diagnosis of hypertension. Patients were randomized to usual care (n = 147) or to the intervention arm (n = 441). Those in the intervention arm were issued with a home BP telemonitoring device. The device transmitted BP readings automatically via the home telephone line. Technical alerts were generated if patients did not transmit their BP readings according to the protocol. During the first six months, 693 technical alerts were generated by 267 patients. About half of these patients (112) generated more than two technical alerts. Resolution of the alerts showed that 61% were caused by patient non-adherence. Patients who generated ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749161 Sun, 30 Aug 2009 23:00:00 +0100 2749161 http://www.medworm.com/index.php?rid=2749160&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F275%3Frss%3D1 Parents of preterm-born infants need support after returning to their homes with their baby. We studied the experience of certified paediatric nurses (CPNs) with the use of videoconferencing between the neonatal intensive care unit and the families' home. Families were given a home videoconferencing unit, which allowed them to contact staff at the neonatal unit, day and night. Over a period of 12 months, ten families used the videoconferencing equipment. Families made a median of 4 telemedicine calls each (range 2–30). Narrative interviews were performed with 10 CPNs after the study ended. Qualitative thematic content analysis was applied to the interview data and one theme was identified: smoothing the transition of infants from the neonatal unit to the families' home. The CPNs foun... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749160 Sun, 30 Aug 2009 23:00:00 +0100 2749160 http://www.medworm.com/index.php?rid=2749159&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F6%2F269%3Frss%3D1 We evaluated the implementation of a video consultation service in a regional community of paediatric physiotherapists. Twenty-two paediatric therapists in primary care settings and a rehabilitation centre participated in this study. The implementation comprised three phases: introduction, learning and consultation. Evaluation of the implementation focused on the participants' satisfaction with regard to the implementation procedure, the education received, the technical helpdesk support and the usage of the application once put into practice. The introduction phase was very short (only two sessions) but the learning phase took much longer; it took 12 months for 21 therapists to complete the learning phase. Only 14 of the 21 therapists entered the actual consultation phase. Participants we... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2749159 Sun, 30 Aug 2009 23:00:00 +0100 2749159 http://www.medworm.com/index.php?rid=2586195&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F268%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586195 Wed, 08 Jul 2009 23:00:00 +0100 2586195 http://www.medworm.com/index.php?rid=2586194&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F264%3Frss%3D1 Bioethics consultations are necessary to ensure excellent patient care and all US hospitals are required to provide access to bioethics consultants for cases raising ethical or moral dilemmas. However, there is a paucity of trained clinical ethicists. While assistance from trained bioethicists may be obtained via telephone or email, such methods of contact do not allow a bioethicist to engage fully with all members of the health-care team, the patient and family members. In two recent cases, rural hospitals contacted our centre for assistance with complex ethics cases. We provided a clinical ethics consultation via videoconferencing. The outcomes of the consultations would probably have been inferior had they been performed via telephone. For example, the non-verbal cues allowed the consul... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586194 Wed, 08 Jul 2009 23:00:00 +0100 2586194 http://www.medworm.com/index.php?rid=2586193&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F260%3Frss%3D1 In January 2007, a telestroke system was established between a community hospital lacking a neurologist on call and a stroke centre 70 km away. The telestroke system allowed urgent remote evaluation of the patient by a specialized neurologist, supervised thrombolytic treatment or a decision for urgent transfer to the stroke centre. During the first year of operation of the telestroke system, we studied all acute ischaemic stroke patients admitted to the community hospital and compared the results with the previous year. Approximately the same number of acute stroke patients were admitted to the community hospital in each year (201 cases in 2006 and 198 in 2007). The telestroke system was activated 75 times in 2007, the number of stroke patients evaluated by a specialized neurologist increa... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586193 Wed, 08 Jul 2009 23:00:00 +0100 2586193 http://www.medworm.com/index.php?rid=2586192&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F255%3Frss%3D1 The All India Institute of Medical Sciences (AIIMS) is the apex super-specialty, quaternary referral hospital of India. Its outpatient departments (OPDs) handle over 2.5 million patients every year, a large proportion of whom travel up to 2500 km for treatment because specialist facilities are not available in their regions. We conducted a descriptive study of 58 AIIMS faculty staff members, using a self-administered questionnaire followed by interviews with selected faculty members. During the year 2006, a total of 2,566,492 patients attended the various OPDs at the AIIMS, of whom 1,427,466 (56%) were old patients, i.e. they attended the OPD for follow-up. The questionnaire responses revealed that 55 (95%) of the respondents routinely provided follow-up medical advice to their patients us... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586192 Wed, 08 Jul 2009 23:00:00 +0100 2586192 http://www.medworm.com/index.php?rid=2586191&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F251%3Frss%3D1 We established a pilot tele-ultrasound system between a rural referring hospital and a tertiary care trauma centre to facilitate telementoring during acute trauma resuscitations. Over a 12-month period, 23 tele-ultrasound examinations were completed. The clinical protocol examined both the Focused Assessment with Sonography for Trauma (FAST) and the Extended FAST (EFAST) for pneumothoraxes. Twenty of the examinations were conducted during acute trauma resuscitations and three during live patient simulations. FAST examinations were completed in all 23 cases and EFAST examinations in 17 cases. There were 18 clinical users, of whom 14 completed a survey (76% response rate). Overall, 93% of respondents were either satisfied or very satisfied with the telemedicine interaction and agreed or stro... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586191 Wed, 08 Jul 2009 23:00:00 +0100 2586191 http://www.medworm.com/index.php?rid=2586190&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F243%3Frss%3D1 Patients are interested in secure electronic communication with their health-care providers, but physicians have been slow to adopt the technique into their practice. We have therefore reviewed the literature on secure patient messaging. Relevant studies were identified by Medline search which produced 1065 publications. Of these, 71 relevant articles were read independently by two reviewers. Currently available messaging systems allow for asynchronous communication, physician reimbursement and automated supporting functions such as triaging of patient messages and integration of messaging into medical records. The review showed that patients are satisfied with the use of secure physician messaging systems and find such services to be convenient, time-saving and useful. Physicians do not r... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586190 Wed, 08 Jul 2009 23:00:00 +0100 2586190 http://www.medworm.com/index.php?rid=2586189&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F238%3Frss%3D1 We evaluated the effect of a telemedicine system on maternal and fetal outcome in women with diabetes. A total of 276 pregnant women were enrolled in the study. Women were sequentially assigned to a telemedicine or a control group. There were 88 women with gestational diabetes in the telemedicine group and 115 in the control group; there were 17 women with type 1 diabetes in the telemedicine group and 15 in the control group. Women in telemedicine groups were asked to submit their blood glucose data every week, and had a medical examination at the diabetes clinic once a month. Women in the control groups had a medical examination every two weeks. Subjective outcomes were investigated using the following questionnaires: CES-D for depression, SF-36 for health-related quality of life (QoL), S... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586189 Wed, 08 Jul 2009 23:00:00 +0100 2586189 http://www.medworm.com/index.php?rid=2586188&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F232%3Frss%3D1 Ten laryngectomy patients were assessed using a purpose-designed, multimedia videoconferencing system incorporating a freestanding, self-focusing camera. Swallowing, stoma and communication status were assessed simultaneously by a remote clinician and face-to-face, by a second clinician at the patient's site. The remote trial took place over a distance of approximately 1700 km using a commercial 3G phone network. A satisfaction questionnaire was also completed. There was excellent agreement between the two assessing clinicians. Image quality obtained via the freestanding camera was rated as lower than direct observation, but it was sufficient to assess the stoma and status of the voice prosthesis. During the trial, occasional difficulties with audio delays and image distortion were experie... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586188 Wed, 08 Jul 2009 23:00:00 +0100 2586188 http://www.medworm.com/index.php?rid=2586187&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F226%3Frss%3D1 We have studied how well the need for a medical intervention can be predicted by a telecare monitoring system. During a study period of about 18 months, 45 elderly individuals with congestive heart failure used a home health monitor to enter daily information pertaining to their symptoms and health status. A total of 8576 alerts were generated by the monitoring system, although in most cases, patient and service provider interaction was not required. When system alerts were considered to be serious, or if symptoms persisted, the patient was contacted. A total of 171 key medical events (6 deaths; 28 hospital admissions; 59 changes in medication; 54 cases of advice given; 24 instances where immediate medical attention was recommended) were recorded in the monitoring logs. A multivariate logi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586187 Wed, 08 Jul 2009 23:00:00 +0100 2586187 http://www.medworm.com/index.php?rid=2586186&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F221%3Frss%3D1 We examined the agreement between diagnoses of pigmented skin lesions based on an in-person (face-to-face) dermatological examination and diagnoses based on the study of medical records and images transferred through the web (teledermatoscopy). Two experienced dermatologists examined and diagnosed 64 pigmented skin lesions, which had been surgically excised and undergone histopathology examination. Two years later, the same cases were studied and diagnosed once again by the same dermatologists via the web. There was 72% agreement between the in-person diagnoses and the biopsy results (the gold standard), and 66% agreement between the telediagnoses and the biopsy results. Telemedicine had high sensitivity (87%) and specificity (73%), although there were 4 false-negative diagnoses. A web-bas... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586186 Wed, 08 Jul 2009 23:00:00 +0100 2586186 http://www.medworm.com/index.php?rid=2586185&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F5%2F215%3Frss%3D1 We explored the benefit of video communication in home rehabilitation after shoulder joint replacement and compared it to referral for physiotherapy in the conventional way. A total of 22 patients were included in the study. The intervention group (n = 10) had training at home under the supervision of a physiotherapist at the hospital using videoconferencing. The control group (n = 12) had physiotherapy training in a conventional way in their home town. All patients had the same postoperative, three-phase-programme for two months. The outcome measures were a Visual Analogue Scale (VAS) for pain, range of motion (ROM), shoulder function ability (Constant score and SRQ-S) and health-related quality of life (SF-36). Questions about areas of priority for improvement and general satisfaction wi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2586185 Wed, 08 Jul 2009 23:00:00 +0100 2586185 http://www.medworm.com/index.php?rid=2434487&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F211%3Frss%3D1 A 30-year-old veteran with a diagnosis of schizoaffective disorder and his mother were referred for family-focused therapy (FFT), an empirically-supported, manual-based treatment. The veteran had had multiple hospitalizations and experienced chronic auditory hallucinations for self-harm. Minor modifications to FFT were made for implementation via videoconferencing (at a bandwidth of 384 kbit/s). This may have enhanced the treatment by making the process of communication and problem-solving more explicit. The course of FFT was successfully completed, and the veteran and family showed a high level of satisfaction with care as well as improved medication adherence, good quality of life, high levels of hope, good interpersonal functioning, and very mild negative and positive psychiatric sympto... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434487 Tue, 26 May 2009 04:00:00 +0100 2434487 http://www.medworm.com/index.php?rid=2434486&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F208%3Frss%3D1 An 8-month old girl presented to the Angkor Hospital for Children in Siem Riep, Cambodia with fevers, bilateral eye discharge and an extensive body rash. The rash consisted of large, fluid-filled bullae and significant desquamation. The patient was admitted to the hospital and given intravenous cloxacillin for presumed bullous impetigo. Despite treatment with antibiotics, the skin lesions did not improve and the fevers continued. Telemedicine consultations were initiated by email between Angkor Hospital for Children and paediatric specialists in the USA. Several diagnoses were entertained throughout the subsequent collaborative dialogue. Ultimately, teleconsultation led to a diagnosis of chronic bullous dermatosis of childhood (CBDC), a rare sub-epidermal blistering disease. The child was ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434486 Tue, 26 May 2009 04:00:00 +0100 2434486 http://www.medworm.com/index.php?rid=2434485&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F203%3Frss%3D1 We conducted a feasibility study to find out whether a simple preliminary examination using telemedicine for diagnosis was sufficient to identify sleep-related breathing disorders (SRBD). Night-time pulse oximetry recordings were made in normal home surroundings on patients suffering from sleep apnoea/SRBD by doctors with a range of non-specialist backgrounds. The readings were transmitted to the relevant sleep laboratory, examined and the results returned to the referring doctor. From 80 patients (aged 29 to 60 years), 58 complained about characteristic symptoms (snoring, daytime sleepiness); 33 of these patients showed additional symptoms of associated diseases. In eight patients associated diseases were found without any symptoms. The findings were compatible with SRBD in 58 cases (73%)... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434485 Tue, 26 May 2009 04:00:00 +0100 2434485 http://www.medworm.com/index.php?rid=2434484&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F196%3Frss%3D1 The reliability and validity of assessments and diagnoses made via home telehealth was measured in 42 patients with spinal cord injury. Two telehealth modalities were investigated: telephone-only contact and videoconferencing. The results were compared with a reference (gold-standard) method, the in-person assessment and diagnosis of skin integrity and pressure ulcers. The agreement on the presence of a pressure ulcer was excellent for both telephone and videoconferencing approaches (92% for telephone, 97% for videoconferencing). The diagnoses of the stage of pressure ulcer (on an ordinal scale of 0–4) made via telephone and videoconferencing showed substantial to almost perfect agreement with the in-person diagnoses (Spearman's rho of 0.76 and 0.83, respectively). There was a tenden... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434484 Tue, 26 May 2009 04:00:00 +0100 2434484 http://www.medworm.com/index.php?rid=2434483&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F191%3Frss%3D1 We compared telesonography to usual patient care in a rural clinic in the Dominican Republic. A total of 108 low-income Dominican and Haitian patients volunteered to participate. The patients were randomly assigned to either telesonography or control groups. Patients in the telesonography group were scanned and sonographic images and Request for Interpretation (RFI) forms were sent by email to six volunteer radiologists in the USA. Completed RFI forms were transmitted back to the clinic at the radiologists' earliest convenience. Patients in the control group received an ordinary ultrasound referral, which required travel to a tertiary medical centre where their scans were completed by a local sonographer. Sonographic reports from the control group were hand delivered to the referring physi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434483 Tue, 26 May 2009 04:00:00 +0100 2434483 http://www.medworm.com/index.php?rid=2434482&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F187%3Frss%3D1 We investigated why hospice nurses were slow to adopt videophones to care for their patients. We used the unified theory of acceptance and use of technology (UTAUT) model and the organizational readiness for change (ORC) assessment via interviews and focus groups with hospice staff. Twenty-five hospice employees participated. Eighteen (72%) were in clinical positions and seven were in non-clinical positions (28%). Thirty-nine percent of respondents reported no videophone training, despite the fact that every employee had received training. Only four staff members actually used a videophone with patients. The respondents overwhelmingly stated that they had the organizational resources necessary to use the videophone and that it was easy to operate. Despite initial enthusiasm, leaders in the... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434482 Tue, 26 May 2009 04:00:00 +0100 2434482 http://www.medworm.com/index.php?rid=2434481&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F182%3Frss%3D1 An evaluation was undertaken on the effectiveness and efficiency of care coordination as a means of delivering health services to Australian veterans with a diagnosis of congestive heart failure. The veterans participated in a randomized controlled trial of care coordination that was supported by the Department of Veterans' Affairs (DVA). Of 490 veterans who were recruited, 409 were surveyed at baseline (214 in the intervention group and 195 controls). At follow-up, 288 were surveyed (155 intervention and 133 controls). Information on cost of care and quality of life (QOL) was collected before the commencement of coordinated care and at follow-up after 12 months. Cost of care data were obtained from DVA records. Information on QOL was obtained from telephone interviews, using the Short For... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434481 Tue, 26 May 2009 04:00:00 +0100 2434481 http://www.medworm.com/index.php?rid=2434480&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F175%3Frss%3D1 We conducted a systematic review of the literature on telehealth in Asia. The Medline database was searched, together with three specialist journals, for peer-reviewed articles published in the ten years to June 2007 which were related to any telehealth application involving one or more Asian country. Out of the 1504 abstracts retrieved, 109 articles were selected by two independent reviewers for the final review. The number of published articles on telehealth in Asia increased during the review period. The largest number of studies were conducted in Japan (37%). Most telehealth applications were based on the store-and-forward modality (43%), with 35% using videoconferencing and 15% using a hybrid approach. Most of the studies were descriptive (75%) and only eight included a control group ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434480 Tue, 26 May 2009 04:00:00 +0100 2434480 http://www.medworm.com/index.php?rid=2434479&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F171%3Frss%3D1 We performed a qualitative study of the practice of informed consent for videoconsultation in Canada. Fourteen cases were examined: the 13 provinces and territories, and the Federal jurisdiction representing aboriginal groups. Twenty-seven interviews were conducted with key informants (14 telehealth experts, 13 legal experts). The telehealth experts were people with direct experience of telehealth practice. The majority of the telehealth experts agreed that videoconsultations had not been integrated into the health-care system. An interesting finding of the study was that the integration status of videoconsultations was not indicative of informed consent practices. Telehealth providers favoured express written consent, or risk management practices, although there was a desire to move towar... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434479 Tue, 26 May 2009 04:00:00 +0100 2434479 http://www.medworm.com/index.php?rid=2434478&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F165%3Frss%3D1 We conducted a retrospective study of symptom assessment calls for adult patients at a US call centre, Ask Mayo Clinic. A total of 27,979 symptom assessment calls were received from July 2006 to June 2007. Calls concerning female patients predominated in all age groups and accounted for 71% of calls, but decreased significantly with increasing age. The average duration of an adult call was 10 min, and the duration increased with increasing age of the adult patient. The greatest frequency (8%) of calls were related to symptoms of abdominal pain, followed in frequency by skin problems (6%), pregnancy-related issues (6%), cold symptoms (4%), and chest pain or chest discomfort (4%). Surrogate calls accounted for 14% of adult calls but the proportion was significantly higher (40%) if the patien... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434478 Tue, 26 May 2009 04:00:00 +0100 2434478 http://www.medworm.com/index.php?rid=2434477&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F161%3Frss%3D1 An information architecture is a high-level, conceptual design for a system which describes the fundamental requirements and principles of a system, and details its essential elements and characteristics. I conducted a comprehensive review of published literature on telecare, including government reports and case study papers. This enabled a complete picture to be constructed of telecare system components. The components can be divided into four separate categories: human components, ICT components, telecare operational units and supportive elements. The system requirements cover functional, non-functional and informational requirements. Telecare holds great potential for all sectors of society. Its true value may only be realised when the nature of information within the telecare system i... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2434477 Tue, 26 May 2009 04:00:00 +0100 2434477 http://www.medworm.com/index.php?rid=2334449&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F160%3Frss%3D1 We examined group dynamics involving contests, games and theatrical performances for alcohol learning. To reinforce the information transmitted by telemedicine, 20 group sessions were held in São Paulo, one per week, each lasting one hour. The were 20 students directly involved and about 250 in the audience. The students drew up short theatre scenes, with basic information on the topic. The audience were then challenged to respond whether the subject of the scene was a myth or a truth about alcohol or alcoholism. The creation of a theatrical game required the involvement of student-actors to build the characters and support from telemedicine tools (the virtual human, posters and videos) to provide additional information. This method of presenting knowledge on alcohol can involve oth... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334449 Mon, 13 Apr 2009 04:00:00 +0100 2334449 http://www.medworm.com/index.php?rid=2334448&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F159-b%3Frss%3D1 Brazil is a large country with a population of nearly 200 million people. There are difficulties in providing public health education. To ensure its effectiveness, health education should begin during adolescence, to encourage young people to adopt healthy habits. A web-based tele-education platform was developed. Thirty students from a public high school in the rural city of Tatui took part in a pilot trial. Six teachers coordinated the student's activities. After face-to-face training, the students participated in tele-education, using a ‘cybertutor’ (an educational environment based on the website) and discussion lists. There were 15 face-to-face interactions, followed by more than 200 offline and 50 online interactions. The students learned about seven health topics. During... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334448 Mon, 13 Apr 2009 04:00:00 +0100 2334448 http://www.medworm.com/index.php?rid=2334447&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F159-a%3Frss%3D1 We have investigated the factors which make telemedicine centres sustainable. A pilot study was carried out at two university telemedicine centres in Brazil: the Faculty of Odontology and the Faculty of Medicine at the University of São Paulo. Both centres were supported by long-term government grants. One centre delivered clinical telemedicine services in audiology and odontology, and the other centre delivered clinical services in dermatology, surgery, cardiology, medicine and second-opinions for primary care. A semi-structured interview script was drawn up and after consensus among four referees, interviews were carried out with one telemedicine coordinator from each centre. Analysis of the results showed that telemedicine sustainability is a multidimensional matter, not simply a... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334447 Mon, 13 Apr 2009 04:00:00 +0100 2334447 http://www.medworm.com/index.php?rid=2334446&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F156%3Frss%3D1 A system was developed to allow general practitioners in Swansea to send urgent cancer referrals electronically to consultants at the South West Wales Cancer Centre. Five practices from the Swansea area took part in a pilot trial. Information was extracted from the system to evaluate the e-referral activity of the first six months, during which a total of 99 referrals were submitted electronically; most (81%) were processed within one hour. Evaluation interviews were conducted with staff at the general practices, who were asked to rate the system on a 10-point Likert scale (1 = completely dissatisfied to 10 = completely satisfied); the lowest satisfaction rating given by the practices was 8. The staff agreed that the use of a standard form was beneficial and improved the quality of the ref... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334446 Mon, 13 Apr 2009 04:00:00 +0100 2334446 http://www.medworm.com/index.php?rid=2334445&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F153%3Frss%3D1 A total of 50 patients (affected by traumatic brain injury, stroke or multiple sclerosis) were treated for one month using a rehabilitation protocol. Rehabilitation could be monitored using a Portable Unit (PU) which could be installed in a patient's home allowing the measurement of kinetic and kinematic variables during exercise. In a preliminary analysis, the variables related to four rehabilitation exercises were examined for two patients at baseline and at the end of the one-month treatment. The exercises involved movement of checkers, a pencil, a jar and a key. The results suggest that, even if the overall duration of exercise execution is an important aspect of the rehabilitation process, other variables acquired by the PU might deliver useful information for assessing the patient's ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334445 Mon, 13 Apr 2009 04:00:00 +0100 2334445 http://www.medworm.com/index.php?rid=2334444&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F150%3Frss%3D1 We developed a virtual clinic to assist patients who use insulin pumps in the management of their diabetes. The virtual clinic offered access to information, communication with health professionals and interaction with peers. Seventeen patients were recruited from three hospital clinics. Participants completed questionnaires before and after using the clinic for a six-month period. Usage was initially high but then declined. In the first two months 1691 page-views were recorded, but in the final two months only 355 page-views were registered. Users found participation reassuring. They rated peer interaction as the most desirable and the most useful of the features available. Using an Internet-based clinic to support the self-management of diabetes is feasible and acceptable to patients. (S... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334444 Mon, 13 Apr 2009 04:00:00 +0100 2334444 http://www.medworm.com/index.php?rid=2334443&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F145%3Frss%3D1 We tested three imaging devices for suitability in emergency dental situations for telemedicine. The three devices were a special-purpose oral camera, a digital single lens reflex (DSLR) camera, and the built-in camera of a mobile phone. A total of 20 subjects volunteered to take part in the study. We simulated five different conditions which could affect the quality of the image and measured image transmission times across two widely available mobile networks (a CDMA-based 3G network and a Wireless Broadband Network, WiBRO). The DSLR produced the best quality images, although it was a relatively large device and not easy to use. The oral camera failed to give satisfactory images under certain conditions (i.e. without extra lighting, out of focus and head motion). In contrast, the mobile p... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334443 Mon, 13 Apr 2009 04:00:00 +0100 2334443 http://www.medworm.com/index.php?rid=2334442&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F142%3Frss%3D1 In 1998, a teleradiology system was established in Croatia. It connects 34 CT, MRI and DSA scanners in 29 hospitals with a referral centre in the neurosurgery department in Zagreb. In the first three years of its use, the network saved more than 400,000 km of patient transportation (i.e. without a teleconsultation, all of the patients would have had to be transported to the nearest referral neurosurgical unit). During the first seven years, an archive with 25,366 expert opinions was collected. A total of 7103 (28%) expert opinions were provided for the distant regional hospitals. The most common diagnoses for patients from regional hospitals were neurotrauma (53%), cerebrovascular diseases (22%) and brain tumours (19%). The teleradiology system was used less often for lumbar disc disease (... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334442 Mon, 13 Apr 2009 04:00:00 +0100 2334442 http://www.medworm.com/index.php?rid=2334441&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F139%3Frss%3D1 We collected information about awareness and attitudes to telemedicine from 143 doctors at 14 different hospitals in India, and from 121 patients who had come to New Delhi for treatment from other parts of India. Most doctors felt that telemedicine was important and their opinions were similar in all age groups. Only three of the 14 hospitals had not implemented telemedicine. A total of 86 doctors had used telemedicine. One hundred of the 121 patients were not aware of telemedicine. However, when the concept was explained, most patients had a positive attitude towards telemedicine. The majority of patients who had previously used telemedicine (n = 7) found it satisfactory. It is important that proper hospital training programmes should be organized for all doctors, which will assist in fut... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334441 Mon, 13 Apr 2009 04:00:00 +0100 2334441 http://www.medworm.com/index.php?rid=2334440&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F137%3Frss%3D1 In September 2005 a telemedicine service was started to assist multidisciplinary teams in Wales to improve cancer services. In October 2006 and October 2007 users of videoconferencing equipment at one site completed questionnaires. During October 2006 a total of 18,000 km of car travel were avoided, equivalent to 1696 kg of CO2 emission. During October 2007 a total of 20,800 km of car travel were avoided, equivalent to 2590 kg of CO2 emission. We estimate that 48 trees would take a year to absorb that quantity of CO2. The results of the surveys show that exploiting telemedicine makes better use of staff time, reduces the time spent travelling and assists in reducing climate change by limiting the emissions of CO2. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334440 Mon, 13 Apr 2009 04:00:00 +0100 2334440 http://www.medworm.com/index.php?rid=2334439&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F135%3Frss%3D1 In the USA, several telestroke networks have been successfully implemented in which a stroke centre of excellence provides expertise to community and rural hospitals via telemedicine. Stroke patients can thus receive round-the-clock access to stroke expertise. The Remote Presence (RP) system is used in several of these telestroke networks. The stroke expert uses a laptop and wireless Internet to connect to the RP robot in the peripheral emergency department. This improves the geographical reach of stroke specialist care, and improves patient outcomes as well as conforming with best practice. The stroke network concept combined with telemedicine is a powerful way of transforming stroke care. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334439 Mon, 13 Apr 2009 04:00:00 +0100 2334439 http://www.medworm.com/index.php?rid=2334438&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F132%3Frss%3D1 A literature search was conducted for articles on the role of telemedicine in accident and emergency work. The search yielded 39 relevant papers, which came from 21 independent groups that had used telemedicine in an emergency medicine setting. The articles showed that telemedicine has been applied in a variety of ways from medical advice for paramedics in the disaster setting, to patient follow-up in the fracture clinic. A variety of communications equipment has been tried, including radio links, telephone, email and mobile wireless videoconferencing devices. All such links have been found to transfer information effectively, but success has sometimes been limited by technical failure and by staff lacking confidence in using the systems. Telemedicine has been used widely to support emerge... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334438 Mon, 13 Apr 2009 04:00:00 +0100 2334438 http://www.medworm.com/index.php?rid=2334437&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F129%3Frss%3D1 The Emergency Care Summary (ECS) in Scotland provides essential clinical and demographic information about patients needing unscheduled or emergency care. Information about patients’ medications, adverse drug reactions and allergies is transferred twice every day from GP systems to the ECS. Access is then available to authorised health-care professionals at the national help line, at out-of-hours services and in accident and emergency departments. An economic analysis of the ECS implementation showed that annual benefits exceeded annual costs after about seven years. Approximately 77% of the benefits were non-financial and 23% from redeployed finance. No cash savings were planned and none were realised. As ECS utilisation increased from 2006, the net benefits became positive. This re... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334437 Mon, 13 Apr 2009 04:00:00 +0100 2334437 http://www.medworm.com/index.php?rid=2334436&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F125%3Frss%3D1 We conducted a randomized controlled trial using mobile health technology in an ethnically diverse sample of 137 patients with complicated diabetes. Patients in the intervention group (n = 72) were trained to measure their blood glucose with a sensor which transmitted the readings to a mobile phone via a Bluetooth wireless link. Clinicians were then able to examine and respond to the readings which were viewed with a web-based application. Patients in the control arm of the study (n = 65) did not transmit their readings and received care with their usual doctor in the outpatient and/or primary care setting. The mean follow-up period was 9 months in each group. The default rate was higher in the patients in the intervention arm due to technical problems. In an intention-to-treat analysis th... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334436 Mon, 13 Apr 2009 04:00:00 +0100 2334436 http://www.medworm.com/index.php?rid=2334435&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F122%3Frss%3D1 We assessed the feasibility of obtaining probe microphone measurements of hearing aids at a distance. Face-to-face and remote probe microphone measurements were carried out in 60 hearing aid users (mean age 67 yrs) with uni- or bilateral hearing losses (105 ears tested). The participant and a facilitator were located in a room equipped with a probe microphone system interfaced to a PC. Desktop videoconferencing and application sharing was used to allow an audiologist in another room to instruct the facilitator and control the equipment via the LAN. There were significant correlations between face-to-face and remote real ear unaided response (REUR), aided response (REAR) and insertion gain (REIG) at seven discrete frequencies from 250 to 6000 Hz. Differences between face-to-face and remote ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334435 Mon, 13 Apr 2009 04:00:00 +0100 2334435 http://www.medworm.com/index.php?rid=2334434&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F118%3Frss%3D1 We have conducted a feasibility study to establish whether ENT tele-endoscopy would be a suitable method of service delivery for patients who live in the Shetland Islands. Ten clinics were conducted over a period of 17 months using ISDN-based videoconferencing at a bandwidth of 384 kbit/s. A total of 42 patients were seen in Aberdeen via videoconferencing for a head and neck cancer assessment. Feasibility was confirmed after the first 20 patients, following positive feedback from all concerned and the absence of any significant clinical or technical problems. A total of 42 journeys was avoided, each journey saving 123 kg CO2 per person. A preliminary cost analysis showed that the threshold at which tele-ENT became cheaper than travel was a workload of 35 patients/year. The actual workload ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334434 Mon, 13 Apr 2009 04:00:00 +0100 2334434 http://www.medworm.com/index.php?rid=2334433&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F115%3Frss%3D1 We compared desktop videoconferencing to conventional face-to-face visits for a range of commonly presenting problems in a general practice. A total of 175 patients were recruited. Patients were randomized to one of two arms of the study. In the first arm, the patients completed a visit (virtual or face-to-face) with a physician; they then completed a second visit via the other modality with another physician. In the second arm of the study, subjects had both visits face-to-face; different physicians conducted the two face-to-face consultations. Patients found virtual visits similar to face-to-face visits on most measures, including time spent with the physician, ease of interaction and personal aspects of the interaction. Physicians were also highly satisfied with the virtual visit modali... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334433 Mon, 13 Apr 2009 04:00:00 +0100 2334433 http://www.medworm.com/index.php?rid=2334432&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F112%3Frss%3D1 We have developed a tele-rehabilitation application for training cardiac patients. It uses a modified ergometer bicycle with a set of wireless sensors. While the patient is exercising, the ECG, blood pressure and oxygen-saturation are monitored constantly and automatically. If sensor values exceed pre-defined thresholds, the patient receives an alarm. As a result the training will either be stopped or continued at a reduced load, depending on the severity of the alarm. To measure user acceptance, we introduced the system to 13 members of staff and four patients, who trained on the system every day during their stay in hospital. A total of 39 training sessions were completed. In 27% of the exercise sessions an ECG connection could not be established and in 23%, blood pressure measurement fa... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334432 Mon, 13 Apr 2009 04:00:00 +0100 2334432 http://www.medworm.com/index.php?rid=2334431&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F109%3Frss%3D1 We examined the medical expenditure of elderly residents who used an e-health system in Nishiaizu town. Since 1994, health-related data, such as blood pressure, ECG and blood oxygen, have been transmitted to a remote medical institution via a telecommunications network. We selected 412 users from the list of registered e-health users in the town. We also selected 450 residents who were not e-health users. We sent them questionnaires and obtained 199 valid responses from e-health users and 209 from non-users. Then we examined the receipts of these 408 people, which were kept in paper form in the town office. Based on a multiple regression analysis, we found that users of the e-health system had lower medical expenditure for lifestyle-related illness than non-users. The medical expenditure o... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2334431 Mon, 13 Apr 2009 04:00:00 +0100 2334431 http://www.medworm.com/index.php?rid=2218123&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F108%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218123 Thu, 26 Feb 2009 05:00:00 +0100 2218123 http://www.medworm.com/index.php?rid=2218122&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F102%3Frss%3D1 A mobile telemedicine system, capable of transmitting video and audio simultaneously, was designed for consulting acute stroke patients remotely. It could use a wireless local area network (e.g. inside the hospital) or a mobile phone network (e.g. outside the hospital). When initiating a call, the sending unit chose a suitable encoding profile based on the measured data throughput, in order to allocate appropriate bit rates for video and audio transmission. The system was tested using a portable digital assistant (PDA) type phone and smart phone as receiving units. Video and audio recordings were made from five patients (two normal and three stroke patients) and then transmitted at different rates. Subjectively, both video and audio qualities improved as the data throughput increased. The ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218122 Thu, 26 Feb 2009 05:00:00 +0100 2218122 http://www.medworm.com/index.php?rid=2218121&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F98%3Frss%3D1 We assessed a home monitoring/care coordination programme for veterans with diabetes. Patients enrolled in the programme (n = 387) were followed for four years and compared with a retrospective control group (n = 387). Each patient in the intervention group used a messaging device in the home that was connected by a conventional telephone line. Care coordinators monitored the answers from the devices daily so that early interventions could be made. There were significantly more deaths in the control group (n = 102, 26%) compared with the intervention group (n = 75, 19%). There was longer survival for the intervention group versus the control group (mean survival time 1348 vs 1278 days; P = 0.015). A multivariate analyses indicated that the telemonitoring programme was associated with reduc... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218121 Thu, 26 Feb 2009 05:00:00 +0100 2218121 http://www.medworm.com/index.php?rid=2218120&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F95%3Frss%3D1 We conducted a pilot study of the effectiveness of individual counselling sessions provided by a dietician through telemedicine for patients with diabetes. All participants received a single group education session via videoconference. Those who were randomized to the intervention also received two additional follow-up sessions, four and eight weeks later. Glycosylated haemoglobin and total cholesterol were measured at the start and again 16 weeks later. The patients completed diabetes quality-of-life and telemedicine patient satisfaction surveys. Thirty-two participants consented to participate. Complete data were collected on 13 intervention and 13 control patients. There was a 1% fall in HbA1c in the intervention group from pre- to post-assessment, although this was not significant. The... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218120 Thu, 26 Feb 2009 05:00:00 +0100 2218120 http://www.medworm.com/index.php?rid=2218119&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F89%3Frss%3D1 We compared videoconferencing and face-to-face (FTF) assessments for veterans seeking a mental health evaluation for post-traumatic stress disorder (PTSD). The Clinician-Administered PTSD Scale (CAPS) interview was used in 20 male veterans. There were significant correlations (ranging from 0.74 to 0.92) between the CAPS administered FTF and by videoconferencing on all three subscales, as well as on the total severity score. The confidence intervals for the CAPS scores indicated statistical equivalence between administration FTF and by videoconferencing. The sensitivity of videoconferencing was 0.94 and the specificity was 0.33, compared with FTF assessment. The total and subscale scores suggested that there was a moderate working alliance with both methods. The patients indicated general s... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218119 Thu, 26 Feb 2009 05:00:00 +0100 2218119 http://www.medworm.com/index.php?rid=2218118&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F83%3Frss%3D1 There is very little published information about the outcomes of patients treated by telemedicine in developing countries. Over a two-year period, seven medical students from five universities spent their electives at a hospital in Papua New Guinea. They assisted with the review of a total of 44 e-referrals made by local doctors; the referrals resulted in 61 queries in a wide range of specialties. The major categories of these queries were internal medicine, paediatrics and surgery. Follow-up data were obtained in 22 of the 44 cases (50%) after a median period of 13 weeks (interquartile range 3-19). The cases were reviewed by an independent doctor. Telemedicine was considered to have assisted with the diagnosis in all cases (median score 5 on a five-point scale from 1 = not helpful at all ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218118 Thu, 26 Feb 2009 05:00:00 +0100 2218118 http://www.medworm.com/index.php?rid=2218117&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F77%3Frss%3D1 A mobile phone with a glucometer integrated into the battery pack (the ‘Diabetes Phone’) was launched in Korea in 2003. We compared its effect on management of type 2 diabetes to the Internet-based glucose monitoring system (IBGMS), which had been studied previously. We conducted a randomized trial involving 69 patients for three months. Participants were assigned to an Internet group or a phone group. The phone group communicated with medical staff through the mobile phone only. Their glucose-monitoring data were automatically transferred to individual, web-based charts and they received medical recommendations by short message service. The Internet group used the IBGMS. There were no significant differences between the groups at baseline. After three months' intervention, HbA... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218117 Thu, 26 Feb 2009 05:00:00 +0100 2218117 http://www.medworm.com/index.php?rid=2218116&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F73%3Frss%3D1 We conducted a pilot study to assess the feasibility of tele-follow up in post-operative cases of thyroid and parathyroid diseases. Patients were enrolled after operation at the tertiary hospital in Lucknow who consented to report to the telemedicine centre at Cuttack, approximately 1500 km away. Initially videoconferencing used a single ISDN line (128 kbit/s); subsequently a satellite-based connection (384 kbit/s) was employed. Patients were given a questionnaire to assess their satisfaction with tele-follow up and the financial and work-time savings incurred by them. Over a period of nearly four years, a total of 34 postoperative patients were followed up by telemedicine. A total of 66 tele-visit sessions were held. The average number of visits per patient was two (range 1–6). The ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218116 Thu, 26 Feb 2009 05:00:00 +0100 2218116 http://www.medworm.com/index.php?rid=2218115&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F68%3Frss%3D1 In 1999 we introduced a digital, mobile eye fundus camera for screening type 2 diabetes mellitus patients (adult onset diabetes) in the Finnish county of South-Ostrobothnia. Prior to this, eye fundus examinations were only available in the regional central hospital, and no systematic screening of type 2 (adult onset) diabetes patients was possible. The total number of screenings carried out with the mobile equipment from 1999 to 2006 was 17,471 cases. There were significant benefits, most important from improved coverage of type 2 diabetes patients. Because the mobile system made eye fundus examinations available to patients in their nearest health centre, approximately 85% of all patients with diabetes in the region are now screened. On average this means that each patient is screened onc... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218115 Thu, 26 Feb 2009 05:00:00 +0100 2218115 http://www.medworm.com/index.php?rid=2218114&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F64%3Frss%3D1 There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. Tele-educational resources were mediated by professors and coordinators, and included the use of theoretical content available through the web, discussion lists, Internet chat, activity diaries, 3-D video animations (Virtual Human on Leprosy), classes in video streaming and case simulation. Sixty-five FHT staff members were enrolled. All of them completed the course and 47 participants received a certificate at the end of the course. At the end of the course, 48 course-evaluation questionnaires were answered. A total of 47 participants (98%) considered the cour... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218114 Thu, 26 Feb 2009 05:00:00 +0100 2218114 http://www.medworm.com/index.php?rid=2218113&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F59%3Frss%3D1 In this study, data from 48 participants were collected over a seven-year period. Each participant completed the Cognitive-Behavioural Therapy Knowledge Questionnaire before and after training, as well as a questionnaire about satisfaction. The sample included different training groups, made up of different mental health practitioners with varying levels of motivation and experience in mental health. There was a significant improvement in the participants' knowledge of CBT from pre- to post-training (P < 0.001) as well as high levels of satisfaction with the content and delivery of the programme. The majority of participants had used CBT principles learned in the course during their clinical practice. A range of patients had been treated, from those with anxiety disorders to those with ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218113 Thu, 26 Feb 2009 05:00:00 +0100 2218113 http://www.medworm.com/index.php?rid=2218112&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F55%3Frss%3D1 Much attention is paid to the technical aspects of telemedicine in the development of new applications, but the enthusiasm about what is technically possible very often leads to the user acceptance of such products being neglected. The number of successful and sustainable telemedicine applications would be much higher if developers concentrated more on matters related to the cognitive-emotional situation of the users involved in telemedicine. The users include the care and cure providers, as well as the care and cure receivers. Based on an informal literature search and discussions with telemedicine implementation staff, nine factors have been identified which are essential for the user acceptance of telemedicine applications. All of them are connected more to the cognitive-emotional than ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2218112 Thu, 26 Feb 2009 05:00:00 +0100 2218112 http://www.medworm.com/index.php?rid=2098486&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F51%3Frss%3D1 When visiting patients with serious mental illness at their homes, case managers carried a portable videophone. This was used to access the hospital clinical team via the home telephone line, when an acute clinical need arose in addressing questions related to medication management and treatment planning; travel was therefore avoided. In an acceptability study lasting 12 months, 24 patients received the supplemental videophone mental health service and 19 of them completed a satisfaction survey. Only one patient was not satisfied with the videophone treatment, while 74% of them were very satisfied. Specific areas of satisfaction concerned the savings of time and travel, assistance with medication questions and increased involvement in treatment. No patient reported any difficulty in using ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098486 Mon, 12 Jan 2009 05:00:00 +0100 2098486 http://www.medworm.com/index.php?rid=2098485&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F46%3Frss%3D1 We evaluated the efficacy of two telehealth applications, delivered by telephone and videophone, for improving outcomes of patients following hospital discharge for an acute exacerbation of heart failure. The outcomes measured were patient self-efficacy, satisfaction with care and knowledge of and compliance with prescribed medications. At hospital discharge, patients were randomly assigned to either control (usual care), telephone or videophone groups. Study nurses contacted the intervention patients each week for 90 days after discharge. A total of 148 patients were enrolled: 49 were randomized to usual care, 52 to the videophone intervention and 47 to the telephone intervention. At 90 days, 126 patients (85%) had completed follow-up; at 180 days, 109 patients (74%) had completed follow-... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098485 Mon, 12 Jan 2009 05:00:00 +0100 2098485 http://www.medworm.com/index.php?rid=2098484&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F40%3Frss%3D1 We conducted an economic analysis of a store-and-forward teledermatology system for the routine triage of skin cancer patients. A cost-identification, cost-effectiveness and sensitivity analysis under a societal perspective was used to compare teledermatology with the conventional care alternative. In the period March 2004 to July 2005, a total of 2009 teledermatology referrals were managed from 12 Primary Care Centres (PCCs) of the public health system. The unit cost was of 79.78 per patient in teledermatology, and 129.37 per patient in conventional care (P < 0.005), with an incremental cost of 49.59 per patient in favour of teledermatology. The cost ratio between teledermatology and conventional care was 1.6. There was a significant inverse relation between the unit cost in each parti... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098484 Mon, 12 Jan 2009 05:00:00 +0100 2098484 http://www.medworm.com/index.php?rid=2098483&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F32%3Frss%3D1 Telemedicine projects often fail to grow beyond the pilot phase of implementation. As well as the usual barriers such as reimbursement and legislation, user acceptance of telemedicine technologies is essential. From a design-perspective, it can be hypothesized that a user-centred design approach is missing in the development of telemedicine systems. We have mapped the underlying theoretical dimensions relevant to teleconsultations. An existing framework describing teleconsultations was used as the basis for the study. The perspectives that were taken to complement this framework were: (a) doctor–patient communication; (b) technology-mediated communication; and (c) technology acceptance. A literature search found 303, 42 and 409 articles in the three areas, respectively. Abstract asse... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098483 Mon, 12 Jan 2009 05:00:00 +0100 2098483 http://www.medworm.com/index.php?rid=2098482&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F28%3Frss%3D1 Telepsychiatry is well established in many countries, but there is still little information about its use in routine health care. We reviewed the literature for information on the use of telepsychiatry in mental health services. From 1033 publications identified in the literature search and through references from a separate project, 16 studies or descriptions of the routine use of telepsychiatry services were selected for further review. Eleven of these articles dealt primarily with videoconferencing and five with telephone- based services. Clinical use of videoconferencing in the programmes described by the reviewed papers was modest, with an average of 16 consultations per month. Three of the telephone-based services had large numbers of clients. The papers we reviewed gave limited cons... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098482 Mon, 12 Jan 2009 05:00:00 +0100 2098482 http://www.medworm.com/index.php?rid=2098481&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F23%3Frss%3D1 Telemedicine in China began in the mid-1980s and the early Chinese telemedicine activities were mostly based on store-and-forward techniques as the telecommunication infrastructure required for realtime work was not available. In recent years, telemedicine in China has developed quickly with the rapid growth of telecommunication networks. China now has three major telemedicine networks: the Golden Health Network (GHN), the International MedioNet of China (IMNC) network and the People's Liberation Army (PLA) telemedicine network. Nonetheless, research and application of telemedicine is at a relatively early stage in China. We suggest that the Chinese government needs to make a policy in favour of rural people and invest more in telemedicine, so that they can enjoy low-cost telemedicine serv... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098481 Mon, 12 Jan 2009 05:00:00 +0100 2098481 http://www.medworm.com/index.php?rid=2098480&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F7%3Frss%3D1 Digital cameras, when used correctly, can provide the basis for telemedicine services. The increasing sophistication of digital cameras, combined with the improved speed and availability of the Internet, make them an instrument that every health-care professional should be familiar with. Taking satisfactory images of patients requires clinical photography skills. Photographing charts, monitors, X-ray films and specimens also requires expertise. Image capture using digital cameras is often done with insufficient attention, which can lead to inaccurate study results. The procedures in clinical photography should not vary from camera to camera, or from country to country. Taking a photograph should be a standardised process. There are seven main scenarios in clinical photography and health pr... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098480 Mon, 12 Jan 2009 05:00:00 +0100 2098480 http://www.medworm.com/index.php?rid=2098479&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F1%3Frss%3D1 For doctors working in remote areas, access to medical specialists is crucial in order to provide patients with the best possible health care. Telemedicine is now widely used to obtain second opinions from consultants and is a mainstay of the organization of health care in Antarctica. Taking advantage of our extreme geographical isolation on a polar station, we tested the possibilities for obtaining specialist advice by telemedicine based on email. Two virtual case reports with one question each were sent to six correspondents: two non-governmental organizations (NGOs), two personal acquaintances and two institutions. Initial email replies were received between 13 hours and 7 days later. There were three kinds of reply: well argued and well adapted to our situation (one NGO); argued but no... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2098479 Mon, 12 Jan 2009 05:00:00 +0100 2098479 http://www.medworm.com/index.php?rid=2007475&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F448%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007475 Mon, 01 Dec 2008 05:00:00 +0100 2007475 http://www.medworm.com/index.php?rid=2007474&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F443%3Frss%3D1 We evaluated a care-coordination project assisted by a screen-phone to support and educate caregivers. A total of 113 caregivers of home-dwelling veterans with dementia were recruited to the study: 72 were white, 32 were African American and nine were Hispanic. Caregivers were assessed for burden, depression, coping, quality of life, knowledge and satisfaction. None of the outcome measures changed significantly after 12 months. Forty care-recipient and caregiver dyads responded to the 12-month telephone satisfaction survey. The respondents were more satisfied with the care-coordination (90%) aspect of the programme than the education (77%) or the monitoring (50%). The pilot project suggests that care coordination aided by screen-phones may be a useful model for caregiver support in a manag... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007474 Mon, 01 Dec 2008 05:00:00 +0100 2007474 http://www.medworm.com/index.php?rid=2007473&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F439%3Frss%3D1 Teleradiology in an emergency situation can be used to support rapid neurological decision-making when specialists are remote from the hospital concerned. We have developed a low-cost system using a PDA phone as the receiving equipment. The experimental system was based on a notebook PC to send the images and a PDA phone to receive them. We used commercially available toolbar software for transmitting the information through the mobile phone network. A total of 100 images from clinically suspected strokes within the previous 24 hours were transmitted to a neurologist. The mean size of the original picture was 20.9 kByte and the images were compressed by approximately 2:1 before transmission. The mean transmission time was 48 s per image. The diagnosis from the PDA phone image was in comple... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007473 Mon, 01 Dec 2008 05:00:00 +0100 2007473 http://www.medworm.com/index.php?rid=2007472&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F435%3Frss%3D1 We examined the feasibility of distance diagnosis of oral diseases, using transmission of digital images by email. Twenty-five cases of oral lesions were documented during a 12-month study in a primary care public health clinic in Paraná in Southern Brazil. Clinical electronic charts and images were produced and sent by email to two oral medicine specialists with a median of 10 years experience in the field. The consultants provided a maximum of two clinical hypotheses for each case. In 15 of the 25 cases (60%) both consultants made a correct diagnosis; in seven cases (28%) only one consultant made a correct diagnosis; and in three cases (12%) neither consultant made a correct diagnosis. Thus in 88% of cases, at least one consultant was able to provide the correct diagnosis. The res... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007472 Mon, 01 Dec 2008 05:00:00 +0100 2007472 http://www.medworm.com/index.php?rid=2007471&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F427%3Frss%3D1 We studied the workings of a rehabilitation team in a videoconference setting to note the pros and cons of videoconferencing in the development of interprofessional care plans (ICPs). We recorded every videoconference held by the teams of the specialized centre and the regional centre for clients with traumatic brain injuries over an 18-month period. Thirteen recorded videoconferences, lasting for 30–98 min, were analysed through an observation grid. On the whole, efficient teamwork was observed: the mean productivity level was 96%, while the percentage of time dedicated to the resolution of technical issues was 2%. During the videoconferences, the clinical coordinator and the client addressed the group most often. One of the most commonly mentioned advantages was the good visual con... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007471 Mon, 01 Dec 2008 05:00:00 +0100 2007471 http://www.medworm.com/index.php?rid=2007470&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F421%3Frss%3D1 A district hospital in south-east England used a telecardiology service for fetal cardiac diagnosis alongside an existing arrangement for referring pregnant women directly to perinatal cardiologists in London for detailed fetal echocardiography. Women were identified for referral according to local protocols when having a second trimester anomaly scan. For the telemedicine referrals, the sonographers video-recorded images from the anomaly scans for transmission during monthly videoconferences. The cost of the women's antenatal care was calculated from the specialist assessment until delivery, while family costs were collected in a postal survey. Over 15 months, telemedicine was used in 52 cases, while 24 women were seen in London. The London women were more likely to have had an ultrasound... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007470 Mon, 01 Dec 2008 05:00:00 +0100 2007470 http://www.medworm.com/index.php?rid=2007469&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F415%3Frss%3D1 We conducted a study of videoconferencing for delivering an Augmentative and Alternative Communication (AAC) service. AAC is a clinical field that attempts to compensate for the impairment and disability of people with severe expressive communication disorders. A total of 12 participant groups trialled initial AAC assessments via videoconference at a bandwidth of 768 kbit/s. The participant groups consisted of the client, the assessing speech and language therapist, and those who accompanied them to the session (usually their local speech and language therapist and any relatives or carers). Six of these groups progressed to receive review appointments. Following each of the sessions, all of the participants completed a questionnaire. Participants indicated an 88% satisfaction with the vide... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007469 Mon, 01 Dec 2008 05:00:00 +0100 2007469 http://www.medworm.com/index.php?rid=2007468&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F410%3Frss%3D1 We have developed a mobile pharmacy service system (MPSS) to deliver individualized pharmaceutical care via text messages sent to the mobile phones of patients. The text messages were: (1) reminders about medication – from the day following discharge, reminder messages were automatically sent to patients approximately 10 minutes before their medication was due to be taken. The system stopped sending messages when the prescription ran out and suggested that patients should come to hospital to renew any prescribed medicines; (2) practical information about medicines, such as information about methods of administration; (3) information about adverse drug reactions. In a 3-month trial in a general hospital, 100 patients were provided with pharmaceutical care using the MPSS for an average... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007468 Mon, 01 Dec 2008 05:00:00 +0100 2007468 http://www.medworm.com/index.php?rid=2007467&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F404%3Frss%3D1 We introduced a web-based teledermatology system, the distributed personal health information management system (DPHIMS), into a nursing home in Singapore. The introduction was conducted in two phases. Five staff nurses in Phase 1 and nine nurse aides in Phase 2 performed the data entry and uploaded digital images of the resident's skin condition. By the end of Phase 2, there were 50 residents registered with DPHIMS. The average age of the participants was 82 years and 84% were women. There were 31 first-time referral requests registered in the system during Phase 2. The average time taken to complete a referral request was 86 minutes. The average time taken by the dermatologist to prepare and submit a diagnosis/treatment report was 11 minutes. An online survey form was given to the nurses... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007467 Mon, 01 Dec 2008 05:00:00 +0100 2007467 http://www.medworm.com/index.php?rid=2007466&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F8%2F401%3Frss%3D1 Wireless telemedicine using GSM and GPRS technologies can only provide low bandwidth connections, which makes it difficult to transmit images and video. Satellite or 3G wireless transmission provides greater bandwidth, but the running costs are high. Wireless networks (WLANs) appear promising, since they can supply high bandwidth at low cost. However, the WLAN technology has limitations, such as coverage. A new wireless networking technology named the wireless mesh network (WMN) overcomes some of the limitations of the WLAN. A WMN combines the characteristics of both a WLAN and ad hoc networks, thus forming an intelligent, large scale and broadband wireless network. These features are attractive for telemedicine and telecare because of the ability to provide data, voice and video communica... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=2007466 Mon, 01 Dec 2008 05:00:00 +0100 2007466 http://www.medworm.com/index.php?rid=1873611&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F396%3Frss%3D1 We simulated a cardiopulmonary resuscitation (CPR) scene with a manikin and used two 3G videophones on the caller's side to transmit video to a laptop PC. Five observers (two doctors with experience in emergency medicine and three paramedics) evaluated the video. They judged whether the manikin was breathing and whether they would give advice for CPR; they also graded the confidence of their decision-making. Breathing was only visible from certain orientations of the videophones, at distances below 150 cm with good illumination and a still background. Since the phones produced a degradation in colours and shadows, detection of breathing mainly depended on moving contours. Low camera positioning produced better results than having the camera high up. Darkness, shaking of the camera and a mo... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873611 Mon, 13 Oct 2008 04:00:00 +0100 1873611 http://www.medworm.com/index.php?rid=1873610&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F393%3Frss%3D1 We have developed a prototype home robot to improve drug compliance. The robot is a small mobile device, capable of autonomous behaviour, as well as remotely controlled operation via a wireless datalink. The robot is capable of face detection and also has a display screen to provide facial feedback to help motivate patients and thus increase their level of compliance. An RFID reader can identify tags attached to different objects, such as bottles, for fluid intake monitoring. A tablet dispenser allows drug compliance monitoring. Despite some limitations, experience with the prototype suggests that simple and low-cost robots may soon become feasible for care of people living alone or in isolation. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873610 Mon, 13 Oct 2008 04:00:00 +0100 1873610 http://www.medworm.com/index.php?rid=1873609&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F389%3Frss%3D1 We conducted interviews with two surgeons from the department of gastrointestinal surgery at the University Hospital of North Norway. The results confirmed that interruptions from mobile devices were a problem, especially in surgical theatres, outpatient wards, emergency wards and inpatient rooms. Users in hospitals, especially surgeons and physicians, need a better communication system. Our proposed system would intercept the signals from the existing communication system before they are sent out to the mobile devices. The signals would then be routed through a context-aware system, paired with context information and available rules defined by the doctor, which will decide what to do with the call/page. A single device which integrates both the pager and the phone system, and makes use o... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873609 Mon, 13 Oct 2008 04:00:00 +0100 1873609 http://www.medworm.com/index.php?rid=1873608&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F386%3Frss%3D1 Reliable identification is essential in e-health and telemedicine applications. This necessitates a secure and trustworthy method of communication and collaboration between parties, which depends on common acceptance. This in turn is related to privacy and ethical matters. Different technologies, including biometrics and RFID, allow high levels of security and safety in identifying both human beings and goods. However, the diffusion of standards relating to identity management in e-health is far from satisfactory. In order to support standardization in e-health, the European Commission funded the BioHealth project. This project has proved to be useful in promoting standards and creating awareness among the stakeholders. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873608 Mon, 13 Oct 2008 04:00:00 +0100 1873608 http://www.medworm.com/index.php?rid=1873607&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F381%3Frss%3D1 E-health based on mobile wireless networks is called mobile e-health. Mobile e-health can facilitate computer-supported cooperative work, which encompasses tasks from email and instant messaging to wireless information sharing through broadband and telecommunication networks. In the development of cooperative management systems, the concept of ‘awareness level’ has been introduced. This is based on factors such as the location and actions of the user involved. Mobile e-health can help to achieve cooperation by providing the right awareness levels at the right time. The improved awareness levels allow health professionals to provide patient care with better quality and efficiency. Mobile e-health systems have the potential to take over the mundane tasks of the doctor so that bet... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873607 Mon, 13 Oct 2008 04:00:00 +0100 1873607 http://www.medworm.com/index.php?rid=1873606&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F377%3Frss%3D1 Over a period of five months we observed teleconsultations between general practitioners (GPs) in community care and specialists in hospitals in two Norwegian health regions (A and B). In total, 47 teleconsultations between GPs and specialists were recorded. In region A, teleconsultations were organized when needed to discuss specific medical problems. In region B, teleconsultations took place during the specialists' daily morning meeting. The teleconsultations lasted for 5–40 min. There were three categories of talk. In the first two there was information exchange for patient updates and practical organization of the service. The third category, consultation, was the communicative process in which the GP and the specialist engaged in collaborative work, primarily discussing medical ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873606 Mon, 13 Oct 2008 04:00:00 +0100 1873606 http://www.medworm.com/index.php?rid=1873605&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F372%3Frss%3D1 We have designed and constructed force measurement equipment to assess hand–finger function in pressing tasks. The equipment was used for monitoring the follow-up of five hand-transplanted subjects. Interactive software was integrated into the instrument to monitor the functionality of the hand and fingers during exercises in realtime. The interactive software included biofeedback to provide realtime quantitative responses for the patient and the therapist. Acceptance of the system was investigated with patients and therapists: the system was found to be user-friendly and effective; it was practical both for patients and therapists. The system could be used in a telerehabilitation centre or in a patient's home. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873605 Mon, 13 Oct 2008 04:00:00 +0100 1873605 http://www.medworm.com/index.php?rid=1873604&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F368%3Frss%3D1 We conducted a qualitative study of the system for contagious disease surveillance in Norway. Semi-structured interviews were held with five general practitioners (GPs), including one person responsible for informing GPs in their region about potentially serious disease outbreaks. The interviews suggested that the existing system had several limitations, making it of little relevance to local epidemics or daily medical practice. Specifically, it was difficult and time-consuming for physicians to locate relevant information, and there was a substantial delay between reported diagnoses and eventual feedback about outbreaks. This resulted in information that was too old to be of value. The interviews also investigated design matters related to future realtime disease surveillance systems. The... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873604 Mon, 13 Oct 2008 04:00:00 +0100 1873604 http://www.medworm.com/index.php?rid=1873603&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F363%3Frss%3D1 We propose a technique in which elderly people can be monitored non-intrusively. The information is kept in an ‘active’ health record which becomes alive when attention or action is necessary concerning the condition of the elderly person. The proposed system consists of three main components: a sensor/actor loop, sensor records and associated active services, and a Grid middleware platform. Information is captured in realtime within a collaborative health-care Grid. The Grid connects elderly people, caregivers and medical service providers in ways that reduce unnecessary calls on expensive medical services through an intermediate local service centre (which can be virtual) assisted with Internet communications and monitoring technologies. The proposal should support preventive... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873603 Mon, 13 Oct 2008 04:00:00 +0100 1873603 http://www.medworm.com/index.php?rid=1873602&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F359%3Frss%3D1 The introduction of electronic referrals in Norway started in 1996, when the first standard for an electronic referral was developed. Subsequent implementations of electronic health record (EHR) systems have been tested by a national testing and approval service. Almost all the Norwegian EHR systems comply with the recommended standards, but the volume of electronic referrals remains low: only 8200 referrals were sent electronically in September 2007. In comparison, 125,000 electronic discharge summaries were sent during the same month. There are four elements that need to be in place before smooth communication can occur between the EHRs of the hospitals and the general practitioners. First, the regional health authorities must have a strategy for electronic cooperation. Second, various t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873602 Mon, 13 Oct 2008 04:00:00 +0100 1873602 http://www.medworm.com/index.php?rid=1873601&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F354%3Frss%3D1 We have developed a method for extracting the number of trial participants from abstracts describing randomized controlled trials (RCTs); the number of trial participants may be an indication of the reliability of the trial. The method depends on statistical natural language processing. The number of interest was determined by a binary supervised classification based on a support vector machine algorithm. The method was trialled on 223 abstracts in which the number of trial participants was identified manually to act as a gold standard. Automatic extraction resulted in 2 false-positive and 19 false-negative classifications. The algorithm was capable of extracting the number of trial participants with an accuracy of 97% and an F-measure of 0.84. The algorithm may improve the selection of re... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873601 Mon, 13 Oct 2008 04:00:00 +0100 1873601 http://www.medworm.com/index.php?rid=1873600&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F349%3Frss%3D1 We have studied the use of video-mediated technology to facilitate multidisciplinary meetings where consensus is reached about the diagnosis and treatment of patients. The meetings involved 2–5 sites, with 1–20 participants from each site, and concerned patients with severe diseases in the upper abdomen. During a period of about one year we conducted observations and interviews at the Karolinska hospital and some of the local hospitals. Eight video-mediated consensus meetings were video-recorded and transcribed. The audio and the radiology images presented during the meetings were considered to be most important; video was not critical for the consensus meeting itself, but contributed to a feeling of awareness and social presence. We conclude that video-mediated consensus meeti... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873600 Mon, 13 Oct 2008 04:00:00 +0100 1873600 http://www.medworm.com/index.php?rid=1873599&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F345%3Frss%3D1 Step counting is an important index of motion in telemonitoring. We have developed a wearable system based on a device with a force-sensing resistor. This is affixed at the calf gastrocnemius level to monitor the muscular expansion related to the gait. The gastrocnemius expansion measurement unit (GEMU) was tested on three subjects at Level 2 of the Tinetti test of unbalance, who performed five repetitions of 100 steps at two different speeds (normal and slow). The mean error was less than 0.5%. The GEMU also performed better than an accelerometer unit, which is normally considered to be the best solution for this disability. The system can be integrated into a routine home-care application based on a GSM home-care unit. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873599 Mon, 13 Oct 2008 04:00:00 +0100 1873599 http://www.medworm.com/index.php?rid=1873598&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F342%3Frss%3D1 We investigated a novel tool for assessing image degradation in tele-echocardiography. Different video recordings from an echocardiographic examination were transmitted using commercial videoconferencing equipment via a local area network. Different compression schemes were selected, ranging from MPEG 1 to MPEG 4, with transmission at different bit rates ranging from 1.0 to 4.5 Mbit/s. Three methods were used to compare the transmitted and received video sequences: the peak signal to noise ratio, the Double Stimulus Impairment Scale (DSIS) and the National Telecommunication and Information Administration Virtual Quality Metric (VQM). The results showed that the most useful grading procedure was the subjective DSIS. There was a high correlation between the DSIS results and the VQM. The VQM ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873598 Mon, 13 Oct 2008 04:00:00 +0100 1873598 http://www.medworm.com/index.php?rid=1873597&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F338%3Frss%3D1 We have investigated the changes in the workflow of the cytologist due to the introduction of telepathology. These changes occur in two stages. The first is the use of telepathology as a support methodology using external providers (i.e. outside the hospital) to digitize the slides. The second is the use of telepathology in routine laboratory operations using an internal scanner to digitize the slides. To improve courses in the Master of Cytology programme at the University of La Sapienza, new learning modules were designed, which were made available via the wide area computer network to familiarize students with the new technologies. The new methodologies had three benefits. The first was the high level of knowledge for the student. The second was the cost advantage to the student, who di... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873597 Mon, 13 Oct 2008 04:00:00 +0100 1873597 http://www.medworm.com/index.php?rid=1873596&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F333%3Frss%3D1 There are many home telecare technologies which have been developed specifically for chronic diseases and there are some more generic technologies that could be used as well. For home telecare, the equipment must be certified, the operational routines must be reformed, the infrastructure must be in place, the market must be prepared, the health authorities must be convinced that the system will work and the cost-effectiveness must be evaluated. Organizational and societal changes, such as cost reduction policies and an aging population, are the main driving forces for the development of home telecare, especially for elderly patients. At the moment there is no holistic model for scientific evaluation from different perspectives (e.g. clinical, legal, technical). We suggest that more researc... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873596 Mon, 13 Oct 2008 04:00:00 +0100 1873596 http://www.medworm.com/index.php?rid=1873595&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F7%2F329%3Frss%3D1 We performed two cycles of laboratory-based usability testing of three food registration prototypes for people with diabetes. The design concepts were a commercial web application, various smartphones and a mobile phone photo blogging approach. Six adults with Type 1 diabetes and three adults with Type 2 diabetes participated in the usability tests. The results provided five distinct implications for devices for the future dietary management support of people with diabetes. Study participants valued many of the features offered by the three systems that were tested, although the usability tests also revealed several opportunities to enhance their design. Our findings suggest that further development is justified of mobile dietary and nutritional support for individuals living with diabetes... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1873595 Mon, 13 Oct 2008 04:00:00 +0100 1873595 http://www.medworm.com/index.php?rid=1769652&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F326%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769652 Fri, 05 Sep 2008 04:00:00 +0100 1769652 http://www.medworm.com/index.php?rid=1769651&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F322%3Frss%3D1 We examined the use of telemedicine for improving access to care in a work-site clinic. A prospective study of 100 patients was conducted over a four-month period in a work site that housed 700 employees. Sinusitis (10 visits), upper respiratory tract infections (9 visits), otitis media (9 visits), hypertension (9 visits) and back pain (8 visits) were the most common reasons for the visits. In 99 visits, clinicians were of the opinion that the telemedicine visit felt similar to a face-to-face visit. For most of the visits (67), patients strongly agreed or agreed that telemedicine had a positive effect on their relationship with the health-care provider. The otoscope, microscope and stethoscope telemedicine peripherals were important in aiding diagnosis (and ruling out other causes) in abou... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769651 Fri, 05 Sep 2008 04:00:00 +0100 1769651 http://www.medworm.com/index.php?rid=1769650&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F315%3Frss%3D1 As part of the preparation for a randomized controlled trial, we conducted a pilot study to investigate the feasibility of providing videotelephone-based support to a sample of families (n = 8) with a child diagnosed with cancer, returning home for the first time after diagnosis and initial treatment. Seven of these families received support via videotelephone over a three-month period. Twenty videotelephone calls were made totalling 400 minutes (median 21 min, IQR 16–24). All videotelephone calls involved the specialist nurse providing support to mothers (85%) or fathers (15%) and involved communicating directly with the patient in most of the calls (55%). Social workers were involved in three calls (15%). All families expressed satisfaction with services delivered in this way. Ther... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769650 Fri, 05 Sep 2008 04:00:00 +0100 1769650 http://www.medworm.com/index.php?rid=1769649&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F309%3Frss%3D1 We evaluated the effect of telemedicine compared with traditional telephone conversations when evaluating patients for aeromedical retrieval. A convenience sample of consecutive patients referred for retrieval from Palm Island over a six-month period was compared retrospectively with patients referred during the previous six months. There was a significant difference (P = 0.014) in the number of patients referred in the telemedicine period (113) compared to the previous six months (78), which may have been a seasonal fluctuation. There was a smaller proportion of aeromedical retrievals in the telemedicine period (78%) compared to the control period (92%), P = 0.009. Other significant differences between the telemedicine and control period included a larger proportion of patients not transf... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769649 Fri, 05 Sep 2008 04:00:00 +0100 1769649 http://www.medworm.com/index.php?rid=1769648&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F306%3Frss%3D1 We studied the perceptions of primary care providers (PCPs) about the telemedicine intervention in a trial of telemedicine for management of diabetes in medically under-served areas of New York State. A survey was mailed to 206 rural and 159 urban PCPs. The response rates were 25% and 22%, respectively. Eighty percent of respondents believed that a diabetes telemedicine case management system would help their practice. An overall satisfaction score (possible range 0–80) suggested good acceptability (mean 66, SD 12). In multiple linear regression, the rural location and younger age of the PCPs were independent predictors of higher satisfaction (both P < 0.01). Within-PCP comparisons showed a higher perceived impact on patients, as compared to impact on PCP practices (P < 0.001).... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769648 Fri, 05 Sep 2008 04:00:00 +0100 1769648 http://www.medworm.com/index.php?rid=1769647&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F300%3Frss%3D1 We studied the effects of home telemonitoring in elderly patients with congestive heart failure (CHF) on mortality and rate of hospitalization, compliance with treatment, quality of life and costs of CHF management, by comparison with a group receiving usual care. Fifty-seven elderly CHF patients were randomized to standard care or to home telemonitoring-based care and followed for 12 months. In the subjects who were monitored, weekly reports on their clinical status were obtained and their management was modified accordingly. Home telemonitoring was associated with improvements in the composite endpoint of mortality and rate of hospitalizations (P = 0.006), a better compliance with therapy, more frequent use of beta-blockers and statins, lower total cholesterol level and a better reported... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769647 Fri, 05 Sep 2008 04:00:00 +0100 1769647 http://www.medworm.com/index.php?rid=1769646&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F295%3Frss%3D1 We studied a new teamwork-based teleconsultation model for treating patients with diabetes, where a specialist in diabetes care, a diabetes nurse and a patient attended by videoconference. The study series consisted of all the patients (n = 101) at three health centres in northern Finland whose care was provided by a single physician at a remote diabetes clinic. A total of 101 patients with diabetes (19 of type 1 and 82 of type 2) were studied at baseline and at 10–14 months after the first consultation. Mean HbA1c was 8.0% at baseline and 7.6% at follow-up (P = 0.007). The proportion of patients with poor glycaemic control decreased from 32% to 13%. Mean LDL cholesterol was 3.3 mmol/L at baseline and 2.7 mmol/L at follow-up (P < 0.001). The percentage of patients with optimum lip... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769646 Fri, 05 Sep 2008 04:00:00 +0100 1769646 http://www.medworm.com/index.php?rid=1769645&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F290%3Frss%3D1 We conducted a multicentre study in five Italian hospitals to assess the feasibility of a remote monitoring service for the follow-up of implanted cardiac devices. The system was designed to monitor device performance as well as physiological aspects of the patient's condition. Sixty-seven patients (mean age 64 years) affected by chronic heart failure and with a biventricular implantable cardioverter defibrillator for cardiac re-synchronization therapy (CRT-D) were enrolled for a three-month observation period. A total of 267 device recordings were transmitted through the ordinary telephone network, with a success rate of 99%. The telemonitoring service was more efficient than conventional face-to-face follow-up in terms of the time savings: both for physicians (4.7 minutes versus 15 minut... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769645 Fri, 05 Sep 2008 04:00:00 +0100 1769645 http://www.medworm.com/index.php?rid=1769644&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F6%2F285%3Frss%3D1 We surveyed health service providers in Namibia to find out how they used information and communication technologies (ICTs) to deliver health services to their patients. A structured questionnaire was administered to 21 health service providers in two regions of the country (one urban, one rural). There was overwhelming consensus among the health service providers that ICTs were very important, especially for medical services (100%). Ninety-one percent of health service providers viewed ICT as helping them to interact with other providers in other health institutions. The most commonly used ICT was the telephone, which was used in the admission areas of most health institutions (36%); the next most commonly used ICT was the PC (23%). The most commonly used channels for communication with p... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=1769644 Fri, 05 Sep 2008 04:00:00 +0100 1769644