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. Wed, 08 Feb 2012 18:41:26 +0100 http://www.medworm.com/index.php?rid=5610547&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F59%3Frss%3D1 We reviewed our experience with the Tanzanian Telemedicine Network in supporting paediatric care at 40 small, rural hospitals in the country. The network began operating in 2008. Store and forward telemedicine was provided via the open source software iPath. The 33 volunteer consultants were based in several countries, although most of them had practical experience in Tanzania. During the first three years of network operation there were 533 referrals. There were 159 paediatric cases (median age five years). Three paediatric specialists provided most consultations (64%), but other specialists provided recommendations when required. The response time was usually less than two days (median 6 h; inter-quartile range 2–24 h). A precise recommendation was not always provided, but since al... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610547 Fri, 20 Jan 2012 05:00:00 +0100 5610547 http://www.medworm.com/index.php?rid=5610546&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F54%3Frss%3D1 We evaluated the diagnostic quality of first-trimester ultrasound images transmitted in realtime using low-cost telecommunications. A prospective sample of fetal ultrasound images from 11 weeks to 13 weeks and six days of pregnancy was obtained from pregnant women over 18 years old. The examinations were transmitted in realtime to three independent examiners who carried out a qualitative assessment based on parameters established by the Fetal Medicine Foundation. All fetal structures could be viewed and the quality of images received by the examiners was considered normal. There were significant differences for crown-rump length and nuchal translucency in the transmitted images but the loss in definition was acceptable. Thus the quality of images transmitted via the Internet through the us... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610546 Fri, 20 Jan 2012 05:00:00 +0100 5610546 http://www.medworm.com/index.php?rid=5610545&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F47%3Frss%3D1 A literature review was conducted to identify research into multiple-contact (i.e. extended) telemedicine interventions for substance-use disorder. The goals were: (1) to describe the methodology used to evaluate telemedicine interventions; (2) to identify the range of interventions which have been formally evaluated; and (3) to summarize the findings. Fourteen databases and Google Scholar were searched, as well as bibliographies of relevant papers and online conference abstracts. There were 50 studies which met the inclusion criteria, of which 50% were randomized controlled trials. The studies most frequently reported the effect on substance use and 61% of those findings fully supported telemedicine interventions. Although the studies reported persistent challenges in sustaining participa... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610545 Fri, 20 Jan 2012 05:00:00 +0100 5610545 http://www.medworm.com/index.php?rid=5610544&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F42%3Frss%3D1 We developed an instrument to measure the satisfaction of lung transplant recipients with home monitoring. The survey comprised 15 items, each scored on a five-point Likert-type scale (from strongly disagree to strongly agree). Three additional free-text items enabled subjects to provide comments. The survey had a scoring range of 15–75. In a test group of 43 patients, the internal consistency (Cronbach's alpha) was 0.93 overall for all questions. The intra-class correlation for scores from the same 27 patients approximately 2.5 months apart was 0.77 for the total score. The survey was used to evaluate subject satisfaction in a randomized controlled trial of a computerized algorithm for triaging lung transplant recipients. Surveys were mailed to 50 study subjects and were returned by... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610544 Fri, 20 Jan 2012 05:00:00 +0100 5610544 http://www.medworm.com/index.php?rid=5610543&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F37%3Frss%3D1 We reviewed web-based interventions for overweight and obesity prevention. A literature search was conducted using seven electronic databases. Manually searched articles were also included. Thirty studies fulfilled the inclusion criteria. Of these, 13 studied physical activity, eight studied dietary practices and nine studied a combination of physical activity and dietary practice. Twenty-eight of the studies (93%) reported positive changes in moderate to vigorous physical activity level, fruit and vegetable intake and psychological factors. A meta-analysis showed there were improvements, though not significant, in fruit and vegetable consumption (standardised mean difference, SMD = 0.61; 95% CI =–0.13 to 1.35) and physical activity (SMD = 0.15; 95% CI =–0.06 to 0.35). The revi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610543 Fri, 20 Jan 2012 05:00:00 +0100 5610543 http://www.medworm.com/index.php?rid=5610542&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F32%3Frss%3D1 We assessed the feasibility of using a photographic foot imaging device (PFID) as a tele-monitoring tool in the home environment of patients with diabetes who were at high risk of ulceration. Images of the plantar foot were taken three times a week over a period of four months in the home of 22 high-risk patients. The images were remotely assessed by a diabetic foot specialist. At the end of the study, 12% of images were missing, mainly due to modem or server failures (66%), or non-adherence (11%). All three referrals for diagnosed ulcers and 31 of 32 referrals for abundant callus resulted in treatment. Health-related quality of life (EQ-5D visual analogue scale), increased from 7.5 at baseline to 7.9 at end of follow-up, but not significantly. Mean scores on a visual analogue scale for di... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610542 Fri, 20 Jan 2012 05:00:00 +0100 5610542 http://www.medworm.com/index.php?rid=5610541&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F26%3Frss%3D1 We developed a new type of mobile teleradiology system using an ultramobile PC (UMPC) for web-based remote viewing over a wireless network. We assessed the diagnostic performance of this system for abdominal CT interpretation. Performance was compared with an emergency department clinical monitor using a DICOM viewer. A total of 100 abdominal CT examinations were presented to four observers. There were 56 examinations showing appendicitis and 44 which were normal. The observers viewed the images using a UMPC display and an LCD monitor and rated each examination on a five-point scale. Receiver operating characteristics (ROC) analysis was used to test for differences. The sensitivity and specificities of all observers were similarly high. The average area under the ROC curve for readings per... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610541 Fri, 20 Jan 2012 05:00:00 +0100 5610541 http://www.medworm.com/index.php?rid=5610540&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F20%3Frss%3D1 We conducted a feasibility study of a 12-week walking intervention administered through an Interactive Voice Response (IVR) system and mobile phones. We also examined the added benefit of a human coach. Post-menopausal women (n = 71) were given a daily-steps goal, which they monitored using a pedometer. Each day, they answered an automated call from the IVR system to their mobile phone and provided assessments of walking goals and mood. Every evening, they called the IVR system to report their steps, answered a brief questionnaire and received a message with a helpful hint. Participants took less time to complete a one-mile walk after the intervention, compared to baseline (0.77 min, SE = 0.22, P < 0.001). In addition, a significant loss in body weight (0.93 kg, SE = 0.31) and body-mass... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610540 Fri, 20 Jan 2012 05:00:00 +0100 5610540 http://www.medworm.com/index.php?rid=5610539&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F17%3Frss%3D1 In 2007, the VA Connecticut Healthcare System began a home electronic messaging programme for mental health patients. During the first two years, 76 patients with diagnoses of schizophrenia, post traumatic stress disorder, depression and substance-use disorders received a home messaging device, which was connected via an ordinary telephone line. There were daily questions, which were based on disease management protocols, and included alerts, data and educational components. Patient data were sent to a nurse practitioner each day for triage and follow-up. Patients used the device for at least six months. In the six months prior to enrolment, 42 patients were hospitalized for 46 admissions. In the following six months, six patients were hospitalized for nine admissions (P < 0.0001). In t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610539 Fri, 20 Jan 2012 05:00:00 +0100 5610539 http://www.medworm.com/index.php?rid=5610538&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F13%3Frss%3D1 We examined the feasibility of telemedicine clinics for patients with chronic kidney disease (not on dialysis) for a period of 18 months. Telemedicine clinics were run at two peripheral hospitals about 100 km from the specialist hospital in Ottawa. A total of 115 questionnaires were completed by patients and providers during the period March 2009 to July 2009. The participants were overwhelmingly positive and wanted telemedicine to continue. Some patients indicated they would discontinue follow-up care if they had to travel to Ottawa. The analysis of staff hours worked showed almost no increase following the introduction of telemedicine. Telemedicine is therefore feasible for follow-up care of remote chronic kidney disease patients. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610538 Fri, 20 Jan 2012 05:00:00 +0100 5610538 http://www.medworm.com/index.php?rid=5610537&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F7%3Frss%3D1 We conducted a pilot study to assess the feasibility of telecytology as a diagnostic tool in difficult cases originating from a hospital in East Africa. Forty cytology cases considered difficult by a referring pathologist were posted on a telepathology website. Six pathologists independently assessed the static images. Telecytology diagnoses were compared with the consensus diagnoses made on glass slides and also with the histogical diagnoses when available. The diagnostic agreement of the six pathologists was 71–93% and tended to be higher for pathologists with more experience. Reasons for discordance included poor image quality, presence of diagnostic cells in thick areas of smears, sampling bias and screening errors. The consensus diagnoses agreed with histological diagnoses in al... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610537 Fri, 20 Jan 2012 05:00:00 +0100 5610537 http://www.medworm.com/index.php?rid=5610536&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F18%2F1%2F1%3Frss%3D1 A systematic review of studies of the cost-effectiveness of telemedicine and telecare was undertaken from 1990 until September 2010. Twelve databases were searched, using economic evaluation terms combined with telemedicine terms. The search identified 80 studies which were classed as full economic evaluations; the majority (38) were cost-consequence analyses. There were 15 cost-effectiveness analyses (CEA) and seven cost-utility analyses (CUA). In the period January 2004 to September 2010 there were 47 studies. Eleven were CEA and seven were CUA. Economic tools are being increasingly used for telemedicine and telecare studies, although better reporting of the methodologies and findings of the economic evaluations is required. Nonetheless, the results of the review were consistent with pre... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5610536 Fri, 20 Jan 2012 05:00:00 +0100 5610536 http://www.medworm.com/index.php?rid=5477546&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F459%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477546 Tue, 06 Dec 2011 05:00:00 +0100 5477546 http://www.medworm.com/index.php?rid=5477545&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F451%3Frss%3D1 In one-to-one telephone coaching, the patient receives regular telephone calls from a health professional. We have reviewed the evidence for one-to-one telephone coaching. Following a literature search we retrieved 41 articles which reported on the development and the efficacy of 34 separate telephone coaching interventions for LTC management. Telephone coaching for LTC management has only occurred in the last ten years, is becoming increasingly prevalent, and is dominated by interventions in North America and Europe. Twenty-seven (79%) of the studies reported on randomised designs involving at least one control or comparison group/condition. Of the 34 interventions reviewed, 17 (50%) were aimed at diabetes management and 17 (50%) were designed to manage chronic cardiovascular conditions. ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477545 Tue, 06 Dec 2011 05:00:00 +0100 5477545 http://www.medworm.com/index.php?rid=5477544&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F446%3Frss%3D1 We assessed the effect of a kiosk educational module on HIV screening rates and patient knowledge about HIV testing. The evaluation was performed in a walk-in clinic offering routine HIV screening. During alternating two-week periods, patients were referred either to view a kiosk-based, educational module prior to receiving usual care, or the kiosk module was turned off and no alterations to care processes were made. The primary outcome was HIV testing rate. The secondary outcome was knowledge about HIV rapid screening, as measured with a questionnaire. There were 71 patients in the kiosk periods and 79 patients in the usual-care periods. The overall HIV testing rate was 41%. The kiosk period was not associated with greater odds of HIV testing (OR 0.7; 95% CI: 0.4–1.4). In 44 patient... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477544 Tue, 06 Dec 2011 05:00:00 +0100 5477544 http://www.medworm.com/index.php?rid=5477543&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F441%3Frss%3D1 We investigated the factors that affected the use of a realtime telemetry system (RTS) in emergency ambulances. During the study, a total of 7144 patients were transported to a hospital in the city of Wonju via ambulance. In 466 of these cases (7%), the Emergency Medical Technician (EMT) used the RTS. Based on the Elaboration Likelihood Model, we extracted variables from the run records, such as the qualifications of the EMT, level of the patient's consciousness and the transport time. The results indicated that EMTs with higher levels of expertise were more likely to use the RTS when the level of patient consciousness was low, regardless of transport time. Conversely, EMTs with low levels of expertise were more likely to use the RTS when the transport time from scene to hospital was long ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477543 Tue, 06 Dec 2011 05:00:00 +0100 5477543 http://www.medworm.com/index.php?rid=5477542&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F437%3Frss%3D1 We calculated the incremental cost per quit of a telephone care intervention versus usual care using the provider's perspective. The study population was 819 smokers at five US Veterans Affairs (VA) primary care clinics. They enrolled in the clinical trial between June 2001 and December 2002. After 12 months the participants were assessed for short- and long-term abstinence over the previous six months. VA records were used to extract the cost of VA services over 12 months, and the cost of care purchased by the VA from others. Intervention costs were derived through micro-costing. On average, the intervention cost $142 per person, excluding medications. The average cost of all VA-funded medical care during the study period was $8959 in the telephone-care arm and $7939 in the usual care arm... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477542 Tue, 06 Dec 2011 05:00:00 +0100 5477542 http://www.medworm.com/index.php?rid=5477541&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F432%3Frss%3D1 We compared the effectiveness of two media (text messages and pamphlets) in imparting health education to mothers of preschool children. Mothers and their children were randomized into two groups. There were 72 mothers and their children in the pamphlet group and 71 in the text message group. The mothers were given health education by one of the two modes for four weeks. Knowledge, attitude and practices of the mothers were assessed by a questionnaire pre- and post-intervention. Visible plaque scores of their children were also recorded pre- and post-intervention. There were significant improvements in knowledge (P < 0.001), attitude (P < 0.001) and practices (P < 0.001) in both groups. There was also a significant reduction in visible plaque scores (P < 0.001) in both groups. ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477541 Tue, 06 Dec 2011 05:00:00 +0100 5477541 http://www.medworm.com/index.php?rid=5477540&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F427%3Frss%3D1 We examined the decisions made about transfer of patients with minor injuries, when telemedicine support was provided to the remote nurses in two different ways: the telemedicine doctor either used a video link, or a telephone call with viewing of digital X-ray images (a low resolution version of Picture Archiving and Communications Systems [PACS]). A quasi-randomized study design was used, with a panel of 20 emergency medicine doctors who independently reviewed previously-stored consultations using the two modalities. In total, 60 case reviews were conducted during five sessions, representing 33 different cases from the routine workload of Minor Treatment Centres in Scotland. More experienced doctors transferred fewer patients than less experienced doctors. The proportion of patients tran... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477540 Tue, 06 Dec 2011 05:00:00 +0100 5477540 http://www.medworm.com/index.php?rid=5477539&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F421%3Frss%3D1 We adapted a commercial bathroom scale in order to acquire the raw data from the weight sensors and then to send them to a server via a mobile phone. We investigated the usability and acceptability of the device in a long-term experiment with 22 elderly users that produced more than 5000 weight recordings. Four basic variables were extracted from the vertical force measurements and the stabilogram. The technology was accepted unreservedly, presumably because it did not differ from devices usually encountered in the home. The quantitative results showed a high variability of day-to-day measurement, which was countered by taking a moving average. A balance index was able to identify changes in balance over time. The preliminary results appear promising. (Source: Journal of Telemedicine and T... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477539 Tue, 06 Dec 2011 05:00:00 +0100 5477539 http://www.medworm.com/index.php?rid=5477538&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F417%3Frss%3D1 Although it has been assumed that telephone triage can directly benefit patients by facilitating early diagnosis and treatment, this potential benefit has not been well documented. Using appendicitis cases ascertained from claims data, we compared telephone triage recommendations with what the callers originally intended to do. Over a two-year period, there were 20,230 calls to a telephone triage centre in the US where insurance information was available. Of these, 12,709 calls (63%) had insurance claims made within seven days of the call. Among these calls, 46 had a diagnosis of appendicitis. In 72% of calls concerning appendicitis, the telephone triage recommendation was for a more rapid evaluation than the caller originally intended (P < 0.0001). In 91% of the appendicitis cases, tri... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477538 Tue, 06 Dec 2011 05:00:00 +0100 5477538 http://www.medworm.com/index.php?rid=5477537&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F412%3Frss%3D1 In our previous study, in 1997, we evaluated the cost of teleconsultations in a primary care centre compared with the cost of the conventional alternative, travelling to the hospital. The results showed that teleconsultations were cheaper than patient travel when the annual workload was more than 110 patients in ophthalmology and 115 patients in dermatology. Using the same method of analysis for 2009 data showed that cost savings would occur if the annual workload was 20 patients in ophthalmology and 17 patients in dermatology. The main differences between the two studies are the reduced cost of the technology (which was based on PCs in 2009) and the increased cost of staff. Both studies show that teleconsultations can be cost-effective in a relatively small health centre. The cost of tech... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477537 Tue, 06 Dec 2011 05:00:00 +0100 5477537 http://www.medworm.com/index.php?rid=5477536&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F8%2F403%3Frss%3D1 We conducted a systematic review of video communication in home care to provide insight into the ratio between the costs and financial benefits (i.e. cost savings). Four databases (PUBMED, EMBASE, COCHRANE LIBRARY, CINAHL) were searched for studies on video communication for patients living at home (up to December 2009). Studies were only included when data about the costs of video communication as well as the financial benefits were presented. The methodological quality of the included studies was assessed. Nine studies, mainly conducted in the US, met the inclusion criteria. The methodological quality was poor, except for one study. Most studies (8 of the 9) did not demonstrate that the financial benefits were significantly greater than the costs of video communication. One study –... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5477536 Tue, 06 Dec 2011 05:00:00 +0100 5477536 http://www.medworm.com/index.php?rid=5297856&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F397%3Frss%3D1 We investigated satisfaction with a Swedish telenursing service and the health-care-seeking behaviour among callers who received a less urgent level of health care than they expected. A postal questionnaire was sent to a random selection of callers (n = 273) to Swedish Healthcare Direct in October 2008. The ‘cases’ were 18 callers where the telenurse recommended a lower level of health care than the caller expected and who were not in complete agreement with the nurse. The ‘controls’ were 22 callers who either received a lower recommendation, or were in disagreement with the recommendation. There were no differences between cases, controls and other callers regarding background factors or the telenurse classification of emergency. However, both cases and controls co... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297856 Fri, 07 Oct 2011 04:00:00 +0100 5297856 http://www.medworm.com/index.php?rid=5297855&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F392%3Frss%3D1 We investigated community pharmacists' management of skin conditions in order to identify a need for further educational support. Twenty community pharmacists in Queensland completed a questionnaire regarding their management of skin conditions and their opinions regarding the usefulness of a potential teledermatology service. The pharmacists' accuracy in managing skin conditions was tested by a dermatologist who reviewed the pharmacists' advice in 33 cases obtained by 14 pharmacists. Overall agreement between the pharmacists and the dermatologist was moderate, with a kappa statistic of 0.58 (P < 0.05) The uptake of a potential teledermatology service was investigated in one pharmacy over one month. Five patients were offered the teledermatology service. Of these, two patients consented... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297855 Fri, 07 Oct 2011 04:00:00 +0100 5297855 http://www.medworm.com/index.php?rid=5297854&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F387%3Frss%3D1 We investigated the effect of text message reminders about medication administration. The study concerned children with cystic fibrosis. We provided 20 children (aged 5–12 years) with pagers that they could customize. For the first two weeks, we sent friendly text messages (non-reminder content) near medication times to acquaint them with the use of the pager. For the second two weeks, we sent messages reminding children to take their medications. The parents completed a survey to assess the child's overall use of the pager and degree of participation in medication management. Sixteen out of 20 children completed the study. Of these, 14 children (88%) were able to help notify parents when medications were due. Children as young as seven years of age may be able to receive reminders a... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297854 Fri, 07 Oct 2011 04:00:00 +0100 5297854 http://www.medworm.com/index.php?rid=5297853&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F382%3Frss%3D1 During an eight-year period, 358 patients with chronic heart failure (CHF) were enrolled in a six-month home-based telemanagement (HBT) programme. The efficacy of the programme was evaluated in two four-year periods, based on changes in clinical, functional, Quality of Life (QoL) status and rate of hospital readmission. The New York Heart Association (NYHA) class and the number of patients with comorbidities increased significantly in the second period, while the number of patients with beta-blockers decreased significantly (P < 0.01). Following the HBT programme, non-cardiovascular hospital readmission rate and all-cause readmission rate increased by 11% (P < 0.03) and 13% (P < 0.05), respectively. On re-evaluation after six months (238 patients) there was a general improvement i... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297853 Fri, 07 Oct 2011 04:00:00 +0100 5297853 http://www.medworm.com/index.php?rid=5297852&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F378%3Frss%3D1 We conducted a needs assessment to ascertain patients’ interests and preferences for using email reminders (‘E-minders’) to assist in the self-management of their depression. The E-minders would help patients achieve remission by reminding them of their personal strategies for self-management and their personalized sources of support. Once patients had achieved remission, E-minders would be used to remind them of their original symptoms of depression so that they could monitor for recurrence. Results from a focus group with eight patients suggested that patients would be interested in using E-minders. However, they should not be used to replace aspects of treatment but rather to supplement existing depression treatment regimens. (Source: Journal of Telemedicine and Teleca... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297852 Fri, 07 Oct 2011 04:00:00 +0100 5297852 http://www.medworm.com/index.php?rid=5297851&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F371%3Frss%3D1 We evaluated the technical and organisational feasibility of a multifunctional telemedicine system in an emergency medical service (EMS) from the user's perspective. The telemedicine system was designed to transmit vital signs data and 12-lead-ECG data, send still pictures and allow voice communication and video transmission from an ambulance. The data were sent to a teleconsultation centre staffed with EMS physicians (tele-EMS physician). The system was used in 157 EMS missions. The applications were used successfully on 80% of missions for real-time vital signs transmission and on 97% for video transmission. The quality of the transmitted still images (n = 64) was: 23% excellent, 50% good, 17% moderate, 9% rather poor and 0% unusable. The quality of the video streaming (n = 36) was: 33% ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297851 Fri, 07 Oct 2011 04:00:00 +0100 5297851 http://www.medworm.com/index.php?rid=5297850&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F365%3Frss%3D1 We conducted a randomized controlled trial for 12 weeks in patients with type 2 diabetes living in a rural part of Korea. The intervention group (n = 35) was managed by a diabetes centre which provided specialized management mediated by a primary health-care nurse who used a PDA-type blood glucometer with a bar code detector to measure the capillary glucose levels. The control group (n = 36) received usual care. Compared with baseline, HbA1c was significantly reduced at three-month follow-up in the intervention group (8.0% vs. 7.5%; P < 0.01), but not in the control group. Total cholesterol was significantly reduced in the intervention group (10.7 mmol/L vs. 10.4 mmol/L; P = 0.043). Fasting plasma glucose and triglyceride levels were lower at follow-up in both groups, but the difference... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297850 Fri, 07 Oct 2011 04:00:00 +0100 5297850 http://www.medworm.com/index.php?rid=5297849&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F358%3Frss%3D1 Patients failing to attend hospital appointments contribute to inefficient use of resources. We conducted a systematic review of studies providing a reminder to patients by phone, short message service (SMS) or automated phone calls. A PubMed search was conducted to identify articles published after 1999, describing studies of non-attendance at hospital appointments. In addition, we searched the references in the included papers. In total, 29 studies were included in the review. Four had two intervention arms which were treated as independent studies, giving a total of 33 estimates. The papers were analysed by two observers independently. A study quality score was developed and used to weight the data. Weighted means of the absolute and the relative changes in non-attendance were calculate... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297849 Fri, 07 Oct 2011 04:00:00 +0100 5297849 http://www.medworm.com/index.php?rid=5297848&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F350%3Frss%3D1 We conducted a systematic review of studies of observer agreement for medical specialist diagnosis via videoconferencing. The review was based on searches of electronic databases and a hand search of relevant journals and reference lists between 1966 and June 2010. There were 20 studies comparing videoconferencing diagnosis with a non-telemedicine alternative by reporting a measure of agreement. Half of the studies were in the field of dermatology; these studies provided solid support for the reliability of videoconferencing. The other 10 studies were in psychiatry, geriatrics, minor injuries, neurology and rheumatology. Reliability of diagnosis via videoconferencing was confirmed in all studies. In the studies where physical examination was an element of the diagnostic process, results we... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297848 Fri, 07 Oct 2011 04:00:00 +0100 5297848 http://www.medworm.com/index.php?rid=5297847&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F346%3Frss%3D1 In 2009, we established a pilot telehealth service to a sleep laboratory in Garden City, Kansas, approximately 600 km from the Kansas University Medical Center. Videoconferencing was used for polysomnography (PSG) study follow-up, patient monitoring and sleep laboratory medical management. It allowed the sleep specialist to treat patients and collaborate with sleep laboratory personnel from a distance without extensive travel. In the first six months the telemedicine clinic was held on six occasions. There were 18 new patient evaluations and four follow up visits. The most common diagnosis was obstructive sleep apnoea. The videoconferencing equipment and the intraoral camera worked well. Interviewing and examining patients via telemedicine was very similar to doing it in-person. Telemedici... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297847 Fri, 07 Oct 2011 04:00:00 +0100 5297847 http://www.medworm.com/index.php?rid=5297846&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F7%2F341%3Frss%3D1 We evaluated a tele-education programme for primary care staff in Pernambuco State, Brazil. During 2008 and 2009, tele-education sessions occurred four times each week for one hour per day. The topics included public health, child and adolescent health, mental health and nursing. After each session, participants completed an evaluation questionnaire. A total of 73 municipalities and 141 health centres participated in the programme. There were 254 tele-education sessions scheduled during the 20-month study period; of these, 224 sessions were successfully performed and 30 were cancelled. We collected 3504 responses from the satisfaction survey. There was high acceptance of the programme: 97% rated it as excellent or good. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5297846 Fri, 07 Oct 2011 04:00:00 +0100 5297846 http://www.medworm.com/index.php?rid=5163790&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F338%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163790 Thu, 25 Aug 2011 23:00:00 +0100 5163790 http://www.medworm.com/index.php?rid=5163789&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F336%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163789 Thu, 25 Aug 2011 23:00:00 +0100 5163789 http://www.medworm.com/index.php?rid=5163788&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F332%3Frss%3D1 We describe the case of a US veteran from the war in Afghanistan with post-traumatic stress disorder (PTSD). The patient was undergoing treatment at home via telehealth as part of a research trial. In week six, he presented with severe suicidal ideation and required emergency hospitalization. Through a series of immediate enhanced communications (i.e. by videoconference) between the patient, patient's family, treatment team and local resources, the patient's symptoms were assessed to identify suicidality and an intervention was successfully carried out, involving the development of a safety plan and eventual transportation to an inpatient unit at the local Veterans Administration Medical Center, where he was hospitalized for three days. This demonstrates the value of telehealth in identify... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163788 Thu, 25 Aug 2011 23:00:00 +0100 5163788 http://www.medworm.com/index.php?rid=5163787&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F328%3Frss%3D1 We conducted a pilot study of the feasibility of videoconferencing as a mode of neuropsychological assessment in young people (14–30 years) from a rural area of New South Wales experiencing early psychosis. All participants (n = 11) completed assessments both face-to-face and by videoconference at a bandwidth of 384 kbit/s. Assessments included confirmation of diagnosis, quality of life and neurocognitive functioning. There was a strong correlation between modes of assessment for most instruments. Bland-Altman plots indicated that in general the mean difference between face-to-face and videoconference modes of assessment was close to zero with significant bias only evident for general cognitive functioning (WTAR), where videoconferencing produced higher ratings than face-to-face asse... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163787 Thu, 25 Aug 2011 23:00:00 +0100 5163787 http://www.medworm.com/index.php?rid=5163786&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F324%3Frss%3D1 We evaluated an ask-the-doctor service which was set up as one of the accessory services of a health education website in Iran. The study lasted for five months. A total of 500 enquiries were submitted to the question and answer system. Eighty enquiries were excluded because they were duplicated submissions, not replied to by doctors or gave insufficient information for a reply. Most enquirers (33%) were female and aged 21–35 years. The most frequently asked questions were about embarrassing and sensitive topics, particularly on women's health and mental health. The majority of the questions were submitted on behalf of the enquirers themselves, with only 13% asking for others (children, parents, friends). Although there are various problems associated with online consultation, it doe... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163786 Thu, 25 Aug 2011 23:00:00 +0100 5163786 http://www.medworm.com/index.php?rid=5163785&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F318%3Frss%3D1 We evaluated a mobile phone application (Nutricam) for recording dietary intake. It allowed users to capture a photograph of food items before consumption and store a voice recording to explain the contents of the photograph. This information was then sent to a website where it was analysed by a dietitian. Ten adults with type 2 diabetes (BMI 24.1–47.9 kg/m2) recorded their intake over a three-day period using both Nutricam and a written food diary. Compared to the food diary, energy intake was under-recorded by 649 kJ (SD 810) using the mobile phone method. However, there was no trend in the difference between dietary assessment methods at levels of low or high energy intake. All subjects reported that the mobile phone system was easy to use. Six subjects found that the time taken t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163785 Thu, 25 Aug 2011 23:00:00 +0100 5163785 http://www.medworm.com/index.php?rid=5163784&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F313%3Frss%3D1 We investigated the effects of the introduction of mobile computing on the quality of home care nursing practice in Québec. The software, which structured and organized the nursing activities in patients' homes, was installed sequentially in nine community health centres. The completeness of the nursing notes was compared in 77 paper records (pre-implementation) and 73 electronic records (post-implementation). Overall, the introduction of the software was associated with an improvement in the completeness of the nursing notes. All 137 nurse users were asked to complete a structured questionnaire. A total of 101 completed questionnaires were returned (74% response rate). Overall, the nurses reported a very high level of satisfaction with the quality of clinical information collected.... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163784 Thu, 25 Aug 2011 23:00:00 +0100 5163784 http://www.medworm.com/index.php?rid=5163783&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F308%3Frss%3D1 Smartphone applications (or apps) are becoming increasingly popular. The lack of regulation or guidance for health-related apps means that the validity and reliability of their content is unknown. We have conducted a review of available apps relating to the generic condition of pain. The official application stores for five major smartphone platforms were searched: iPhone, Android, Blackberry, Nokia/Symbian and Windows Mobile. Apps were included if they reported a focus on pain education, management or relief, and were not solely aimed at health-care professionals (HCPs). A total of 111 apps met the inclusion criteria. The majority of apps reviewed claimed some information provision or electronic manual component. Diary tracking of pain variables was also a common feature. There was a low ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163783 Thu, 25 Aug 2011 23:00:00 +0100 5163783 http://www.medworm.com/index.php?rid=5163782&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F303%3Frss%3D1 We examined the main factors affecting the intention of physicians to use teledermatology using a modified Technology Acceptance Model (TAM). The investigation was carried out during a teledermatology pilot study conducted in Spain. A total of 276 questionnaires were sent to physicians by email and 171 responded (62%). Cronbach's alpha was acceptably high for all constructs. Theoretical variables were well correlated with each other and with the dependent variable (Intention to Use). Logistic regression indicated that the original TAM model was good at predicting physicians' intention to use teledermatology and that the variables Perceived Usefulness and Perceived Ease of Use were both significant (odds ratios of 8.4 and 7.4, respectively). When other theoretical variables were added, the ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163782 Thu, 25 Aug 2011 23:00:00 +0100 5163782 http://www.medworm.com/index.php?rid=5163781&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F298%3Frss%3D1 We studied 138 patients admitted for heart failure (HF). Patients were allocated one of three treatment strategies. Group 1 (G1, n = 50) were given usual care for HF, Group 2 (G2, n = 56) received a multi-disciplinary team approach, while Group 3 (G3, n = 32) had home telephone self-monitoring. Telemonitoring was based on the answers to three simple queries about bodyweight change, dyspnoea and general health. The system stratified the HF severity of each patient once a week, and recommended a prompt medical appointment or simple follow-up. Over a 12-month follow-up period, there were 43 adverse events (cardiovascular deaths and rehospitalizations for HF: G1 = 22, G2 = 14, G3 = 7). There was no difference between G2 and G3 (P = 0.78) but there was significant disadvantage with usual care (... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163781 Thu, 25 Aug 2011 23:00:00 +0100 5163781 http://www.medworm.com/index.php?rid=5163780&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F293%3Frss%3D1 To improve the management of soldiers with combat-related mental health problems, an interdisciplinary telepsychiatry service was established between a clinic at the Fort Bragg army base and the Veterans Affairs (VA) Medical Center in Salem. In the first 12 months of operation, 120 soldiers (105 males) were seen in a total of 394 telepsychiatry sessions. The time spent on telepsychiatry by the six VA psychiatrists increased from 13 hours in the first month to 41 hours in the twelfth month. The number of telepsychiatry sessions increased from nine in the first month to 56 in the twelfth month. The mean global assessment of function score (GAF) in the soldiers increased significantly (P < 0.001) from 58.0 at intake to 62.3 at the last visit. Soldiers received VA telepsychiatry on average ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163780 Thu, 25 Aug 2011 23:00:00 +0100 5163780 http://www.medworm.com/index.php?rid=5163779&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F288%3Frss%3D1 We conducted a randomized controlled trial to evaluate the perception, satisfaction and utilization of a home telehealth service for frail elderly people living independently in their home communities. Control group subjects continued with their usual care and intervention group subjects were able to supplement their usual care with the use of a web portal. The web portal allowed videoconferencing and electronic messaging between home care nurses and clients, ordering health-related and home care services, access to health-related information and general access to the Internet. A total of 99 eligible people (59 female, 40 male) from one urban and one rural study site agreed to participate in the study. Eighty-four subjects were active participants for nine months. There were no significant... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163779 Thu, 25 Aug 2011 23:00:00 +0100 5163779 http://www.medworm.com/index.php?rid=5163778&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F281%3Frss%3D1 We systematically reviewed the evidence on the effectiveness of telerehabilitation (TR) applications. The review included reports on rehabilitation for any disability, other than mental health conditions, and drug or alcohol addiction. All forms of telecommunications technology for TR and all types of study design were considered. Study quality was assessed using an approach that considered both study performance and study design. Judgements were made on whether each TR application had been successful, whether reported outcomes were clinically significant, and whether further data were needed to establish the application as suitable for routine use. Sixty-one scientifically credible studies that reported patient outcomes or administrative changes were identified through computerized litera... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163778 Thu, 25 Aug 2011 23:00:00 +0100 5163778 http://www.medworm.com/index.php?rid=5163777&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F6%2F279%3Frss%3D1 This brief paper sets out arguments for the introduction of new technologies into telecare and lifestyle monitoring that can detect and monitor the emotive state of patients. The significantly increased use of computers by older people will enable the elements of emotive computing to be integrated with features such as keyboards and webcams, to provide additional information on emotional state. When this is combined with other data, there will be significant opportunities for system enhancement and the identification of changes in user status, and hence of need. The ubiquity of home computing makes the keyboard a very attractive, economic and non-intrusive means of data collection and analysis. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5163777 Thu, 25 Aug 2011 23:00:00 +0100 5163777 http://www.medworm.com/index.php?rid=5110731&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F273%3Frss%3D1 We have examined the hypothesis that home telemonitoring, when added to conventional home care in rural settings, results in less acute care hospitalization and more discharge to the community. Five US rural home health agencies of different types participated in the study. All agencies were not-for-profit and served low-income patients in designated health professional shortage areas or medically underserved areas/populations. A prospective treatment group was telemonitored daily in the home during the period 1 October 2006 to 31 May 2009 (n = 1419). An historical control group was selected sequentially backwards from 30 September 2006 (n = 1502). Both groups had home health services for approximately 50 days (P = 0.76). We used logistic regression modelling, with covariate data captured ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110731 Sun, 07 Aug 2011 23:00:00 +0100 5110731 http://www.medworm.com/index.php?rid=5110730&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F268%3Frss%3D1 We conducted a retrospective controlled study to assess the safety and effectiveness of intravenous thrombolysis via videoconferencing, followed by patient transport to a specialized stroke unit. Between 2006 and 2009, 47 stroke patients were treated in peripheral hospitals in the county of Salzburg in Austria by intravenous thrombolysis via telemedicine; 304 patients who were treated with intravenous thrombolysis at a stroke unit served as the control group. The mean age of the patients was 67 years in the telemedicine group and 71 years in the control group. Haemorrhagic bleeding occurred in 6.4% of the telemedicine group compared to 7.6% of the control group. The mean onset-to-needle time was 113 min in the telemedicine group and 122 min in the control group (P = 0.263). At three-month ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110730 Sun, 07 Aug 2011 23:00:00 +0100 5110730 http://www.medworm.com/index.php?rid=5110729&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F263%3Frss%3D1 We conducted an online survey and interviews amongst mental health workers in Canada who reported experience in working with rural and remote First Nations (although not necessarily telemental health). Sixty-three respondents (of the 164) to the online survey reported experience in working with clients in remote and rural First Nations. Only 16 of the online survey respondents with remote and rural First Nations experience reported having received training in videoconferencing use. When asked how frequently they used videoconferencing with clients, 51% reported never using it, 19% used it once every few months and 10% reported using it a few times a month. Approximately 50% of participants reported finding it useful. Approximately 38% found the technology easy or very easy to use, and 15% ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110729 Sun, 07 Aug 2011 23:00:00 +0100 5110729 http://www.medworm.com/index.php?rid=5110728&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F257%3Frss%3D1 We conducted a randomized controlled trial to investigate the efficacy and safety of a system for online glucose monitoring of type 2 diabetes patients. The software automatically filtered the self-monitored blood glucose data to reduce physicians' time. In the control group, the physicians had to contact the patients manually. We measured the time spent by physicians for online management in a 24-week study. Seventy-nine patients were recruited. The frequency of physicians' online monitoring of the patients was decreased by 55% in patients with HbA1c ≤ 6.5% and by 29% when HbA1c > 6.5% (P < 0.01). Physicians' log-in time was reduced by 67% and 55% in patients with HbA1c ≤6.5% and >6.5%, respectively (P <0.05). HbA1c levels were maintained at <6.5% during the study per... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110728 Sun, 07 Aug 2011 23:00:00 +0100 5110728 http://www.medworm.com/index.php?rid=5110727&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F251%3Frss%3D1 Telemedicine has been used in the Solomon Islands since 2000. We used quantitative and qualitative methods to examine telemedicine use in the Solomon Islands from January 2006 to June 2009. During the study period 66 telemedicine cases were submitted to the store and forward telemedicine system being used there. These included orthopaedic, oncology, cardiothoracic, infectious, congenital, gastroenterology and dermatology cases. Most cases (52%) were submitted by doctors at the National Referral Hospital (NRH) in Honiara. The majority of responses came from the NRH (27%). A final, firm recommendation regarding patient diagnosis and/or care was given for 46% of the cases. Interviews were conducted with 23 stakeholders in the Solomon Islands and in Australia to better understand the current a... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110727 Sun, 07 Aug 2011 23:00:00 +0100 5110727 http://www.medworm.com/index.php?rid=5110726&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F245%3Frss%3D1 To engage more US combat veterans in PTSD treatment, we offered a psychological intervention that could be initiated in primary care and completed using the Internet. Participants (n = 31) were randomized to complete either Written Emotional Disclosure (WED) or time management narratives on a secure Internet website. In the WED group, participants wrote about their thoughts and emotions regarding one traumatic combat experience in three 20-min sessions. Writing instructions encouraged exposure to traumatic memories and cognitive processing of trauma. The intervention was found to be feasible and safe to implement. Although follow-up assessments did not reveal significant group differences in PTSD symptoms, half of the WED participants reported symptom reductions. Content analyses revealed ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110726 Sun, 07 Aug 2011 23:00:00 +0100 5110726 http://www.medworm.com/index.php?rid=5110725&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F240%3Frss%3D1 We studied the feasibility of low-cost videoconferencing (using Skype) in urban community health clinics for speech, language and hearing screening of children up to six years of age. During a two-year study, screening services were provided via videoconferencing at two community clinics in an inner city area of Cleveland, Ohio. In total, 411 screenings were completed. Of these, 358 children (87%) received hearing screenings, 377 (92%) received tympanometry screening and 263 (64%) received speech and language screening only. A total of 151 children were aged three years or under (37%). The reliability of pure tone hearing screening (n = 7), DPOAE screening (n = 51) and speech-language screening (n = 10) was 100%. Typanometry screenings (n = 55) were 84% reliable. Families reported a high l... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110725 Sun, 07 Aug 2011 23:00:00 +0100 5110725 http://www.medworm.com/index.php?rid=5110724&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F235%3Frss%3D1 We investigated patients' adherence to recommendations after telephone triage at the Swiss Centre for Telemedicine. We studied cases where the medical problem was assessed as not requiring an immediate face-to-face consultation. Two weeks after teleconsultation, follow-up telephone interviews were conducted with 1129 self-care patients. The patients were asked if they had adhered to the telephone recommendations and whether they had had a subsequent face-to-face consultation. A total of 1003 patients (88%) were available for the follow-up telephone interview. Of those, 85% reported that they had adhered to all self-care recommendations and 86% had followed the advice about further use of the health-care system. Overall, 28% of patients had attended a face-to-face consultation. Half of them... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110724 Sun, 07 Aug 2011 23:00:00 +0100 5110724 http://www.medworm.com/index.php?rid=5110723&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F231%3Frss%3D1 We compared the activity estimated by a pedometer and an accelerometer in coronary artery disease patients included in a phase III cardiac rehabilitation programme. Nine patients were divided into two groups and wore the pedometer for four weeks, and then subsequently the accelerometer for four weeks, or vice versa. The recorded daily exercise level (total daily steps and calories burned) was measured for each patient and compared with oxygen uptake and ventilatory threshold measured by ergospirometry at the end of the study. There was a significant correlation between the calories measured by the accelerometer and the ventilatory threshold (i.e. the sub-maximal capacity), r = 0.75 (P = 0.05). There was a significant correlation between the measured steps on the accelerometer and the venti... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110723 Sun, 07 Aug 2011 23:00:00 +0100 5110723 http://www.medworm.com/index.php?rid=5110722&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F226%3Frss%3D1 We created a website for patients and families that allowed them to review clinic test results, review educational materials related to these results and post questions to their diabetes educator. Fingerstick haemoglobin A1c (HbA1c) testing and periodic use of a continuous glucose monitoring system (CGMS) were offered to all patients. The HbA1c and CGMS results were posted to the website after each clinic visit. A total of 52 patients with type 1 diabetes were enrolled in the study. There were 16 patients with HbA1c values within ADA guidelines and 16 with HbA1c values above guidelines; 20 patients were excluded for various reasons. Users of the website were defined as families who logged in four or more times over the six-month study period. For patients whose HbA1c started above ADA guid... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110722 Sun, 07 Aug 2011 23:00:00 +0100 5110722 http://www.medworm.com/index.php?rid=5110721&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F222%3Frss%3D1 We assessed the feasibility and diagnostic accuracy of Internet-based telepathology compared with conventional microscopic examination. A total of 96 cases from the routine workload of the Department of Pathology at the Mulago Hospital in Uganda were examined by robotic telemicroscopy via the Internet at the Fuerth Hospital in Germany. The telepathology diagnoses were compared with those of conventional microscopy. Email and Skype telephony were used to exchange clinical and diagnostic information. The reference diagnosis (gold standard) was established by consensus between two or more experienced pathologists using both conventional microscopy and telemicroscopy; immunohistochemistry was used whenever it was necessary. It took approximately 30 min for a pathologist to learn to use the tel... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110721 Sun, 07 Aug 2011 23:00:00 +0100 5110721 http://www.medworm.com/index.php?rid=5110720&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F5%2F217%3Frss%3D1 We studied patients who were eligible for phase II cardiac rehabilitation. Rehabilitation was delivered either conventionally or by telemedicine using videoconferencing. There were 226 participants: 173 at the conventional site and 53 at the telemedicine site. At baseline, blood pressure, anthropometric measurements, lipid profiles, activity levels, dietary intake and behaviours were assessed. Assessments at baseline were repeated after 12 weeks, at the end of the rehabilitation programme. There were no significant differences (P > 0.05) in the change from baseline to post-programme values between the conventional and the telemedicine groups. The results show the suitability of telemedicine for delivering cardiac rehabilitation for risk factor modification and exercise monitoring to pat... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=5110720 Sun, 07 Aug 2011 23:00:00 +0100 5110720 http://www.medworm.com/index.php?rid=4843648&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F214%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843648 Wed, 18 May 2011 23:00:00 +0100 4843648 http://www.medworm.com/index.php?rid=4843647&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F210%3Frss%3D1 Circular frame treatment for limb reconstruction involves repeated follow-up visits, and a substantial number of these appointments are for pin site review only. We have encouraged our frame patients to take photographs of their pin sites when they carry out their weekly dressing changes. The photographs are taken with mobile phones or digital cameras by the patients themselves, and the images sent to us by email. We reply within 24 hours, with either reassurance or appropriate instructions as indicated. In the past 12 months, five patients have had their pin sites reviewed remotely using this method, and have expressed a high level of satisfaction. These early results are encouraging. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843647 Wed, 18 May 2011 23:00:00 +0100 4843647 http://www.medworm.com/index.php?rid=4843646&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F203%3Frss%3D1 Visual inspection of the cervix with application of 4% acetic acid (VIA) is an inexpensive alternative to cytology-based screening in areas where resources are limited, such as in many developing countries. We have examined the diagnostic agreement between off-site (remote) expert diagnosis using photographs of the cervix (photographic inspection with acetic acid, PIA) and in-person VIA. The images for remote evaluation were taken with a mobile phone and transmitted by MMS. The study population consisted of 95 HIV-positive women in Gaborone, Botswana. An expert gynaecologist made a definitive positive or negative reading on the PIA results of 64 out of the 95 women whose PIA images were also read by the nurse midwives. The remaining 31 PIA images were deemed insufficient in quality for a r... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843646 Wed, 18 May 2011 23:00:00 +0100 4843646 http://www.medworm.com/index.php?rid=4843645&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F199%3Frss%3D1 We conducted a study to test whether new third generation (3G) mobile phones could be integrated into service as a working tool between plastic surgeons. During an eight-month period, 58 multimedia consultations were performed involving 57 patients. The majority of the consultations were for trauma or wounds. All consultations comprised a digital photograph taken with the integrated camera and sent via the Multimedia Messaging Service (MMS). In 86% of the cases the residents reported that multimedia information contributed to their ability to independently handle similar cases in future. Satisfaction scores were high among all participants. We believe that a multimedia consultation in a hospital setting adds information to an ordinary telephone call, thus decreasing medico-legal risks. We ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843645 Wed, 18 May 2011 23:00:00 +0100 4843645 http://www.medworm.com/index.php?rid=4843644&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F195%3Frss%3D1 We compared the effectiveness of home telerehabilitation with conventional rehabilitation following knee replacement surgery (total knee arthroplasty, TKA). Forty-eight patients (mean age 66 years) who received TKA were recruited prior to discharge from hospital after surgery and were randomly assigned to telerehabilitation or usual care. Telerehabilitation sessions (16 per participant over two months) were conducted by trained physiotherapists using videoconferencing to the patient's home via an Internet connection (512 kbit/s upload speed). Disability and function were measured using standardized outcome measures in face-to-face evaluations at three times (prior to and at the end of treatment, and four months after the end of treatment). Clinical outcomes improved significantly for all s... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843644 Wed, 18 May 2011 23:00:00 +0100 4843644 http://www.medworm.com/index.php?rid=4843643&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F190%3Frss%3D1 There is no clear understanding about the concept of technology adoption in the health-care environment. Compatibility is one of the factors affecting telehealth adoption. We investigated the key factors of telehealth's compatibility with health centre activities. Qualitative research was carried out in 2007–2009, with 55 interviews in seven health centres and in one special care hospital. The people interviewed were physicians, nurses and physiotherapists. After analysing the interview material, we concluded that compatibility has three aspects: individual, process and organizational compatibility. Individual compatibility was manifested in four different ways: from the viewpoints of professionals, patients, communication and cooperation. Three aspects of process compatibility were ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843643 Wed, 18 May 2011 23:00:00 +0100 4843643 http://www.medworm.com/index.php?rid=4843642&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F185%3Frss%3D1 The evidence base for lifestyle monitoring is relatively weak, even though there are significant numbers of commercial installations around the world. We conducted a literature review to summarize the current position with regard to lifestyle monitoring based on sensors in the home. In total, 74 papers met the inclusion criteria. Only four papers reported trials involving 20 or more subjects, with a further 21 papers reporting trials involving one or more subjects. Most papers (n = 49) were concerned with technology development. Motion detection was the most common of the technologies employed, followed by door and electrical appliance usage. The predominant monitoring strategy was that of detecting changes in activity. However, little attention has been given to determining when or how ch... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843642 Wed, 18 May 2011 23:00:00 +0100 4843642 http://www.medworm.com/index.php?rid=4843641&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F177%3Frss%3D1 Telephone-delivered cognitive behavioural therapy (CBT) is an increasingly popular mode of delivering care. We conducted a systematic review which focused on physical health outcomes. Literature searches were conducted to identify randomized controlled trials (RCTs) comparing telephone-delivered CBT for improving physical health with any other therapy or routine care in patients with chronic illness. Eight RCTs (1093 patients) met the eligibility criteria and were included in the review. Six of the eight RCTs compared the telephone intervention with routine care, one trial employed symptom monitoring as the control condition and the final trial compared telephone CBT to telephone supportive emotion-focused therapy. Meta-analysis found that telephone-delivered CBT significantly improved phy... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843641 Wed, 18 May 2011 23:00:00 +0100 4843641 http://www.medworm.com/index.php?rid=4843640&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F168%3Frss%3D1 We conducted a systematic review of the applications and technical features of digital interactive television (DITV) in the health and social care fields. The Web of Knowledge and IEEE Xplore databases were searched for articles published between January 2000 and March 2010 which related to DITV systems facilitating the communication of information to/from an individual's home with either a health or social care application. Out of 1679 articles retrieved, 42 met the inclusion criteria and were selected for review. An additional 20 articles were obtained from online grey literature sources. Twenty-five DITV systems operating in health and social care were identified, including seven commercial systems. The most common applications were related to health care, such as vital signs monitoring... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843640 Wed, 18 May 2011 23:00:00 +0100 4843640 http://www.medworm.com/index.php?rid=4843639&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F4%2F163%3Frss%3D1 In West Glasgow email has evolved from a rapid means of arranging therapy appointments with adults who stammer into a medium for exchange of therapeutic messages with some clients. Since 2004, sixteen clients have used email to communicate as part of their therapy programme. The benefits include improving access to services, supporting speech change, facilitating lasting personal growth, improving clinical decision-making, equalizing the therapist-client relationship and enhancing caseload management. Although this experience suggests that email is appropriate for stammering therapy, the effectiveness and ethics of, and the rationale for, clinical practice that includes email need careful consideration. Further research is required to formally evaluate the client experience. (Source: Journ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4843639 Wed, 18 May 2011 23:00:00 +0100 4843639 http://www.medworm.com/index.php?rid=4665794&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F161%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665794 Thu, 31 Mar 2011 23:00:00 +0100 4665794 http://www.medworm.com/index.php?rid=4665793&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F158%3Frss%3D1 A 56-year-old man was on the transplant list with end-stage liver disease secondary to hepatitis C when a donor liver became available at a location 545 km away. The procurement team, consisting of a senior and junior fellow, went on the retrieval, while the staff surgeon remained in the hospital with the recipient. At the time of organ procurement, a suspicious lesion was identified in the left lateral lobe. The transplant fellows took intraoperative pictures of the lesion with a smart phone and sent them to the staff surgeon for advice. A teleconsultation, facilitated by images sent from the smart phone, took place over the next 22 min. The decision was made to proceed with the transplant, as it was felt that the lesion could be resected from the liver allograft. Had the fellows not been... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665793 Thu, 31 Mar 2011 23:00:00 +0100 4665793 http://www.medworm.com/index.php?rid=4665792&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F154%3Frss%3D1 The remote recognition of root canal orifices was tested on 50 images of endodontically accessed teeth acquired with an intra-oral camera. The images were stored on a laptop computer and were presented to 20 observers who marked the visible canal orifices using software which stored the canal locations in standard files. The marked positions were verified on histological slices. In 87% of the cases, the canal locations were marked correctly. Inter-observer reliability depended on the location of the reviewed root canal (kappa = 0.44–0.77). The detection rate was related to the professional experience of the observers. The maximum proportion of accurate detections was found for the observers with more than 10 years of professional experience. The minimum proportion of accurate detecti... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665792 Thu, 31 Mar 2011 23:00:00 +0100 4665792 http://www.medworm.com/index.php?rid=4665791&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F150%3Frss%3D1 We explored the feasibility of engaging young black men in a 12-week text messaging programme about HIV prevention. There were two non-randomized groups of 30 young men each. The participants were aged 16–20 years, self-identifying as black or African-American, sexually active, who owned a mobile phone and lived in Philadelphia. They received three text messages per week for 12 weeks. People in the intervention group received text messages about HIV prevention, while those in the control group received text messages about nutrition. The intervention participants showed trends in increased monogamy at follow-up compared to controls. Awareness of sexual health was significantly higher in the intervention group. Condom norms were significantly higher for the control group. There were no... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665791 Thu, 31 Mar 2011 23:00:00 +0100 4665791 http://www.medworm.com/index.php?rid=4665790&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F146%3Frss%3D1 We used a pre-post design to compare the health and care utilization of patients receiving telehaemodialysis services in two James Bay Cree communities. The Cree are an Amerindian First Nation living in the remote James Bay region. The same group of dialysed patients (n = 19) was followed longitudinally over a two-year period: 12 months pre and 12 months post. Analysis of variables measuring the patients' health conditions showed that the quality of care provided was well within recognized good practice guidelines. Repeated measures ANOVA on the variables measuring care utilization showed a significant decrease in the monthly number of medication changes over time (P < 0.01). Different telehaemodialysis models were used in the two communities (virtual patient rounds and telecase reviews... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665790 Thu, 31 Mar 2011 23:00:00 +0100 4665790 http://www.medworm.com/index.php?rid=4665789&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F142%3Frss%3D1 We investigated the feasibility of videophones for the delivery of problem-solving therapy (PST) for informal hospice caregivers. Informal hospice caregivers were randomly assigned to receive PST from researchers using videophones, instead of communicating in face-to-face sessions. Outcome measures included caregiver anxiety, quality of life and problem-solving abilities, technical quality of videosessions and satisfaction of participants (including both subjects and researchers). A total of 42 hospice caregivers were enrolled (mean age 62 years). A total of 112 videocall attempts were documented. Of these, 100 (89%) resulted in successful videocalls and 12 (11%) were cases in which a call was not established. The average videocall duration was 38 min (range 18–84 min). The overall t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665789 Thu, 31 Mar 2011 23:00:00 +0100 4665789 http://www.medworm.com/index.php?rid=4665788&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F137%3Frss%3D1 When new information and communication technologies are implemented there are organizational effects. Picture Archiving and Communication Systems (PACS) have been implemented not only within radiology but also within the orthopaedic context. We studied the impact of PACS on the work practice and professional role of orthopaedic surgeons in relation to radiologists. Qualitative interviews were performed with 15 surgeons at two hospitals. The interviews were transcribed, analysed and then coded using grounded theory. Three main categories were defined: professional role, diagnostic practice and technology used. There was a shift in orthopaedics from a single to a mixed profession, and from a relatively static practice in interpreting images to a more flexible practice, where every orthopaedi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665788 Thu, 31 Mar 2011 23:00:00 +0100 4665788 http://www.medworm.com/index.php?rid=4665787&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F133%3Frss%3D1 It is often difficult for emergency department staff to follow up the primary closure of simple facial lacerations. This is important to allow closure of the feedback loop. Consecutive patients who were sutured by a single operator using the same technique were asked to send a photograph of the laceration six months and 12 months afterwards. The patients had Internet access and a digital camera, or a mobile phone with a camera. They were given a leaflet with the details of the email address or mobile number to send the picture to. A reminder telephone call was made to each patient at six months and 12 months, and the email address or mobile number to send the picture to was given again. In each telephone call patients were asked to grade the healing on a 5-point scale from 1 = very happy t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665787 Thu, 31 Mar 2011 23:00:00 +0100 4665787 http://www.medworm.com/index.php?rid=4665786&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F127%3Frss%3D1 We compared the use of telemonitoring in patients with chronic obstructive pulmonary disease (COPD) and adult patients with cystic fibrosis (CF). Seventy patients (51 CF and 19 COPD) were enrolled in two studies of six months' duration. Patients used a personal data assistant (PDA) attached to a spirometer to score symptoms and to perform daily spirometry. Criteria for diagnosis of exacerbations of COPD and CF were pre-defined. When exacerbations were detected, patients were offered treatment according to a pre-designed protocol. Thirty-two (63%) CF patients and one (5%) COPD patient withdrew from the studies due to lack of adherence to daily recording. For those who remained in the study, COPD patients recorded more study days (139) than CF patients (113), P = 0.03. The median number of e... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665786 Thu, 31 Mar 2011 23:00:00 +0100 4665786 http://www.medworm.com/index.php?rid=4665785&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F123%3Frss%3D1 We assessed the effects of a care coordination home-telehealth (CCHT) programme on health service utilization. The subjects (n = 387 for each group) were US veterans diagnosed with diabetes and followed for 48 months. The service utilization measures were numbers of all-cause inpatient stays and outpatient visits during the follow-up period. We used generalized linear mixed models to estimate the adjusted effects of the CCHT programme on service use over time. Compared with the controls, the CCHT clients were less likely to be admitted for inpatient care during the first (P < 0.001) and second (P < 0.01) six-month follow-up period, and were consistently more likely to visit outpatient clinics (P < 0.001) during the whole 48-month follow-up period. The likelihood of increase in out... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665785 Thu, 31 Mar 2011 23:00:00 +0100 4665785 http://www.medworm.com/index.php?rid=4665784&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F118%3Frss%3D1 We reviewed surrogate calls (i.e. those made on behalf of the patient) to a national triage call centre to determine whether there were differences between calls made by surrogates and self calls. During a three-year period there were 14,646 calls (14% of the total) made by a surrogate on behalf of the patient. Surrogate calls, as a percentage of total calls, increased with the age of the patient from 12% in the 18–34 year age group to 43% in the 80 and over age group (P < 0.0001). The symptoms of vomiting or nausea and dizziness or light-headedness were significantly more likely to be reported by surrogate callers than self callers. Surrogates reported a higher original intention of taking patients to the hospital emergency department (ED) compared with self callers across all ad... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665784 Thu, 31 Mar 2011 23:00:00 +0100 4665784 http://www.medworm.com/index.php?rid=4665783&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F3%2F109%3Frss%3D1 We conducted a systematic review of literature relating to videoconferencing in therapeutic interventions for chronic conditions. Two hundred articles were reviewed in detail, 35 of which were relevant to the study. Of these, eight were randomized controlled trials (RCTs) and the remainder were service evaluations, pilot studies and case studies. Two major themes emerged, relating specifically to videoconferencing: clinical outcomes and patient satisfaction. There were 14 studies which measured clinical outcomes of interventions for chronic conditions delivered by videoconferencing. A range of evidence, including four RCTs of high quality, indicates that interventions for a variety of conditions, including psychological and physical, delivered by videoconferencing produce similar outcomes ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4665783 Thu, 31 Mar 2011 23:00:00 +0100 4665783 http://www.medworm.com/index.php?rid=4518700&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F105%3Frss%3D1 We describe a young woman from a rural village in Nepal who suffered multiple wasp and hornet stings. She collapsed and was managed by a telephone consultation between a village health worker and a hospital specialist. The patient recovered fully. Not only was the telephone consultation efficient in terms of cost savings from avoided hospital treatment, but it was also effective since, with conventional care, there was a strong possibility that the patient would have died on her way to hospital. This case illustrates the potential for telephone-delivered rural care and management in emergency situations. (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518700 Thu, 24 Feb 2011 00:00:00 +0100 4518700 http://www.medworm.com/index.php?rid=4518699&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F99%3Frss%3D1 We developed an educational website for parents of paediatric patients with kidney diseases in Russia. Parents could ask questions regarding their child's illness and submit information, including medical summaries and scanned or electronic images. A US-trained specialist in paediatric nephrology reviewed the information provided and advised about further evaluation or referral, as well as discussing possible treatment plans. In the first nine months, 141 distinct users communicated through the website. Fifty-eight percent of patients were female. An analysis of 70 cases suggested that in 45% there had been overdiagnosis of common paediatric problems, such as urinary tract infection and pyelonephritis. Users completed an anonymous satisfaction survey. The response rate was 84% (n = 59/70).... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518699 Thu, 24 Feb 2011 00:00:00 +0100 4518699 http://www.medworm.com/index.php?rid=4518698&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F93%3Frss%3D1 We assessed caller satisfaction with an illicit drug helpline in Australia (the Cannabis Information and Helpline, CIH). A 10-min telephone interview was conducted with 200 volunteers who called the service during 2009 (121 called regarding themselves and 79 called regarding another person's cannabis use). Callers were a mean of 43 years of age and typically female (59%). Callers showed high levels of satisfaction with the service: the mean CSQ-8 score was 28.2 (SD = 4.3). Participants who found the service easy to access and those who felt their needs were met reported the highest satisfaction. A linear regression analysis was conducted to identify the significant predictors of participants' satisfaction with the CIH. The ease with which the participant was able to get through to a counse... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518698 Thu, 24 Feb 2011 00:00:00 +0100 4518698 http://www.medworm.com/index.php?rid=4518697&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F88%3Frss%3D1 Many mobile phones allow two-way video communication, which permits callers to hear and see each other. If used during medical emergencies, bystanders can receive supervision and guidance from medical staff based on visual information. We investigated whether video calls from mobile phones could improve the confidence of lay rescuers. High school students (n = 180) were randomly assigned in groups of three to communicate via video calls or via ordinary mobile phone calls. They received realtime guidance from experienced nurse dispatchers at an emergency medical dispatch centre during 10-min scenarios of simulated cardiac arrest. Each student answered a questionnaire to assess understanding, confidence and usefulness of the technology. The mean age was 17.3 years in the video group and 17.9... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518697 Thu, 24 Feb 2011 00:00:00 +0100 4518697 http://www.medworm.com/index.php?rid=4518696&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F83%3Frss%3D1 We conducted a telephone survey of all patients referred to a realtime telemedicine consultation at the Centre for Telehealth in Bogotá. Over a six-month period, 281 teleconsultations were conducted, and we were able to retrieve telephone numbers for 156 patients. Of these, 121 patients (78%) agreed to answer the questionnaire. Eighty percent of the respondents were satisfied or very satisfied with the teleconsultation and 63% would use telemedicine again. Sixty-five percent thought that telemedicine improved their medical care. More than 50% believed that telemedicine had a positive effect in terms of medical care improvement, time- and cost-savings. Twenty-seven percent felt that teleconsultation was not as good as a traditional face-to-face consultation. Lack of familiarity with ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518696 Thu, 24 Feb 2011 00:00:00 +0100 4518696 http://www.medworm.com/index.php?rid=4518695&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F78%3Frss%3D1 Uncomplicated urinary tract infections (UUTI) in women are frequent reasons for consultations in general practice. We evaluated the effectiveness and safety of telemedical management at a telemedicine centre in Switzerland. Management followed evidence-based protocols, including teleprescription of an antibiotic. Consecutive UUTI patients who had a teleconsultation including the prescription of an antibiotic were followed up three days later about symptom relief, adverse events or the need to visit a doctor. Of a total of 526 eligible women, follow-up information was available for 95%. Three days after teleconsultation, 79% of patients reported complete symptom relief, and 92% reported a reduction of UUTI symptoms. Five percent of patients reported deterioration, e.g. due to an increase of... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518695 Thu, 24 Feb 2011 00:00:00 +0100 4518695 http://www.medworm.com/index.php?rid=4518694&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F71%3Frss%3D1 A literature review was carried out to identify the key challenges in the implementation of telehealth. This was followed by a survey of organisations in England involved in telehealth projects in order to understand the challenges they faced. Ten of the 13 health or local authority organisations surveyed had telehealth projects and three were at the planning stage. The analysis revealed seven key challenges facing implementers of telehealth in England. Based on the findings from the literature review and the survey, a model was constructed and a checklist drawn up. The model contained the following elements: identifying issues, needs and partners; producing a strategy; securing funding; implementing changes; and monitoring and evaluating a telehealth project. The checklist was validated b... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518694 Thu, 24 Feb 2011 00:00:00 +0100 4518694 http://www.medworm.com/index.php?rid=4518693&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F65%3Frss%3D1 In 2003, the Institute of Tropical Medicine (ITM) in Antwerp set up an Internet-based decision support service to assist health-care workers in the management of difficult HIV/AIDS cases. This service is available to physicians working in resource-limited settings. Between April 2003 and December 2009, the telemedicine service received 1058 queries, from more than 40 countries, mostly resource-constrained. In the first six years there were 952 queries, of which 459 (49%) were posted on the web-based telemedicine discussion forum and the rest sent by email. All queries were handled by a co-ordinator who forwarded them to a network of specialists, based at the ITM and at other institutions. The average time to provide a first reply was 24 hours. Almost half of the queries received in the fir... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518693 Thu, 24 Feb 2011 00:00:00 +0100 4518693 http://www.medworm.com/index.php?rid=4518692&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F2%2F55%3Frss%3D1 The lack of systematically collected and analysed data about the effect of telemedicine on patient-provider communication is a frequently cited barrier for why video communication has yet to reach its full potential. Existing research provides little information about the subtle and detailed changes in communication that take place over video. Comprehensive investigations of actual medical encounter behaviour are therefore required, including verbal content analysis, which uses interaction analysis systems (IAS) to describe and categorize the communication that has taken place. Ten IAS studies were identified in the literature. Although it is difficult to generalize due to differences in methodology and context, some tentative conclusions can be drawn. First, on-site providers tend to be s... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4518692 Thu, 24 Feb 2011 00:00:00 +0100 4518692 http://www.medworm.com/index.php?rid=4339473&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F54%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339473 Wed, 12 Jan 2011 00:00:00 +0100 4339473 http://www.medworm.com/index.php?rid=4339472&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F49%3Frss%3D1 We developed a telemedicine system for remote guidance of emergency airway management called the Tele-Airway Management System (TAMS). In a pilot study we examined the usefulness of the TAMS for intubations of actual patients in a hospital emergency department. Twenty-five patients were allocated randomly either to a TAMS group or to an on-scene directed (OSD) group. A total of 12 were intubated using the TAMS. The mean time to intubation (TAMS 62 s vs. OSD 56 s) and the success rate was not different between the two groups (P > 0.05). There were two oesophageal intubations in the TAMS group and four in the OSD group, but this was not significantly different (P = 0.36). There were no mechanical or technical errors such as disconnection during use of the TAMS. The pilot study demonstrate... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339472 Wed, 12 Jan 2011 00:00:00 +0100 4339472 http://www.medworm.com/index.php?rid=4339471&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F41%3Frss%3D1 We reviewed the literature on the use of text messaging for clinical and healthy behaviour interventions. Electronic databases were searched in December 2009 using keywords related to text messaging and health interventions. The final review included 24 articles. Of those, seven covered medication adherence, eight discussed clinical management and nine reported on health-related behaviour modification. Sixteen were randomized controlled trials (RCT), five were non-controlled pre-post comparison studies and three were feasibility pilots not reporting a behavioural outcome. The frequency of messaging ranged from multiple messages daily to one message per month. Among the 16 RCTs, 10 reported significant improvement with interventions and six reported differences suggesting positive trends. T... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339471 Wed, 12 Jan 2011 00:00:00 +0100 4339471 http://www.medworm.com/index.php?rid=4339470&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F36%3Frss%3D1 We examined the feasibility of home videoconferencing for providing cancer genetic education and risk information to people at risk. Adults with possible hereditary colon or breast and ovarian cancer syndromes were offered Internet-based counselling. Participants were sent web cameras and software to install on their home PCs. They watched a prerecorded educational video and then took part in a live counselling session with a genetic counsellor. A total of 31 participants took part in Internet counselling sessions. Satisfaction with counselling was high in all domains studied, including technical (mean 4.3 on a 1–5 scale), education (mean 4.7), communication (mean 4.8), psychosocial (mean 4.1) and overall (mean 4.2). Qualitative data identified technical aspects that could be improve... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339470 Wed, 12 Jan 2011 00:00:00 +0100 4339470 http://www.medworm.com/index.php?rid=4339469&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F31%3Frss%3D1 We examined 62 telehealth websites using four assessment criteria: design, literacy, information and telehealth content. The websites came from the member list of the American Telemedicine Association and the Office for the Advancement of Telehealth and partner sites, and were included if they were currently active and at least three clicks deep. Approximately 130 variables were examined for each website by two independent researchers. The websites reviewed contained most of the design variables (mean 74%, SD 6), but fewer of those relating to literacy (mean 26%, SD 6), website information (mean 35%, SD 16) and telehealth content (mean 37%, SD 18). Only 29% of websites encouraged users to ask about telehealth, and 19% contained information on overcoming telehealth barriers. Nonetheless, 84... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339469 Wed, 12 Jan 2011 00:00:00 +0100 4339469 http://www.medworm.com/index.php?rid=4339468&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F25%3Frss%3D1 We investigated the experience of ten patients who received video-based physiotherapy at home for two months after a shoulder joint replacement. Videoconferencing took place via the patient's home broadband connection at a bandwidth of 256–768 kbit/s. Qualitative interviews were carried out, transcribed and analysed. Through qualitative content analysis six categories were identified: (1) a different reinforced communication; (2) pain-free exercising as an effective routine; (3) from a dependent patient to a strengthened person at home; (4) closeness at a distance; (5) facilitated daily living; and (6) continuous physiotherapy chain. The access to bodily knowledge, continuity, collaboration and being at home were all aspects that contributed to the patients' recovery. The patients de... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339468 Wed, 12 Jan 2011 00:00:00 +0100 4339468 http://www.medworm.com/index.php?rid=4339467&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F20%3Frss%3D1 A store-and-forward teleconsultation network was developed as a web application in order to provide second opinions on retinal diseases. The system provided automatic notification messages to the referring doctor and the consulted ophthalmologist by mobile phone message (SMS) and email. Images in the electronic medical record (EMR) could be examined in detail using special magnification software. Of the 19 ophthalmologists who agreed to participate, 17 used the teleconsultation network during the pilot trial (89%). During the four-week study period, a total of 52 EMRs containing 82 images were uploaded by the participating ophthalmologists. In 46 cases (89%), a second opinion was provided by the consulted ophthalmologist. Thirty-three of the cases (72%) were related to macular diseases and... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339467 Wed, 12 Jan 2011 00:00:00 +0100 4339467 http://www.medworm.com/index.php?rid=4339466&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F15%3Frss%3D1 We investigated the feasibility of night-time pulse-oximetry telemedicine. We compared polysomnography (PSG) as the gold standard with simultaneously recorded pulse-oximetry from a wrist pulse-oximeter. The results were evaluated by a sleep specialist and compared with outpatient polygraphy. A total of 135 consecutive patients (mean age 55 years, mean body mass index 31.6 kg/m2) were studied. Patients with minor, moderate and severe PSG findings were grouped together and compared to those without PSG findings; the resulting sensitivity was 1 and specificity 0.35. In addition, patients with and without minor PSG findings were grouped together and compared to those with moderate and severe PSG findings; the resulting sensitivity was 0.66 and the specificity was 0.98. The receiver operating c... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339466 Wed, 12 Jan 2011 00:00:00 +0100 4339466 http://www.medworm.com/index.php?rid=4339465&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F7%3Frss%3D1 We conducted a systematic review of large, well-conducted randomised trials designed to evaluate the effectiveness of telemonitoring on patients with congestive heart failure (CHF). Two people reviewed 125 articles independently and selected 13 articles for final review. These studies concerned 3480 patients. The follow-up period of the studies was 3–15 months. Pooled estimate results showed that there was an overall reduction in all-cause mortality (P = 0.02). There was no overall reduction in all-cause hospital admission (P = 0.84), although there was a reduction in CHF hospital admission (P = 0.0004). There was no reduction in all-cause emergency admission (P = 0.67). There was no significant difference in length of stay in hospital, medication adherence or cost. Telemonitoring in... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339465 Wed, 12 Jan 2011 00:00:00 +0100 4339465 http://www.medworm.com/index.php?rid=4339464&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F1%3Frss%3D1 We conducted a systematic review of telerehabilitation interventions in stroke care. The following databases were searched: Medline, Embase, DARE-NHSEED-HTA (INAHTA) and the Cochrane Library. Nine studies, all published after 2000, were included in the review. A wide variety of telemedicine interventions in post-stroke rehabilitation care was identified. Four studies had been carried out in the USA, two in the Netherlands, two in Italy and one in China. There were four randomized controlled trials and one qualitative analysis. Four studies used an observational study design/case series. Home-based telerehabilitation interventions showed promising results in improving the health of stroke patients and in supporting caregivers. Telemedicine systems based on a virtual environment for upper ex... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4339464 Wed, 12 Jan 2011 00:00:00 +0100 4339464 http://www.medworm.com/index.php?rid=4201352&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F473%3Frss%3D1 (No summary is available for this citation) (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201352 Wed, 24 Nov 2010 00:00:00 +0100 4201352 http://www.medworm.com/index.php?rid=4201351&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F471%3Frss%3D1 (No summary is available for this citation) (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201351 Wed, 24 Nov 2010 00:00:00 +0100 4201351 http://www.medworm.com/index.php?rid=4201350&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F467%3Frss%3D1 We conducted a 13-month study to investigate whether videoconferencing could be used for diagnosis and for making treatment plans for patients requiring prosthetic or oral rehabilitation treatment. The consultations took place between a specialist dental treatment unit in a central hospital and general dental practitioners in seven regional health centres. Videoconferencing was conducted using standard commercial units via an IP network, at bandwiths of 762 kbit/s – 2 Mbit/s. In total, 24 patients and 25 professionals (18 dentists, 2 dental hygienists and 5 nurses) took part. There were no technical problems. In 24 out of 27 teleconsultations, a diagnosis or treatment plan could be made. All participating dentists were satisfied with the consultation process and indicated that the te... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201350 Wed, 24 Nov 2010 00:00:00 +0100 4201350 http://www.medworm.com/index.php?rid=4201349&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F462%3Frss%3D1 Three home health agencies conducted daily telemonitoring of patients in western Montana. The agencies all used monitoring equipment of the same type, which provided up to six vital-signs measurements (heart rate, oxygen saturation, systolic blood pressure, diastolic blood pressure, glucose and bodyweight). There were 337 patients in all, two-thirds of whom were female. These patients were monitored for a total of 16,999 person-days. The rate of occurrence of any vital-sign measurement falling outside acceptable ranges was 33.8 per patient per 60-day period. The highest alert rate for a specific vital sign was for decreased SpO2 (6.4 per patient per 60-day period). The central station nurse took follow-up action at a rate of 26.0 per patient per 60-day period; case manager nurses took foll... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201349 Wed, 24 Nov 2010 00:00:00 +0100 4201349 http://www.medworm.com/index.php?rid=4201348&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F458%3Frss%3D1 We examined the use of tailored messages sent to the mobile phones of obese adolescents enrolled in a weight-management programme, as a means of increasing adherence. The feasibility study was conducted in three phases: (1) a library of 90 messages was developed about five weight-related behaviours; (2) a computer application was developed to tailor these messages to participants' characteristics; the SMS messages (text and images) were sent to mobile phones daily; (3) a three-month trial of the intervention was performed with 20 adolescents. Semi-structured interviews were conducted to assess the participants' perceptions of the intervention and the participants', providers' and computer consultants' reports about technology performance. These interviews revealed that participants were en... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201348 Wed, 24 Nov 2010 00:00:00 +0100 4201348 http://www.medworm.com/index.php?rid=4201347&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F454%3Frss%3D1 We collected data about telephone triage calls concerning children in Sweden. A sample of 110 paediatric calls were recorded. The transcribed data were analysed regarding word count, reasons for calling, results of calls, ages and gender of children, and gender of parents. The median call length was 4.4 min and the median child's age was 3.5 years. Mothers made 73% of calls, but mothers and fathers called to the same extent about daughters and sons, and regardless of age. The most common reasons for calls were ear problems, rash/wound or fever. In nearly half the calls, the telenurses provided self-care advice. Call length, word count or caller's part of word count did not differ according to gender of parents or children. However, mothers were more likely to receive self-care advice while... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201347 Wed, 24 Nov 2010 00:00:00 +0100 4201347 http://www.medworm.com/index.php?rid=4201346&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F447%3Frss%3D1 Tertiary teledermatology (TTD), where a general dermatologist consults a specialized dermatologist on difficult cases, is a relatively new telemedicine service. We evaluated TTD in a Dutch university hospital, where 13 general dermatologists used TTD to consult 11 specialized dermatologists and two residents at the university medical centre. We measured the avoided referrals to the university centre, the usability of the system and the user acceptance of it. During a three-month study, general dermatologists consulted via TTD 28 times. In 17 of the consultations (61%), the general dermatologists would have referred their patients to the university centre if teledermatology had not been available. Referral was not necessary after teledermatology for 12 of these 17 consultations (71%). The m... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201346 Wed, 24 Nov 2010 00:00:00 +0100 4201346 http://www.medworm.com/index.php?rid=4201345&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F441%3Frss%3D1 We investigated how older Hong Kong people perceive the application of telecommunication technologies in products that could enhance their safety at home. The telecare devices in the present study were: (1) the Personal Emergency Link Service (PELS), a 24-hour personal emergency link service; (2) a home-based non-intrusive motion monitoring system; and (3) a wearable vital signs monitoring system. Data were collected from a convenience sample of 368 elderly persons aged 65 years or above from 15 District Elderly Community Centres in Hong Kong, through a structured questionnaire administered during face-to-face interviews by trained interviewers. All three telecare devices were generally perceived as useful by the elderly participants: the PELS by 96% of them, the home-based non-intrusive m... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201345 Wed, 24 Nov 2010 00:00:00 +0100 4201345 http://www.medworm.com/index.php?rid=4201344&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F433%3Frss%3D1 We investigated the feasibility of a mobile-phone based system for patients with type 2 diabetes who had recently commenced insulin therapy but remained poorly controlled. The system was evaluated in a feasibility study in a general practice setting with 23 patients over six months. A total of 22 patients successfully completed the study and used the system for a mean of 217 days (range 162–376). Blood glucose control improved, as reflected by a mean decrease in HbA1c of 0.66% (P = 0.05), with the mean insulin dose increasing by 17 units (P = 0.006). Blood glucose monitoring compliance was high, with readings available for 6.2 days per week, although use of the mobile phone decreased during the study. On average, the mobile phone diary was used for 3.5 days per week. Insulin dose adj... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201344 Wed, 24 Nov 2010 00:00:00 +0100 4201344 http://www.medworm.com/index.php?rid=4201343&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F429%3Frss%3D1 We evaluated tele-ophthalmology for diabetic retinopathy screening in a primary care setting. Four general practitioners (GPs) were taught to assess non-mydriatic retinography images of patients with diabetes. After training, a total of 1223 patients were screened using this method: 926 (76%) did not have diabetic retinopathy and 297 (24%) were referred for an ophthalmologic assessment. Of the 297 patients, 186 (15%) did not have diabetic retinopathy and were considered to be false positives, 85 (7%) had diabetic retinopathy and in 26 cases (2%) the retinography images were unreadable. The specificity of GPs for detecting diabetic retinopathy by non-mydriatic retinography was 83%. Ophthalmologists also assessed 120 patients who had been diagnosed as normal to detect false negatives. Ten pa... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201343 Wed, 24 Nov 2010 00:00:00 +0100 4201343 http://www.medworm.com/index.php?rid=4201342&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F422%3Frss%3D1 We conducted a systematic review to identify the extent to which the process of screening for cognitive impairment in older adults has been validated for administration by telephone. A search of electronic databases and a handsearch of relevant journals and reference lists were carried out for studies published between 1966 and 2008. The database search identified 411 studies and handsearching found another seven. Fourteen studies were finally identified as relevant to the review: three concerned a modified telephone version of the Mini-Mental State Examination (MMSE); five concerned the Telephone Interview for Cognitive Status; one study tested a telephone-administered Short Portable Mental Status Questionnaire; four studies tested the validity of newly developed tools; and the remaining ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201342 Wed, 24 Nov 2010 00:00:00 +0100 4201342 http://www.medworm.com/index.php?rid=4201341&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F8%2F417%3Frss%3D1 A pilot trial of telemedicine in primary care began in the village of Letham in 1998. The service provided conventional consultations with the district nurse, plus teleconsultations with a general practitioner (GP) at the health centre in Forfar, a few km away. In the first year, the videoconferencing link was used by 14 patients, all aged over 65 years. The telemedicine service was judged to be successful and subsequently expanded to patients of any age. It was used for a wide range of health matters, including postnatal care, mental health problems, physical ailments, receiving test results and discussions with the doctor. During the 11-year study period, a total of 646 teleconsultations were conducted, a median rate of 65 per year. A qualitative evaluation of the service was conducted i... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4201341 Wed, 24 Nov 2010 00:00:00 +0100 4201341 http://www.medworm.com/index.php?rid=4057379&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F414%3Frss%3D1 (No summary is available for this citation) (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057379 Mon, 11 Oct 2010 21:28:50 +0100 4057379 http://www.medworm.com/index.php?rid=4057378&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F409%3Frss%3D1 We investigated recruitment into a randomised controlled trial (RCT) following contact with a generalist telephone counselling service. Telephone counsellors were required to ask callers if they would be willing to receive a telephone call to discuss their possible involvement in a trial designed to evaluate the use of a web-based mental health intervention. The five centres involved answered a total of 34,722 counselling calls during the recruitment period. Only 9% of callers were invited by the telephone counsellor to receive the recruitment call and of all callers, only 2.6% agreed. Common reasons reported by the telephone counsellors for not referring eligible applicants to the trial included their view that it was inappropriate to ask the caller, feeling uncomfortable about asking the... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057378 Mon, 11 Oct 2010 21:28:50 +0100 4057378 http://www.medworm.com/index.php?rid=4057377&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F403%3Frss%3D1 We examined the costs and safety of follow-up of patients with an implantable cardioverter defibrillator (ICD). In a prospective study, a remote monitoring system was used to interrogate ICD devices via telephone. Twenty patients with an ICD were followed up conventionally (clinic visits) or remotely at 1, 3 and 6 months after implantation of the ICD. A total of 30 transmissions of ICD data were made via the remote monitoring system. Five transmissions (17%) were interrupted, mainly due to a loss of telemetry, but no data were lost. The duration of the remote follow-up was 12.7 min less than follow-up in clinic (25.8 min, P < 0.05). Five of the remote follow-up transmissions concerned arrhythmia episodes. These lasted significantly longer than those without arrhythmia (16.6 vs. 4.9 min,... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057377 Mon, 11 Oct 2010 21:28:50 +0100 4057377 http://www.medworm.com/index.php?rid=4057376&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F394%3Frss%3D1 We reviewed telehealth applications which were being used in palliative care settings in the UK. Electronic database searches (Medline, CINAHL, PsychInfo and Embase), searches of the grey literature and cited author searches were conducted. In total, 111 papers were identified and 21 documents were included in the review. Telehealth was being used by a range of health professionals in oncology care settings that included specialist palliative care, hospices, primary care settings, nursing homes and hospitals as well as patients and carers. The most common applications were: out-of-hours telephone support, advice services for palliative care patients, carers and health professionals, videoconferencing for interactive case discussions, consultations and assessments, and training and educatio... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057376 Mon, 11 Oct 2010 21:28:50 +0100 4057376 http://www.medworm.com/index.php?rid=4057375&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F389%3Frss%3D1 We developed a secure, web-based system for parent-professional and inter-professional communication. The aim was to improve communication in the care of children with cerebral palsy. We conducted a six-month trial of the system in three Dutch health-care regions. The participants were the parents of 30 cerebral palsy patients and 120 professional staff involved in their care. Information about system usage was extracted from the system's database. The experience of the parents and professionals was evaluated by a questionnaire after six months. The system proved to be technically robust and reliable. A total of 21 parents (70%) and 66 professionals (55%) used the system. The parents submitted 111 questions and 59 responses, with a mean of 5 questions (range 1–17) and 3 responses (ra... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057375 Mon, 11 Oct 2010 21:28:50 +0100 4057375 http://www.medworm.com/index.php?rid=4057374&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F383%3Frss%3D1 Adverse events such as deaths following telephone triage calls are rare, suggesting that the process is basically safe. However, if calls tend to concern mostly minor illnesses, then adverse events following calls would be uncommon even if the triage process itself was flawed. We investigated hospitalization rates following triage calls and compared them to hospitalization following two other types of medical access, emergency department (ED) visits and office visits. For the Ask Mayo Clinic telephone triage centre, hospitalization rates for adult calls concerning chest pain and abdominal pain were each 13%. Based on national survey data, hospitalization for adult ED visits concerning the same symptoms were 33% (chest pain) and 19% (abdominal pain). Office visits had hospitalization rates ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057374 Mon, 11 Oct 2010 21:28:50 +0100 4057374 http://www.medworm.com/index.php?rid=4057373&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F378%3Frss%3D1 We have investigated game design and usability for three mobile phone video games designed to deliver diabetes education. The games were refined using focus groups. Six people with diabetes participated in the first focus group and five in the second. Following the focus groups, we incorporated the new findings into the game design, and then conducted a field test to evaluate the games in the context in which they would actually be used. Data were collected remotely about game usage by eight people with diabetes. The testers averaged 45 seconds per question and answered an average of 50 total nutrition questions each. They self-reported playing the game for 10–30 min, which coincided with the measured metrics of the game. Mobile games may represent a promising new way to engage the u... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057373 Mon, 11 Oct 2010 21:28:49 +0100 4057373 http://www.medworm.com/index.php?rid=4057372&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F374%3Frss%3D1 Over a three-year period we performed 630 carotid endarterectomy procedures in 588 patients. From these we selected 90 patients (group A) who fulfilled the criteria for discharge one day after surgery. These patients were given an electronic blood pressure meter, a videophone for use at home and an antihypertensive drug (amlodipine). Using web-based videoconferencing, we monitored the patients every 4 hours for the first two days. The other 498 patients (group B) were discharged on the second postoperative day. There were no significant differences between the groups in demographic characteristics, risk factors, carotid lesions, operative time, postoperative complications or blood loss. No cervical hematomas developed in group A. No patients needed to be readmitted because of major complic... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057372 Mon, 11 Oct 2010 21:28:49 +0100 4057372 http://www.medworm.com/index.php?rid=4057371&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F368%3Frss%3D1 We conducted a pilot trial of electronic technology integrated into the treatment of children and adolescents who are overweight or obese. A total of 30 patients (mean age 14 years, mean BMI 32.7 kg/m2) were admitted to our hospital to participate in a structured treatment and teaching programme (STTP). To assess physical activity and eating habits, a mobile motion sensor board (MoSeBo) or a sensor for physical activity, integrated into a mobile phone with digital camera (DiaTrace) was used. Over an average period of four days of monitoring, the mean intensity (15.4 activity units) and duration of physical activity (267 min/d) were recorded with the mobile sensors. The mean time spent walking was 64 min/d, running 11 min/d, cycling 24 min/d and car driving 21 min/d. There were significant ... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057371 Mon, 11 Oct 2010 21:28:49 +0100 4057371 http://www.medworm.com/index.php?rid=4057370&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F363%3Frss%3D1 We studied the effect of telephone-linked computer (TLC) communication in patients being treated with home enteral nutrition. A total of 290 patients were enrolled in the study which compared two groups of patients who were recruited at different times (control: 193, TLC: 97). At baseline there were no significant differences in characteristics or clinical practice between the two groups. Over a three-month period, 823 automatic telephone calls were dialled out to the TLC patients and in 787 of the calls (96%) there were complete responses to all questions. A total of 205 alert messages were generated for the 823 calls. Less than 10% were false alerts. All health outcome measures, the EQ-5D and three components of the SF-36 improved slightly with time in both groups, but there was no signi... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057370 Mon, 11 Oct 2010 21:28:49 +0100 4057370 http://www.medworm.com/index.php?rid=4057369&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F359%3Frss%3D1 We have conducted a pilot trial of a home telemonitoring system involving 60 adult patients with cystic fibrosis (CF) enrolled at four Italian CF centres. Thirty randomly selected patients received a home device to perform spirometry and to measure oxygen saturation. The data were transferred to a data centre which forwarded them to the patient's CF clinic. The telemonitoring system was evaluated using questionnaires completed by patients and their doctors. The doctors reported that telemonitoring was useful in monitoring their patients' health status and in decreasing the CF centre workload. The data transfer procedure posed no particular problems for the patients. The major difficulties reported by the patients were night-time saturimetry measurements, and in the first week of the study,... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057369 Mon, 11 Oct 2010 21:28:49 +0100 4057369 http://www.medworm.com/index.php?rid=4057368&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F7%2F355%3Frss%3D1 We have developed a telemedicine elective for fourth-year medical students to learn about the delivery of primary care telemedicine. The goals were to expose medical students to telemedicine as a method for delivery of primary care and to reinforce the importance of doctor-patient communication during the health-care encounter. The elective lasted four weeks. It had three components: two online introductory courses to telemedicine; site visits to near and distant telemedicine sites; and a reflective writing paper. In the first year, seven medical students out of a class of 230 chose the telemedicine elective from a list of 188 alternatives. Evaluation ratings and the students’ written comments, along with end-of-course discussions, indicated that the telemedicine elective was a valua... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=4057368 Mon, 11 Oct 2010 21:28:49 +0100 4057368 http://www.medworm.com/index.php?rid=3905242&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F344%3Frss%3D1 We designed a business model for deploying a myofeedback-based teletreatment service. An iterative and combined qualitative and quantitative action design approach was used for developing the business model and the related value network. Insights from surveys, desk research, expert interviews, workshops and quantitative modelling were combined to produce the first business model and then to refine it in three design cycles. The business model engineering strategy provided important insights which led to an improved, more viable and feasible business model and related value network design. Based on this experience, we conclude that the process of early stage business model engineering reduces risk and produces substantial savings in costs and resources related to service deployment. (Source... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905242 Thu, 26 Aug 2010 22:37:55 +0100 3905242 http://www.medworm.com/index.php?rid=3905241&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F336%3Frss%3D1 We investigated the potential prognostic factors for clinically relevant improvements in pain intensity and pain-related disability after myofeedback-based teletreatment. Sixty-five female computer users, 56 female patients with whiplash-associated disorders and 18 female patients with non-specific neck and shoulder pain participated in the study. They received myofeedback-based teletreatment or usual treatment. Questionnaires concerning prognostic factors, pain and disability were completed before the start of the intervention (baseline) and at follow-ups at the end of the intervention, and after 3 and 6 months. Logistic regression analyses were performed in order to investigate prognostic factors for clinically relevant improvement. In the intervention group, improvement in pain intensit... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905241 Thu, 26 Aug 2010 22:37:55 +0100 3905241 http://www.medworm.com/index.php?rid=3905240&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F329%3Frss%3D1 We evaluated the clinical effects of a myofeedback-based teletreatment service in terms of pain, pain-related disability and work ability. We also investigated the time investment/savings of this treatment with respect to conventional care. Sixty-five women with neck and shoulder pain at work participated in the study. Thirty-three took part in the teletreatment and 32 participated in a control group which continued with conventional care. Questionnaires were completed before the start of the intervention (baseline) and at initial follow-up (T0) and 3 months (T3) after the intervention ended. A general linear model analysis for repeated measurements showed an improvement in terms of pain and work ability for both groups taken together, with no differences between them. Non-parametric tests... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905240 Thu, 26 Aug 2010 22:37:55 +0100 3905240 http://www.medworm.com/index.php?rid=3905239&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F322%3Frss%3D1 We investigated the ease of use and usefulness as a measure of patient satisfaction, compliance, clinical benefit and its mutual relationships concerning a teletreatment application for chronic pain. Fifty-two subjects with neck and shoulder pain received and completed a four-week myofeedback-based teletreatment intervention. Prior to the onset of the intervention (at baseline) and immediately after the intervention they were asked to fill in questionnaires to measure discrepancies (gap scores) between expectations and experiences with the ease of use and usefulness of the treatment, as well as pain intensity and pain disability. In addition, the actual use of the system (i.e. the volume of muscle activity data available on the server) was logged. The subjects reported a significantly high... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905239 Thu, 26 Aug 2010 22:37:55 +0100 3905239 http://www.medworm.com/index.php?rid=3905238&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F316%3Frss%3D1 We investigated the effectiveness and efficiency of a four-week myofeedback-based teletreatment service in subjects with non-specific neck and shoulder pain. Subjects were recruited in Belgium, Germany and the Netherlands and randomly allocated to the intervention or conventional care. Subjects in the intervention group received four weeks of myofeedback training. Pain intensity and disability were evaluated by questionnaires at baseline, immediately after four weeks of treatment and at follow-up 3 months later. To investigate efficiency, the time-investment of both therapists and patients were assessed. Seventy-one subjects were included in the study (36 in the intervention group and 35 in the conventional care group). Myofeedback-based teletreatment was at least as effective clinically a... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905238 Thu, 26 Aug 2010 22:37:55 +0100 3905238 http://www.medworm.com/index.php?rid=3905237&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F308%3Frss%3D1 The myofeedback-based teletreatment system allows patients to receive tactile and/or visual feedback on muscle activity and muscle relaxation times. Health-care professionals can analyse muscle activity and muscle relaxation times and provide guidance to the patient on the course of treatment. The system was evaluated in a small clinical trial. Qualitative data were obtained by interviews and visual inspection of graphical patient data during the trial. Quantitative data were based on post-trial data analysis. We used a revised version of the information systems success model to evaluate the teletreatment system, and focused on the success categories of system use and user satisfaction. The evaluation found good input data quality, system quality and information quality. Both system use an... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905237 Thu, 26 Aug 2010 22:37:55 +0100 3905237 http://www.medworm.com/index.php?rid=3905236&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F302%3Frss%3D1 Lack of user acceptance of telemedicine services is an important barrier to deployment and stresses the need for involving users, i.e. medical professionals. However, the involvement of users in the service development process of telemedicine services is difficult because of (a) the knowledge gap between the expertise of medical and technical experts; (b) the language gap, i.e. the use of different terminologies between the medical and the technical professions; and (c) the methodological gap in applying requirement methods to multidisciplinary scientific matters. We have developed a guideline in which the medical and technical domains meet. The guideline can be used to develop a scenario from which requirements can be elicited. In a retrospective analysis of a myofeedback-based teletreatm... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905236 Thu, 26 Aug 2010 22:37:55 +0100 3905236 http://www.medworm.com/index.php?rid=3905235&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F294%3Frss%3D1 A telemedicine application has a better chance of being accepted if the users can easily handle it and if the application fulfils the clinical needs of both patients and professionals. This requires a methodology for development in which three key matters need to be dealt with: (1) clinical content; (2) design; and (3) outcome. Concerning the clinical content, telemedicine services for patients with chronic disorders that aim to increase their level of functioning need to monitor aspects of the patient's functioning and provide adequate feedback about this. Promising parameters of functioning are related to general physical activity and muscle activation patterns. Providing adequate feedback requires choices about the content of the information, the modality of the feedback and its timing.... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905235 Thu, 26 Aug 2010 22:37:55 +0100 3905235 http://www.medworm.com/index.php?rid=3905234&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F6%2F291%3Frss%3D1 (Source: Journal of Telemedicine and Telecare) Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3905234 Thu, 26 Aug 2010 22:37:55 +0100 3905234 http://www.medworm.com/index.php?rid=3738798&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F286%3Frss%3D1 We have evaluated the feasibility of using the mobile phone short message service (SMS) for symptom monitoring in patients with asthma. All consecutive patients admitted to hospital for asthma during an 11-month period were considered for enrolment (n = 497). Those meeting the inclusion criteria were randomized into a control (n = 60) and intervention group (n = 60). Patients in the intervention group received SMS messages according to a structured workflow, while patients in the control group had no SMS support. In the intervention group, the mean response rate to the messages was 82%. There was an improvement in the Asthma Control Test (ACT) scores in 36 subjects in the intervention group compared to 28 subjects in the control group. There were reductions in the number of nebulizations i... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738798 Fri, 09 Jul 2010 19:30:05 +0100 3738798 http://www.medworm.com/index.php?rid=3738797&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F281%3Frss%3D1 We assessed the feasibility of using a camcorder mobile phone for teleconsulting about cardiac echocardiography. The diagnostic performance of evaluating left ventricle (LV) systolic function was measured by three emergency medicine physicians. A total of 138 short echocardiography video sequences (from 70 subjects) was selected from previous emergency room ultrasound examinations. The measurement of LV ejection fraction based on the transmitted video displayed on a mobile phone was compared with the original video displayed on the LCD monitor of the ultrasound machine. The image quality was evaluated using the double stimulation impairment scale (DSIS). All observers showed high sensitivity. There was an improvement in specificity with the observer's increasing experience of cardiac ultra... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738797 Fri, 09 Jul 2010 19:30:05 +0100 3738797 http://www.medworm.com/index.php?rid=3738796&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F276%3Frss%3D1 There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20–150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews, we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738796 Fri, 09 Jul 2010 19:30:05 +0100 3738796 http://www.medworm.com/index.php?rid=3738795&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F270%3Frss%3D1 We developed an interactive mobile-phone based application, SmartDiet, that analyzes daily nutrition intake and patterns of daily exercise. It provides a personalized diet profile and promotes knowledge about nutrition using a diet game. We evaluated the effectiveness of the SmartDiet application in terms of acquiring dietary information, weight control and user satisfaction. A case-control study was conducted over a six-week period, with 19 people in the intervention group and 17 people in the control group. During the study, a total of 235 successful data transmissions were performed from the mobile phones and there was a mean of 12.4 transmissions per participant. The three body composition measures (fat mass, weight and body mass index) decreased significantly after the intervention in... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738795 Fri, 09 Jul 2010 19:30:04 +0100 3738795 http://www.medworm.com/index.php?rid=3738794&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F265%3Frss%3D1 We investigated the perceptions of people about the safety, security and privacy of a telecare monitoring system for adults with developmental disabilities living in residential settings. The telecare system was used by remote caregivers overnight, when staff were not present in the homes. We surveyed 127 people from different stakeholder groups in the state of Indiana. The people surveyed included those with knowledge or experience of telecare, and those without. The stakeholders were clients, their advocates, service provider administrators and independent case coordinators. The responses in each category for every group were positive except one: only 4 of the 11 telecare case coordinators agreed that the telecare system provided a secure environment. Overall, the telecare system was per... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738794 Fri, 09 Jul 2010 19:30:04 +0100 3738794 http://www.medworm.com/index.php?rid=3738793&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F260%3Frss%3D1 We studied self-observations related to weight management recorded with a Wellness Diary application on a mobile phone. The data were recorded by 27 participants in a 12-week study, which included a short weight management lecture followed by independent usage of the Wellness Diary. We studied the validity of self-observed weight, and behavioural changes and weight patterns related to weight management success. Self-observed weight data tended to underestimate pre- and poststudy measurements, but there were high correlations between the measures (r ≥ 0.80). The amount of physical activity correlated significantly with weight loss (r = 0.44) as did different measures representing healthy changes in dietary behaviours (r ≥ 0.45). Weight changes and the weekly rhythms of weight indicate... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738793 Fri, 09 Jul 2010 19:30:04 +0100 3738793 http://www.medworm.com/index.php?rid=3738792&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F253%3Frss%3D1 We conducted a six-month randomised controlled trial of home telemonitoring for patients with chronic obstructive pulmonary disease (COPD). A total of 40 stable patients with moderate to severe COPD who had completed pulmonary rehabilitation took part. They were randomised to receive standard care (controls) or standard care plus home telemonitoring (intervention). During the monitoring period, patients in the telemonitoring group recorded their symptoms and physical observations twice daily. The data were transmitted automatically at night via the home telephone line. Nurses could access the data through a website and receive alerting email messages if certain conditions were detected. The patients completed the St George's Respiratory Questionnaire, Hospital Anxiety and Depression and th... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738792 Fri, 09 Jul 2010 19:30:04 +0100 3738792 http://www.medworm.com/index.php?rid=3738791&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F248%3Frss%3D1 We evaluated the validity of remote pure tone audiometric testing conducted from North America on subjects in South Africa. Desktop-sharing computer software was used to control an audiometer in Pretoria from Dallas, and PC-based videoconferencing was employed for clinician and subject communication. Thirty adult subjects were assessed, and the pure tone audiometric thresholds (125–8000 Hz) obtained through conventional face-to-face and remote testing were compared. Face-to-face and remote audiometry thresholds differed by 10 dB in only 4% of cases overall. The limits of agreement between the two techniques were –8 and 7 dB with a 90% confidence interval of –5 to 5 dB. The average reaction times to stimulus presentations were similar, within –108 and 121 ms. The ave... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738791 Fri, 09 Jul 2010 19:30:04 +0100 3738791 http://www.medworm.com/index.php?rid=3738790&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F243%3Frss%3D1 We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data were collected during 2007 from all county councils that participated in the SHD and were analysed using content analysis. Incident reports were then compared concerning differences in reported categories and who reported the errors. The 426 incident reports included 452 errors. Of the analysed incident reports, 41% concerned accessibility problems, 25% incorrect assessment, 15% routines/guidelines, 13% technical problems and 6% information and communication. The most frequent... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738790 Fri, 09 Jul 2010 19:30:04 +0100 3738790 http://www.medworm.com/index.php?rid=3738789&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F237%3Frss%3D1 A telepsychiatry project was conducted to improve access to culturally appropriate care providers (i.e. culturally competent, bilingual clinicians) by the use of videoconferencing. A self-completed retrospective questionnaire survey was conducted with asylum seekers, refugees and migrants. The purpose of the referral was either for diagnostic assessment with a subsequent treatment recommendation, or for treatment via telepsychiatry. The service was free of charge for the patients involved. Over a period of 34 months (starting in January 2005), 61 patients participated in the pilot project. The patients' residency status was: refugees (n = 45), asylum seekers (n = 12), migrants (n = 3) and domestic (n = 1). A total of 318 telepsychiatry sessions (lasting 35–45 min) was conducted, with... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738789 Fri, 09 Jul 2010 19:30:04 +0100 3738789 http://www.medworm.com/index.php?rid=3738788&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F232%3Frss%3D1 We developed a wireless personal digital assistant (PDA)-based teleradiology terminal which allowed a secure connection to the hospital's Picture Archiving and Communication System (PACS) through the DICOM protocol. Ten members of the hospital's medical staff completed a questionnaire about its mobility, usability, stability, performance and diagnostic efficiency in a real health-care environment. There was a high degree of satisfaction with the system's mobility (mean score 4.1, SD 1.0, on a five-point scale), usability (mean score 4.2, SD 1.1), stability (mean score 3.9, SD 0.4) and performance (mean score 4.2, SD 0.6). The system was evaluated as a tool for providing assistance in diagnosing thyroid nodules from ultrasound images. A total of 144 ultrasound images with thyroid nodules we... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738788 Fri, 09 Jul 2010 19:30:04 +0100 3738788 http://www.medworm.com/index.php?rid=3738787&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F5%2F229%3Frss%3D1 It has been reported that economic evaluations of telemedicine are less adherent to methodological standards than economic evaluations in other fields. Systematic reviews also show that most studies evaluate benefits in terms of the cost savings, with no assessment of the health benefits for patients. In a recent review of economic evaluations, I found 33 articles that measured both costs and non-resource consequences of using telemedicine in direct patient care. This represents a considerable increase compared to previous reviews. The articles analysed were highly diverse in both study context and applied methods. Most studies used multiple outcome measures, such as diagnostic accuracy, blood glucose levels, wound size or quality-adjusted life-years gained. The effectiveness measures appe... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3738787 Fri, 09 Jul 2010 19:30:04 +0100 3738787 http://www.medworm.com/index.php?rid=3608841&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F224%3Frss%3D1 We have developed a personalised self management system to support self management of chronic conditions with support from health-care professionals. Accelerometers are used to measure gross levels of activity, for example walking around the house, and used to infer higher level activity states, such as standing, sitting and lying. A smart phone containing an accelerometer and a global positioning system (GPS) module can be used to monitor outdoor activity, providing both activity and location based information. Heart rate, blood pressure and weight are recorded and input to the system by the user. A decision support system (DSS) detects abnormal activity and distinguishes life style patterns. The DSS is used to assess the self management process, and automates feedback to the user, consis... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3608841 Fri, 28 May 2010 23:34:59 +0100 3608841 http://www.medworm.com/index.php?rid=3608840&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F221%3Frss%3D1 We studied the patient experience of a telephone booster intervention, i.e. weekly reinforcement of the clinic advice regarding lifestyle modification advice to support weight loss. Forty six adults with Type 2 diabetes and a body mass index >28 kg/m2 were randomised into either intervention (n = 25) or control (n = 21) groups. Semi-structured interviews were conducted with the intervention group participants to explore their views and experiences. The patients were satisfied or very satisfied with the telephone calls and most would recommend the intervention to others in a similar situation. The content of the telephone follow-up met their need for on-going support. The benefits arising from the telephone calls included: being reminded to comply with their regimen; prompting and motiva... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3608840 Fri, 28 May 2010 23:34:59 +0100 3608840 http://www.medworm.com/index.php?rid=3608839&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F215%3Frss%3D1 Detailed information about the composition of the carbon footprint of the NHS in the Grampian health region, and in Scotland generally, is not available at present. Based on the limited information available, our best guess is that travel emissions in Grampian are substantial, perhaps 49,000 tonnes CO2 per year. This is equivalent to 233 million km of car travel per year. A well-established telemedicine network in the Grampian region, which saves over 2000 patient journeys a year from community hospitals, avoids about 260,000 km travel per year, or about 59 tonnes CO2 per year. Therefore using telehealth as it has been used historically (primarily to facilitate hospital-to-hospital interactions) seems unlikely to have a major environmental impact – although of course there may be oth... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3608839 Fri, 28 May 2010 23:34:59 +0100 3608839 http://www.medworm.com/index.php?rid=3608838&cid=s_37249_21_f&fid=37249&url=http%3A%2F%2Fjtt.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F211%3Frss%3D1 An observational study was conducted of two different videoconferencing services offered by the Royal Brompton and Harefield NHS Trust (RBH), a tertiary centre for cardiology in London. In the first, specialist cardiology advice was provided by telemedicine (384 kbit/s bandwidth) to four district general hospitals in England. In the second, specialist cardiology advice was provided via a low-cost videoconferencing system (128 kbit/s bandwidth) to the Mother and Child Institute in Belgrade. The hospitals chose to use the equipment for different purposes and in different ways. However, at the end of the study, they continued to use telemedicine for the normal provision of clinical services. The success of the projects can be partly attributed to the staff involved and in particular, to the t... Journal of Telemedicine and Telecare journals http://www.medworm.com/rss/comments.php?id=3608838 Fri, 28 May 2010 23:34:59 +0100 3608838