Science.gov

Sample records for launches telehealth demonstration

  1. Telehealth

    MedlinePlus

    ... independence TELEHEALTH AND INSURANCE Not all health insurance companies pay for all telehealth services. And services may ... a good idea to check with your insurance company to be sure telehealth services will be covered.

  2. Telehealth

    MedlinePlus

    Telehealth; Telemedicine; Mobile health (mHealth); Remote patient monitoring; E-health ... American Telemedicine Association. What Is Telehealth? www.americantelemed.org/about-telemedicine/what-is-telemedicine#.Vfsv-t9Viko . Accessed October 8, ...

  3. Magnetic Launch Assist System Demonstration

    NASA Technical Reports Server (NTRS)

    1999-01-01

    This Quick Time movie demonstrates the Magnetic Launch Assist system, previously referred to as the Magnetic Levitation (Maglev) system, for space launch using a 5 foot model of a reusable Bantam Class launch vehicle on a 50 foot track that provided 6-g acceleration and 6-g de-acceleration. Overcoming the grip of Earth's gravity is a supreme challenge for engineers who design rockets that leave the planet. Engineers at the Marshall Space Flight Center have developed and tested Magnetic Launch Assist technologies that could levitate and accelerate a launch vehicle along a track at high speeds before it leaves the ground. Using electricity and magnetic fields, a Magnetic Launch Assist system would drive a spacecraft along a horizontal track until it reaches desired speeds. A full-scale, operational track would be about 1.5-miles long and capable of accelerating a vehicle to 600 mph in 9.5 seconds. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the takeoff, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  4. Magnetic Launch Assist Demonstration Test

    NASA Technical Reports Server (NTRS)

    2001-01-01

    This image shows a 1/9 subscale model vehicle clearing the Magnetic Launch Assist System, formerly referred to as the Magnetic Levitation (MagLev), test track during a demonstration test conducted at the Marshall Space Flight Center (MSFC). Engineers at MSFC have developed and tested Magnetic Launch Assist technologies. To launch spacecraft into orbit, a Magnetic Launch Assist System would use magnetic fields to levitate and accelerate a vehicle along a track at very high speeds. Similar to high-speed trains and roller coasters that use high-strength magnets to lift and propel a vehicle a couple of inches above a guideway, a launch-assist system would electromagnetically drive a space vehicle along the track. A full-scale, operational track would be about 1.5-miles long and capable of accelerating a vehicle to 600 mph in 9.5 seconds. This track is an advanced linear induction motor. Induction motors are common in fans, power drills, and sewing machines. Instead of spinning in a circular motion to turn a shaft or gears, a linear induction motor produces thrust in a straight line. Mounted on concrete pedestals, the track is 100-feet long, about 2-feet wide and about 1.5-feet high. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the take-off, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  5. Launch Vehicle Demonstrator Using Shuttle Assets

    NASA Technical Reports Server (NTRS)

    Threet, Grady E., Jr.; Creech, Dennis M.; Philips, Alan D.; Water, Eric D.

    2011-01-01

    The Marshall Space Flight Center Advanced Concepts Office (ACO) has the leading role for NASA s preliminary conceptual launch vehicle design and performance analysis. Over the past several years the ACO Earth-to-Orbit Team has evaluated thousands of launch vehicle concept variations for a multitude of studies including agency-wide efforts such as the Exploration Systems Architecture Study (ESAS), Constellation, Heavy Lift Launch Vehicle (HLLV), Heavy Lift Propulsion Technology (HLPT), Human Exploration Framework Team (HEFT), and Space Launch System (SLS). NASA plans to continue human space exploration and space station utilization. Launch vehicles used for heavy lift cargo and crew will be needed. One of the current leading concepts for future heavy lift capability is an inline one and a half stage concept using solid rocket boosters (SRB) and based on current Shuttle technology and elements. Potentially, the quickest and most cost-effective path towards an operational vehicle of this configuration is to make use of a demonstrator vehicle fabricated from existing shuttle assets and relying upon the existing STS launch infrastructure. Such a demonstrator would yield valuable proof-of-concept data and would provide a working test platform allowing for validated systems integration. Using shuttle hardware such as existing RS-25D engines and partial MPS, propellant tanks derived from the External Tank (ET) design and tooling, and four-segment SRB s could reduce the associated upfront development costs and schedule when compared to a concept that would rely on new propulsion technology and engine designs. There are potentially several other additional benefits to this demonstrator concept. Since a concept of this type would be based on man-rated flight proven hardware components, this demonstrator has the potential to evolve into the first iteration of heavy lift crew or cargo and serve as a baseline for block upgrades. This vehicle could also serve as a demonstration

  6. Magnetic Launch Assist System Demonstration Test

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Engineers at the Marshall Space Flight Center (MSFC) have been testing Magnetic Launch Assist Systems, formerly known as Magnetic Levitation (MagLev) technologies. To launch spacecraft into orbit, a Magnetic Launch Assist system would use magnetic fields to levitate and accelerate a vehicle along a track at a very high speed. Similar to high-speed trains and roller coasters that use high-strength magnets to lift and propel a vehicle a couple of inches above a guideway, the launch-assist system would electromagnetically drive a space vehicle along the track. A full-scale, operational track would be about 1.5-miles long and capable of accelerating a vehicle to 600 mph in 9.5 seconds. This photograph shows a subscale model of an airplane running on the experimental track at MSFC during the demonstration test. This track is an advanced linear induction motor. Induction motors are common in fans, power drills, and sewing machines. Instead of spinning in a circular motion to turn a shaft or gears, a linear induction motor produces thrust in a straight line. Mounted on concrete pedestals, the track is 100-feet long, about 2-feet wide, and about 1.5- feet high. The major advantages of launch assist for NASA launch vehicles is that it reduces the weight of the take-off, the landing gear, the wing size, and less propellant resulting in significant cost savings. The US Navy and the British MOD (Ministry of Defense) are planning to use magnetic launch assist for their next generation aircraft carriers as the aircraft launch system. The US Army is considering using this technology for launching target drones for anti-aircraft training.

  7. Launch Vehicle Demonstrator Using Shuttle Assets

    NASA Technical Reports Server (NTRS)

    Creech, Dennis M.; Threet, Grady E., Jr.; Waters, Eric D.

    2011-01-01

    Study Objective is to characterize the performance capabilities of an inline, shuttle-derived launch vehicle using two design strategies: the first as an early program demonstrator utilizing high structural margins, maximum shuttle assets, and minimal pad impact, the later having undergone structural optimization, flying operational mission GR&A and serving as a baseline for evolutionary upgrades.

  8. Launch Vehicle Demonstrator Using Shuttle Assets

    NASA Technical Reports Server (NTRS)

    Creech, Dennis M.; Threet, Grady E., Jr.; Philips, Alan D.; Waters, Eric D.

    2011-01-01

    The Advanced Concepts Office at NASA's George C. Marshall Space Flight Center undertook a study to define candidate early heavy lift demonstration launch vehicle concepts derived from existing space shuttle assets. The objective was to determine the performance capabilities of these vehicles and characterize potential early demonstration test flights. Given the anticipated budgetary constraints that may affect America's civil space program, and a lapse in U.S. heavy launch capability with the retirement of the space shuttle, an early heavy lift launch vehicle demonstration flight would not only demonstrate capabilities that could be utilized for future space exploration missions, but also serve as a building block for the development of our nation s next heavy lift launch system. An early heavy lift demonstration could be utilized as a test platform, demonstrating capabilities of future space exploration systems such as the Multi Purpose Crew Vehicle. By using existing shuttle assets, including the RS-25D engine inventory, the shuttle equipment manufacturing and tooling base, and the segmented solid rocket booster industry, a demonstrator concept could expedite the design-to-flight schedule while retaining critical human skills and capital. In this study two types of vehicle designs are examined. The first utilizes a high margin/safety factor battleship structural design in order to minimize development time as well as monetary investment. Structural design optimization is performed on the second, as if an operational vehicle. Results indicate low earth orbit payload capability is more than sufficient to support various vehicle and vehicle systems test programs including Multi-Purpose Crew Vehicle articles. Furthermore, a shuttle-derived, hydrogen core vehicle configuration offers performance benefits when trading evolutionary paths to maximum capability.

  9. Space-X Launches Falcon 9 on Demonstration Flight

    NASA Video Gallery

    SpaceX's Falcon 9 rocket and Dragon spacecraft launched from Launch Complex 40 at Cape Canaveral Air Force Station at 10:43 a.m. EST on Wednesday, Dec. 8. This is first demonstration flight for NAS...

  10. X-33 Demonstrates Reusable Launch Vehicle Technologies

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA is developing advanced technologies that will revolutionize America's space launch capabilities and unleash the commercial potential of space. The challenge is to develop advanced technologies for affordable reusble launch vehicles. NASA's goal is to reduce the payload cost of access to space by an order of magnitude, from $10,000 to $1,000 per pound, within 10 years, and by an additional order of magnitude, to $100's per pound within 25 years. This research is part of NASA's Aeronautics and Space Transportation Technology (ASTT) Enterprise's strategy to sustain U.S. leadership in aeronautics and space. The Enterprise has set bold goals that are grouped into Three Pillars: Global Civil Aviation, Revolutionary Technology Leaps and Access to Space.

  11. CSTAR support for the commercial Launch Voucher Demonstration Program

    NASA Technical Reports Server (NTRS)

    Myers, Carter H.

    1993-01-01

    Congress mandated a Launch Voucher Demonstration Program (LVDP) in the NASA FY 1993 Authorization Bill. This program was to have been put into place by October 1, 1993 and would end on September 30, 1995, with a report to Congress on January 31, 1996. CSTAR was asked to provide a participatory relationship to NASA concerning the Launch Voucher Demonstration Program, specifically due to CSTAR's COMET experience and knowledge of the CCDS payload and transportation planning, budgeting, and contract management process. This paper describes CSTAR's involvement in the development of the Launch Voucher Demonstration Program.

  12. The X-34 Demonstrator Loading Onto Launch Vehicle

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Pictured is the X-34 Demonstrator, part of the Pathfinder Program, being attached to an aircraft. After takeoff, the X-34 would be launched from the aircraft to begin its mission. The Pathfinder Program flight experiments would demonstrate a number of advanced launch vehicles and spacecraft technologies such as nontraditional propulsion systems, improvements and irnovations to conventional propulsion systems, safe abort capabilities, vehicle health management systems, composite structures, and new thermal protection systems. The X-34 program was cancelled in 2001.

  13. How X-37 Technology Demonstration Supports Reusable Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Manley, David J.; Cervisi, Richard T.; Staszak, Paul R.

    2000-01-01

    This presentation discusses, in viewgraph form, how X-37 Technology Demonstration Supports Reusable Launch Vehicles. The topics include: 1) X-37 Program Objectives; 2) X-37 Description; 3) X-37 Vehicle Characteristics; 4) X-37 Expands the Testbed Envelope to Orbital Capability; 5) Overview of X-37 Flight Test Program; 6) Thirty-Nine Technologies and Experiments are Being Demonstrated on the X-37; 7) X-37 Airframe/Structures Technologies; 8) X-37 Mechanical, Propulsion, and Thermal System Technologies and Experiments; 9) X-37 GN&C Technologies; 10) X-37 Avionics, Power, and Software Technologies and Experiments; and 11) X-37 Technologies and Experiments Support Reusable Launch Vehicle Needs.

  14. X-33 Reusable Launch Vehicle Demonstrator, Spaceport and Range

    NASA Technical Reports Server (NTRS)

    Letchworth, Gary F.

    2011-01-01

    The X-33 was a suborbital reusable spaceplane demonstrator, in development from 1996 to early 2001. The intent of the demonstrator was to lower the risk of building and operating a full-scale reusable vehicle fleet. Reusable spaceplanes offered the potential to lower the cost of access to space by an order of magnitude, compared with conventional expendable launch vehicles. Although a cryogenic tank failure during testing ultimately led to the end of the effort, the X-33 team celebrated many successes during the development. This paper summarizes some of the accomplishments and milestones of this X-vehicle program, from the perspective of an engineer who was a member of the team throughout the development. X-33 Program accomplishments include rapid, flight hardware design, subsystem testing and fabrication, aerospike engine development and testing, Flight Operations Center and Operations Control Center ground systems design and construction, rapid Environmental Impact Statement NEPA process approval, Range development and flight plan approval for test flights, and full-scale system concept design and refinement. Lessons from the X-33 Program may have potential application to new RLV and other aerospace systems being developed a decade later.

  15. Telehealth Education in Nursing Curricula.

    PubMed

    Ali, Nagia S; Carlton, Kay Hodson; Ali, Omar S

    2015-01-01

    Telehealth care is a fast-growing avenue of providing health care services at a distance. A descriptive study was conducted to identify trends of telehealth education in 43 schools of nursing. Findings reflected inadequate integration of telehealth in classroom content, simulation, and clinical experiences. Interviews with 4 nursing leaders of telehealth provided some recommendations on how to integrate telehealth education in nursing curricula. PMID:25689080

  16. The Reusable Launch Vehicle Technology Program and the X-33 Advanced Technology Demonstrator

    NASA Technical Reports Server (NTRS)

    Cook, Stephen A.

    1995-01-01

    The goal of the Reusable Launch Vehicle (RLV) technology program is formulated, and the primary objectives of RLV are listed. RLV technology program implementation phases are outlined. X-33 advanced technology demonstrator is described. Program management is addressed.

  17. Telehealth brings benefits.

    PubMed

    2016-08-01

    A telehealth clinical lead writing in Primary Health Care says that for the NHS to thrive, front line staff and patients must be empowered. New ways of working are needed and the use of technology should be maximised. Telehealth allows nurses to work more efficiently, communicate better with patients and families, and improve health outcomes cost-effectively. The author encourages frontline nurses to implement changes in the work place and suggests NHS Change Day in October as a starting point. The article also notes the importance of social media in opening up opportunities to connect with other nurses. PMID:27484572

  18. STS-26 launch and entry crew equipment demonstration at Naval Weapons Center

    NASA Technical Reports Server (NTRS)

    1988-01-01

    STS-26 launch and entry crew equipment demonstration is conducted by JSC Crew and Thermal Systems Division's (CTSD's) employee James O. Schlosser at the Naval Weapons Center, China Lake, California. Schlosser (left) gives a briefing on the new crew equipment baselined for STS-26 as Astronaut James P. Bagian models the new gear. Included in the package are navy blue launch and entry suit (LES), launch and entry helmet (LEH), parachute, life raft, and survival gear. A mission specialist seat is visible in background between the two men.

  19. Telehealth in developmental-behavioral pediatrics.

    PubMed

    Soares, Neelkamal S; Langkamp, Diane L

    2012-10-01

    Developmental-behavioral pediatrics (DBP) is recognized as one of the fields with the greatest shortages of pediatric subspecialists. Families who access care often must travel great distances to tertiary academic medical centers or endure long waiting lists. While the shortages are likely to persist due to limited provider availability and an increasing number of children with developmental and behavioral disorders being identified, our field must look to innovative ways to reduce the barriers to access. One such way is telehealth, the use of videoconferencing to deliver DBP services to underserved populations. We aim to describe the practical uses of telehealth for the delivery of diagnostic and management clinical services in a variety of settings and for the additional educational and research benefits of the modality. We will highlight the obstacles to setting up a successful DBP telehealth practice and direct readers to resources to address these in their communities. Most of all, we will demonstrate the benefit to families and children, practitioners, and health care systems of supplementing traditional in-person DBP services with telehealth modalities to enhance outreach and engagement with communities. PMID:23027140

  20. Evolving telehealth reimbursement in Australia.

    PubMed

    Bursell, S-E; Zang, S; Keech, A C; Jenkins, A J

    2016-08-01

    Video-based consultation is the only telehealth service reimbursed by the Medicare Benefits Schedule in Australia, but the uptake of telehealth is still low and inconsistent. There is a clear need for the development of appropriate medical evidence to support implementation of telehealth services. With the ubiquitous use of mobile phones, mobile health becomes important in facilitating health services and impacting clinical outcomes anywhere. PMID:27553999

  1. Maternity telehealth: ringing the changes.

    PubMed

    Finlay, Dorothy; Brown, Sheona

    2013-12-01

    This article describes NHS Scotland's Maternity telehealth options project and the implementation of the recommendations made. This 17-month project resulted in the development of national documentation for recording telehealth calls; the development of a self-directed eLearning tool on maternity telehealth call structure which was made available to all health boards in Scotland; a comprehensive programme of training on telehealth for student midwives; a programme of 'Train-the-trainer' events for qualified midwives to enable the cascade of learning throughout the service. The project also involved collaboration with Health Scotland, signposting for women to contact the appropriate caregiver at the appropriate time. PMID:24386706

  2. Task Type E report for National Launch Demonstration Center (NLDC) (Task 32)

    NASA Astrophysics Data System (ADS)

    Elliot, G. E.

    1991-12-01

    The objective of this task was to define National Launch Demonstration Center (NLDC) requirements in support of National Launch System (NLS) Joint Program Office (JPO) Level 11 Task #32, NLDC Requirement Definition. The following document provided the basis for the study: Task authorization - Contract FO4701-88-C-0109, Modification P00025, SOW 3.2.11, Define NLDC Requirements. The Task was structured into the following series of activities: (1) identify NLS vehicle, operations, or information system requirements which could be demonstrated, integrated, validated, or verified using the NLDC; (2) establish groundrules and constraints for the NLDC; (3) develop a time phased approach for implementing the NLDC to match the NLS need dates and Spaceport Florida Authority/JPO funding availability; (4) support development of NLS JPO NLDC Plan; and (5) support development of NLS JPO NLDC Coordination Briefing.

  3. Apollo 11 Astronauts Exit Launch Pad Elevator After Countdown Demonstration Test

    NASA Technical Reports Server (NTRS)

    1969-01-01

    Apollo 11 crew members (left to right) Neil Armstrong, Edwin Aldrin, and Michael Collins, wearing space suits, leave the elevator after descending from the top of the launch tower. The three had just completed participation in the countdown demonstration test for the upcoming Apollo 11 mission. The Apollo 11 mission, the first lunar landing mission, launched from the Kennedy Space Center (KSC) in Florida via the Marshall Space Flight Center (MSFC) developed Saturn V launch vehicle on July 16, 1969 and safely returned to Earth on July 24, 1969. Aboard the space craft were astronauts Neil A. Armstrong, commander; Michael Collins, Command Module (CM) pilot; and Edwin E. (Buzz) Aldrin Jr., Lunar Module (LM) pilot. The CM, 'Columbia', piloted by Collins, remained in a parking orbit around the Moon while the LM, 'Eagle'', carrying astronauts Armstrong and Aldrin, landed on the Moon. On July 20, 1969, Armstrong was the first human to ever stand on the lunar surface, followed by Aldrin. During 2½ hours of surface exploration, the crew collected 47 pounds of lunar surface material for analysis back on Earth. With the success of Apollo 11, the national objective to land men on the Moon and return them safely to Earth had been accomplished.

  4. Covering and Reimbursing Telehealth Services.

    PubMed

    Blackman, Kate

    2016-01-01

    Policymakers who are striving to achieve better health care, improved health outcomes and lower costs are considering new strategies and technologies. Telehealth is a tool that uses technology to provide health services remotely, and state leaders are looking to it now more than ever as a way to address workforce gaps and reach underserved patients. Among the challenges facing state lawmakers who are working to introduce or expand telehealth is how to handle covering patients and reimbursing providers. PMID:27032126

  5. Development of the Telehealth Usability Questionnaire (TUQ)

    PubMed Central

    PARMANTO, BAMBANG; LEWIS, ALLEN NELSON; GRAHAM, KRISTIN M.; BERTOLET, MARNIE H.

    2016-01-01

    Current telehealth usability questionnaires are designed primarily for older technologies, where telehealth interaction is conducted over dedicated videoconferencing applications. However, telehealth services are increasingly conducted over computer-based systems that rely on commercial software and a user supplied computer interface. Therefore, a usability questionnaire that addresses the changes in telehealth service delivery and technology is needed. The Telehealth Usability Questionnaire (TUQ) was developed to evaluate the usability of telehealth implementation and services. This paper addresses: (1) the need for a new measure of telehealth usability, (2) the development of the TUQ, (3) intended uses for the TUQ, and (4) the reliability of the TUQ. Analyses indicate that the TUQ is a solid, robust, and versatile measure that can be used to measure the quality of the computer-based user interface and the quality of the telehealth interaction and services. PMID:27563386

  6. Development of the Telehealth Usability Questionnaire (TUQ).

    PubMed

    Parmanto, Bambang; Lewis, Allen Nelson; Graham, Kristin M; Bertolet, Marnie H

    2016-01-01

    Current telehealth usability questionnaires are designed primarily for older technologies, where telehealth interaction is conducted over dedicated videoconferencing applications. However, telehealth services are increasingly conducted over computer-based systems that rely on commercial software and a user supplied computer interface. Therefore, a usability questionnaire that addresses the changes in telehealth service delivery and technology is needed. The Telehealth Usability Questionnaire (TUQ) was developed to evaluate the usability of telehealth implementation and services. This paper addresses: (1) the need for a new measure of telehealth usability, (2) the development of the TUQ, (3) intended uses for the TUQ, and (4) the reliability of the TUQ. Analyses indicate that the TUQ is a solid, robust, and versatile measure that can be used to measure the quality of the computer-based user interface and the quality of the telehealth interaction and services. PMID:27563386

  7. Demonstration/Validation of Environmentally-Preferable Coatings for Launch Facilities

    NASA Technical Reports Server (NTRS)

    Lewis, Pattie

    2011-01-01

    Kennedy Space Center (KSC) is responsible for a number of facilities/structures with metallic structural and non-structural components in a highly corrosive environment. Metals require periodic maintenance activity to guard against the insidious effects of corrosion and thus ensure that structures meet or exceed design or performance life. The standard practice for protecting metallic substrates in atmospheric environments is the application of an applied coating system. Applied coating systems work via a variety of methods (barrier, galvanic and/or inhibitor) and adhere to the substrate through a combination of chemical and physical bonds. Maintenance at KSC and other NASA Centers is governed by NASA-STD-50088 (Protective Coating of Carbon Steel, Stainless Steel, and Aluminum on Launch Structures, Facilities, and Ground Support Equipment) which establishes practices for the protective coating of ground support equipment and related facilities used by or for NASA programs and projects. The Standard is for the design of non-flight hardware used to support the operations of receiving, transportation, handling, assembly, inspection, test, checkout, service, and launch of space vehicles and payloads at NASA launch, landing, or retrieval sites. These criteria and practices contained within the Standard may be used for items used at the manufacturing, development, and test sites upstream of the launch, landing, or retrieval sites. The objective of this effort is to demonstrate and validate environmentally-preferable alternatives in accordance with NASA-STD-50088 and KSC requirements which can then be added to the Approved Products List. This Test Protocol contains the critical requirements and tests necessary to qualify alternatives for structural steel applications. These tests were derived from engineering, performance, and operational impact (supportability) requirements defined by a consensus of KSC participants. A Test Report will document the results of the testing

  8. Demonstrating the Performance Benefits of the Strutjet RBCC for Space Launch Architectures

    NASA Technical Reports Server (NTRS)

    Siebenhaar, Adam; Bulman, Mel; Johnson, Richard; Fazah, Mike

    1999-01-01

    The Rocket Based Combined Cycle (RBCC) engine synergistically combines the best elements of airbreathing and rocket propulsion to benefit a wide range of future reusable launch vehicles (RLV). Aerojet's Strutjet RBCC offers high Isp during mid-phase acceleration, and high thrust for boost and final ascent phases. The result is a relatively low gross weight vehicle that reduces thrust requirements compared with all-rocket solutions. Relative to combination propulsion systems, the integrated propulsive elements of the Strutjet reduce engine weight and complexity. This paper will summarize the results of tests demonstrating our latest hydrogen-fueled Strutjet RBCC engine performance, including inlet operability and performance over a range of conditions, sea level static and Mach 2.4 rocket thrust augmentation, ramjet and scramjet performance, combined scramjet/rocket performance at Mach 8, and ascent mode rocket performance. These tests have significantly advanced the technology readiness of the Strutjet engine and substantiate the performance benefits of RBCC engines for reusable launch vehicle applications. A companion paper provides a focus on Strutjet as a basis for advanced air and space architecture, covering hydrogen and hydrocarbon fuels and cooled structures.

  9. Max Launch Abort System (MLAS) Landing Parachute Demonstrator (LPD) Drop Test

    NASA Technical Reports Server (NTRS)

    Shreves, Christopher M.

    2011-01-01

    The Landing Parachute Demonstrator (LPD) was conceived as a low-cost, rapidly-developed means of providing soft landing for the Max Launch Abort System (MLAS) crew module (CM). Its experimental main parachute cluster deployment technique and off-the-shelf hardware necessitated a full-scale drop test prior to the MLAS mission in order to reduce overall mission risk. This test was successfully conducted at Wallops Flight Facility on March 6, 2009, with all vehicle and parachute systems functioning as planned. The results of the drop test successfully qualified the LPD system for the MLAS flight test. This document captures the design, concept of operations and results of the drop test.

  10. Experiences of front-line health professionals in the delivery of telehealth: a qualitative study

    PubMed Central

    MacNeill, Virginia; Sanders, Caroline; Fitzpatrick, Ray; Hendy, Jane; Barlow, James; Knapp, Martin; Rogers, Anne; Bardsley, Martin; Newman, Stanton P

    2014-01-01

    Background Telehealth is an emerging field of clinical practice but current UK health policy has not taken account of the perceptions of front-line healthcare professionals expected to implement it. Aim To investigate telehealth care for people with long-term conditions from the perspective of the front-line health professional. Design and setting A qualitative study in three sites within the UK (Kent, Cornwall, and the London Borough of Newham) and embedded in the Whole Systems Demonstrator evaluation, a large cluster randomised controlled trial of telehealth and telecare for patients with long-term and complex conditions. Method Semi-structured qualitative interviews with 32 front-line health professionals (13 community matrons, 10 telehealth monitoring nurses and 9 GPs) involved in the delivery of telehealth. Data were analysed using a modified grounded theory approach. Results Mixed views were expressed by front-line professionals, which seem to reflect their levels of engagement. It was broadly welcomed by nursing staff as long as it supplemented rather than substituted their role in traditional patient care. GPs held mixed views; some gave a cautious welcome but most saw telehealth as increasing their work burden and potentially undermining their professional autonomy. Conclusion Health care professionals will need to develop a shared understanding of patient self-management through telehealth. This may require a renegotiation of their roles and responsibilities. PMID:24982492

  11. Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving?

    PubMed

    Liu, Sheena Xin; Xiang, Rui; Lagor, Charles; Liu, Nan; Sullivan, Kathleen

    2016-01-01

    Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs. PMID:27528868

  12. Earth-to-Orbit Laser Launch Simulation for a Lightcraft Technology Demonstrator

    NASA Astrophysics Data System (ADS)

    Richard, J. C.; Morales, C.; Smith, W. L.; Myrabo, L. N.

    2006-05-01

    Optimized laser launch trajectories have been developed for a 1.4 m diameter, 120 kg (empty mass) Lightcraft Technology Demonstrator (LTD). The lightcraft's combined-cycle airbreathing/rocket engine is designed for single-stage-to-orbit flights with a mass ratio of 2 propelled by a 100 MW class ground-based laser built on a 3 km mountain peak. Once in orbit, the vehicle becomes an autonomous micro-satellite. Two types of trajectories were simulated with the SORT (Simulation and Optimization of Rocket Trajectories) software package: a) direct GBL boost to orbit, and b) GBL boost aided by laser relay satellite. Several new subroutines were constructed for SORT to input engine performance (as a function of Mach number and altitude), vehicle aerodynamics, guidance algorithms, and mass history. A new guidance/steering option required the lightcraft to always point at the GBL or laser relay satellite. SORT iterates on trajectory parameters to optimize vehicle performance, achieve a desired criteria, or constrain the solution to avoid some specific limit. The predicted laser-boost performance for the LTD is undoubtedly revolutionary, and SORT simulations have helped to define this new frontier.

  13. Demonstrating the Performance Benefits of the Strutjet RBCC for Space Launch Architectures

    NASA Technical Reports Server (NTRS)

    Johnson, D.

    1998-01-01

    The Rocket Based Combined Cycle (RBCC) engine synergistically combines the best elements of airbreathing and rocket propulsion to benefit a wide range of future reusable launch vehicles. Aerojet's Strutjet RBCC offers high I(sub sp) during mid-phase acceleration, and high thrust for boost and final ascent phases. The result is a relatively low gross weight vehicle with lower thrust requirements than comparable all-rocket solutions. Relative to combination propulsion systems, the integrated propulsive elements of the Strutjet reduce engine weight and complexity. In the recent NASA Highly Reusable Space Transportation (HRST) study, vehicles with RBCC-class engines were projected to have lower per flight operations costs than comparable rockets. The more benign operating environment of the RBCC engine primary rockets (2000 psi chamber pressure, lower internal temperatures, gas generator cycle) lead to longer service life, fewer maintenance actions, and increased reliability. Operations costs are typically the most significant contributor to life cycle costs. RBCC-powered vehicles lend themselves naturally to horizontal takeoff, which typically requires less thrust for a given gross vehicle weight when compared to an all-rocket-powered vehicle. The lower thrust requirements reduce engine size and/or quantity, reducing the n of ground personnel and facilities required to maintain the vehicle. The reduced sensitivity to mass fraction also allows the vehicle to be designed with higher margins for improved life and reliability. Because of its multi-mode ascent operation and ability to perform long cruise segments, the strutjet RBCC offers RLV designers a chance to create vehicles with an unprecedented level of mission flexibility. Features such as supersonic cruise, flyback, off-set launch, self-ferry, horizontal takeoff and landing, multi-base operation, and flexible aborts open up a broad range of potential revenue producing missions. The Strutjet can lead to low

  14. Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy.

    PubMed

    Varghese, Sunil; Scott, Richard E

    2004-01-01

    Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend. PMID:15104917

  15. Demonstration of Launch Vehicle Slosh Instability on Pole-Cart Platform

    NASA Technical Reports Server (NTRS)

    Pei, Jing; Rothhaar, Paul

    2015-01-01

    Liquid propellant makes up a significant portion of the total weight for large launch vehicles such as Saturn V, Space Shuttle, and the Space Launch System (SLS). Careful attention must be given to the influence of fuel slosh motion on the stability of the vehicle. A well-documented slosh danger zone occurs when the slosh mass is between the vehicle center of mass and the center of percussion. Passive damping via slosh baffle is generally required when the slosh mass is within this region. The pole-cart hardware system, typically used for academic purposes, has similar dynamic characteristics as an unstable launch vehicle. This setup offers a simple and inexpensive way of analyzing slosh dynamics and its impact on flight control design. In this paper, experimental and numerical results from the pole-cart system will be shown and direct analogies to launch vehicle slosh dynamics will be made.

  16. The role of human factors in telehealth.

    PubMed

    Demiris, George; Charness, Neil; Krupinski, Elizabeth; Ben-Arieh, David; Washington, Karla; Wu, John; Farberow, Bonne

    2010-05-01

    The purpose of this article is to provide an overview of the field of human factors (HFs) and its role in telehealth. We discuss HF concepts and methodologies that affect the design, implementation, and evaluation of telehealth applications and provide examples from numerous application areas that highlight the significance of HF principles and methodologies. We also provide recommendations for inclusion of HFs in telehealth system design and evaluation, and discuss resulting implications for system designers, practitioners, vendors, and policy makers. PMID:20420540

  17. NASA's Space Launch System Advanced Booster Engineering Demonstration and Risk Reduction Efforts

    NASA Technical Reports Server (NTRS)

    Crumbly, Christopher M.; May, Todd; Dumbacher, Daniel

    2012-01-01

    The National Aeronautics and Space Administration (NASA) formally initiated the Space Launch System (SLS) development in September 2011, with the approval of the program s acquisition plan, which engages the current workforce and infrastructure to deliver an initial 70 metric ton (t) SLS capability in 2017, while using planned block upgrades to evolve to a full 130 t capability after 2021. A key component of the acquisition plan is a three-phased approach for the first stage boosters. The first phase is to complete the development of the Ares and Space Shuttle heritage 5-segment solid rocket boosters for initial exploration missions in 2017 and 2021. The second phase in the booster acquisition plan is the Advanced Booster Risk Reduction and/or Engineering Demonstration NASA Research Announcement (NRA), which was recently awarded after a full and open competition. The NRA was released to industry on February 9, 2012, and its stated intent was to reduce risks leading to an affordable Advanced Booster and to enable competition. The third and final phase will be a full and open competition for Design, Development, Test, and Evaluation (DDT&E) of the Advanced Boosters. There are no existing boosters that can meet the performance requirements for the 130 t class SLS. The expected thrust class of the Advanced Boosters is potentially double the current 5-segment solid rocket booster capability. These new boosters will enable the flexible path approach to space exploration beyond Earth orbit, opening up vast opportunities including near-Earth asteroids, Lagrange Points, and Mars. This evolved capability offers large volume for science missions and payloads, will be modular and flexible, and will be right-sized for mission requirements. NASA developed the Advanced Booster Engineering Demonstration and/or Risk Reduction NRA to seek industry participation in reducing risks leading to an affordable Advanced Booster that meets the SLS performance requirements. Demonstrations and

  18. NASA's Space Launch System Advanced Booster Engineering Demonstration and/or Risk Reduction Efforts

    NASA Technical Reports Server (NTRS)

    Crumbly, Christopher M.; Dumbacher, Daniel L.; May, Todd A.

    2012-01-01

    The National Aeronautics and Space Administration (NASA) formally initiated the Space Launch System (SLS) development in September 2011, with the approval of the program s acquisition plan, which engages the current workforce and infrastructure to deliver an initial 70 metric ton (t) SLS capability in 2017, while using planned block upgrades to evolve to a full 130 t capability after 2021. A key component of the acquisition plan is a three-phased approach for the first stage boosters. The first phase is to complete the development of the Ares and Space Shuttle heritage 5-segment solid rocket boosters (SRBs) for initial exploration missions in 2017 and 2021. The second phase in the booster acquisition plan is the Advanced Booster Risk Reduction and/or Engineering Demonstration NASA Research Announcement (NRA), which was recently awarded after a full and open competition. The NRA was released to industry on February 9, 2012, with a stated intent to reduce risks leading to an affordable advanced booster and to enable competition. The third and final phase will be a full and open competition for Design, Development, Test, and Evaluation (DDT&E) of the advanced boosters. There are no existing boosters that can meet the performance requirements for the 130 t class SLS. The expected thrust class of the advanced boosters is potentially double the current 5-segment solid rocket booster capability. These new boosters will enable the flexible path approach to space exploration beyond Earth orbit (BEO), opening up vast opportunities including near-Earth asteroids, Lagrange Points, and Mars. This evolved capability offers large volume for science missions and payloads, will be modular and flexible, and will be right-sized for mission requirements. NASA developed the Advanced Booster Engineering Demonstration and/or Risk Reduction NRA to seek industry participation in reducing risks leading to an affordable advanced booster that meets the SLS performance requirements

  19. Diabetes Telehealth and Computerized Decision Support Systems: A Sound System with a Human Touch Is Needed

    PubMed Central

    Holmström, Inger

    2010-01-01

    Telehealth holds the promise of improved consistency and fast and equal access to care, and will have great impact on future care. To enhance its quality and safety, computerized decision support systems (CDSS) have been launched. This commentary focuses specifically on the impact of telehealth and CDSS on diabetes patient management. Ideally, clinical information should be linked to evidence based recommendations and guidelines in the CDSS to provide tailored recommendations at the moment of care. However, technical support such as CDSS is not enough. The human touch is essential. A named healthcare provider with access to telehealth and CDSS seems to promise a way of providing both patient-centered and evidence-based care. PMID:20663469

  20. Practical aspects of telehealth: establishing telehealth in an institution.

    PubMed

    Sabesan, S; Allen, D T; Caldwell, P; Loh, P K; Mozer, R; Komesaroff, P A; Talman, P; Williams, M; Shaheen, N; Grabinski, O

    2014-02-01

    The fifth in a series of papers on practical aspects of telehealth, this paper discusses telehealth models that can facilitate the provision of specialist services to rural and remote patients closer to home. Some of the barriers to successful implementation of these models relates to workforce, funding and infrastructure at rural sites, as well as the traditional mindset of healthcare professionals. Therefore, the rural sector needs to be adequately resourced for telehealth models to be substantive and successful. This paper describes the development of a large teleoncology network over a vast geographical area in North Queensland. Adequate resourcing for the rural sites and undertaking quality improvement activities has continually enhanced the model over a 5- to 6-year period. The benefits of this model of care are twofold: (i) patients received their care closer to home and (ii) the workforce, service capabilities and infrastructure for the hospital in Mt Isa (a rural town 900 km away from its tertiary centre) has improved. PMID:24528818

  1. Assessing home care agencies' readiness for telehealth.

    PubMed

    Demiris, George; Patrick, Timothy; Khatri, Naresh

    2003-01-01

    Home healthcare is facing a set of challenging new realities in the 21st century such as funding limitations and increased life expectancy. Many believe that the use of telehealth enabling patients at home to interact with nurses at the clinical site using videoconferencing technology, will be a cost-effective solution to providing quality care services. Many agencies have adopted or are planning on implementing a telehealth solution. Level of agencies' readiness can lead to a lower level of risk, and a more successful innovation outcome. We developed a framework for assessing home care agencies' readiness for telehealth consisting of 35 items. This instrument can be used as a decision support tool for agencies that are about to implement a telehealth system as well as a formative or summative evaluation tool for agencies already utilizing telehealth. PMID:14728330

  2. Space Launch System NASA Research Announcement Advanced Booster Engineering Demonstration and/or Risk Reduction

    NASA Technical Reports Server (NTRS)

    Crumbly, Christopher M.; Craig, Kellie D.

    2011-01-01

    The intent of the Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) effort is to: (1) Reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS (2) Enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. Key Concepts (1) Offerors must propose an Advanced Booster concept that meets SLS Program requirements (2) Engineering Demonstration and/or Risk Reduction must relate to the Offeror s Advanced Booster concept (3) NASA Research Announcement (NRA) will not be prescriptive in defining Engineering Demonstration and/or Risk Reduction

  3. Telehealth: An Assessment of Growth and Distribution.

    ERIC Educational Resources Information Center

    Grigsby, William J.

    2002-01-01

    National surveys of telehealth networks, 1994-99, examined program characteristics; clinical activities (telemedicine); nonclinical activities related to continuing medical education, paraprofessional training, health promotion, administration, and research; technology; and barriers to growth and sustainability. Despite growing utilization,…

  4. A Storable, Hybrid Mars Ascent Vehicle Technology Demonstrator for the 2020 Launch Opportunity

    NASA Astrophysics Data System (ADS)

    Chandler, A. A.; Karabeyoglu, M. A.; Cantwell, B. J.; Reeve, R.; Goldstein, B. G.; Hubbard, G. S.

    2012-06-01

    A Phoenix sized mission including a reduced payload, two-stage, hybrid Mars Ascent Vehicle technology demonstrator is proposed for the 2020 opportunity. The hybrid MAV is storable on Mars and would retire risk for a Mars Sample Return campaign.

  5. Practical aspects of telehealth: doctor-patient relationship and communication.

    PubMed

    Sabesan, S; Allen, D; Caldwell, P; Loh, P K; Mozer, R; Komesaroff, P A; Talman, P; Williams, M; Shaheen, N; Grabinski, O

    2014-01-01

    The fourth in a series of articles about the practical aspects of telehealth, this paper provides advice and information for specialists to communicate effectively with patients during a telehealth video consultation. PMID:24450527

  6. Telehealth in the school setting: an integrative review.

    PubMed

    Reynolds, Cori A; Maughan, Erin D

    2015-02-01

    Telehealth, the provision of health care through long-distance telecommunications technology, is a tool that can be used by school nurses to address and improve the health status of schoolchildren. The purpose of this literature review is to examine research related to implementation of telehealth in the school setting. A review of the literature was conducted using CINAHL, ERIC, Medline, and PubMed databases and the search terms such as telehealth, telecare, telemedicine, school, and schools. Fifteen research studies related to telehealth in the school setting were identified. Themes identified included benefits, barriers, feasibility, and limitations of telehealth. Implications for practice are presented, along with the potential of telehealth to integrate with the Affordable Care Act. School nurses who use telehealth can further meet the health needs of children in their care. The future of health care and school nursing is changing, and telehealth is a tool that can improve care in an innovative and efficient way. PMID:24970886

  7. [An overview of telehealth initiatives in Latin America].

    PubMed

    dos Santos, Alaneir de Fátima; D'Agostino, Marcelo; Bouskela, Maurício Simon; Fernandéz, Andrés; Messina, Luiz Ary; Alves, Humberto José

    2014-01-01

    This article aimed to systematize the views on telehealth in Latin America and to present the experience of building an instrument for monitoring the development of telehealth initiatives based on the reality of this region. A group was structured to coordinate telehealth efforts in Latin America, with members appointed by the ministries of health of 16 countries. Five thematic groups were also set up. Based on international experiences and focusing on the reality of telehealth in the continent, an instrument was created to monitor the development of telehealth in Latin America. Several countries have national telehealth projects: Brazil, Colombia, Ecuador, Mexico, Panama. Others are in the process of development and early deployment: Bolivia, Costa Rica, Cuba, El Salvador, Guatemala, Peru, Venezuela. The instrument described in the article, which is still being tested, proposes a characterization of countries according to their telehealth development stage: nonexistent, nascent, intermediate, advanced, and exemplary. Currently, important telehealth initiatives are already underway in Latin America. PMID:25211578

  8. A Pilot Exploration of Speech Sound Disorder Intervention Delivered by Telehealth to School–Age Children

    PubMed Central

    Grogan-Johnson, Susan; Gabel, Rodney M.; Taylor, Jacquelyn; Rowan, Lynne E.; Alvares, Robin; Schenker, Jason

    2011-01-01

    This article describes a school-based telehealth service delivery model and reports outcomes made by school-age students with speech sound disorders in a rural Ohio school district. Speech therapy using computer-based speech sound intervention materials was provided either by live interactive videoconferencing (telehealth), or conventional side-by-side intervention. Progress was measured using pre- and post-intervention scores on the Goldman Fristoe Test of Articulation-2 (Goldman & Fristoe, 2002). Students in both service delivery models made significant improvements in speech sound production, with students in the telehealth condition demonstrating greater mastery of their Individual Education Plan (IEP) goals. Live interactive videoconferencing thus appears to be a viable method for delivering intervention for speech sound disorders to children in a rural, public school setting. PMID:25945180

  9. Theory-based telehealth and patient empowerment.

    PubMed

    Suter, Paula; Suter, W Newton; Johnston, Donna

    2011-04-01

    Health care technology holds great potential to improve the quality of health care delivery. One effective technology is remote patient monitoring, whereby patient data, such as vital signs or symptom reports, are captured from home monitoring devices and transmitted to health care professionals for review. The use of remote patient monitoring, often referred to as telehealth, has been widely adopted by health care providers, particularly home care agencies. Most agencies have invested in telehealth to facilitate the early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure and diabetes. This technology has been successfully harnessed by agencies to reduce rehospitalization rates through remote data interpretation and the provision of timely interventions. We propose that the use of telehealth by home care agencies and other health care providers be expanded to empower patients and promote disease self-management with resultant improved health care outcomes. This article describes how remote monitoring, in combination with the application of salient adult learning and cognitive behavioral theories and applied to telehealth care delivery and practice, can promote improved patient self-efficacy with disease management. We present theories applicable for improving health-related behaviors and illustrate how theory-based practices can be implemented in the field of home care. Home care teams that deliver theory-based telehealth function as valuable partners to physicians and hospitals in an integrated health care delivery system. PMID:21241182

  10. Demonstration of the Dynamic Flowgraph Methodology using the Titan 2 Space Launch Vehicle Digital Flight Control System

    NASA Technical Reports Server (NTRS)

    Yau, M.; Guarro, S.; Apostolakis, G.

    1993-01-01

    Dynamic Flowgraph Methodology (DFM) is a new approach developed to integrate the modeling and analysis of the hardware and software components of an embedded system. The objective is to complement the traditional approaches which generally follow the philosophy of separating out the hardware and software portions of the assurance analysis. In this paper, the DFM approach is demonstrated using the Titan 2 Space Launch Vehicle Digital Flight Control System. The hardware and software portions of this embedded system are modeled in an integrated framework. In addition, the time dependent behavior and the switching logic can be captured by this DFM model. In the modeling process, it is found that constructing decision tables for software subroutines is very time consuming. A possible solution is suggested. This approach makes use of a well-known numerical method, the Newton-Raphson method, to solve the equations implemented in the subroutines in reverse. Convergence can be achieved in a few steps.

  11. Proposal for a telehealth concept in the translational research model

    PubMed Central

    Silva, Angélica Baptista; Morel, Carlos Médicis; de Moraes, Ilara Hämmerli Sozzi

    2014-01-01

    OBJECTIVE To review the conceptual relationship between telehealth and translational research. METHODS Bibliographical search on telehealth was conducted in the Scopus, Cochrane BVS, LILACS and MEDLINE databases to find experiences of telehealth in conjunction with discussion of translational research in health. The search retrieved eight studies based on analysis of models of the five stages of translational research and the multiple strands of public health policy in the context of telehealth in Brazil. The models were applied to telehealth activities concerning the Network of Human Milk Banks, in the Telemedicine University Network. RESULTS The translational research cycle of human milk collected, stored and distributed presents several integrated telehealth initiatives, such as video conferencing, and software and portals for synthesizing knowledge, composing elements of an information ecosystem, mediated by information and communication technologies in the health system. CONCLUSIONS Telehealth should be composed of a set of activities in a computer mediated network promoting the translation of knowledge between research and health services. PMID:24897057

  12. Telehealth Innovations in Health Education and Training

    PubMed Central

    De, Suvranu; Hall, Richard W.; Johansen, Edward; Meglan, Dwight; Peng, Grace C.Y.

    2010-01-01

    Abstract Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences. PMID:20155874

  13. Telehealth innovations in health education and training.

    PubMed

    Conde, José G; De, Suvranu; Hall, Richard W; Johansen, Edward; Meglan, Dwight; Peng, Grace C Y

    2010-01-01

    Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences. PMID:20155874

  14. Occupational Therapy Home Safety Intervention via Telehealth.

    PubMed

    Breeden, Lori E

    2016-01-01

    Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist. In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety. After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions. Sessions were recorded and transcribed. Data were examined using content analysis. The content analysis identified the following themes: the value of photos to support learning; the value of narrative learning related to home safety education; and abstract versus concrete learners. Procedural findings are included to support future endeavors. Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention. PMID:27563389

  15. Occupational Therapy Home Safety Intervention via Telehealth

    PubMed Central

    BREEDEN, LORI E.

    2016-01-01

    Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist. In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety. After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions. Sessions were recorded and transcribed. Data were examined using content analysis. The content analysis identified the following themes: the value of photos to support learning; the value of narrative learning related to home safety education; and abstract versus concrete learners. Procedural findings are included to support future endeavors. Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention. PMID:27563389

  16. Towards a Formal Representation of Processes and Objects Regarding the Delivery of Telehealth Services: The Telehealth Ontology (TEON).

    PubMed

    Santana, Filipe; Schulz, Stefan; Campos, Amadeu; Novaes, Magdala A

    2015-01-01

    This study introduces ontological aspects concerning the Telehealth Ontology (TEON), an ontology that represents formal-ontological content concerning the delivery of telehealth services. TEON formally represents the main services, actors and other entity types relevant to telehealth service delivery. TEON uses the upper level ontology BioTopLite2 and reuses content from the Ontology for Biomedical Investigations (OBI). The services embedded in telehealth services are considered as essential as the common services provided by the health-related practices. We envision TEON as a service to support the development of telehealth systems. TEON might also enable the integration of heterogeneous telehealth systems, and provide a base to automatize the processing of telehealth-related content. PMID:26262407

  17. Home Telehealth Video Conferencing: Perceptions and Performance

    PubMed Central

    Morris, Greg; Pech, Joanne; Rechter, Stuart; Carati, Colin; Kidd, Michael R

    2015-01-01

    Background The Flinders Telehealth in the Home trial (FTH trial), conducted in South Australia, was an action research initiative to test and evaluate the inclusion of telehealth services and broadband access technologies for palliative care patients living in the community and home-based rehabilitation services for the elderly at home. Telehealth services at home were supported by video conferencing between a therapist, nurse or doctor, and a patient using the iPad tablet. Objective The aims of this study are to identify which technical factors influence the quality of video conferencing in the home setting and to assess the impact of these factors on the clinical perceptions and acceptance of video conferencing for health care delivery into the home. Finally, we aim to identify any relationships between technical factors and clinical acceptance of this technology. Methods An action research process developed several quantitative and qualitative procedures during the FTH trial to investigate technology performance and users perceptions of the technology including measurements of signal power, data transmission throughput, objective assessment of user perceptions of videoconference quality, and questionnaires administered to clinical users. Results The effectiveness of telehealth was judged by clinicians as equivalent to or better than a home visit on 192 (71.6%, 192/268) occasions, and clinicians rated the experience of conducting a telehealth session compared with a home visit as equivalent or better in 90.3% (489/540) of the sessions. It was found that the quality of video conferencing when using a third generation mobile data service (3G) in comparison to broadband fiber-based services was concerning as 23.5% (220/936) of the calls failed during the telehealth sessions. The experimental field tests indicated that video conferencing audio and video quality was worse when using mobile data services compared with fiber to the home services. As well, statistically

  18. Scout Launch

    NASA Technical Reports Server (NTRS)

    1961-01-01

    Scout Launch. James Hansen wrote: 'As this sequence of photos demonstrates, the launch of ST-5 on 30 June 1961 went well; however, a failure of the rocket's third stage doomed the payload, a scientific satellite known as S-55 designed for micrometeorite studies in orbit.'

  19. Personalized Telehealth in the Future: A Global Research Agenda.

    PubMed

    Dinesen, Birthe; Nonnecke, Brandie; Lindeman, David; Toft, Egon; Kidholm, Kristian; Jethwani, Kamal; Young, Heather M; Spindler, Helle; Oestergaard, Claus Ugilt; Southard, Jeffrey A; Gutierrez, Mario; Anderson, Nick; Albert, Nancy M; Han, Jay J; Nesbitt, Thomas

    2016-01-01

    As telehealth plays an even greater role in global health care delivery, it will be increasingly important to develop a strong evidence base of successful, innovative telehealth solutions that can lead to scalable and sustainable telehealth programs. This paper has two aims: (1) to describe the challenges of promoting telehealth implementation to advance adoption and (2) to present a global research agenda for personalized telehealth within chronic disease management. Using evidence from the United States and the European Union, this paper provides a global overview of the current state of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide a uniform framework for identifying and rapidly replicating best practices, while concurrently fostering global collaboration in the development and rigorous testing of new and emerging telehealth technologies. In this paper, the members of the Transatlantic Telehealth Research Network offer a 12-point research agenda for future telehealth applications within chronic disease management. PMID:26932229

  20. Personalized Telehealth in the Future: A Global Research Agenda

    PubMed Central

    2016-01-01

    As telehealth plays an even greater role in global health care delivery, it will be increasingly important to develop a strong evidence base of successful, innovative telehealth solutions that can lead to scalable and sustainable telehealth programs. This paper has two aims: (1) to describe the challenges of promoting telehealth implementation to advance adoption and (2) to present a global research agenda for personalized telehealth within chronic disease management. Using evidence from the United States and the European Union, this paper provides a global overview of the current state of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide a uniform framework for identifying and rapidly replicating best practices, while concurrently fostering global collaboration in the development and rigorous testing of new and emerging telehealth technologies. In this paper, the members of the Transatlantic Telehealth Research Network offer a 12-point research agenda for future telehealth applications within chronic disease management. PMID:26932229

  1. Managing congestive heart failure using home telehealth.

    PubMed

    Schneider, Nina M

    2004-10-01

    Congestive heart failure (CHF) is the leading cause of rehospitalization and loss of revenue for home care agencies and hospitals. This article outlines how an agency used telehealth to provide CHF patients quality care and improved outcomes while decreasing the number of skilled home nursing visits and reducing rehospitalization rates to 1.2%. PMID:15486513

  2. Telehealth interventions to reduce management complications in type 1 diabetes: A review

    PubMed Central

    Balkhi, Amanda M; Reid, Adam M; Westen, Sarah C; Olsen, Brian; Janicke, David M; Geffken, Gary R

    2015-01-01

    Type 1 diabetes is a chronic illness with a high burden of care. While effective interventions and recommendations for diabetes care exist, the intensive nature of diabetes management makes compliance difficult. This is especially true in children and adolescents as they have unique psychosocial and diabetes needs. Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions, namely time, cost, and access. Telehealth interventions allow for the dissemination of these interventions to a broader audience. Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use. While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over in-person interventions, many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered. These and other challenges are discussed with recommendations for researchers and telehealth providers provided. PMID:25897348

  3. Telehealth tools for public health, emergency, or disaster preparedness and response: a summary report.

    PubMed

    Alverson, Dale C; Edison, Karen; Flournoy, Larry; Korte, Brenda; Magruder, Charles; Miller, Craig

    2010-01-01

    Rapid advances in telehealth development and adoption are increasing the spectrum of information and communication technologies that can be applied not only to individual patient care but more broadly to population health as well. Participants in this breakout session were asked to address, from their diverse perspectives, a series of questions relating to the current and potential uses of telehealth applications and networks for public health and emergency/disaster preparedness and response systems. Participants identified several gaps in current understanding and research emphasis. There is a clear need for more and larger outcome studies to assess the impact and cost benefit of telehealth applications in terms of improving public health at the population and community levels. In addition, more research is needed to demonstrate the ability of telehealth tools and technologies to facilitate and extend the reach of major national clinical and public health research initiatives. Perhaps most importantly, the National Institutes of Health should develop and/or strengthen strategic partnerships with other funding agencies with overlapping or complementary interests to accelerate interdisciplinary research in this rapidly evolving but relatively understudied and complex field. PMID:20043703

  4. Nurses Leading the Transformation of Patient Care Through Telehealth.

    PubMed

    Yesenofski, Lori; Kromer, Sharon; Hitchings, Kim

    2015-12-01

    The essential role of nurses in leading, developing, and improving Lehigh Valley Health Network (LVHN) telehealth services and programs was a key reason the organization was selected to receive the American Nurses Credentialing Center 2013 Magnet® Prize. This article describes the application of telehealth as a nurse-led technology. The innovations within LVHN telehealth services are presented as well as essential success factors of design, implementation, and evaluation. PMID:26565644

  5. DEMONSTRATION OF IN SITU DEHALOGENATION OF DNAPL THROUGH INJECTION OF EMULSIFIED ZERO-VALIENT IRON AT LAUNCH COMPLEX 34 IN CAPE CANAVERAL AIR FORCE STATION, FLORIDA

    EPA Science Inventory

    The purpose of this project was to evaluate the technical and cost performance of emulsified zero-valent iron (EZVI) technology when applied to DNAPL contaminants in the saturated zone. This demonstration was conducted at Launch Complex 34, Cape Canaveral Air Force Station, FL, w...

  6. A Review of Telehealth Service Implementation Frameworks

    PubMed Central

    van Dyk, Liezl

    2014-01-01

    Despite the potential of telehealth services to increase the quality and accessibility of healthcare, the success rate of such services has been disappointing. The purpose of this paper is to find and compare existing frameworks for the implementation of telehealth services that can contribute to the success rate of future endeavors. After a thorough discussion of these frameworks, this paper outlines the development methodologies in terms of theoretical background, methodology and validation. Finally, the common themes and formats are identified for consideration in future implementation. It was confirmed that a holistic implementation approach is needed, which includes technology, organizational structures, change management, economic feasibility, societal impacts, perceptions, user-friendliness, evaluation and evidence, legislation, policy and governance. Furthermore, there is some scope for scientifically rigorous framework development and validation approaches. PMID:24464237

  7. What Facilitates the Use of Telehealth Applications Among Nurses?

    PubMed

    Koivunen, Marita; Saranto, Kaija

    2016-01-01

    This presentation describes the preliminary results of the facilitators of the use of telehealth applications from nurses' point of view based on a qualitative systematic literature review synthetizing 25 previously published papers. The study brought out two main categories that facilitate the use of telehealth among nurses: 1) Nurses' skills and attitudes, and 3) Changes in nurses' work and operations. PMID:27332423

  8. The Use of Telehealth in Schools. Position Statement. Revised

    ERIC Educational Resources Information Center

    Hoffmann, Susan; Dolatowski, Rosemary; McDowell, Bernadette; Mancuso, Patty; Rochkes, Laura L.; Wavra, Theresa Ernst; Selekman, Janice

    2012-01-01

    Telehealth has been defined as "the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration" (United States Department of Health and Human Services [USDHHS], n.d.). Telehealth enables collaboration of…

  9. An Art Therapy Solution to a Telehealth Problem.

    ERIC Educational Resources Information Center

    Collie, Kate; Cubranic, Davor

    1999-01-01

    Describes a gap that exists in the area of telehealth, the use of telecommunications technology to increase equality of access to healthcare, and proposes that computer-assisted distance art therapy can fill the need for telehealth delivery methods. Discusses a research study in which a computer system that supports distance art therapy was…

  10. Telehealth in the School Setting: An Integrative Review

    ERIC Educational Resources Information Center

    Reynolds, Cori A.; Maughan, Erin D.

    2015-01-01

    Telehealth, the provision of health care through long-distance telecommunications technology, is a tool that can be used by school nurses to address and improve the health status of schoolchildren. The purpose of this literature review is to examine research related to implementation of telehealth in the school setting. A review of the literature…

  11. Telehealth: important concepts for future nursing practice in space environments.

    PubMed

    Chonin, A

    1998-01-01

    The concept of telehealth has become a vital issue to healthcare providers in this day of instantaneous, varied, and technology-based communications. This article discusses the issues and implications of telehealth to nurses on Earth and in future space environments. Telehealth will be defined as currently implemented and the legal ramifications of practice across state lines, national borders, rural, and in remote and hazardous locations (space environments: orbital, Moon and Mars bases) will be delineated. The age of information is now here, and the age of communication is beginning. Telehealth is and will be an important means of providing communication links and healthcare to clients and providers alike. Healthcare professionals need to be aware of important concepts related to telehealth for their current and future practice. PMID:11871451

  12. Using the Australian and New Zealand Telehealth Committee framework to evaluate telehealth: identifying conceptual gaps.

    PubMed

    Hughes, Emma; King, Chris; Kitt, Sharon

    2002-12-01

    Telehealth is strongly supported in policy rhetoric as being economically significant to Australia, but evaluation standards have been insufficiently developed to ensure that this is the case. The use of one such evaluation standard, the Australian and New Zealand Telehealth Committee (ANZTC) framework, for telehealth evaluation in Australia makes good sense. However, that framework emphasizes economic and technical considerations at the expense of social contexts. Furthermore, there must be questions about the utility of a framework which, it appears, has been used to evaluate only a single telehealth project in Australia. The combination of the economic rationalism of health-care policy and the technological determinism of a tool model of information and communication technologies (ICTs) can result in evaluations that fail to match the complexities of the intersection of health-care and ICTs. Using the ANZTC framework while at the same time focusing on explaining, rather than just describing, the links between interventions and outcomes seems a reasonable compromise. This involves understanding complex socio-technical networks and relationships, and requires investigators to engage with the gulf between private opinions, public statements and actual behaviour. PMID:12537899

  13. Using the Australian and New Zealand Telehealth Committee framework to evaluate telehealth: identifying conceptual gaps.

    PubMed

    Hughes, Emma; King, Chris; Kitt, Sharon

    2002-01-01

    Telehealth is strongly supported in policy rhetoric as being economically significant to Australia, but evaluation standards have been insufficiently developed to ensure that this is the case. The use of one such evaluation standard, the Australian and New Zealand Telehealth Committee (ANZTC) framework, for telehealth evaluation in Australia makes good sense. However, that framework emphasizes economic and technical considerations at the expense of social contexts. Furthermore, there must be questions about the utility of a framework which, it appears, has been used to evaluate only a single telehealth project in Australia. The combination of the economic rationalism of health-care policy and the technological determinism of a tool model of information and communication technologies (ICTs) can result in evaluations that fail to match the complexities of the intersection of health-care and ICTs. Using the ANZTC framework while at the same time focusing on explaining, rather than just describing, the links between interventions and outcomes seems a reasonable compromise. This involves understanding complex socio-technical networks and relationships, and requires investigators to engage with the gulf between private opinions, public statements and actual behaviour. PMID:12661616

  14. Telehealth Regulatory and Legal Considerations: Frequently Asked Questions

    PubMed Central

    Cason, Jana; Brannon, Janice A.

    2011-01-01

    As telehealth gains momentum as a service delivery model in the United States within the rehabilitation professions, regulatory and legal questions arise. This article examines the following questions: Is there a need to secure licenses in two states (i.e., where the practitioner resides, and where the client is located), before engaging in telehealth?Do state laws differ concerning if and how telehealth can occur?Do any states expressly disallow telehealth?Can services delivered through telehealth be billed the same way as services provided in-person?If practitioners fulfill the requirements to maintain licensure (e.g., continuing education obligations) in their state of residence, do they also need to fulfill the requirements to maintain licensure for the state in which the client resides?Will professional malpractice insurance cover services delivered through telehealth?Does a sole practitioner need to abide by HIPAA regulations?Responses to these questions are offered to raise awareness of the regulatory and legal implications associated with the use of a telehealth service delivery model within the professions of occupational therapy, physical therapy, speech-language pathology and audiology. PMID:25945185

  15. Post-disaster Gulf Coast Recovery Using Telehealth

    PubMed Central

    Kim, Thomas J.; Eastburn, Sasha L.; Icenogle, Marjorie L.; Slagle, Michelle; Nuriddin, Azizeh H.; Brantley, Katrina M.; Foreman, Rachel D.; Buckner, Ayanna V.

    2013-01-01

    Abstract Objective: The Gulf Coast continues to struggle with service need far outpacing available resources. Since 2005, the Regional Coordinating Center for Hurricane Response (RCC) at Morehouse School of Medicine, Atlanta, GA, has supported telehealth solutions designed to meet high service needs (e.g., psychiatry) within primary care and other healthcare organizations. The overall RCC vision is to support autonomous, useful, and sustainable telehealth programs towards mitigating unmet disaster-related needs. Subjects and Methods: To assess Gulf Coast telehealth experiences, we conducted semistructured interviews with both regional key informants and national organizations with Gulf Coast recovery interests. Using qualitative-descriptive analysis, interview transcripts were analyzed to identify shared development themes. Results: Thirty-eight key informants were interviewed, representing a 77.6% participation rate among organizations engaged by the RCC. Seven elements critical to telehealth success were identified: Funding, Regulatory, Workflow, Attitudes, Personnel, Technology, and Evaluation. These key informant accounts reveal shared insights with telehealth regarding successes, challenges, and recommendations. Conclusions: The seven elements critical to telehealth success both confirm and organize development principles from a diverse collective of healthcare stakeholders. The structured nature of these insights suggests a generalizable framework upon which other organizations might develop telehealth strategies toward addressing high service needs with limited resources. PMID:23427981

  16. Telehealth: current practices and future directions

    NASA Astrophysics Data System (ADS)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  17. The Telehealth Skills, Training, and Implementation Project: An Evaluation Protocol

    PubMed Central

    Bonney, Andrew; Mullan, Judy; Moscova, Michelle; Barnett, Stephen; Iverson, Don; Saffioti, Daniel; Eastland, Elisabeth; Guppy, Michelle; Weston, Kathryn; Wilson, Ian; Hudson, Judith Nicky; Pond, Dimity; Gill, Gerard; Hespe, Charlotte

    2015-01-01

    Background Telehealth appears to be an ideal mechanism for assisting rural patients and doctors and medical students/registrars in accessing specialist services. Telehealth is the use of enhanced broadband technology to provide telemedicine and education over distance. It provides accessible support to rural primary care providers and medical educators. A telehealth consultation is where a patient at a general practice, with the assistance of the general practitioner or practice nurse, undertakes a consultation by videoconference with a specialist located elsewhere. Multiple benefits of telehealth consulting have been reported, particularly those relevant to rural patients and health care providers. However there is a paucity of research on the benefits of telehealth to medical education and learning. Objective This protocol explains in depth the process that will be undertaken by a collaborative group of universities and training providers in this unique project. Methods Training sessions in telehealth consulting will be provided for participating practices and students. The trial will then use telehealth consulting as a real-patient learning experience for students, general practitioner trainees, general practitioner preceptors, and trainees. Results Results will be available when the trial has been completed in 2015. Conclusions The protocol has been written to reflect the overarching premise that, by building virtual communities of practice with users of telehealth in medical education, a more sustainable and rigorous model can be developed. The Telehealth Skills Training and Implementation Project will implement and evaluate a theoretically driven model of Internet-facilitated medical education for vertically integrated, community-based learning environments PMID:25567780

  18. A product-service system approach to telehealth application design.

    PubMed

    Flores-Vaquero, Paul; Tiwari, Ashutosh; Alcock, Jeffrey; Hutabarat, Windo; Turner, Chris

    2016-06-01

    A considerable proportion of current point-of-care devices do not offer a wide enough set of capabilities if they are to function in any telehealth system. There is a need for intermediate devices that lie between healthcare devices and service networks. The development of an application is suggested that allows for a smartphone to take the role of an intermediate device. This research seeks to identify the telehealth service requirements for long-term condition management using a product-service system approach. The use of product-service system has proven to be a suitable methodology for the design and development of telehealth smartphone applications. PMID:25466775

  19. Telehealth: A Rapidly Developing Service Delivery Model For Occupational Therapy

    PubMed Central

    Cason, Jana

    2014-01-01

    Over the past decade, the practice of occupational therapy has been increasingly influenced by technological advances in the use of information and communication technologies (ICT) and associated changes in health care policy. Emergent from this evolution is the application of telehealth to deliver occupational therapy services to a client who is in a different physical location than the provider. This article furnishes an overview of the evidence for telehealth use in occupational therapy, discusses key policy considerations, and provides resources to guide practitioners in the ethical use of telehealth. PMID:25945220

  20. Telehealth: a rapidly developing service delivery model for occupational therapy.

    PubMed

    Cason, Jana

    2014-01-01

    Over the past decade, the practice of occupational therapy has been increasingly influenced by technological advances in the use of information and communication technologies (ICT) and associated changes in health care policy. Emergent from this evolution is the application of telehealth to deliver occupational therapy services to a client who is in a different physical location than the provider. This article furnishes an overview of the evidence for telehealth use in occupational therapy, discusses key policy considerations, and provides resources to guide practitioners in the ethical use of telehealth. PMID:25945220

  1. IRIS Launch Animation

    NASA Video Gallery

    This animation demonstrates the launch and deployment of NASA's Interface Region Imaging Spectrograph (IRIS) mission satellite via a Pegasus rocket. The launch is scheduled for June 26, 2013 from V...

  2. 75 FR 2595 - Proposed Information Collection (Care Coordination Home Telehealth (CCHT) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Care Coordination Home Telehealth (CCHT) Activity: Comment... use of other forms of information technology. Title: Care Coordination Home Telehealth (CCHT)...

  3. 75 FR 15496 - Agency Information Collection (Care Coordination Home Telehealth (CCHT)) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Care Coordination Home Telehealth (CCHT)) Activity Under OMB Review...).'' SUPPLEMENTARY INFORMATION: Title: Care Coordination Home Telehealth (CCHT) Patient Satisfaction Survey, VA...

  4. Telehealth: the backbone of healthcare financing.

    PubMed

    Suleiman, Abu Bakar

    2004-01-01

    Malaysia, like many other countries faces major challenges in meeting increasing demands with limited resources. Changes in demography, life-style diseases, increasing consumer expectations, new medical technologies and rapid economic growth all fuel demand for more healthcare services. There are problems related to the distribution and delivery of healthcare services, and there is inadequate integration of healthcare delivery and continuity of care is a major concern. Resources tend to be concentrated in the very expensive hospital sector, although services would be cost-effectively and conveniently delivered at primary care level. There is no ideal healthcare system, and how healthcare is supported and organized for service delivery influences the country's social, economic and political well-being. Like many other countries, Malaysia is undergoing health reform in meeting these challenges, and is becoming more reliant on telemedicine and telehealth. PMID:15747978

  5. Tele-Health and neurology: what is possible?

    PubMed

    Timpano, Francesca; Bonanno, Lilla; Bramanti, Alessia; Pirrotta, Fabio; Spadaro, Letteria; Bramanti, Placido; Lanzafame, Pietro

    2013-12-01

    Emerging information and communication technology is changing medical and psychological practice by enabling the provision of services across time and distance, yet there are significant concerns about these applications. Given the emerging nature of trial evidence in teleneurology, our aim is to provide a narrative review, in order to investigate possible oncoming fields of applications that are very important in healthcare practices delivered to patients affected by neurological diseases. We will focus on the use of Tele-Health in neurological practice, highlighting the potential benefits of applying information and communication technology also to psychosocial and educational aspects of neurological diseases treatment. This work is based on PubMed search, manual search of published abstracts/conference proceedings, and consultation with investigators in neurological disease. We refer also to the broader Tele-Health research concerning mental diseases. Tele-Health has obvious advantages in rural areas, where it improves access to health services, obviating the need for patients and healthcare workers to travel and assuring continuance to healthcare services delivery. Even in urban areas, however, Tele-Health can improve access to health services and to information. It may sometimes also be cheaper than conventional practice, even if there is generally limited knowledge of the cost-effectiveness of Tele-Health services compared to conventional methods of delivering health services. PMID:23430169

  6. The Promise of Direct-to-Consumer Telehealth for Disaster Response and Recovery.

    PubMed

    Uscher-Pines, Lori; Fischer, Shira; Chari, Ramya

    2016-08-01

    Telehealth has great promise to improve and even revolutionize emergency response and recovery. Yet telehealth in general, and direct-to-consumer (DTC) telehealth in particular, are underutilized in disasters. Direct-to-consumer telehealth services allow patients to request virtual visits with health care providers, in real-time, via phone or video conferencing (online video or mobile phone applications). Although DTC services for routine primary care are growing rapidly, there is no published literature on the potential application of DTC telehealth to disaster response and recovery because these services are so new. This report presents several potential uses of DTC telehealth across multiple disaster phases (acute response, subacute response, and recovery) while noting the logistical, legal, and policy challenges that must be addressed to allow for expanded use. Uscher-Pines L , Fischer S , Chari R . The promise of direct-to-consumer telehealth for disaster response and recovery. Prehosp Disaster Med. 2016;31(4):454-456. PMID:27216971

  7. Positive Clinical Outcomes Are Synergistic With Positive Educational Outcomes When Using Telehealth Consulting in General Practice: A Mixed-Methods Study

    PubMed Central

    Bonney, Andrew; Teuss, Grigorijs; Guppy, Michelle; Lafferre, Danielle; Mullan, Judy; Barnett, Stephen

    2016-01-01

    their views. In the analysis of the qualitative data, five themes emerged from the analyses concerning the educational benefits of Telehealth Consulting for different levels of learners, while three themes were identified concerning clinical benefits. Conclusions The results demonstrated strong synergies between the learning derived from the telehealth consulting and the clinical benefits to the patient and clinicians involved. PMID:26858152

  8. Experience and hopes for telehealth in Tokelau.

    PubMed

    Adam, P

    2000-09-01

    The two key factors affecting healthcare in Tokelau are its small population and its great isolation. Both of these make telehealth a critical issue for the development of health services and it is hard to see how the services can develop to a modern standard without a larger component of telemedicine. The Tokelau islands consist of three roughly equal atolls usually served by 1-2 doctors who deal with all aspects of medical care. There is a small hospital on each atoll and each is staffed by a Nurse manager, two staff nurses and some nurse aides. There is a need for a communication facility for the nurse on the atoll(s) without a doctor to consult with a doctor about medical cases; doctors to consult each other; and for doctors to consult outside specialists about the management of cases. Distance education for health care staff is another perceived need. The current communications systems are still basic and although there is a PeaceSat terminal on each atoll it has largely failed to provide the above communication needs and most is still done by the costly telephone system. Recently ITC has been made a priority for the health department. PMID:11588926

  9. Feasibility and Acceptance of a Telehealth Intervention to Promote Symptom Management during Treatment for Head and Neck Cancer.

    PubMed

    Head, Barbara A; Keeney, Cynthia; Studts, Jamie L; Khayat, Mamdouh; Bumpous, Jeffrey; Pfeifer, Mark

    2011-01-01

    Patients undergoing treatment for head and neck cancers have a myriad of distressing symptoms and treatment side effects which significantly alter communication and lower quality of life. Telehealth technology has demonstrated promise in improving patient-provider communication by delivering supportive educational content and guidance to patients in their homes. A telehealth intervention using a simple telemessaging device was developed to provide daily education, guidance, and encouragement for patients undergoing initial treatment of head and neck cancer. The goal of this article is to report the feasibility and acceptance of the intervention using both quantitative and qualitative measures. No eligible patients declined participation based on technology issues. Participants completed the intervention over 86% of the expected days of use. Direct nursing contact was seldom needed during the study period. Satisfaction with the technology and the intervention was very high. In this study a telehealth intervention was shown to be feasible, well accepted, and regularly used by patients experiencing extreme symptom burden and declining quality of life as a result of aggressive treatment for head and neck cancer. PMID:21499540

  10. Use of a telehealth system by older adults with hypertension

    PubMed Central

    Czaja, Sara J; Lee, Chin Chin; Arana, Neysari; Nair, Sankaran N; Sharit, Joseph

    2016-01-01

    We conducted a feasibility study of a home telehealth system that monitored blood pressure and bodyweight. A total of 34 participants with hypertension (10 males and 24 females) had the telemedicine system installed in their homes. Their mean age was 72 years and 94% of them self-identified as Hispanic. The telehealth system transmitted blood pressure and bodyweight data to a server. There was also a messaging function that was used to send a daily reminder to the participants. Participants used the telehealth system for six months. Ten participants were lost to follow up and 24 participants completed the entire study. Participants had strong positive perceptions regarding the usability and usefulness of the telemedicine system. Most of them (92%) found the device easy to use and 96% felt that the training they received prepared them to use the device. The providers indicated that use of the system improved their ability to manage their patients. The results of the study suggest that use of the telehealth system for home monitoring in Hispanic patients with hypertension is feasible. PMID:24803275

  11. Sustainable Rural Telehealth Innovation: A Public Health Case Study

    PubMed Central

    Singh, Rajendra; Mathiassen, Lars; Stachura, Max E; Astapova, Elena V

    2010-01-01

    Objective To examine adoption of telehealth in a rural public health district and to explain how the innovation became sustainable. Study Setting Longitudinal, qualitative study (1988–2008) of the largest public health district in Georgia. Study Design Case study design provided deep insights into the innovation's social dynamics. Punctuated equilibrium theory helped present and make sense of the process. We identified antecedent conditions and outcomes, and we distinguished between episodes and encounters based on the disruptive effects of events. Data Collection Twenty-five semistructured interviews with 19 decision makers and professionals, direct observations, published papers, grant proposals, technical specifications, and other written materials. Principal Findings Strong collaboration within the district, with local community, and with external partners energized the process. Well-functioning outreach clinics made telehealth desirable. Local champions cultivated participation and generative capability, and overcame barriers through opportunistic exploitation of technological and financial options. Telehealth usage fluctuated between medical and administrative operations in response to internal needs and contextual dynamics. External agencies provided initial funding and supported later expansion. Conclusions Extensive internal and external collaboration, and a combination of technology push and opportunistic exploitation, can enable sustainable rural telehealth innovation. PMID:20459449

  12. Attitudes toward Telehealth Use among Rural Residents: A Danish Survey

    ERIC Educational Resources Information Center

    Sorensen, Jens F. L.

    2008-01-01

    Context: Rural communities tend to be underserved by medical services. Low access to medical services affects quality of life and may also affect settlement decisions. The use of telehealth has often been mentioned as an alternative way to provide health care services in remote, underserved areas. One prerequisite for successful delivery of health…

  13. TeleCITE: Telehealth--A Cochlear Implant Therapy Exchange

    ERIC Educational Resources Information Center

    Stith, Joanna; Stredler-Brown, Arlene; Greenway, Pat; Kahn, Gary

    2012-01-01

    What might bring the efforts of a physician, a speech-language pathologist, a teacher of the deaf and hard of hearing, and a nurse together? The answer is the innovative use of telepractice to deliver high quality, family-centered early intervention to infants and toddlers with hearing loss. TeleCITE: Telehealth--A Cochlear Implant Therapy…

  14. Telehealth on heart failure: results of the Recap project.

    PubMed

    Varon, Carolina; Alao, Morenikeji; Minter, Jan; Stapleton, Michelle; Thomson, Stuart; Jaecques, Siegfried; Rocca, Hans-Peter Bl; Huffel, Sabine V

    2015-09-01

    Telehealth has become a very important tool that allows the monitoring of heart failure patients in a home environment. However, little is known about the effect that such monitoring systems have on patients' compliance, evolution and self-care behaviour. In particular, the effect that the selected user interface has on these factors is unknown. This study aims to investigate this, and to determine some practicalities that must be considered when designing and implementing a telehealth programme for heart failure. To achieve this, daily measurements of blood pressure, pulse, SpO2 and weight were collected from 534 patients suffering from heart failure. In addition, they were asked to fill in the European heart failure self-care behaviour scale questionnaire and the EQ-5D quality of life questionnaire, before and after the monitoring period. Two telehealth systems were used, the Motiva platform provided by Philips and the standalone unit provided by Docobo, the Doc@Home system. Significant differences were found between both systems concerning the compliance and adherence of patients. Moreover, a general, positive effect of telehealth was identified due to the fact that patients showed an increased self-awareness when managing their condition. These findings are supported by behavioural changes and a better understanding of heart failure from the patients' perspective. PMID:25962654

  15. Bridging the Gap: Telehealth in Profoundly Rural America.

    ERIC Educational Resources Information Center

    Holderegger, John; Fortune, Jon; Fortune, Barbara

    This report describes the activities and outcomes of a pioneering Telehealth project in which clinical psychologists use state of the art satellite technology to consult with paraprofessionals who live and provide treatment settings to persons with the dual diagnosis of developmental disabilities and mental illnesses. The goal is to provide early…

  16. 42 CFR 414.65 - Payment for telehealth services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for telehealth services. 414.65 Section 414.65 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Physicians and Other Practitioners § 414.65 Payment...

  17. World Federation Of Occupational Therapists’ Position Statement On Telehealth

    PubMed Central

    2014-01-01

    The purpose of this document is to state the World Federation of Occupational Therapists’ (WFOT) position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT) to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider) as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy. Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served, and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed. PMID:25945221

  18. Telehealth: Families Finding Ways to Connect in Rural Colorado

    ERIC Educational Resources Information Center

    Kaiser, Kristen

    2011-01-01

    JFK Partners, at the University of Colorado Denver, School of Medicine, is currently implementing a study on the use of telehealth (receiving treatment or services using videoconferencing technology, such as Skype) and youth with autism spectrum disorder (ASD) and anxiety. The study is an exploratory grant from Health Resources and Services…

  19. World Federation of occupational therapists' position statement on telehealth.

    PubMed

    2014-01-01

    The purpose of this document is to state the World Federation of Occupational Therapists' (WFOT) position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT) to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider) as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy. Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served, and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed. PMID:25945221

  20. Asynchronous telehealth: a scoping review of analytic studies

    PubMed Central

    Deshpande, Amol; Khoja, Shariq; Lorca, Julio; McKibbon, Ann; Rizo, Carlos; Husereau, Donald; Jadad, Alejandro R

    2009-01-01

    Background Asynchronous telehealth captures clinically important digital samples (e.g., still images, video, audio, text files) and relevant data in one location and subsequently transmits these files for interpretation at a remote site by health professionals without requiring the simultaneous presence of the patient involved and his or her health care provider. Its utility in the health care system, however, still remains poorly defined. We conducted this scoping review to determine the impact of asynchronous telehealth on health outcomes, process of care, access to health services, and health resources. Methods A search was performed up to December 2006 of MEDLINE, CINAHL, HealthSTAR, the Database of Abstracts of Reviews of Effectiveness, and The Cochrane Library. Studies were included if they contained original data on the use of asynchronous telehealth and were published in English in a peer-reviewed journal. Two independent reviewers screened all articles and extracted data, reaching consensus on the articles and data identified. Data were extracted on general study characteristics, clinical domain, technology, setting, category of outcome, and results. Study quality (internal validity) was assessed using the Jadad scale for randomized controlled trials and the Downs and Black index for non-randomized studies. Summary data were categorized by medical specialty and presented qualitatively. Results The scoping review included 52 original studies from 238 citations identified; of these 52, almost half focused on the use of telehealth in dermatology. Included studies were characterized by diverse designs, interventions, and outcomes. Only 16 studies were judged to be of high quality. Most studies showed beneficial effects in terms of diagnostic accuracy, wait times, referral management, and satisfaction with services. Evidence on the impact of asynchronous telehealth on resource use in dermatology suggests a reduction in the number of, or avoidance of, in

  1. The organising vision for telehealth and telecare: discourse analysis

    PubMed Central

    Procter, Rob; Wherton, Joe; Sugarhood, Paul; Shaw, Sara

    2012-01-01

    Objective To (1) map how different stakeholders understand telehealth and telecare technologies and (2) explore the implications for development and implementation of telehealth and telecare services. Design Discourse analysis. Sample 68 publications representing diverse perspectives (academic, policy, service, commercial and lay) on telehealth and telecare plus field notes from 10 knowledge-sharing events. Method Following a familiarisation phase (browsing and informal interviews), we studied a systematic sample of texts in detail. Through repeated close reading, we identified assumptions, metaphors, storylines, scenarios, practices and rhetorical positions. We added successive findings to an emerging picture of the whole. Main findings Telehealth and telecare technologies featured prominently in texts on chronic illness and ageing. There was no coherent organising vision. Rather, four conflicting discourses were evident and engaged only minimally with one another's arguments. Modernist discourse presented a futuristic utopian vision in which assistive technologies, implemented at scale, would enable society to meet its moral obligations to older people by creating a safe ‘smart’ home environment where help was always at hand, while generating efficiency savings. Humanist discourse emphasised the uniqueness and moral worth of the individual and tailoring to personal and family context; it considered that technologies were only sometimes fit for purpose and could create as well as solve problems. Political economy discourse envisaged a techno-economic complex of powerful vested interests driving commodification of healthcare and diversion of public funds into private business. Change management discourse recognised the complicatedness of large-scale technology programmes and emphasised good project management and organisational processes. Conclusion Introduction of telehealth and telecare is hampered because different stakeholders hold different assumptions

  2. The Church as a Bridge to Deliver Health Resources Via Telehealth

    ClinicalTrials.gov

    2016-05-11

    Obesity; Diet, Food, and Nutrition; Church; Healthcare Disparities; Minority Health; Mobile Health; Telehealth; Community-based Participatory Research; Primary Health Care; Weight Loss Programs; Health Behavior

  3. Discovering untapped relationship potential with patients in telehealth: a qualitative interview study

    PubMed Central

    Wolf, Axel; Ali, Lilas; Sonntag, Steffen Mark; Ekman, Inger

    2016-01-01

    Objectives To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. Design 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed using an iterative process of 3 coding rounds. Participants 20 telehealth professionals. Setting A telehealth service centre in the south of Germany that provided care for 12 000 patients with chronic heart failure across Germany. Results Non-video telehealth technology creates an atmosphere that fosters sharing of personal information and a non-judgemental attitude. This facilitates the delivery of fair and equal healthcare. A combination of a protocol-driven service structure along with shared team and organisational values provide a basis for establishing long-term healthcare relationships. However, each contact between a telehealth professional and a patient has an uncertain outcome and requires skilful negotiation of the relationship. Although care provision was personalised, there was scope to include the patients as ‘experts on their own illness’ to a greater extent as advocated by person-centred care. Currently, provision of person-centred care is not sufficiently addressed in telehealth professional training. Conclusions Telehealth offers a viable environment for the delivery of person-centred care for patients with long-standing disease. Current telehealth training programmes may be enhanced by teaching person-centred care skills. PMID:26936904

  4. Tablet PC Enabled Body Sensor System for Rural Telehealth Applications

    PubMed Central

    Panicker, Nitha V.; Kumar, A. Sukesh

    2016-01-01

    Telehealth systems benefit from the rapid growth of mobile communication technology for measuring physiological signals. Development and validation of a tablet PC enabled noninvasive body sensor system for rural telehealth application are discussed in this paper. This system includes real time continuous collection of physiological parameters (blood pressure, pulse rate, and temperature) and fall detection of a patient with the help of a body sensor unit and wireless transmission of the acquired information to a tablet PC handled by the medical staff in a Primary Health Center (PHC). Abnormal conditions are automatically identified and alert messages are given to the medical officer in real time. Clinical validation is performed in a real environment and found to be successful. Bland-Altman analysis is carried out to validate the wrist blood pressure sensor used. The system works well for all measurements. PMID:26884757

  5. Tablet PC Enabled Body Sensor System for Rural Telehealth Applications.

    PubMed

    Panicker, Nitha V; Kumar, A Sukesh

    2016-01-01

    Telehealth systems benefit from the rapid growth of mobile communication technology for measuring physiological signals. Development and validation of a tablet PC enabled noninvasive body sensor system for rural telehealth application are discussed in this paper. This system includes real time continuous collection of physiological parameters (blood pressure, pulse rate, and temperature) and fall detection of a patient with the help of a body sensor unit and wireless transmission of the acquired information to a tablet PC handled by the medical staff in a Primary Health Center (PHC). Abnormal conditions are automatically identified and alert messages are given to the medical officer in real time. Clinical validation is performed in a real environment and found to be successful. Bland-Altman analysis is carried out to validate the wrist blood pressure sensor used. The system works well for all measurements. PMID:26884757

  6. Exploring challenges to telehealth communication by specialists in poison information.

    PubMed

    Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

    2012-01-01

    The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals. PMID:21873282

  7. Professional liability risks and risk management for nurses in telehealth.

    PubMed

    McLean, Pat

    2003-01-01

    This paper will identify professional liability risks including licensure and malpractice risks associated with the delivery of professional health care services by nurses through the medium of information and communications technology (ICT). Risk management strategies to address these risks will be presented. In Canada, telehealth is defined as "the use of communications and information technology to deliver health and healthcare services and information over large and small distances" (Industry Canada, 1997). The use of ICT to deliver professional health care services in Canada is growing rapidly. New health care call centres, staffed by registered nurses, have burgeoned in the past 2 years and other health care organizations are now offering similar services. Whereas, in the "good old days", all health care providers were cautioned against giving health care information over the telephone because of the risk of error and possible malpractice suits, this is now an accepted practice. It is important to recognize that the legal risks are as high as they ever were unless they are appropriately managed through a variety of risk management strategies. Self-regulating groups of Canadian health professionals are also struggling with the legal ramifications of telehealth in relation to the locus of accountability of the health professional, when the client lives in a different jurisdiction from the nurse. This presentation will stress the importance of risk management in telehealth delivery. It is vitally important for the protection of the public and of health care professionals that telehealth services are delivered in a way that minimizes the risk of harm and subsequent legal action. PMID:15074758

  8. Health care on demand: four telehealth priorities for 2016.

    PubMed

    Grube, Mark E; Kaufman, Kenneth; Clarin, Dan; O'Riordan, Jason

    2016-01-01

    Consumers who are accustomed to on-demand, virtual services are looking for more convenient ways to access health care. Giving patients the opportunity to connect with physicians remotely can promote higher patient satisfaction and engagement. Telehealth options may have a high start-up cost, but that cost is likely well-justified by the potential to enhance quality, outcomes, and customer attraction and satisfaction/retention over the long-term. PMID:26863834

  9. E-learning and telehealth: measuring your success.

    PubMed

    Kobb, Rita F; Lane, Robert J; Stallings, Deidre

    2008-08-01

    Organizations that provide training for their employees are interested in translating training expenditures into benefits. Even though there are several common methodologies that are used to train employees, finding the right methodology to stimulate learning and develop a competent workforce while reducing fiscal burdens can be challenging. One such method that continues to grow in popularity is e-learning. For the purpose of this discussion, e-learning refers to Internet-based or online training. The Veterans Health Administration's (VHA's) Office of Care Coordination (OCC) was established in July 2003 to oversee the national implementation of its telehealth initiatives. As part of this implementation, the OCC created a national center, the Sunshine Training Center, to work directly with the VHA's Employees Education System (EES) to develop a home telehealth Web-based curriculum. After 3 years, the Sunshine Training Center and EES initiated an Impact Evaluation Process. Over five hundred staff completed the online impact survey. This number represented a 74% response rate. Staff responded overwhelmingly in the positive on the benefits of e-learning for building telehealth skills. PMID:18729757

  10. Telehealth application on the rehabilitation of children and adolescents

    PubMed Central

    dos Santos, Maria Tereza N.; Moura, Sarah Costa D. O.; Gomes, Ludmila Mourão X.; Lima, Ana Henriques; Moreira, Rafaela Silva; Silva, Caroline Duarte; Guimarães, Eliane Marina P.

    2014-01-01

    Objective: To systematically review the literature on the telehealth initiatives in telerehabilitation practices in children and adolescents from zero to 18 years old. Data sources: Randomized and controlled clinical trials published in the past ten years (January 2002 to February 2012) in Medline/PubMed, Medline/BVS, PEDro and Cochrane Library databases. The descriptors "telemedicine", "rehabilitation" and "telehealth" were used in three different languages (English, Portuguese and Spanish). Data synthesis: From the 20 studies found in the literature, nine were included in this review. Most of the studies showed that telerehabilitation is able to produce better results in the treatment when compared to the traditional methods, providing less frequency of symptoms, better disease control, better quality of life and greater adherence to treatment. Conclusions: Telerehabilitation is a viable and effective strategy in the treatment of common diseases in children and adolescents. However, there are few studies on the subject in this age group. Although telehealth is already consolidated worldwide, there are no studies in Brazil that used the telerehabilitation in children and adolescents, which reinforces the need for more research and investments. PMID:24676201

  11. Education of health professionals using a proposed telehealth system.

    PubMed Central

    Chang, B. L.; Trelease, R.

    1999-01-01

    The movement of health care from hospitals to the community has demanded a major shift in the way in which health care professionals are being taught. This paper describes the collaboration of the Schools of Nursing and Medicine in the use of telehealth technology for the education of health care professionals. The specific aims of the project were to use the technology for the verification of the students' assessment and physical examinations, for the conduct of multi-professional patient rounds, and provision of consultations to professionals at remote sites. Capitalizing on the Schools' previous experience for observing students via computer technology at remote sites, we employed PC-based workstations, specialized peripherals, and Internet connecting protocols to implement a telehealth project for professional clinical education. Initial student, faculty and staff reactions were generally positive. The formal evaluation plan focuses on students, faculty, and staff. Structured questionnaires are used and a comparison of learning by telehealth technology will be made with alternative (more conventional) methods in evaluating knowledge and quality of verification of physical examination findings, and satisfaction with the learning process. Images Figure 1 Figure 2 Figure 3 PMID:10566408

  12. A Phase II Trial of Telehealth Delivery of the Lidcombe Program of Early Stuttering Intervention

    ERIC Educational Resources Information Center

    Lewis, Christine; Packman, Ann; Onslow, Mark; Simpson, Judy M.; Jones, Mark

    2008-01-01

    Purpose: The aims of this study were to evaluate the efficacy of telehealth delivery of the Lidcombe Program of Early Stuttering Intervention, compared with a control group, and to determine the number of children who could be regarded as "responders." Method: A speech-language pathologist provided telehealth delivery of the Lidcombe Program…

  13. Pediatric Obesity Management in Rural Clinics in California and the Role of Telehealth in Distance Education

    ERIC Educational Resources Information Center

    Shaikh, Ulfat; Nettiksimmons, Jasmine; Romano, Patrick

    2011-01-01

    Objective: To determine health care provider needs related to pediatric obesity management in rural California and to explore strategies to improve care through telehealth. Methods: Cross-sectional survey of health care providers who treated children and adolescents at 41 rural clinics with existing telehealth connectivity. Results: Most of the…

  14. Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

    ERIC Educational Resources Information Center

    Wainer, Allison L.; Ingersoll, Brooke R.

    2015-01-01

    Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

  15. For telehealth to succeed, privacy and security risks must be identified and addressed.

    PubMed

    Hall, Joseph L; McGraw, Deven

    2014-02-01

    The success of telehealth could be undermined if serious privacy and security risks are not addressed. For example, sensors that are located in a patient's home or that interface with the patient's body to detect safety issues or medical emergencies may inadvertently transmit sensitive information about household activities. Similarly, routine data transmissions from an app or medical device, such as an insulin pump, may be shared with third-party advertisers. Without adequate security and privacy protections for underlying telehealth data and systems, providers and patients will lack trust in the use of telehealth solutions. Although some federal and state guidelines for telehealth security and privacy have been established, many gaps remain. No federal agency currently has authority to enact privacy and security requirements to cover the telehealth ecosystem. This article examines privacy risks and security threats to telehealth applications and summarizes the extent to which technical controls and federal law adequately address these risks. We argue for a comprehensive federal regulatory framework for telehealth, developed and enforced by a single federal entity, the Federal Trade Commission, to bolster trust and fully realize the benefits of telehealth. PMID:24493763

  16. 77 FR 50549 - Agency Information Collection: Emergency Submission for OMB Review (Telehealth in the Parkinson's...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... AFFAIRS Agency Information Collection: Emergency Submission for OMB Review (Telehealth in the Parkinson's... for information needed to improve the care and clinical outcomes of patients with Parkinson's disease... ``Telehealth in the Parkinson's Disease Research, Education and Clinical Center (PADRECC): The Key to...

  17. Telehealth: seven strategies to successfully implement disruptive technology and transform health care.

    PubMed

    Schwamm, Lee H

    2014-02-01

    "Telehealth" refers to the use of electronic services to support a broad range of remote services, such as patient care, education, and monitoring. Telehealth must be integrated into traditional ambulatory and hospital-based practices if it is to achieve its full potential, including addressing the six domains of care quality defined by the Institute of Medicine: safe, effective, patient-centered, timely, efficient, and equitable. Telehealth is a disruptive technology that appears to threaten traditional health care delivery but has the potential to reform and transform the industry by reducing costs and increasing quality and patient satisfaction. This article outlines seven strategies critical to successful telehealth implementation: understanding patients' and providers' expectations, untethering telehealth from traditional revenue expectations, deconstructing the traditional health care encounter, being open to discovery, being mindful of the importance of space, redesigning care to improve value in health care, and being bold and visionary. PMID:24493761

  18. An Analysis Of State Telehealth Laws And Regulations For Occupational Therapy And Physical Therapy

    PubMed Central

    Calouro, Christine; Kwong, Mei Wa; Gutierrez, Mario

    2014-01-01

    This study conducted a scan of telehealth occupational therapy and physical therapy state laws and regulations. The laws and regulations were analyzed to determine the potential effect they could have on occupational therapists’ and physical therapists’ utilization of telehealth. The results indicate that the majority of occupational therapy and physical therapy boards are silent on telehealth. A handful of physical therapy laws and regulations address “consultation by means of telecommunication,” but do not provide any guidance for practitioners seeking to provide direct telehealth-delivered services to patients. Of the few states that do provide guidance, policy had the potential to provide clarity or inhibit adoption. The findings suggest that as state boards consider crafting telehealth regulations, they should do so in a manner that facilitates, rather than hampers adoption, while upholding their providers to a high standard of care. PMID:25945218

  19. The Process for the Formulation of the International Telehealth Position Statement for Occupational Therapy

    PubMed Central

    JACOBS, KAREN; CASON, JANA; MCCULLOUGH, ANN

    2015-01-01

    The World Federation of Occupational Therapists (WFOT) consists of 84 member organizations representing over 420,000 occupational therapists internationally (WFOT, 2014). In 2014, WFOT published the WFOT Telehealth Position Statement on the use of telehealth in occupational therapy. The process for the formulation of the official document involved reviewing WFOT member organizations’ telehealth position statements and data collected from a survey sent to member organizations’ delegates in April 2014. Qualitative data from 39 countries yielded factors to consider in five key areas: licensure/registration requirements, the cost of technology, privacy and security, reimbursement/payment models, and other issues (e.g., need for collaboration/transfer of knowledge, client selection, provider competencies, standard of care). The WFOT Telehealth Position Statement addressed each of these areas. The collaborative effort resulting in the development of the WFOT Telehealth Position Statement serves as a model for other international organizations. PMID:27563380

  20. NPP Launch

    NASA Video Gallery

    NASA's National Polar-orbiting Operational Environmental Satellite System Preparatory Project (NPP) spacecraft was launched aboard a Delta II rocket at 5:48 a.m. EDT today, on a mission to measure ...

  1. Evaluation of a Telehealth Service for COPD and HF patients: Clinical outcome and patients' perceptions.

    PubMed

    Odeh, Bassel; Kayyali, Reem; Nabhani-Gebara, Shereen; Philip, Nada; Robinson, Patricia; Wallace, Catherine Russell

    2015-07-01

    NHS Croydon Health Services and NHS Croydon Clinical Commissioning Group have been providing telehealth services for the past 36 months. The aim of this study was to measure the impact of telehealth when implemented as a service within a standard patient care pathway. To measure the clinical outcomes, the number of A&E visits and hospital admissions, recorded on the NHS Secondary Uses Service database, were compared before and after the implementation of the telehealth service. The number of all events despite its cause and the number of events related to the patients' diagnosed condition were collected. To elicit patients' perceptions about the telehealth service, a cross sectional survey of patients registered on the triage manager database was used to explore their perceptions, concerns and general satisfaction with the telehealth service via a 4 point likert scale questionnaire. The data of 48 patients were collected and telehealth reduced the number of both A&E and hospital admission due to all causes by 13% (P = 0.42) and 22% (P = 0.048), respectively. When only the events directly related to the patient's diagnosed condition were considered, a reduction by 36% (P = 0.03) and 28% (P = 0.02) was recorded for A&E visits and hospital admission respectively. 27 patients consented to participate in the survey. Overall, patients were very satisfied with telehealth services. Patients agreed that telehealth had improved their health, it was a convenient form of health care delivery for them and they were more involved in the decisions about their care or treatment. In addition, since being on telehealth, patients' confidence in managing their health increased from somewhat confident to confident. Telehealth, when provided as a service within a standard care pathway, seems to decrease hospital admissions and A&E visits. Good patient satisfaction suggests that the current service is accepted and it could be further expanded to include a larger number of

  2. Integrating Telehealth Care-Generated Data With the Family Practice Electronic Medical Record: Qualitative Exploration of the Views of Primary Care Staff

    PubMed Central

    Davidson, Emma

    2013-01-01

    Background Telehealth care is increasingly being employed in the management of long-term illness. Current systems are largely managed via “stand-alone” websites, which require additional log-ons for clinicians to view their patients’ symptom records and physiological measurements leading to frustrating delays and sometimes failure to engage with the record. However, there are challenges to the full integration of patient-acquired data into family physicians’ electronic medical records (EMR) in terms of reliability, how such data can best be summarized and presented to avoid overload to the clinicians, and how clarity of responsibility is managed when multiple agencies are involved. Objective We aimed to explore the views of primary care clinicians on the acceptability, clinical utility, and, in particular, the benefits and risks of integrating patient-generated telehealth care data into the family practice EMR and to explore how these data should be summarized and presented in order to facilitate use in routine care. Methods In our qualitative study, we carried out semi-structured interviews with clinicians with experience of and naïve to telehealth care following demonstration of pilot software, which illustrated various methods by which data could be incorporated into the EMR. Results We interviewed 20 clinicians and found 2 overarching themes of “workload” and “safety”. Although clinicians were largely positive about integrating telehealth care data into the EMR, they were concerned about the potential increased workload and safety issues, particularly in respect to error due to data overload. They suggested these issues could be mitigated by good system design that summarized and presented data such that they facilitated seamless integration with clinicians’ current routine processes for managing data flows, and ensured clear lines of communication and responsibility between multiple professionals involved in patients’ care. Conclusions

  3. Task 4 supporting technology. Part 2: Detailed test plan for thermal seals. Thermal seals evaluation, improvement and test. CAN8-1, Reusable Launch Vehicle (RLV), advanced technology demonstrator: X-33. Leading edge and seals thermal protection system technology demonstration

    NASA Technical Reports Server (NTRS)

    Hogenson, P. A.; Lu, Tina

    1995-01-01

    The objective is to develop the advanced thermal seals to a technology readiness level (TRL) of 6 to support the rapid turnaround time and low maintenance requirements of the X-33 and the future reusable launch vehicle (RLV). This program is divided into three subtasks: (1) orbiter thermal seals operation history review; (2) material, process, and design improvement; and (3) fabrication and evaluation of the advanced thermal seals.

  4. A Pilot Study to Engage and Counsel HIV-Positive African American Youth Via Telehealth Technology

    PubMed Central

    Yuan, Patrick; John, Malcolm; Sheon, Nicolas; Johnson, Mallory O.

    2013-01-01

    Abstract Antiretroviral nonadherence is a strong determinant of virologic failure and is negatively correlated with survival. HIV-positive African American youth have lower antiretroviral adherence and treatment engagement than other populations. We assessed the feasibility and acceptability of a telehealth (remote videoconferencing) medication counseling intervention as an innovative approach to address these disparities. HIV-positive African American youth (18–29 years old) on antiretrovirals were enrolled in a telehealth medication counseling session, followed by a semi-structured qualitative interview to explore likes/dislikes of the format, modality, and content; potential impact on adherence; privacy issues; and interaction quality. Fourteen participants with a mean age of 24 years, who were 86% male, and had a mean self-reported adherence in the past month of 89%, were interviewed. Participants stated that they liked telehealth, would use it if offered in clinic/research settings, and indicated that their privacy was maintained. Participants described telehealth as convenient and efficient, with positive impact on their knowledge. Telehealth provided a modality to interact with providers that participants described as less intimidating than in-person visits. Telehealth is feasible and acceptable for delivering medication counseling to HIV-positive African American youth when conducted in a controlled clinical setting and may improve quality of patient-provider dialogue. Use of telehealth may lead to more disclosure of treatment difficulties, increased patient comfort, and improved health education. PMID:23991691

  5. Task–Technology Fit of Video Telehealth for Nurses in an Outpatient Clinic Setting

    PubMed Central

    Finkelstein, Stanley M.

    2014-01-01

    Abstract Background: Incorporating telehealth into outpatient care delivery supports management of consumer health between clinic visits. Task–technology fit is a framework for understanding how technology helps and/or hinders a person during work processes. Evaluating the task–technology fit of video telehealth for personnel working in a pediatric outpatient clinic and providing care between clinic visits ensures the information provided matches the information needed to support work processes. Materials and Methods: The workflow of advanced practice registered nurse (APRN) care coordination provided via telephone and video telehealth was described and measured using a mixed-methods workflow analysis protocol that incorporated cognitive ethnography and time–motion study. Qualitative and quantitative results were merged and analyzed within the task–technology fit framework to determine the workflow fit of video telehealth for APRN care coordination. Results: Incorporating video telehealth into APRN care coordination workflow provided visual information unavailable during telephone interactions. Despite additional tasks and interactions needed to obtain the visual information, APRN workflow efficiency, as measured by time, was not significantly changed. Analyzed within the task–technology fit framework, the increased visual information afforded by video telehealth supported the assessment and diagnostic information needs of the APRN. Conclusions: Telehealth must provide the right information to the right clinician at the right time. Evaluating task–technology fit using a mixed-methods protocol ensured rigorous analysis of fit within work processes and identified workflows that benefit most from the technology. PMID:24841219

  6. The use of telehealth to assist remote hospital resuscitation and aeromedical retrieval tasking: a 12-month case review.

    PubMed

    Sharpe, Kate; Elcock, Mark; Aitken, Peter; Furyk, Jeremy

    2012-07-01

    We evaluated the use of telehealth for patients who had suffered a cardiac or respiratory arrest, and were medically coordinated from the Queensland coordination hub at Townsville. We conducted a review of all cardiac or respiratory arrest cases where teleheath had been used prior to aeromedical retrieval. The doctors involved in the cases completed an evaluation form about the use of telehealth during the resuscitation. During the 12-month study period 6460 patients were medically coordinated from Townsville. Telehealth was used 51 times, i.e. for 0.8% of all transfers. Of the 51 uses of telehealth, nine were for patients having a cardiac/respiratory arrest, i.e. 18% of telehealth use at Townsville was for patients undergoing resuscitation following cardiac or respiratory arrest. All eight medical coordinators and three of eight referring doctors responded to the survey. Most medical coordinators stated that telehealth assisted communication and aided assessment. Most medical coordinators and some referring doctors felt that it improved the quality of patient care. The free text comments on telehealth use for remote area resuscitation were generally very supportive. While the telehealth equipment was easy to use, minor audio problems reinforce the need for systems to be wholly reliable. A set of guidelines to aid future telehealth assisted resuscitation was produced. The present study suggests that telehealth use is beneficial during active resuscitation efforts. PMID:22302764

  7. “Real-World” Practical Evaluation Strategies: A Review of Telehealth Evaluation

    PubMed Central

    Masters, Caitlin; Kvedar, Joseph; Jethwani, Kamal

    2014-01-01

    Background Currently, the increasing interest in telehealth and significant technological breakthroughs of the past decade create favorable conditions for the widespread adoption of telehealth services. Therefore, expectations are high that telehealth can help alleviate prevailing challenges in health care delivery. However, in order to translate current research to policy and facilitate adoption by patients and health care providers, there is need for compelling evidence of the effectiveness of telehealth interventions. Such evidence is gathered from rigorously designed research studies, which may not always be practical in many real-world settings. Objective Our aim was to summarize current telehealth evaluation strategies and challenges and to outline practical approaches to conduct evaluation in real-world settings using one of our previously reported telehealth initiatives, the Diabetes Connect program, as a case study. Methods We reviewed commonly used current evaluation frameworks and strategies, as well as best practices based on successful evaluative efforts to date to address commonly encountered challenges in telehealth evaluation. These challenges in telehealth evaluation and commonly used frameworks are described relevant to the evaluation of Diabetes Connect, a 12-month Web-based blood glucose monitoring program. Results Designers of telehealth evaluation frameworks must give careful consideration to the elements of planning, implementation, and impact assessment of interventions. Evaluating performance at each of these phases is critical to the overall success of an intervention. Although impact assessment occurs at the end of a program, our review shows that it should begin at the point of problem definition. Critical to the success of an evaluative strategy is early planning that involves all stakeholders to identify the overall goals of the program and key measures of success at each phase of the program life cycle. This strategy should enable

  8. A Pilot Study of Prolonged Exposure Therapy for Posttraumatic Stress Disorder Delivered via Telehealth Technology

    PubMed Central

    Tuerk, Peter W.; Yoder, Matthew; Ruggiero, Kenneth J; Gros, Daniel F.; Acierno, Ron

    2015-01-01

    We present a pilot study of 12 veterans diagnosed with combat-related PTSD and treated with prolonged exposure therapy (PE) via telehealth technology. A reference sample of 35 combat veterans treated with in-person PE in the same clinic is also included for a comparison. Feasibility and clinical outcomes of interest include: technical performance and practicality of the telehealth equipment, patient safety, treatment completion rates, number of sessions required for termination, and clinical outcomes. Results indicated large statistically significant decreases in self-reported pathology for veterans treated with PE via telehealth technology. Preliminary results support the feasibility and safety of the modality. Suggestions for the implementation of PE via telehealth technology are discussed. PMID:20135675

  9. Telehealth Cognitive Behavior Therapy for Co-Occurring Insomnia and Depression Symptoms in Older Adults

    PubMed Central

    Lichstein, Kenneth L.; Scogin, Forrest; Thomas, S. Justin; DiNapoli, Elizabeth A.; Dillon, Haley R.; McFadden, Anna

    2015-01-01

    Objective Telehealth has proven effective with a wide range of disorders, but there is a paucity of data on the use of telehealth using cognitive-behavior therapy (CBT) with late-life insomnia and depression. This pilot study was designed to examine the feasibility and effectiveness of using telehealth to treat older adults with comorbid insomnia and depression living in rural Alabama. Method Five patients received 10 sessions of CBT for insomnia and depression. Patients were engaged in treatment via Skype from their primary care physician’s office. Assessments were conducted at baseline, posttreatment, and 2-month follow-up. Results Patients exhibited clinically significant improvement in both insomnia (sleep diaries and Insomnia Severity Index) and depression (Hamilton Rating Scale for Depression) at posttreatment, and these gains were well maintained at 2-month follow-up. Conclusions These preliminary data suggest that telehealth may be an effective means of providing treatment to older adults, including underserved populations. PMID:24014056

  10. 78 FR 76193 - Agency Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction... Retaining Nurses at State Homes).'' SUPPLEMENTARY INFORMATION: Title: Care Coordination Home...

  11. Telehealth etiquette in home healthcare: the key to a successful visit.

    PubMed

    Haney, Tina; Kott, Karen; Fowler, Christianne

    2015-05-01

    The use of telehealth by home healthcare agencies is growing. It has been shown to reduce rehospitalizations by up to 62%, reduce costs, and increase efficiency. Due to the use of telehealth technology, new and unique rules of etiquette must be followed to make both the patient and clinician comfortable and satisfied with the process. Little literature exists regarding telehealth etiquette. This article explores the techniques and methods that home care clinicians should utilize to assure that the telehealth experience is positive and effective. After providing a less successful scenario, steps for success are outlined and a suggested successful conclusion is provided for the scenario. Home care agencies will benefit greatly from expanding their ability to visit patients in different ways. Simple steps need to be taken to assure successful visits that follow the rules for assuring patient comfort, autonomy, and protection. PMID:25943217

  12. 77 FR 13195 - Exempting In-Home Video Telehealth From Copayments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-06

    ... between VAMCs and VA Centers of Specialized Care, such as those established for Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI) and Multiple Sclerosis (MS). Clinical video telehealth uses...

  13. DEMONSTRATION OF BIODEGRADATION OF DENSE, NONAQUEOUS-PHASE LIQUIDS (DNAPL)THROUGH BIOSTIMULATION AND BIOAUGMENTATION AT LAUNCH COMPLEX 34 IN CAPE CANAVERAL AIR FORCE STATION, FLORIDA

    EPA Science Inventory

    Biostimulation involves stimulating indigenous microbial cultures by adding nutrients whereas bioaugmentation involves introducing microbial cultures that are particularly adept at degrading these contaminants into the target aquifer. This demonstration involved biostimulation fo...

  14. Who is Using Telehealth in Primary Care? Safety Net Clinics and Health Maintenance Organizations (HMOs).

    PubMed

    Coffman, Megan; Moore, Miranda; Jetty, Anuradha; Klink, Kathleen; Bazemore, Andrew

    2016-01-01

    Despite rapid advancements in telehealth services, only 15% of family physicians in a 2014 survey reported using telehealth; use varied widely according to the physician's practice setting or designation. Users were significantly more likely than nonusers to work in federally designated "safety net" clinics and health maintenance organizations (HMOs) but not more likely than nonusers to report working in a patient-centered medical home (PCMH) or accountable care organization. PMID:27390373

  15. Implementation of Video Telehealth to Improve Access to Evidence-Based Psychotherapy for Posttraumatic Stress Disorder

    PubMed Central

    Kauth, Michael R.; Hudson, Sonora; Martin, Lindsey A.; Ramsey, David J.; Daily, Lawrence; Rader, John

    2015-01-01

    Abstract Background: Increasing access to psychotherapy for posttraumatic stress disorder (PTSD) is a primary focus of the Department of Veterans Affairs (VA) healthcare system. Delivery of treatment via video telehealth can expand availability of treatment and be equally effective as in-person treatment. Despite VA efforts, barriers to establishing telehealth services remain, including both provider acceptance and organizational obstacles. Thus, development of specific strategies is needed to implement video telehealth services in complex healthcare systems, like the VA. Materials and Methods: This project was guided by the Promoting Action on Research Implementation in Health Services framework and used external facilitation to increase access to psychotherapy via video telehealth. The project was conducted at five VA Medical Centers and their associated community clinics across six states in the South Central United States. Results: Over a 21-month period, 27 video telehealth clinics were established to provide greater access to evidence-based psychotherapies for PTSD. Examination of change scores showed that participating sites averaged a 3.2-fold increase in unique patients and a 6.5-fold increase in psychotherapy sessions via video telehealth for PTSD. Differences between participating and nonparticipating sites in both unique patients and encounters were significant (p=0.041 and p=0.009, respectively). Two groups emerged, separated by degree of engagement in the facilitation intervention. Facilitation was perceived as useful by providers. Conclusions: To our knowledge, this is the first prospective study of external facilitation as an implementation strategy for telehealth. Our findings suggest that external facilitation is an effective and acceptable strategy to support providers as they establish clinics and make complex practice changes, such as implementing video telehealth to deliver psychotherapy. PMID:25714664

  16. 14 CFR 415.133 - Safety at end of launch.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Launch Vehicle From a Non-Federal Launch Site § 415.133 Safety at end of launch. An applicant must demonstrate compliance with § 417.129 of this chapter, for any proposed launch of a launch vehicle with a... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Safety at end of launch. 415.133...

  17. 14 CFR 415.133 - Safety at end of launch.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Launch Vehicle From a Non-Federal Launch Site § 415.133 Safety at end of launch. An applicant must demonstrate compliance with § 417.129 of this chapter, for any proposed launch of a launch vehicle with a... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Safety at end of launch. 415.133...

  18. 14 CFR 415.133 - Safety at end of launch.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Launch Vehicle From a Non-Federal Launch Site § 415.133 Safety at end of launch. An applicant must demonstrate compliance with § 417.129 of this chapter, for any proposed launch of a launch vehicle with a... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Safety at end of launch. 415.133...

  19. 14 CFR 415.133 - Safety at end of launch.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Launch Vehicle From a Non-Federal Launch Site § 415.133 Safety at end of launch. An applicant must demonstrate compliance with § 417.129 of this chapter, for any proposed launch of a launch vehicle with a... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety at end of launch. 415.133...

  20. Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

    PubMed

    Nagel, Daniel A; Penner, Jamie L

    2016-03-01

    Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. PMID:25858897

  1. A pilot trial of a speech pathology telehealth service for head and neck cancer patients.

    PubMed

    Burns, Clare L; Ward, Elizabeth C; Hill, Anne J; Malcolm, Karen; Bassett, Lynell; Kenny, Lizbeth M; Greenup, Phillip

    2012-12-01

    We explored the feasibility of providing access to specialist speech pathology services via telehealth for patients with head and neck cancer. A weekly telehealth clinic was conducted between the speech pathology departments of a tertiary hospital and a regional hospital in Queensland. Over a 5-month period, 50 telehealth sessions were conducted for 18 patients. There were 38 patient consultations, nine case discussions between clinicians and three clinical training sessions relating to the skills needed for specific client management (e.g. voice prosthesis selection). Eight sessions had multidisciplinary involvement. All cases were successfully managed via telehealth. All patients agreed that they were comfortable using telehealth and would be happy to use it again in future. Both clinicians agreed that they could competently assess patients using the telehealth system. There appeared to be financial benefits for the patient, because by receiving specialist intervention at a local facility their travel expenses were lower. There was also the opportunity for workforce training and development through online case discussion and clinical consultation. PMID:23209274

  2. Designing Clinically Valuable Telehealth Resources: Processes to Develop a Community-Based Palliative Care Prototype

    PubMed Central

    Morgan, Deidre Diane; Swetenham, Kate; To, Timothy Hong Man; Currow, David Christopher

    2014-01-01

    Background Changing population demography and patterns of disease are increasing demands on the health system. Telehealth is seen as providing a mechanism to support community-based care, thus reducing pressure on hospital services and supporting consumer preferences for care in the home. Objective This study examined the processes involved in developing a prototype telehealth intervention to support palliative care patients involved with a palliative care service living in the community. Methods The challenges and considerations in developing the palliative care telehealth prototype were reviewed against the Center for eHealth Research (CeHRes) framework, a telehealth development model. The project activities to develop the prototype were specifically mapped against the model’s first four phases: multidisciplinary project management, contextual inquiry, value specification, and design. This project has been developed as part of the Telehealth in the Home: Aged and Palliative Care in South Australia initiative. Results Significant issues were identified and subsequently addressed during concept and prototype development. The CeHRes approach highlighted the implicit diversity in views and opinions among participants and stakeholders and enabled issues to be considered, resolved, and incorporated during design through continuous engagement. Conclusions The CeHRes model provided a mechanism that facilitated “better” solutions in the development of the palliative care prototype by addressing the inherent but potentially unrecognized differences in values and beliefs of participants. This collaboration enabled greater interaction and exchange among participants resulting in a more useful and clinically valuable telehealth prototype. PMID:25189279

  3. Initial Impressions of Community-Dwelling Older Adults and Case Managers about Community-Based Telehealth Kiosks

    PubMed Central

    Courtney, Karen L.; Lingler, Jennifer H.; Mecca, Laurel Person; Garlock, Laurie A.; Schulz, Richard; Dick, Andrew W.; Olshansky, Ellen

    2010-01-01

    Community-based (multi-user) telehealth interventions may be beneficial for older adults, but there is little research regarding community-based telehealth. We used a qualitative descriptive approach to examine the acceptability and perceived value of community-based telehealth kiosks with regard to current health self-management practices of community-dwelling older adults as a first step in feasibility assessment. Participants included residents (n=6) and community agency case managers (n=3) of a HUD-subsidized senior apartment building. Both positive impressions and concerns of each group are presented. Findings helped guide the plans for future telehealth kiosk implementation and training. PMID:20509594

  4. Effectiveness of a Telehealth Service Delivery Model for Treating Attention-Deficit/Hyperactivity Disorder: A Community-Based Randomized Controlled Trial

    PubMed Central

    Myers, Kathleen; Stoep, Ann Vander; Zhou, Chuan; McCarty, Carolyn A.; Katon, Wayne

    2015-01-01

    Objective To test the effectiveness of a telehealth service delivery model for the treatment of children with attention-deficit/hyperactivity disorder (ADHD) that provided pharmacological treatment and caregiver behavior training. Method The Children’s ADHD Telemental Health Treatment Study (CATTS) was a randomized controlled trial with 223 children referred by 88 primary care providers (PCPs) in 7 communities. Children randomized to the experimental telehealth service model received 6 sessions over 22 weeks of combined pharmacotherapy, delivered by child psychiatrists through videoconferencing, and caregiver behavior training, provided in person by community therapists who were supervised remotely. Children randomized to the control service delivery model received treatment with their PCPs augmented with a telepsychiatry consultation. Outcomes were diagnostic criteria for ADHD and oppositional defiant disorder (ODD) and role performance on the Vanderbilt ADHD Rating Scale (VADRS) completed by caregivers (VADRS-Caregivers) and teachers (VADRS-Teachers) and impairment on the Columbia Impairment Scale-Parent Version (CIS-P). Measures were completed at 5 assessments over 25 weeks. Results Children in both service models improved. Children assigned to the telehealth service model improved significantly more than children in the augmented primary care arm for VADRS-Caregiver criteria for inattention (χ2[4]=19.47, p<.001), hyperactivity (χ2[4]=11.91, p=0.02), combined ADHD (χ2[4]=14.90, p=0.005), ODD (χ2[4]=10.05, p=0.04), and VADRS-Caregiver role performance (χ2 [4]=12.40, p=0.01) and CIS-P impairment (χ2[4]=20.52, p<.001). For the VADRS-Teacher diagnostic criteria, children in the telehealth service model had significantly more improvement in hyperactivity (χ2[4]=11.28, p=0.02) and combined ADHD (χ2[4]=9.72, p=0.045). Conclusion The CATTS trial demonstrated the effectiveness of a telehealth service model to treat ADHD in communities with limited access to

  5. Center forTelehealth and Cybermedicine Research, University of New Mexico Health Sciences Center: a model of a telehealth program within an academic medical center.

    PubMed

    Alverson, Dale C; Dion, Denise; Migliorati, Margaret; Rodriguez, Adrian; Byun, Hannah W; Effertz, Glen; Duffy, Veronica; Monge, Benjamin

    2013-05-01

    An overview of the Center for Telehealth and Cybermedicine Research at the University of New Mexico Health Sciences Center was presented along with several other national and international programs as part of the of a symposium-workshop on telehealth, "Sustaining and Realizing the Promise of Telemedicine," held at the University of Michigan Health System in Ann Arbor, MI, May 18-19, 2012 and hosted by the University of Michigan Telemedicine Resource Center and its Director, Rashid Bashshur. This article describes our Center, its business plan, and a view to the future. PMID:23317516

  6. Are telehealth technologies for hypertension care and self-management effective or simply risky and costly?

    PubMed

    McKoy, June; Fitzner, Karen; Margetts, Miranda; Heckinger, Elizabeth; Specker, James; Roth, Laura; Izenberg, Maxwell; Siegel, Molly; McKinney, Shannon; Moss, Gail

    2015-06-01

    Hypertension is a prevalent chronic disease that requires ongoing management and self-care. The disease affects 31% of American adults and contributed to or caused the deaths of 348,000 Americans in 2008, fewer than 50% of whom effectively self-managed the disease. However, self-management is complex, with patients requiring ongoing support and easy access to care. Telehealth may help foster the knowledge and skills necessary for those with hypertension to engage in successful self-management. This paper considers the applicability, efficacy, associated risks, and cost-effectiveness of telehealth for individuals and populations with hypertension. Telehealth is a broad term, encompassing telemedicine and mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders. Telemedicine may have considerable utility for people diagnosed with hypertension who have poor access or social barriers that constrain access, but potential risks exist. Telehealth technology is evolving rapidly, even in the absence of fully proven cost-effectiveness and efficacy. Considering the cost of inpatient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider. Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of health care providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events must be obtained, and robust risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for hypertension self-management. PMID:25290443

  7. Loading of Launch Vehicle when Launching from Floating Launch Platform

    NASA Astrophysics Data System (ADS)

    Agarkov, A. V.; Pyrig, V. A.

    2002-01-01

    equator, which is a most effective way from payload capability standpoint. But mobility of the Launch Platform conditions an increase in LV loading as compared with onground launch. Therefore, to provide efficiency of lounching from LP requires solving certain issues to minimize LV loading at launch processing. The paper at hand describes ways to solve these issues while creating and operating the international space launch system Sea Launch, which provides commercial spacecraft launches onboard Zenit-3SL launch vehicle from the floating launch platform located at the equator in the Pacific. Methods to decrease these loads by selecting the optimum position of LP and by correcting LP trim and heel were described. In order to account for impact of weather changing (i.e. waves and winds) and launch support operations on the launch capability, a system of predicted load calculation was designed. By measuring LP roll and pitch parameters as well as wind speed and direction, the system defines loading at LV root section, compares it with the allowable value and, based on the compavision, forms a conclusion on launch capability. launches by Sea Launch.

  8. The Diffusion of Telehealth in Rural American Indian Communities: A Retrospective Survey of Key Stakeholders

    PubMed Central

    Manson, Spero M.; Bair, Byron; Dailey, Nancy; Shore, Jay H.

    2012-01-01

    Abstract Objective: Mental health issues are a serious concern for many American Indian Veterans, especially for post-traumatic stress disorder and related psychiatric conditions. Yet, acquiring mental health treatment can be a challenge in Native communities where specialized services are largely unavailable. Consequently, telehealth is increasingly being suggested as a way to expand healthcare access on or near reservation lands. In this study, we wanted to understand the factors affecting the diffusion of telehealth clinics that provided mental health care to rural, American Indian Veterans. Materials and Methods: We surveyed 39 key personnel and stakeholders who were involved in the decision-making process, technological infrastructure, and implementation of three clinics. Using Roger Everett's Diffusion Theory as a framework, we gathered information about specific tasks, factors hindering progress, and personal reactions to telehealth both before and after implementation. Results: Many participants expressed initial concerns about using telehealth; however, most became positive over time. Factors that influenced participants' viewpoint largely included patient and staff feedback and witnessing the fulfillment of a community health need. The use of outside information to support the implementation of the clinics and personal champions also showed considerable influence in the clinics' success. Conclusion: The findings presented here address critical gaps in our understanding of telehealth diffusion and inform research strategies regarding the cultural issues and outcomes related to telemental health services. Information contained in this report serves as a long overdue guide for developing telemental health programs and policies among American Indians, specifically, and rural populations in general. PMID:22082106

  9. Expendable launch vehicle propulsion

    NASA Technical Reports Server (NTRS)

    Fuller, Paul N.

    1991-01-01

    The current status is reviewed of the U.S. Expendable Launch Vehicle (ELV) fleet, the international competition, and the propulsion technology of both domestic and foreign ELVs. The ELV propulsion technology areas where research, development, and demonstration are most needed are identified. These propulsion technology recommendations are based on the work performed by the Commercial Space Transportation Advisory Committee (COMSTAC), an industry panel established by the Dept. of Transportation.

  10. Telehealth in audiology: the need and potential to reach underserved communities.

    PubMed

    Swanepoel, De Wet; Clark, Jackie L; Koekemoer, Dirk; Hall, James W; Krumm, Mark; Ferrari, Deborah V; McPherson, Bradley; Olusanya, Bolajoko O; Mars, Maurice; Russo, Iêda; Barajas, Jose J

    2010-03-01

    Permanent hearing loss is a leading global health care burden, with 1 in 10 people affected to a mild or greater degree. A shortage of trained healthcare professionals and associated infrastructure and resource limitations mean that hearing health services are unavailable to the majority of the world population. Utilizing information and communication technology in hearing health care, or tele-audiology, combined with automation offer unique opportunities for improved clinical care, widespread access to services, and more cost-effective and sustainable hearing health care. Tele-audiology demonstrates significant potential in areas such as education and training of hearing health care professionals, paraprofessionals, parents, and adults with hearing disorders; screening for auditory disorders; diagnosis of hearing loss; and intervention services. Global connectivity is rapidly growing with increasingly widespread distribution into underserved communities where audiological services may be facilitated through telehealth models. Although many questions related to aspects such as quality control, licensure, jurisdictional responsibility, certification and reimbursement still need to be addressed; no alternative strategy can currently offer the same potential reach for impacting the global burden of hearing loss in the near and foreseeable future. PMID:20151929

  11. Mortality Benefit of a Fourth-Generation Synchronous Telehealth Program for the Management of Chronic Cardiovascular Disease: A Longitudinal Study

    PubMed Central

    Hung, Chi-Sheng; Yu, Jiun-Yu; Lin, Yen-Hung; Chen, Ying-Hsien; Huang, Ching-Chang; Lee, Jen-Kuang; Chuang, Pao-Yu; Chen, Ming-Fong

    2016-01-01

    Background We have shown that a fourth-generation telehealth program that analyzes and responds synchronously to data transferred from patients is associated with fewer hospitalizations and lower medical costs. Whether a fourth-generation telehealth program can reduce all-cause mortality has not yet been reported for patients with chronic cardiovascular disease. Objective We conducted a clinical epidemiology study retrospectively to determine whether a fourth-generation telehealth program can reduce all-cause mortality for patients with chronic cardiovascular disease. Methods We enrolled 576 patients who had joined a telehealth program and compared them with 1178 control patients. A Cox proportional hazards model was fitted to analyze the impact of risk predictors on all-cause mortality. The model adjusted for age, sex, and chronic comorbidities. Results There were 53 (9.3%) deaths in the telehealth group and 136 (11.54%) deaths in the control group. We found that the telehealth program violated the proportional hazards assumption by the Schoenfeld residual test. Thus, we fitted a Cox regression model with time-varying covariates. The results showed an estimated hazard ratio (HR) of 0.866 (95% CI 0.837-0.896, P<.001; number needed to treat at 1 year=55.6, 95% CI 43.2-75.7 based on HR of telehealth program) for the telehealth program on all-cause mortality after adjusting for age, sex, and comorbidities. The time-varying interaction term in this analysis showed that the beneficial effect of telehealth would increase over time. Conclusions The results suggest that our fourth-generation telehealth program is associated with less all-cause mortality compared with usual care after adjusting for chronic comorbidities. PMID:27177497

  12. Reusable Launch Vehicle Technology Program

    NASA Technical Reports Server (NTRS)

    Freeman, Delma C., Jr.; Talay, Theodore A.; Austin, R. Eugene

    1996-01-01

    Industry/NASA Reusable Launch Vehicle (RLV) Technology Program efforts are underway to design, test, and develop technologies and concepts for viable commercial launch systems that also satisfy national needs at acceptable recurring costs. Significant progress has been made in understanding the technical challenges of fully reusable launch systems and the accompanying management and operational approaches for achieving a low-cost program. This paper reviews the current status of the Reusable Launch Vehicle Technology Program including the DC-XA, X-33 and X-34 flight systems and associated technology programs. It addresses the specific technologies being tested that address the technical and operability challenges of reusable launch systems including reusable cryogenic propellant tanks, composite structures, thermal protection systems, improved propulsion, and subsystem operability enhancements. The recently concluded DC-XA test program demonstrated some of these technologies in ground and flight tests. Contracts were awarded recently for both the X-33 and X-34 flight demonstrator systems. The Orbital Sciences Corporation X-34 flight test vehicle will demonstrate an air-launched reusable vehicle capable of flight to speeds of Mach 8. The Lockheed-Martin X-33 flight test vehicle will expand the test envelope for critical technologies to flight speeds of Mach 15. A propulsion program to test the X-33 linear aerospike rocket engine using a NASA SR-71 high speed aircraft as a test bed is also discussed. The paper also describes the management and operational approaches that address the challenge of new cost-effective, reusable launch vehicle systems.

  13. The effect of telehealth systems and satisfaction with health expenditure among patients with metabolic syndrome.

    PubMed

    Uei, Shu-Lin; Tsai, Chung-Hung; Kuo, Yu-Ming

    2016-04-29

    Telehealth cost analysis has become a crucial issue for governments in recent years. In this study, we examined cases of metabolic syndrome in Hualien County, Taiwan. This research adopted the framework proposed by Marchand to establish a study process. In addition, descriptive statistics, a t test, analysis of variance, and regression analysis were employed to analyze 100 questionnaires. The results of the t$ test revealed significant differences in medical health expenditure, number of clinical visits for medical treatment, average amount of time spent commuting to clinics, amount of time spent undergoing medical treatment, and average number of people accompanying patients to medical care facilities or assisting with other tasks in the past one month, indicating that offering telehealth care services can reduce health expenditure. The statistical analysis results revealed that customer satisfaction has a positive effect on reducing health expenditure. Therefore, this study proves that telehealth care systems can effectively reduce health expenditure and directly improve customer satisfaction with medical treatment. PMID:27163314

  14. Achieving greater consistency in telehealth project evaluations to improve organisational learning.

    PubMed

    Maeder, Anthony; Gray, Kathleen; Borda, Ann; Poultney, Nathan; Basilakis, Jim

    2015-01-01

    Telehealth pilot projects and trial implementations are numerous but are often not fully evaluated, preventing construction of a sound evidence base and so limiting their adoption. We describe the need for a generic Telehealth project evaluation framework, within which evaluation is undertaken based on existing health systems performance indicators, using appropriately chosen measures. We provide two case studies explaining how this approach could be applied, in Australian and Canadian settings. It is argued that this framework type of approach to evaluation offers better potential for incorporating the learnings from resultant evaluations into business decisions by "learning organisations", through alignment with organisational performance considerations. PMID:25980709

  15. Launch summary for 1978

    NASA Technical Reports Server (NTRS)

    Vostreys, R. W.

    1978-01-01

    Sounding rocket, satellite, and space probe launchings are presented. Time, date, and location of the launches are provided. The sponsoring countries and the institutions responsible for the launch are listed.

  16. Developing and validating the French-Canadian version of the practitioner and organizational telehealth readiness assessment tools.

    PubMed

    Légaré, Emilie; Vincent, Claude; Lehoux, Pascale; Anderson, Donna; Kairy, Dahlia; Gagnon, Marie-Pierre; Jennett, Penny

    2010-01-01

    Only one telehealth readiness assessment tool, that of Jennett et al., covers all types of telehealth projects, regardless of health-care provision context. However, this instrument is only available in English and has not undergone psychometric evaluation. We developed a French-Canadian version of the Practitioner Telehealth Readiness Assessment Tool and the Organizational Telehealth Readiness Assessment Tool. Transcultural validity was assessed by nine practitioners and 12 clinical project co-ordinators or administrators. For practitioners and managers, there was no significant difference between the scores of the English and the French versions of the questionnaires. The results showed that the telehealth readiness of co-ordinators or administrators was greater than that of practitioners when the range in scores was taken into account. The French-Canadian versions of the two questionnaires make it possible to assess telehealth readiness among French speakers. However, other studies involving patients will be necessary to validate the Patient-Public Telehealth Readiness Assessment Tool. PMID:20386034

  17. Implementation of a telehealth programme for patients with severe chronic obstructive pulmonary disease treated with long-term oxygen therapy.

    PubMed

    Jódar-Sánchez, Francisco; Ortega, Francisco; Parra, Carlos; Gómez-Suárez, Cristina; Jordán, Ana; Pérez, Pablo; Bonachela, Patricia; Leal, Sandra; Barrot, Emilia

    2013-01-01

    We conducted a pilot study of the effectiveness of home telehealth for patients with advanced chronic obstructive pulmonary disease treated with long-term oxygen therapy. Patients were randomized into a telehealth group (n = 24) and a control group (n = 21) who received usual care. Patients in the telehealth group measured their vital signs on weekdays and performed spirometry on two days per week. The data were transmitted automatically to a clinical call centre. After four months of monitoring the mean number of accident and emergency department visits in the telehealth group was slightly lower than in the control group (0.29 versus 0.43, P = 0.25). The mean number of hospital admissions was 0.38 in the telehealth group and 0.14 in the control group (P = 0.47). During the study a total of 40 alerts were detected. The clinical triage process detected eight clinical exacerbations which were escalated by the case manager for a specialist consultation. There were clinically important differences in health-related quality of life in both groups. The mean score on the SGRQ was 10.9 versus 4.5 in the control group (P = 0.53). The EuroQol-5D score improved by 0.036 in the telehealth group and by 0.003 in the control group (P = 0.68). Both patients and healthcare professionals showed a high level of satisfaction with the telehealth programme. PMID:23393057

  18. CubeSat Launch Initiative

    NASA Technical Reports Server (NTRS)

    Higginbotham, Scott

    2016-01-01

    The National Aeronautics and Space Administration (NASA) recognizes the tremendous potential that CubeSats (very small satellites) have to inexpensively demonstrate advanced technologies, collect scientific data, and enhance student engagement in Science, Technology, Engineering, and Mathematics (STEM). The CubeSat Launch Initiative (CSLI) was created to provide launch opportunities for CubeSats developed by academic institutions, non-profit entities, and NASA centers. This presentation will provide an overview of the CSLI, its benefits, and its results.

  19. STS-53 Launch and Landing

    NASA Technical Reports Server (NTRS)

    1992-01-01

    Footage of various stages of the STS-53 Discovery launch is shown, including shots of the crew at breakfast, getting suited up, and departing to board the Orbiter. The launch is seen from many vantage points, as is the landing. On-orbit activities show the crew performing several medical experiments, such as taking a picture of the retina and measuring the pressure on the eyeball. One crewmember demonstrates how to use the rowing machine in an antigravity environment.

  20. Small Space Launch: Origins & Challenges

    NASA Astrophysics Data System (ADS)

    Freeman, T.; Delarosa, J.

    2010-09-01

    The United States Space Situational Awareness capability continues to be a key element in obtaining and maintaining the high ground in space. Space Situational Awareness satellites are critical enablers for integrated air, ground and sea operations, and play an essential role in fighting and winning conflicts. The United States leads the world space community in spacecraft payload systems from the component level into spacecraft, and in the development of constellations of spacecraft. In the area of launch systems that support Space Situational Awareness, despite the recent development of small launch vehicles, the United States launch capability is dominated by an old, unresponsive and relatively expensive set of launchers in the Expandable, Expendable Launch Vehicles (EELV) platforms; Delta IV and Atlas V. The United States directed Air Force Space Command to develop the capability for operationally responsive access to space and use of space to support national security, including the ability to provide critical space capabilities in the event of a failure of launch or on-orbit capabilities. On 1 Aug 06, Air Force Space Command activated the Space Development & Test Wing (SDTW) to perform development, test and evaluation of Air Force space systems and to execute advanced space deployment and demonstration projects to exploit new concepts and technologies, and rapidly migrate capabilities to the warfighter. The SDTW charged the Launch Test Squadron (LTS) with the mission to develop the capability of small space launch, supporting government research and development space launches and missile defense target missions, with operationally responsive spacelift for Low-Earth-Orbit Space Situational Awareness assets as a future mission. This new mission created new challenges for LTS. The LTS mission tenets of developing space launches and missile defense target vehicles were an evolution from the squadrons previous mission of providing sounding rockets under the Rocket

  1. The influence of a telehealth project on healthcare professional recruitment and retention in remote areas in Mali: A longitudinal study

    PubMed Central

    Mbemba, Gisèle Irène Claudine; Bagayoko, Cheick Oumar; Gagnon, Marie-Pierre; Hamelin-Brabant, Louise; Simonyan, David A

    2016-01-01

    Objectives: The telehealth project EQUI-ResHuS (in French, Les TIC pour un accès Équitable aux Ressources Humaines en Santé) aimed to contribute to more equitable access to care and support practice in remote regions in Mali. This study explored the evolution of perceptions concerning telehealth among healthcare professionals in the four district health centres that participated in the EQUI-ResHus project and identified variables influencing their perceptions of telehealth impact on recruitment and retention of health professionals. Methods: One year after a first survey (T1), a second data collection (T2) was carried out among healthcare professionals using a 91-item questionnaire. Questions assessing telehealth use and perceptions and perceived impact on recruitment and retention of healthcare professionals were rated on a 5-point Likert scale. A total of 10 independent variables were considered for the analyses. A Wilcoxon signed-rank test was performed to detect differences between T1 and T2, and a bivariate linear regression model for repeated measures was carried out to assess the impact of independent variables on dependent variables. Results: There were no noticeable changes in perceptions related to telehealth influence on recruitment and retention. Only access to information and communication technology significantly differed between T1 and T2 according the Wilcoxon rank test (p = 0.001). Perceived influence of telehealth on recruitment and retention was mostly explained by attitude towards telehealth, perceived effect on recruitment and retention and barriers to recruitment and retention. Conclusion: Based on our results, telehealth was perceived as having a positive influence but mostly indirect influence on healthcare professional recruitment and retention. Also, there were no major changes after 1 year of telehealth use. PMID:27231552

  2. Cassini launch contingency effort

    NASA Astrophysics Data System (ADS)

    Chang, Yale; O'Neil, John M.; McGrath, Brian E.; Heyler, Gene A.; Brenza, Pete T.

    2002-01-01

    Cassini launch, JHU/APL's on-station real-time launch contingency activities were implemented. Live news from NASA Select TV of a successful Cassini launch and interplanetary injection precluded any further contingency actions. The Cassini launch contingency effort contributed to mission safety and demonstrated successful cooperation between several agencies. .

  3. Reusable Launch Vehicle Technology Program

    NASA Technical Reports Server (NTRS)

    Freeman, Delma C., Jr.; Talay, Theodore A.; Austin, R. Eugene

    1997-01-01

    Industry/NASA reusable launch vehicle (RLV) technology program efforts are underway to design, test, and develop technologies and concepts for viable commercial launch systems that also satisfy national needs at acceptable recurring costs. Significant progress has been made in understanding the technical challenges of fully reusable launch systems and the accompanying management and operational approaches for achieving a low cost program. This paper reviews the current status of the RLV technology program including the DC-XA, X-33 and X-34 flight systems and associated technology programs. It addresses the specific technologies being tested that address the technical and operability challenges of reusable launch systems including reusable cryogenic propellant tanks, composite structures, thermal protection systems, improved propulsion and subsystem operability enhancements. The recently concluded DC-XA test program demonstrated some of these technologies in ground and flight test. Contracts were awarded recently for both the X-33 and X-34 flight demonstrator systems. The Orbital Sciences Corporation X-34 flight test vehicle will demonstrate an air-launched reusable vehicle capable of flight to speeds of Mach 8. The Lockheed-Martin X-33 flight test vehicle will expand the test envelope for critical technologies to flight speeds of Mach 15. A propulsion program to test the X-33 linear aerospike rocket engine using a NASA SR-71 high speed aircraft as a test bed is also discussed. The paper also describes the management and operational approaches that address the challenge of new cost effective, reusable launch vehicle systems.

  4. Reusable launch vehicle technology program

    NASA Astrophysics Data System (ADS)

    Freeman, Delma C.; Talay, Theodore A.; Austin, R. Eugene

    Industry/NASA reusable launch vehicle (RLV) technology program efforts are underway to design, test, and develop technologies and concepts for viable commercial launch systems that also satisfy national needs at acceptable recurring costs. Significant progress has been made in understanding the technical challenges of fully reusable launch systems and the accompanying management and operational approaches for achieving a low-cost program. This paper reviews the current status of the RLV technology program including the DC-XA, X-33 and X-34 flight systems and associated technology programs. It addresses the specific technologies being tested that address the technical and operability challenges of reusable launch systems including reusable cryogenic propellant tanks, composite structures, thermal protection systems, improved propulsion, and subsystem operability enhancements. The recently concluded DC-XA test program demonstrated some of these technologies in ground and flight tests. Contracts were awarded recently for both the X-33 and X-34 flight demonstrator systems. The Orbital Sciences Corporation X-34 flight test vehicle will demonstrate an air-launched reusable vehicle capable of flight to speeds of Mach 8. The Lockheed-Martin X-33 flight test vehicle will expand the test envelope for critical technologies to flight speeds of Mach 15. A propulsion program to test the X-33 linear aerospike rocket engine using a NASA SR-71 high speed aircraft as a test bed is also discussed. The paper also describes the management and operational approaches that address the challenge of new cost-effective, reusable launch vehicle systems.

  5. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions.

    PubMed

    Darkins, Adam; Ryan, Patricia; Kobb, Rita; Foster, Linda; Edmonson, Ellen; Wakefield, Bonnie; Lancaster, Anne E

    2008-12-01

    Between July 2003 and December 2007, the Veterans Health Administration (VHA) introduced a national home telehealth program, Care Coordination/Home Telehealth (CCHT). Its purpose was to coordinate the care of veteran patients with chronic conditions and avoid their unnecessary admission to long-term institutional care. Demographic changes in the veteran population necessitate VHA increase its noninstitutional care (NIC) services 100% above its 2007 level to provide care for 110,000 NIC patients by 2011. By 2011, CCHT will meet 50% of VHA's anticipated NIC provision. CCHT involves the systematic implementation of health informatics, home telehealth, and disease management technologies. It helps patients live independently at home. Between 2003 and 2007, the census figure (point prevalence) for VHA CCHT patients increased from 2,000 to 31,570 (1,500% growth). CCHT is now a routine NIC service provided by VHA to support veteran patients with chronic conditions as they age. CCHT patients are predominantly male (95%) and aged 65 years or older. Strict criteria determine patient eligibility for enrollment into the program and VHA internally assesses how well its CCHT programs meet standardized clinical, technology, and managerial requirements. VHA has trained 5,000 staff to provide CCHT. Routine analysis of data obtained for quality and performance purposes from a cohort of 17,025 CCHT patients shows the benefits of a 25% reduction in numbers of bed days of care, 19% reduction in numbers of hospital admissions, and mean satisfaction score rating of 86% after enrolment into the program. The cost of CCHT is $1,600 per patient per annum, substantially less than other NIC programs and nursing home care. VHA's experience is that an enterprise-wide home telehealth implementation is an appropriate and cost-effective way of managing chronic care patients in both urban and rural settings. PMID:19119835

  6. The Nature and Requirements of Work in University-Based Telehealth Units: A Qualitative Study

    ERIC Educational Resources Information Center

    Seale, Deborah E.

    2013-01-01

    Telehealth units are one of many university administrative units created to foster innovation in universities over the last 40 years. Despite the proliferation of such units, few organizational studies have examined the work undertaken inside of these units. This qualitative study used a sequential two-part research design to understand the…

  7. Telehealth Delivery of the Camperdown Program for Adults Who Stutter: A Phase I Trial

    ERIC Educational Resources Information Center

    O'Brian, Sue; Packman, Ann; Onslow, Mark

    2008-01-01

    Purpose: This Phase I trial investigated the viability of telehealth delivery of the Camperdown Program with adults who stutter. This program involves speech restructuring. Method: All treatment was conducted remotely with participant-clinician contact occurring by telephone and e-mail. Results: Ten adults completed the program. The group showed…

  8. Use of Telehealth for Research and Clinical Measures in Cochlear Implant Recipients: A Validation Study

    ERIC Educational Resources Information Center

    Hughes, Michelle L.; Goehring, Jenny L.; Baudhuin, Jacquelyn L.; Diaz, Gina R.; Sanford, Todd; Harpster, Roger; Valente, Daniel L.

    2012-01-01

    Purpose: The goal of this study was to compare clinical and research-based cochlear implant (CI) measures using telehealth versus traditional methods. Method: This prospective study used an ABA design (A = laboratory, B = remote site). All measures were made twice per visit for the purpose of assessing within-session variability. Twenty-nine adult…

  9. Telehealth Videoconferencing for Children With Hemophilia and Their Families: A Clinical Project.

    PubMed

    Jacobson, Kimberly; Hooke, Mary C

    2016-07-01

    Telehealth is the use of electronic information and telecommunications technologies to support long-distance health care. It supports quality health care that is accessible, and time- and cost-effective. Telehealth videoconferencing may enhance the care for hemophilia patients who are experiencing a bleed by supporting real-time detailed assessment including appearance, range of motion, and ambulation in addition to the traditional phone methods of verbal description of appearance, pain, and function. The aim of this clinical project was to evaluate the feasibility of using telehealth videoconferencing in children with severe hemophilia in the home setting. Twelve patients with severe hemophilia ages 2to 18 years, who had more than 2 breakthrough bleeds in the past year, and had Internet access with a computer camera were included. The incidence of bleeding was low; however, videoconferencing was effective for 3 patients who completed 4 video appointments. Patients and staff reported that videoconferencing improved communication and satisfaction. Telehealth videoconferencing is a feasible tool for managing bleeding disorders in the home setting. PMID:26510644

  10. Current Clinical Status of Telehealth in Korea: Categories, Scientific Basis, and Obstacles

    PubMed Central

    Kim, Hun-Sung; Kim, Hyunah; Lee, Suehyun; Lee, Kye Hwa

    2015-01-01

    Objectives Through telehealth, medical services have expanded beyond spatial boundaries and are now available in living spaces outside of hospitals. It can also contribute to patient medical knowledge improvement because patients can access their hospital records and data from home. However, concepts of telehealth are rather vague in Korea. Methods We refer to several clinical reports to determine the current clinical status of and obstacles to telehealth in Korea. Results Patients' health conditions are now reported regularly to doctors remotely, and patients can receive varied assistance. Self-improvement based on minute details that are beyond medical staff's reach is another possible benefit that may be realized with the help of a variety of medical equipment (sensors). The feasibility, clinical effect, and cost-benefit of telehealth have been verified by scientific evidence. Conclusions Patients will be able to improve their treatment adherence by receiving help from various professionals, such as doctors, nurses, nutritionists, and sports therapists. This means that the actual treatment time per patient will increase as well. Ultimately, this will increase the quality of patients' self-administration of care to impede disease progression and prevent complications. PMID:26618030

  11. Telehealth: New Directions and Technology for Health Care Delivery in the Schools.

    ERIC Educational Resources Information Center

    Miller, Thomas W.

    Advances in technology and health care delivery have included the use of telemedicine and telepsychology for crisis intervention, assessment, treatment, and education of patients. The use of telemedicine and telepsychology is examined for a variety of health care services to rural America. Telehealth has been considered a partial solution to the…

  12. Process models for telehealth: an industrial approach to quality management of distant medical practice.

    PubMed Central

    Kangarloo, H.; Dionisio, J. D.; Sinha, U.; Johnson, D.; Taira, R. K.

    1999-01-01

    Process modeling is explored as an approach for prospectively managing the quality of a telemedicine/telehealth service. This kind of prospective quality management is more appropriate for dynamic health care environments compared to traditional quality assurance programs. A vector model approach has also been developed to match a process model to the needs of a particular site. Images Figure 4 PMID:10566418

  13. The Effect of Technology and Testing Environment on Speech Perception Using Telehealth with Cochlear Implant Recipients

    ERIC Educational Resources Information Center

    Goehring, Jenny L.; Hughes, Michelle L.; Baudhuin, Jacquelyn L.; Valente, Daniel L.; McCreery, Ryan W.; Diaz, Gina R.; Sanford, Todd; Harpster, Roger

    2012-01-01

    Purpose: In this study, the authors evaluated the effect of remote system and acoustic environment on speech perception via telehealth with cochlear implant recipients. Method: Speech perception was measured in quiet and in noise. Systems evaluated were Polycom visual concert (PVC) and a hybrid presentation system (HPS). Each system was evaluated…

  14. 77 FR 58952 - Exempting In-Home Video Telehealth From Copayments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-25

    ... Federal Register on March 6, 2012, 77 FR 13195, VA amended 38 CFR 17.108 to eliminate copayments for in-home video telehealth. VA published a companion substantially identical proposed rule at 77 FR 13236 on... described in 77 FR 13195 and 77 FR 13236, the direct final rule became effective on May 7, 2012, because...

  15. Preliminary Findings of a Telehealth Approach to Parent Training in Autism

    ERIC Educational Resources Information Center

    Vismara, Laurie A.; McCormick, Carolyn; Young, Gregory S.; Nadhan, Anna; Monlux, Katerina

    2013-01-01

    Telehealth or online communication technologies may lessen the gap between intervention requirements for children with autism spectrum disorders (ASDs) and the available resources to provide these services. This study used a video conferencing and self-guided website to provide parent training in the homes of children with ASD. The first eight…

  16. Home area network for optimizing telehealth services--empirical simulation analysis.

    PubMed

    Shah, Mohib A; Kim, Jinman; Khadra, Mohamed H; Feng, Dagan

    2014-01-01

    Telehealth applications such as Video-over-IP and remote sensor monitoring are rapidly growing in utilisation and it has now expanded to the patient's homes. These Telehealth applications are, however highly delay sensitive and require high quality (and bandwidth priority) in order to provide satisfactory performances. However, at the patient's home area network (HAN) environment, typically there is no Internet traffic management system which highly affects the quality of these applications. As HAN expands its capacity by adding new devices in its network, the need for a network management system become urgent and necessary. In this study, we propose an infrastructure based method to improve Telehealth application quality by managing the quality and distribution of the Internet traffic among the connected devices in a HAN environment. We setup a HAN environment using existing devices readily available at home and tested the setting with typical Telehealth application needs that includes Video-over-IP, VoIP, data and other multimedia traffic. Our simulation results showed that our method is capable of providing better services. Our method indicated that it can provide ~11% lesser packet-loss under 12Mbps background traffic, while increasing 10% of the CPU load for Traffic management. PMID:25570222

  17. Pediatric Tele-Health Consultation to Rural Schools and Clinics in the Pacific Northwest

    ERIC Educational Resources Information Center

    Sulzbacher, Stephen; Mas, Jennifer; Larson, Eric H.; Shurtleff, David B.

    2004-01-01

    The primary telehealth technology described in these articles is interactive video teleconferencing (IVTC), which allows parties at both ends of the communication to see and hear each other. The author have used this application during the past decade for consultation with rural practitioners and schools, and it has become a primary focus of our…

  18. Development of Standardized Clinical Training Cases for Diagnosis of Sexual Abuse using a Secure Telehealth Application

    ERIC Educational Resources Information Center

    Frasier, Lori D.; Thraen, Ioana; Kaplan, Rich; Goede, Patricia

    2012-01-01

    Objectives: The training of physicians, nurse examiners, social workers and other health professional on the evidentiary findings of sexual abuse in children is challenging. Our objective was to develop peer reviewed training cases for medical examiners of child sexual abuse, using a secure web based telehealth application (TeleCAM). Methods:…

  19. Advanced Launch Development Program status

    NASA Technical Reports Server (NTRS)

    Colgrove, Roger

    1990-01-01

    The Advanced Launch System is a joint NASA - Air Force program originally directed to define the concept for a modular family of launch vehicles, to continue development programs and preliminary design activities focused primarily on low cost to orbit, and to offer maturing technologies to existing systems. The program was restructed in the spring of 1990 as a result of funding reductions and renamed the Advanced Launch Development Program. This paper addresses the program's status following that restructuring and as NASA and the Air Force commence a period of deliberation over future space launch needs and the budgetary resources available to meet those needs. The program is currently poised to protect a full-scale development decision in the mid-1990's through the appropriate application of program resources. These resources are concentrated upon maintaining the phase II system contractor teams, continuing the Space Transportation Engine development activity, and refocusing the Advanced Development Program demonstrated activities.

  20. Closed end launch tube (CELT)

    NASA Astrophysics Data System (ADS)

    Lueck, Dale E.; Parrish, Clyde F.

    2001-02-01

    As an alternative to magnetic propulsion for launch assist, the authors propose a pneumatic launch assist system. Using off-the-shelf components, coupled with familiar steel and concrete construction, a launch assist system can be brought from the initial feasibility stage, through a flight capable 5000 kg demonstrator to a deployed full size launch assist system in 10 years. The final system would be capable of accelerating a 450,000 kg vehicle to 270 ms-1. The CELT system uses commercially available compressors and valves to build a fail-safe system in less than half the time of a full Mag-Lev (magnetic levitation) system, and at a small fraction of the development cost. The resulting system could be ready in time to support some Gen 2 (Generation 2) vehicles, as well as the proposed Gen 3 vehicle. .

  1. Closed End Launch Tube (CELT)

    NASA Technical Reports Server (NTRS)

    Lueck, Dale E.; Parrish, Clyde F.; Delgado, H. (Technical Monitor)

    2000-01-01

    As an alternative to magnetic propulsion for launch assist, the authors propose a pneumatic launch assist system. Using off the shelf components, coupled with familiar steel and concrete construction, a launch assist system can be brought from the initial feasibility stage, through a flight capable 5000 kg. demonstrator to a deployed full size launch assist system in 10 years. The final system would be capable of accelerating a 450,000 kg. vehicle to 270 meters per second. The CELT system uses commercially available compressors and valves to build a fail-safe system in less than half the time of a full Mag-Lev (magnetic levitation) system, and at a small fraction of the development cost. The resulting system could be ready in time to support some Gen 2 (generation 2) vehicles, as well as the proposed Gen 3 vehicle.

  2. Developing next-generation telehealth tools and technologies: patients, systems, and data perspectives.

    PubMed

    Ackerman, Michael J; Filart, Rosemarie; Burgess, Lawrence P; Lee, Insup; Poropatich, Ronald K

    2010-01-01

    The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth? PMID:20043711

  3. Developing Next-Generation Telehealth Tools and Technologies: Patients, Systems, and Data Perspectives

    PubMed Central

    Filart, Rosemarie; Burgess, Lawrence P.; Lee, Insup; Poropatich, Ronald K.

    2010-01-01

    Abstract The major goals of telemedicine today are to develop next-generation telehealth tools and technologies to enhance healthcare delivery to medically underserved populations using telecommunication technology, to increase access to medical specialty services while decreasing healthcare costs, and to provide training of healthcare providers, clinical trainees, and students in health-related fields. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers. In the development, marketing, adoption, and implementation of these tools and technologies, communication, training, cultural sensitivity, and end-user customization are critical pieces to the process. Next-generation tools and technologies are vehicles toward personalized medicine, extending the telemedicine model to include cell phones and Internet-based telecommunications tools for remote and home health management with video assessment, remote bedside monitoring, and patient-specific care tools with event logs, patient electronic profile, and physician note-writing capability. Telehealth is ultimately a system of systems in scale and complexity. To cover the full spectrum of dynamic and evolving needs of end-users, we must appreciate system complexity as telehealth moves toward increasing functionality, integration, interoperability, outreach, and quality of service. Toward that end, our group addressed three overarching questions: (1) What are the high-impact topics? (2) What are the barriers to progress? and (3) What roles can the National Institutes of Health and its various institutes and centers play in fostering the future development of telehealth? PMID:20043711

  4. Bauru School of Dentistry Tele-Health League: an educational strategy applied to research, teaching and extension among applications in tele-health

    PubMed Central

    da SILVA, Andressa Sharllene Carneiro; RIZZANTE, Fabio Antonio Piola; PICOLINI, Mirela Machado; de CAMPOS, Karis; CORRÊA, Camila de Castro; FRANCO, Elen Caroline; PARDO-FANTON, Cássia de Souza; BLASCA, Wanderléia Quinhoneiro; BERRETIN-FELIX, Giédre

    2011-01-01

    Tele-health is more than an innovative alternative; it is an excellent tool that enables access to health and education in health, making it possible to minimize distances, optimize time and reduce costs. Based on these advantages, some Brazilian Universities have used these actions in strategies of education, research and extension, aiming at the application of Tele-health in Brazil. In that way, the Bauru School of Dentistry - University of São Paulo (FOB-USP) has applied the use of information and communication technologies in health by means of a "Tele-Health League" (TL), in order to diagnose, prevent and treat diseases, in addition to educate the population and health services. Objective The present study aims to introduce the characteristics of the Tele-Health League of FOB-USP, as well as the development of its projects. Material and Methods The Tele-Health League consisted as a Diffusion Course approved by the Provost of Culture and Academic Extension of the University of São Paulo. It is composed as a large group enclosing professoriate coordinator, academician principal, contributing professors and league members, those, diversified between undergraduates students, graduated, health employees, technology and information areas. The participant members are evaluated by the presence frequency (minimum of 85%), and by the performance of tests and paperwork about the theoretical content provided. Results In four years of activities, the TLFOB-USP obtained a high satisfaction index (90%), an increased number of vacancies due to the interest to become a member, more commitment of the professors of the University and the accomplishment of association with other Brazilian leagues. It is emphasized that the approval percentage of the course results in approval from approximately half of its members. Also, it is important to identify and repair the causes related to the quitting of some members. Conclusions The results showed that the TLFOB-USP members, adjoining

  5. Hype, harmony and human factors: applying user-centered design to achieve sustainable telehealth program adoption and growth.

    PubMed

    Rossos, P G; St-Cyr, O; Purdy, B; Toenjes, C; Masino, C; Chmelnitsky, D

    2015-01-01

    Despite decades of international experience with the use of information and communication technologies in healthcare delivery, widespread telehealth adoption remains limited and progress slow. Escalating health system challenges related to access, cost and quality currently coincide with rapid advancement of affordable and reliable internet based communication technologies creating unprecedented opportunities and incentives for telehealth. In this paper, we will describe how Human Factors Engineering (HFE) and user-centric elements have been incorporated into the establishment of telehealth within a large academic medical center to increase acceptance and sustainability. Through examples and lessons learned we wish to increase awareness of HFE and its importance in the successful implementation, innovation and growth of telehealth programs. PMID:25980714

  6. 14 CFR 417.125 - Launch of an unguided suborbital launch vehicle.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... energy to reach any populated area in any direction from the launch point; or (2) A launch operator demonstrates through the licensing process that the launch will be conducted using a wind weighting safety system that meets the requirements of paragraph (c) of this section. (c) Wind weighting safety system....

  7. TElehealth in CHronic disease: mixed-methods study to develop the TECH conceptual model for intervention design and evaluation

    PubMed Central

    Thomas, Clare; O'Cathain, Alicia; Rogers, Anne; Pope, Catherine; Yardley, Lucy; Fahey, Tom; Lewis, Glyn; Large, Shirley; Edwards, Louisa; Rowsell, Alison; Segar, Julia; Brownsell, Simon; Montgomery, Alan A

    2015-01-01

    Objective To develop a conceptual model for effective use of telehealth in the management of chronic health conditions, and to use this to develop and evaluate an intervention for people with two exemplar conditions: raised cardiovascular disease risk and depression. Design The model was based on several strands of evidence: a metareview and realist synthesis of quantitative and qualitative evidence on telehealth for chronic conditions; a qualitative study of patients’ and health professionals’ experience of telehealth; a quantitative survey of patients’ interest in using telehealth; and review of existing models of chronic condition management and evidence-based treatment guidelines. Based on these evidence strands, a model was developed and then refined at a stakeholder workshop. Then a telehealth intervention (‘Healthlines’) was designed by incorporating strategies to address each of the model components. The model also provided a framework for evaluation of this intervention within parallel randomised controlled trials in the two exemplar conditions, and the accompanying process evaluations and economic evaluations. Setting Primary care. Results The TElehealth in CHronic Disease (TECH) model proposes that attention to four components will offer interventions the best chance of success: (1) engagement of patients and health professionals, (2) effective chronic disease management (including subcomponents of self-management, optimisation of treatment, care coordination), (3) partnership between providers and (4) patient, social and health system context. Key intended outcomes are improved health, access to care, patient experience and cost-effective care. Conclusions A conceptual model has been developed based on multiple sources of evidence which articulates how telehealth may best provide benefits for patients with chronic health conditions. It can be used to structure the design and evaluation of telehealth programmes which aim to be acceptable to

  8. Fifth FLTSATCOM to be launched

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Launch of the FLTSATOOM-E, into an elliptical orbit by the Atlas Centaur launch vehicle is announced. The launch and relevant launch operations are described. A chart of the launch sequence for FLTSATCOM-E communication satellite is given.

  9. Reaching Out to Older Veterans in Need: The Elko Clinic Demonstration Project

    ERIC Educational Resources Information Center

    Juretic, Meghan; Hill, Robert; Luptak, Marilyn; Rupper, Randall; Bair, Byron; Floyd, James; Westfield, Brian; Dailey, Nancy K.

    2010-01-01

    Context: The challenge of providing meaningful health care services to veterans living in rural communities is a major public health concern that involves redefining the traditional facility-based model of care delivery employed in urban areas. Purpose: This paper describes the steps of a demonstration project, the Elko Telehealth Outreach Clinic.…

  10. New Horizons Launch Contingency Effort

    NASA Astrophysics Data System (ADS)

    Chang, Yale; Lear, Matthew H.; McGrath, Brian E.; Heyler, Gene A.; Takashima, Naruhisa; Owings, W. Donald

    2007-01-01

    describes JHU/APL's roles and responsibilities in the launch contingency effort, and the specific tasks to fulfill those responsibilities. The overall effort contributed to mission safety and demonstrated successful cooperation between several agencies.

  11. Shuttle Era: Launch Directors

    NASA Video Gallery

    A space shuttle launch director is the leader of the complex choreography that goes into a shuttle liftoff. Ten people have served as shuttle launch directors, making the final decision whether the...

  12. Space Launch System Animation

    NASA Video Gallery

    NASA is ready to move forward with the development of the Space Launch System -- an advanced heavy-lift launch vehicle that will provide an entirely new national capability for human exploration be...

  13. Launch Vehicle Operations Simulator

    NASA Technical Reports Server (NTRS)

    Blackledge, J. W.

    1974-01-01

    The Saturn Launch Vehicle Operations Simulator (LVOS) was developed for NASA at Kennedy Space Center. LVOS simulates the Saturn launch vehicle and its ground support equipment. The simulator was intended primarily to be used as a launch crew trainer but it is also being used for test procedure and software validation. A NASA/contractor team of engineers and programmers implemented the simulator after the Apollo XI lunar landing during the low activity periods between launches.

  14. 14 CFR 420.19 - Launch site location review-general.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... site, at least one type of expendable or reusable launch vehicle can be flown from the launch point... have more than one type of launch vehicle flown from a launch point, the applicant shall demonstrate that each type of expendable or reusable launch vehicle planned to be flown from the launch point...

  15. 14 CFR 420.19 - Launch site location review-general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... site, at least one type of expendable or reusable launch vehicle can be flown from the launch point... have more than one type of launch vehicle flown from a launch point, the applicant shall demonstrate that each type of expendable or reusable launch vehicle planned to be flown from the launch point...

  16. Launch Summary for 1979

    NASA Technical Reports Server (NTRS)

    Vostreys, R. W.

    1980-01-01

    Spacecraft launching for 1979 are identified and listed under the categories of (1) sounding rockets, and (2) artificial Earth satellites and space probes. The sounding rockets section includes a listing of the experiments, index of launch sites and tables of the meanings and codes used in the launch listing.

  17. Launch summary for 1980

    NASA Technical Reports Server (NTRS)

    Vostreys, R. W.

    1981-01-01

    Sounding rockets, artificial Earth satellites, and space probes launched betweeen January 1 and December 31, 1980 are listed. Data tabulated for the rocket launchings show launching site, instruments carried, date of launch, agency rocket identification, sponsoring country, experiment discipline, peak altitude, and the experimenter or institution responsible. Tables for satellites and space probes show COSPAR designation, spacecraft name, country, launch date, epoch date, orbit type, apoapsis, periapsis and inclination period. The functions and responsibilities of the World Data Center and the areas of scientific interest at the seven subcenters are defined. An alphabetical listing of experimenters using the sounding rockets is also provided.

  18. Electron launching voltage monitor

    DOEpatents

    Mendel, C.W.; Savage, M.E.

    1992-03-17

    An electron launching voltage monitor measures MITL voltage using a relationship between anode electric field and electron current launched from a cathode-mounted perturbation. An electron launching probe extends through and is spaced from the edge of an opening in a first MITL conductor, one end of the launching probe being in the gap between the MITL conductor, the other end being adjacent a first side of the first conductor away from the second conductor. A housing surrounds the launching probe and electrically connects the first side of the first conductor to the other end of the launching probe. A detector detects the current passing through the housing to the launching probe, the detected current being representative of the voltage between the conductors. 5 figs.

  19. Electron launching voltage monitor

    DOEpatents

    Mendel, Clifford W.; Savage, Mark E.

    1992-01-01

    An electron launching voltage monitor measures MITL voltage using a relationship between anode electric field and electron current launched from a cathode-mounted perturbation. An electron launching probe extends through and is spaced from the edge of an opening in a first MITL conductor, one end of the launching probe being in the gap between the MITL conductor, the other end being adjacent a first side of the first conductor away from the second conductor. A housing surrounds the launching probe and electrically connects the first side of the first conductor to the other end of the launching probe. A detector detects the current passing through the housing to the launching probe, the detected current being representative of the voltage between the conductors.

  20. Launch operations efficiency

    NASA Technical Reports Server (NTRS)

    Diloreto, Clem; Fischer, Carl; Atkins, Bob

    1988-01-01

    The paper discusses launch operations from a program perspective. Launch operations cost is a significant part of program cost. New approaches to launch operations, integrated with lessons learned, have the potential to increase safety and reliability as well as reduce cost. Operational efficiency must be an initial program goal. Design technology and management philosophy must be implemented early to ensure operational cost goals. Manufacturing cost and launch cost are related to operational efficiency. True program savings can be realized through implementation of launch operations cost saving approaches which do not correspondingly increase cost in other program areas such as manufacturing and software development and maintenance. Launch rate is a key factor in the cost/flight analysis and the determination of launch operations efficiency goals.

  1. Protocol for a Systematic Review of Telehealth Privacy and Security Research to Identify Best Practices.

    PubMed

    Watzlaf, Valerie J M; Dealmeida, Dilhari R; Zhou, Leming; Hartman, Linda M

    2015-01-01

    Healthcare professionals engaged in telehealth are faced with complex US federal regulations (e.g., HIPAA/HITECH) and could benefit from the guidance provided by best practices in Privacy and Security (P&S). This article describes a systematic review protocol to address this need. The protocol described herein uses the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The PRISMA-P contains 17 items that are considered essential, as well as minimum components to include in systematic reviews. PICOS (participants, interventions, comparisons, outcome(s) and study design of the systematic review) are also relevant to the development of best practices in P&S in telehealth systems. A systematic process can best determine what information should be included and how this information should be retrieved, condensed, analyzed, organized, and disseminated. PMID:27563383

  2. Telehealth: a perspective approach for visceral leishmaniasis (kala-azar) control in India

    PubMed Central

    Bhunia, Gouri Sankar; Kesari, Shreekant; Chatterjee, Nandini; Kumar, Vijay; Das, Pradeep

    2012-01-01

    Visceral leishmaniasis, also known as kala-azar, is a vector borne disease caused by the protozoan parasite, L. donovani. Poor and neglected populations in Indian sub-continent are particularly affected by this disease. Due to the diversity of epidemiological situations, no single diagnosis, treatment, or control will be suitable for all. Control measures through case findings, treatment, and vector control are seldom used, even where they could be useful. Modern tools like telehealth, using space technology, have now come in handy to address issues of disease surveillance, control checking, and evaluation. The present study focuses on telehealth as a current vector control strategy, perspectives on diagnosis, treatment, and control of visceral leishmaniasis as these deserve more attention and research. PMID:23265372

  3. Telehealth: a perspective approach for visceral leishmaniasis (kala-azar) control in India.

    PubMed

    Bhunia, Gouri Sankar; Kesari, Shreekant; Chatterjee, Nandini; Kumar, Vijay; Das, Pradeep

    2012-07-01

    Visceral leishmaniasis, also known as kala-azar, is a vector borne disease caused by the protozoan parasite, L. donovani. Poor and neglected populations in Indian sub-continent are particularly affected by this disease. Due to the diversity of epidemiological situations, no single diagnosis, treatment, or control will be suitable for all. Control measures through case findings, treatment, and vector control are seldom used, even where they could be useful. Modern tools like telehealth, using space technology, have now come in handy to address issues of disease surveillance, control checking, and evaluation. The present study focuses on telehealth as a current vector control strategy, perspectives on diagnosis, treatment, and control of visceral leishmaniasis as these deserve more attention and research. PMID:23265372

  4. Telehealth for "the digital illiterate"--elderly heart failure patients experiences.

    PubMed

    Lind, Leili; Karlsson, Daniel

    2014-01-01

    Telehealth solutions should be available also for elderly patients with no interest in using, or capacity to use, computers and smartphones. Fourteen elderly, severely ill heart failure patients in home care participated in a telehealth study and used digital pens for daily reporting of their health state--a technology never used before by this patient group. After the study seven patients and two spouses were interviewed face-to-face. A qualitative content analysis of the interview material was performed. The informants had no experience of computers or the Internet and no interest in learning. Still, patients found the digital pen and the health diary form easy to use, thus effortlessly adopting to changes in care provision. They experienced an improved contact with the caregivers and had a sense of increased security despite a multimorbid state. Our study shows that, given that technologies are tailored to specific patient groups, even "the digital illiterate" may use the Internet. PMID:25160205

  5. Protocol for a Systematic Review of Telehealth Privacy and Security Research to Identify Best Practices

    PubMed Central

    WATZLAF, VALERIE J.M.; DEALMEIDA, DILHARI R.; ZHOU, LEMING; HARTMAN, LINDA M.

    2015-01-01

    Healthcare professionals engaged in telehealth are faced with complex US federal regulations (e.g., HIPAA/HITECH) and could benefit from the guidance provided by best practices in Privacy and Security (P&S). This article describes a systematic review protocol to address this need. The protocol described herein uses the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The PRISMA-P contains 17 items that are considered essential, as well as minimum components to include in systematic reviews. PICOS (participants, interventions, comparisons, outcome(s) and study design of the systematic review) are also relevant to the development of best practices in P&S in telehealth systems. A systematic process can best determine what information should be included and how this information should be retrieved, condensed, analyzed, organized, and disseminated. PMID:27563383

  6. Home-Based Telehealth Hospitalization for Exacerbation of Chronic Obstructive Pulmonary Disease: Findings from “The Virtual Hospital” Trial

    PubMed Central

    Laursen, Lars C.; Rydahl-Hansen, Susan; Østergaard, Birte; Gerds, Thomas Alexander; Emme, Christina; Schou, Lone; Phanareth, Klaus

    2015-01-01

    Abstract Background: Telehealth interventions for patients with chronic obstructive pulmonary disease (COPD) have focused primarily on stable outpatients. Telehealth designed to handle the acute exacerbation that normally requires hospitalization could also be of interest. The aim of this study was to compare the effect of home-based telehealth hospitalization with conventional hospitalization for exacerbation in severe COPD. Materials and Methods: A two-center, noninferiority, randomized, controlled effectiveness trial was conducted between June 2010 and December 2011. Patients with severe COPD admitted because of exacerbation were randomized 1:1 either to home-based telehealth hospitalization or to continue standard treatment and care at the hospital. The primary outcome was treatment failure defined as re-admission due to exacerbation in COPD within 30 days after initial discharge. The noninferiority margin was set at 20% of the control group's risk of re-admission. Secondary outcomes were mortality, need for manual or mechanical ventilation or noninvasive ventilation, length of hospitalization, physiological parameters, health-related quality of life, user satisfaction, healthcare costs, and adverse events. Results: In total, 57 patients were randomized: 29 participants in the telehealth group and 28 participants in the control group. Testing the incidence of re-admission within 30 days after discharge could not confirm noninferiority (lower 95% confidence limit [CL], −24.8%; p=0.35). Results were also nonsignificant at 90 days (lower 95% CL, −16.2%; p=0.33) and 180 days (lower 95% CL, −16.6%; p =0.33) after discharge. Superiority testing on secondary outcomes showed nonsignificant differences between groups. Healthcare costs have not yet been evaluated. Conclusions: Whether home-based telehealth hospitalization is noninferior to conventional hospitalization requires further investigation. The results indicate that a subgroup of patients with severe COPD

  7. The Contradictions of Telehealth User Experience in Chronic Obstructive Pulmonary Disease (COPD): A Qualitative Meta-Synthesis

    PubMed Central

    Brunton, Lisa; Bower, Peter; Sanders, Caroline

    2015-01-01

    Objective As the global burden of chronic disease rises, policy makers are showing a strong interest in adopting telehealth technologies for use in long term condition management, including COPD. However, there remain barriers to its implementation and sustained use. To date, there has been limited qualitative investigation into how users (both patients/carers and staff) perceive and experience the technology. We aimed to systematically review and synthesise the findings from qualitative studies that investigated user perspectives and experiences of telehealth in COPD management, in order to identify factors which may impact on uptake. Method Systematic review and meta-synthesis of published qualitative studies of user (patients, their carers and clinicians) experience of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease. ASSIA, CINAHL, Embase, Medline, PsychInfo and Web of Knowledge databases were searched up to October 2014. Reference lists of included studies and reference lists of key papers were also searched. Quality appraisal was guided by an adapted version of the CASP qualitative appraisal tool. Findings 705 references (after duplicates removed) were identified and 10 papers, relating to 7 studies were included in the review. Most authors of included studies had identified both positive and negative experiences of telehealth use in the management of COPD. Through a line of argument synthesis we were able to derive new insights from the data to identify three overarching themes that have the ability to either impede or promote positive user experience of telehealth in COPD: the influence on moral dilemmas of help seeking—(enables dependency or self-care); transforming interactions (increases risk or reassurance) and reconfiguration of ‘work’ practices (causes burden or empowerment). Conclusion Findings from this meta-synthesis have implications for the future design and implementation of telehealth services. Future

  8. Nanosatellite Launch Adapter System (NLAS)

    NASA Technical Reports Server (NTRS)

    Chartres, James; Cappuccio, Gelsomina

    2015-01-01

    The Nanosatellite Launch Adapter System (NLAS) was developed to increase access to space while simplifying the integration process of miniature satellites, called nanosats or CubeSats, onto launch vehicles. A standard CubeSat measures about 10 cm square, and is referred to as a 1-unit (1U) CubeSat. A single NLAS provides the capability to deploy 24U of CubeSats. The system is designed to accommodate satellites measuring 1U, 1.5U, 2U, 3U and 6U sizes for deployment into orbit. The NLAS may be configured for use on different launch vehicles. The system also enables flight demonstrations of new technologies in the space environment.

  9. STS-120 on Launch Pad

    NASA Technical Reports Server (NTRS)

    2007-01-01

    A photographer used a fisheye lens attached to an electronic still camera to record a series of photos of the Space Shuttle Discovery at the launch pad while the STS-120 crew was at Kennedy Space Center for the Terminal Countdown Demonstration Test in October 2007. The STS-120 mission launched from Kennedy Space Center's launch pad 39A at 11:38:19 a.m. (EDT) on October 23, 2007. The crew included Scott E. Parazynski, Douglas H. Wheelock, Stephanie D. Wilson, all mission specialists; George D. Zamka, pilot; Pamela A. Melroy, commander; Daniel M. Tani, Expedition 16 flight engineer; and Paolo A. Nespoli, mission specialist representing the European Space Agency (ESA). Major objectives included the installation of the P6 solar array of the port truss and delivery and installment of Harmony, the Italian-built U.S. Node 2 on the International Space Station (ISS).

  10. Sustained Effects of a Nurse Coaching Intervention via Telehealth to Improve Health Behavior Change in Diabetes

    PubMed Central

    Young, Heather; Ward, Deborah; Dharmar, Madan; Tang-Feldman, Yajarayma; Berglund, Lars

    2014-01-01

    Abstract Background: Diabetes educators and self-management programs are scarce in rural communities, where diabetes is the third highest-ranking health concern. The goal of this study was to evaluate the benefits of nurse telehealth coaching for persons with diabetes living in rural communities through a person-centered approach using motivational interviewing (MI) techniques. Materials and Methods: A randomized experimental study design was used to assign participants to receive either nurse telehealth coaching for five sessions (intervention group) or usual care (control group). Outcomes were measured in both groups using the Diabetes Empowerment Scale (DES), SF-12, and satisfaction surveys. Mean scores for each outcome were compared at baseline and at the 9-month follow-up for both groups using a Student's t test. We also evaluated the change from baseline by estimating the difference in differences (pre- and postintervention) using regression methods. Results: Among the 101 participants included in the analysis, 51 received nurse telehealth coaching, and 50 received usual care. We found significantly higher self-efficacy scores in the intervention group compared with the control group based on the DES at 9 months (4.03 versus 3.64, respectively; p<0.05) and the difference in difference estimation (0.42; p<0.05). Conclusions: The nurse MI/telehealth coaching model used in this study shows promise as an effective intervention for diabetes self-management in rural communities. The sustained effect on outcomes observed in the intervention group suggests that this model could be a feasible intervention for long-term behavioral change among persons living with chronic disease in rural communities. PMID:25061688

  11. Using QALYs in telehealth evaluations: a systematic review of methodology and transparency

    PubMed Central

    2014-01-01

    Background The quality-adjusted life-year (QALY) is a recognised outcome measure in health economic evaluations. QALY incorporates individual preferences and identifies health gains by combining mortality and morbidity into one single index number. A literature review was conducted to examine and discuss the use of QALYs to measure outcomes in telehealth evaluations. Methods Evaluations were identified via a literature search in all relevant databases. Only economic evaluations measuring both costs and QALYs using primary patient level data of two or more alternatives were included. Results A total of 17 economic evaluations estimating QALYs were identified. All evaluations used validated generic health related-quality of life (HRQoL) instruments to describe health states. They used accepted methods for transforming the quality scores into utility values. The methodology used varied between the evaluations. The evaluations used four different preference measures (EQ-5D, SF-6D, QWB and HUI3), and utility scores were elicited from the general population. Most studies reported the methodology used in calculating QALYs. The evaluations were less transparent in reporting utility weights at different time points and variability around utilities and QALYs. Few made adjustments for differences in baseline utilities. The QALYs gained in the reviewed evaluations varied from 0.001 to 0.118 in implying a small but positive effect of telehealth intervention on patient’s health. The evaluations reported mixed cost-effectiveness results. Conclusion The use of QALYs in telehealth evaluations has increased over the last few years. Different methodologies and utility measures have been used to calculate QALYs. A more harmonised methodology and utility measure is needed to ensure comparability across telehealth evaluations. PMID:25086443

  12. Video-based telehealth in Australian primary health care: current use and future potential.

    PubMed

    Raven, Melissa; Butler, Caryn; Bywood, Petra

    2013-01-01

    Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers' skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions. PMID:24134865

  13. Achievements and challenges on policies for allied health professionals who use telehealth in the Canadian Arctic.

    PubMed

    Hailey, D; Foerster, V; Nakagawa, B; Wapshall, T M; Murtagh, J A; Smitten, J; Steblecki, J A; Wong, G

    2005-01-01

    We formulated policies and procedures for allied health professionals (AHPs) who provide services using telehealth in Nunavut, Canada's newest Arctic territory. These are a supplement to the clinical policies and procedures already established for Nunavut physicians and nurses. The services were in the areas of audiology, dietetics/nutrition, midwifery, occupational therapy, ophthalmic services, pharmacy, physiotherapy, psychology, respiratory therapy, social work and speech therapy. Documents specific to each of the services were developed, drawing on information from Government of Nunavut data, Nunavut healthcare providers and links made through the Internet. Topics included the scope and limitations of telehealth services, staff responsibilities, training and reporting, professional standards and cultural considerations. We also considered generic policies covering common issues such as jurisdiction, licensing and liability. The policies and procedures for AHPs will enhance and expand the successes already achieved with telehealth in Nunavut. The challenges are to balance the preferred approaches to service provision with the realities of health care and communications in an Arctic setting. PMID:16375792

  14. Development of a Telehealth Intervention for Head and Neck Cancer Patients

    PubMed Central

    Studts, Jamie L.; Bumpous, Jeffrey M.; Gregg, Jennifer L.; Wilson, Liz; Keeney, Cynthia; Scharfenberger, Jennifer A.; Pfeifer, Mark P.

    2009-01-01

    Abstract Treatment for head and neck cancer precipitates a myriad of distressing symptoms. Patients may be isolated both physically and socially and may lack the self-efficacy to report problems and participate as partners in their care. The goal of this project was to design a telehealth intervention to address such isolation, develop patient self-efficacy, and improve symptom management during the treatment experience. Participatory action research and a review of the literature were used to develop electronically administered symptom management algorithms addressing all major symptoms experienced by patients undergoing treatment for head and neck cancers. Daily questions and related messages were then programmed into an easy-to-use telehealth messaging device, the Health Buddy®. Clinician and patient acceptance, feasibility, and technology issues were measured. Using participatory action research is an effective means for developing electronic algorithms acceptable to both clinicians and patients. The use of a simple tele-messaging device as an adjunct to symptom management is feasible, affordable, and acceptable to patients. This telehealth intervention provides support and education to patients undergoing treatment for head and neck cancers. PMID:19199847

  15. Environmental aspects of health care in the Grampian NHS region and the place of telehealth

    PubMed Central

    Wootton, Richard; Tait, Alex; Croft, Amanda

    2010-01-01

    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 other good reasons for persevering with conventional telehealth. On the other hand, telehealth might be useful in reducing staff travel and to a lesser extent, visitor travel. It looks particularly promising for reducing outpatient travel, where substantial carbon savings might be made by reconfiguring the way that certain services are provided. PMID:20511579

  16. Environmental aspects of health care in the Grampian NHS region and the place of telehealth.

    PubMed

    Wootton, Richard; Tait, Alex; Croft, Amanda

    2010-01-01

    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 CO(2) 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 CO(2) 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 other good reasons for persevering with conventional telehealth. On the other hand, telehealth might be useful in reducing staff travel and to a lesser extent, visitor travel. It looks particularly promising for reducing outpatient travel, where substantial carbon savings might be made by reconfiguring the way that certain services are provided. PMID:20511579

  17. A review of paediatric telehealth for pre- and post-operative surgical patients.

    PubMed

    Smith, Anthony C; Garner, Lisa; Caffery, Liam J; McBride, Craig A

    2014-10-01

    The Queensland Telepaediatric Service (QTS) was established in the year 2000 to deliver a broad range of paediatric specialist health services from the Royal Children's Hospital (RCH) in Brisbane, mainly via videoconference. During a 13-year study period, the QTS facilitated 18,949 video consultations, comprising Mental Health (42%), Medicine (30%), Surgery (21%) and Other (8%). We reviewed the surgical services provided through the QTS. There were 3880 video consultations with a paediatric surgeon. Most of these (91%) used fixed videoconferencing units, 8% were delivered via mobile units (robots) and 1% were delivered using Skype. Surgical consultations were provided by telehealth to 106 sites: 89% in Queensland and the rest to other states. The main surgical specialties were burns (50%), ear, nose and throat (19%), general surgery (21%), orthopaedics (9%) and vascular anomalies (2%). During a 12-month audit period, there were 224 teleconsultations in general surgery; the most common reason for referral was for undescended testes (17%). During the study period there was a significant growth in all surgical telehealth activity: linear regression showed an annual increase of 17 cases per year (P < 0.02). In the last four years of the study, there was a substantial growth in the general surgical component, although there was also a reduction in the burns component. Telehealth has potential for other specialist consultations which require periodic assessment and review. PMID:25400001

  18. Virtual worlds and avatars as the new frontier of telehealth care.

    PubMed

    Morie, J; Haynes, E; Chance, E; Purohit, D

    2012-01-01

    We are entering a new age where people routinely visit, inhabit, play in and learn within virtual worlds (VWs). One in eight people worldwide are VW participants, according to the latest 2011 figures from KZERO [1]. VWs are also emerging as a new and advanced form of telehealth care delivery. In addition to existing telehealth care advantages; VWs feature three powerful affordances that can benefit a wide range of physical and psychological issues. First, the highly social nature of VWs encourages social networking and the formation of essential support groups. Secondly, the type of spaces that have been proven in the physical world to promote psychological health and well-being can be virtually recreated. Finally, research suggests that embodied avatar representation within VWs can affect users psychologically and physically. These three aspects of VWs can be leveraged for enhanced patient-client interactions, spaces that promote healing and positive responses, and avatar activities that transfer real benefits from the virtual to the physical world. This paper explains the mounting evidence behind these claims and provides examples of VWs as an innovative and compelling form of telehealth care destined to become commonplace in the future. PMID:22954822

  19. Satisfaction With Telehealth for Cancer Support Groups in Rural American Indian and Alaska Native Communities

    PubMed Central

    Doorenbos, Ardith Z.; Eaton, Linda H.; Haozous, Emily; Towle, Cara; Revels, Laura; Buchwald, Dedra

    2011-01-01

    A descriptive study was conducted to determine the information needs of American Indian (AI) and Alaska Native (AN) cancer survivors and assess satisfaction with and acceptability of telehealth support group services for cancer survivors in AI and AN rural communities. AI and AN cancer survivors were asked to complete the Telehealth Satisfaction Survey and two open-ended questions, one regarding information needs and one seeking comments and suggestions about cancer support group meetings. Thirty-two surveys were returned. Information about nutrition during treatment and treatment-related side effects were the most sought after topics. Participants valued the opportunity to interact with other AI and AN cancer survivors who also lived in remote locations and the usefulness of the information presented. The link with geographically distant survivors was valuable to participants as they felt they were no longer alone in their cancer experiences. Determining survivors’ information needs provides meaningful topics for future support group education. Telehealth is a viable way to facilitate cancer support groups to AI and AN cancer survivors in rural communities. PMID:21112853

  20. The Delta Launch Vehicle Model 2914 Series

    NASA Technical Reports Server (NTRS)

    Gunn, C. R.

    1973-01-01

    The newest Delta launch vehicle configuration, Model 2914 is described for potential users together with recent flight results. A functional description of the vehicle, its performance, flight profile, flight environment, injection accuracy, spacecraft integration requirements, user organizational interfaces, launch operations, costs and reimbursable users payment plan are provided. The versatile, relatively low cost Delta has a flight demonstrated reliability record of 92 percent that has been established in 96 launches over twelve years while concurrently undergoing ten major upratings to keep pace with the ever increasing performance and reliability requirements of its users. At least 40 more launches are scheduled over the next three years from the Eastern and Western Test Ranges.

  1. COSMOS Launch Services

    NASA Astrophysics Data System (ADS)

    Kalnins, Indulis

    2002-01-01

    COSMOS-3M is a two stage launcher with liquid propellant rocket engines. Since 1960's COSMOS has launched satellites of up to 1.500kg in both circular low Earth and elliptical orbits with high inclination. The direct SSO ascent is available from Plesetsk launch site. The very high number of 759 launches and the achieved success rate of 97,4% makes this space transportation system one of the most reliable and successful launchers in the world. The German small satellite company OHB System co-operates since 1994 with the COSMOS manufacturer POLYOT, Omsk, in Russia. They have created the joint venture COSMOS International and successfully launched five German and Italian satellites in 1999 and 2000. The next commercial launches are contracted for 2002 and 2003. In 2005 -2007 COSMOS will be also used for the new German reconnaissance satellite launches. This paper provides an overview of COSMOS-3M launcher: its heritage and performance, examples of scientific and commercial primary and piggyback payload launches, the launch service organization and international cooperation. The COSMOS launch service business strategy main points are depicted. The current and future position of COSMOS in the worldwide market of launch services is outlined.

  2. 66. DETAIL OF LAUNCH CONDUCTOR AND ASSISTANT LAUNCH CONDUCTOR PANELS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    66. DETAIL OF LAUNCH CONDUCTOR AND ASSISTANT LAUNCH CONDUCTOR PANELS IN CONSOLE LOCATED CENTRALLY IN SLC-3E CONTROL ROOM. FROM LEFT TO RIGHT IN BACKGROUND: LAUNCH OPERATOR, LAUNCH ANALYST, AND FACILITIES PANELS. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  3. Launch facilities as infrastructure

    NASA Astrophysics Data System (ADS)

    Trial, Mike

    The idea is put forth that launch facilities in the U.S. impose inefficiencies on launch service providers due to the way they have been constructed. Rather than constructing facilities for a specific program, then discarding them when the program is complete, a better use of the facilities investment would be in constructing facilities flexible enough for use by multiple vehicle types over the course of a 25-year design lifetime. The planned National Launch System (NLS) program offers one possible avenue for the federal government to provide a nucleus of launch infrastructure which can improve launch efficiencies. The NLS goals are to develop a new space launch system to meet civil and national needs. The new system will be jointly funded by DOD and NASA but will actively consider commercial space needs. The NLS will improve reliability, responsiveness, and mission performance, and reduce operating costs. The specifics of the infrastructure concept are discussed.

  4. Using telehealth to augment an intensive case monitoring program in veterans with schizophrenia and suicidal ideation: A pilot trial

    PubMed Central

    Kasckow, John; Zickmund, Susan; Gurklis, John; Luther, James; Fox, Lauren; Taylor, Melissa; Richmond, Ira; Haas, Gretchen L

    2016-01-01

    Veterans with schizophrenia admitted for suicidal ideation were recruited into a post-discharge program consisting of Intensive Case Monitoring (ICM) with daily monitoring with the Health Buddy (HB; experimental group) or ICM alone (control group). This study tested the feasibility of the telehealth monitoring intervention in this population. Secondly, we determined whether augmentation of ICM with our intervention for 3 months would result in a reduction in suicidal ideation. Twenty of 25 telehealth participants could set up the device. Monthly adherence for telehealth participants was > 80%. A qualitative analysis of endpoint surveys revealed that the majority of participants had positive responses. In both groups, there were improvements in Beck Scale for Suicidal Ideation (BSS) scores at endpoint relative to baseline. No group differences were present with survival analysis when using remission (i.e., BSS score = 0) as the outcome; however, in a subgroup with a history of suicide attempt, there was a trend (p = .093) for a higher rate of remission for those in the HB condition. In conclusion, telehealth monitoring for this population appears to be feasible for those who are able to start using the system. The pilot data obtained should help investigators design better telehealth interventions for this population. PMID:27137970

  5. Using telehealth to augment an intensive case monitoring program in veterans with schizophrenia and suicidal ideation: A pilot trial.

    PubMed

    Kasckow, John; Zickmund, Susan; Gurklis, John; Luther, James; Fox, Lauren; Taylor, Melissa; Richmond, Ira; Haas, Gretchen L

    2016-05-30

    Veterans with schizophrenia admitted for suicidal ideation were recruited into a post-discharge program consisting of Intensive Case Monitoring (ICM) with daily monitoring with the Health Buddy (HB; experimental group) or ICM alone (control group). This study tested the feasibility of the telehealth monitoring intervention in this population. Secondly, we determined whether augmentation of ICM with our intervention for 3 months would result in a reduction in suicidal ideation. Twenty of 25 telehealth participants could set up the device. Monthly adherence for telehealth participants was > 80%. A qualitative analysis of endpoint surveys revealed that the majority of participants had positive responses. In both groups, there were improvements in Beck Scale for Suicidal Ideation (BSS) scores at endpoint relative to baseline. No group differences were present with survival analysis when using remission (i.e., BSS score = 0) as the outcome; however, in a subgroup with a history of suicide attempt, there was a trend (p = .093) for a higher rate of remission for those in the HB condition. In conclusion, telehealth monitoring for this population appears to be feasible for those who are able to start using the system. The pilot data obtained should help investigators design better telehealth interventions for this population. PMID:27137970

  6. Launch Services Safety Overview

    NASA Technical Reports Server (NTRS)

    Loftin, Charles E.

    2008-01-01

    NASA/KSC Launch Services Division Safety (SA-D) services include: (1) Assessing the safety of the launch vehicle (2) Assessing the safety of NASA ELV spacecraft (S/C) / launch vehicle (LV) interfaces (3) Assessing the safety of spacecraft processing to ensure resource protection of: - KSC facilities - KSC VAFB facilities - KSC controlled property - Other NASA assets (4) NASA personnel safety (5) Interfacing with payload organizations to review spacecraft for adequate safety implementation and compliance for integrated activities (6) Assisting in the integration of safety activities between the payload, launch vehicle, and processing facilities

  7. GPM: Waiting for Launch

    NASA Video Gallery

    The Global Precipitation Measurement mission's Core Observatory is poised for launch from the Japan Aerospace Exploration Agency's Tanegashima Space Center, scheduled for the afternoon of Feb. 27, ...

  8. Kestrel balloon launch system

    SciTech Connect

    Newman, M.J.

    1991-10-01

    Kestrel is a high-altitude, Helium-gas-filled-balloon system used to launch scientific payloads in winds up to 20 knots, from small platforms or ships, anywhere over land or water, with a minimal crew and be able to hold in standby conditions. Its major components consist of two balloons (a tow balloon and a main balloon), the main deployment system, helium measurement system, a parachute recovery unit, and the scientific payload package. The main scope of the launch system was to eliminate the problems of being dependent of launching on long airfield runways, low wind conditions, and long launch preparation time. These objectives were clearly met with Kestrel 3.

  9. Telehealth for Persons with Severe Functional Disabilities and their Caregivers: Facilitating Self-care Management in the Home Setting

    PubMed Central

    Forducey, Pamela G.; Glueckauf, Robert L.; Bergquist, Thomas; Maheu, Marlene M.; Yutsis, Maya

    2012-01-01

    Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This paper highlights the findings of three pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed. PMID:22662729

  10. Launch Pad in a Box

    NASA Technical Reports Server (NTRS)

    Mantovani, J. G.; Tamasy, G. J.; Mueller, R. P.; Townsend, I. I.; Sampson, J. W.; Lane, M. A.

    2016-01-01

    NASA Kennedy Space Center (KSC) is developing a new deployable launch system capability to support a small class of launch vehicles for NASA and commercial space companies to test and launch their vehicles. The deployable launch pad concept was first demonstrated on a smaller scale at KSC in 2012 in support of NASA Johnson Space Center's Morpheus Lander Project. The main objective of the Morpheus Project was to test a prototype planetary lander as a vertical takeoff and landing test-bed for advanced spacecraft technologies using a hazard field that KSC had constructed at the Shuttle Landing Facility (SLF). A steel pad for launch or landing was constructed using a modular design that allowed it to be reconfigurable and expandable. A steel flame trench was designed as an optional module that could be easily inserted in place of any modular steel plate component. The concept of a transportable modular launch and landing pad may also be applicable to planetary surfaces where the effects of rocket exhaust plume on surface regolith is problematic for hardware on the surface that may either be damaged by direct impact of high speed dust particles, or impaired by the accumulation of dust (e.g., solar array panels and thermal radiators). During the Morpheus free flight campaign in 2013-14, KSC performed two studies related to rocket plume effects. One study compared four different thermal ablatives that were applied to the interior of a steel flame trench that KSC had designed and built. The second study monitored the erosion of a concrete landing pad following each landing of the Morpheus vehicle on the same pad located in the hazard field. All surfaces of a portable flame trench that could be directly exposed to hot gas during launch of the Morpheus vehicle were coated with four types of ablatives. All ablative products had been tested by NASA KSC and/or the manufacturer. The ablative thicknesses were measured periodically following the twelve Morpheus free flight tests

  11. Launch Collision Probability

    NASA Technical Reports Server (NTRS)

    Bollenbacher, Gary; Guptill, James D.

    1999-01-01

    This report analyzes the probability of a launch vehicle colliding with one of the nearly 10,000 tracked objects orbiting the Earth, given that an object on a near-collision course with the launch vehicle has been identified. Knowledge of the probability of collision throughout the launch window can be used to avoid launching at times when the probability of collision is unacceptably high. The analysis in this report assumes that the positions of the orbiting objects and the launch vehicle can be predicted as a function of time and therefore that any tracked object which comes close to the launch vehicle can be identified. The analysis further assumes that the position uncertainty of the launch vehicle and the approaching space object can be described with position covariance matrices. With these and some additional simplifying assumptions, a closed-form solution is developed using two approaches. The solution shows that the probability of collision is a function of position uncertainties, the size of the two potentially colliding objects, and the nominal separation distance at the point of closest approach. ne impact of the simplifying assumptions on the accuracy of the final result is assessed and the application of the results to the Cassini mission, launched in October 1997, is described. Other factors that affect the probability of collision are also discussed. Finally, the report offers alternative approaches that can be used to evaluate the probability of collision.

  12. Foreign launch competition growing

    NASA Astrophysics Data System (ADS)

    Brodsky, R. F.; Wolfe, M. G.; Pryke, I. W.

    1986-07-01

    A survey is given of progress made by other nations in providing or preparing to provide satellite launch services. The European Space Agency has four generations of Ariane vehicles, with a fifth recently approved; a second launch facility in French Guiana that has become operational has raised the possible Ariane launch rate to 10 per year, although a May failure of an Ariane 2 put launches on hold. The French Hermes spaceplane and the British HOTOL are discussed. Under the auspices of the Italian National Space Plane, the Iris orbital transfer vehicle is developed and China's Long March vehicles and the Soviet Protons and SL-4 vehicles are discussed; the Soviets moreover are apparently developing not only a Saturn V-class heavy lift vehicle with a 150,000-kg capacity (about five times the largest U.S. capacity) but also a space shuttle and a spaceplane. Four Japanese launch vehicles and some vehicles in an Indian program are also ready to provide launch services. In this new, tough market for launch services, the customers barely outnumber the suppliers. The competition develops just as the Challenger and Titan disasters place the U.S. at a disadvantage and underline the hard work ahead to recoup its heretofore leading position in launch services.

  13. NASA launch schedule

    NASA Astrophysics Data System (ADS)

    Bell, Peter M.

    The National Aeronautics and Space Administration (NASA) has a record-setting launch schedule for 1984—10 space shuttle flights (see Table 1), 10 satellite deployments from the space shuttle in orbit and 12 unmanned missions using expendable launch vehicles. Also scheduled is the launch on March 1 for the National Oceanic and Atmospheric Administration of Landsat D‧, the nation's second earth resources satellite.The launch activity will begin February 3 with the launch of shuttle mission 41-B using the orbiter Challenger. Two communications satellites will be deployed from 41-B: Westar-VI, for Western Union, and Palapa B-2 for the government of Indonesia. The 8-day mission will feature the first shuttle landing at Kennedy Space Center in Florida; and the first flight of the Manned Maneuvering Unit, a self-contained, propulsive backpack that will allow astronauts to move about in space without being tethered to the spacecraft.

  14. 65. DETAIL OF ASSISTANT LAUNCH CONTROLLER AND LAUNCH CONTROLLER PANELS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    65. DETAIL OF ASSISTANT LAUNCH CONTROLLER AND LAUNCH CONTROLLER PANELS LOCATED NEAR CENTER OF SLC-3E CONTROL ROOM. NOTE 30-CHANNEL COMMUNICATIONS PANELS. PAYLOAD ENVIRONMENTAL CONTROL AND MONITORING PANELS (LEFT) AND LAUNCH OPERATORS PANEL (RIGHT) IN BACKGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  15. Health Insurance Portability and Accountability Act-Compliant Ocular Telehealth Network for the Remote Diagnosis and Management of Diabetic Retinopathy

    SciTech Connect

    Li, Yaquin; Karnowski, Thomas Paul; Tobin Jr, Kenneth William; Giancardo, Luca; Garg, Seema; Fox, Karen; Chaum, Edward

    2011-01-01

    In this article, we present the design and implementation of a regional ocular telehealth network for remote assessment and management of diabetic retinopathy (DR), including the design requirements, network topology, protocol design, system work flow, graphics user interfaces, and performance evaluation. The Telemedical Retinal Image Analysis and Diagnosis Network is a computer-aided, image analysis telehealth paradigm for the diagnosis of DR and other retinal diseases using fundus images acquired from primary care end users delivering care to underserved patient populations in the mid-South and southeastern United States.

  16. STS-85 Discovery Launch

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Blasting through the hazy late morning sky, the Space Shuttle Discovery soars from Launch Pad 39A at 10:41 a.m. EDT Aug. 7 on the 11-day STS-85 mission. Aboard Discovery are Commander Curtis L. Brown, Jr.; Pilot Kent V. Rominger, Payload Commander N. Jan Davis, Mission Specialist Robert L. Curbeam, Jr., Mission Specialist Stephen K. Robinson and Payload Specialist Bjarni V. Tryggvason, a Canadian Space Agency astronaut . The primary payload aboard the Space Shuttle orbiter Discovery is the Cryogenic Infrared Spectrometers and Telescopes for the Atmosphere-Shuttle Pallet Satellite-2 (CRISTA-SPAS-2) free-flyer. The CRISTA-SPAS-2 will be deployed on flight day 1 to study trace gases in the Earths atmosphere as a part of NASAs Mission to Planet Earth program. Also aboard the free-flying research platform will be the Middle Atmosphere High Resolution Spectrograph Instrument (MAHRSI). Other payloads on the 11-day mission include the Manipulator Flight Demonstration (MFD), a Japanese Space Agency-sponsored experiment. Also in Discoverys payload bay are the Technology Applications and Science-1 (TAS-1) and International Extreme Ultraviolet Hitchhiker-2 (IEH-2) experiments.

  17. Students Participate in Rocket Launch Project

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Filled with anticipation, students from three Huntsville area high schools: Randolph, Sparkman, and Johnson High Schools, counted down to launch the rockets they designed and built at the Army test site on Redstone Arsenal in Huntsville, Alabama. The projected two-mile high launch culminated more than a year's work and demonstrated the student team's ability to meet the challenge set by the Marshall Space Flight Center's (MSFC) Student Launch Initiative (SLI) program to apply science and math to experience, judgment, and common sense, and proved to NASA officials that they have successfully built reusable launch vehicles (RLVs), another challenge set by NASA's SLI program. MSFC's SLI program is an educational effort that aims to motivate students to pursue careers in science, math, and engineering. It provides hands-on, practical aerospace experience. In this picture, Randolph High School students are assembling their rocket in preparation for launch.

  18. Effect of telehealth on hospital utilisation and mortality in routine clinical practice: a matched control cohort study in an early adopter site

    PubMed Central

    Steventon, Adam; Ariti, Cono; Fisher, Elizabeth; Bardsley, Martin

    2016-01-01

    Objectives To assess the effects of a home-based telehealth intervention on the use of secondary healthcare and mortality. Design Observational study of a mainstream telehealth service, using person-level administrative data. Time to event analysis (Cox regression) was performed comparing telehealth patients with controls who were matched using a machine-learning algorithm. Setting A predominantly rural region of England (North Yorkshire). Participants 716 telehealth patients were recruited from community, general practice and specialist acute care, between June 2010 and March 2013. Patients had chronic obstructive pulmonary disease, congestive heart failure or diabetes, and a history of associated inpatient admission. Patients were matched 1:1 to control patients, also selected from North Yorkshire, with respect to demographics, diagnoses of health conditions, previous hospital use and predictive risk score. Interventions Telehealth involved the remote exchange of medical data between patients and healthcare professionals as part of the ongoing management of the patient's health condition. Monitoring centre staff alerted healthcare professionals if the telemonitored data exceeded preset thresholds. Control patients received usual care, without telehealth. Primary and secondary outcome measures Time to the first emergency (unplanned) hospital admission or death. Secondary metrics included time to death and time to first admission, outpatient attendance and emergency department visit. Results Matched controls and telehealth patients were similar at baseline. Following enrolment, telehealth patients were more likely than matched controls to experience emergency admission or death (adjusted HR 1.34, 95% CI 1.16 to 1.56, p<0.001). They were also more likely to have outpatient attendances (adjusted HR=1.25, 1.11 to 1.40, p<0.001), but mortality rates were similar between groups. Sensitivity analyses showed that we were unlikely to have missed reductions in the

  19. Hi-C Launch

    NASA Video Gallery

    The High resolution Coronal Imager (Hi-C) was launched on a NASA Black Brant IX two-stage rocket from White Sands Missile Range in New Mexico July 11, 2012. The experiment reached a maximum velocit...

  20. Commercial space launches

    NASA Astrophysics Data System (ADS)

    Robb, David W.

    1984-04-01

    While the space shuttle is expected to be the principle Space Transportation System (STS) of the United States, the Reagan Administration is moving ahead with the President's declared space policy of encouraging private sector operation of expendable launch vehicles (ELV's). With the signing of the “Commercial Space Launch Law” on October 30, the administration hopes that it has opened up the door for commercial ventures into space by streamlining regulations and coordinating applications for launches. The administration considers the development and operation of private sector ELV's as an important part of an overall U.S. space policy, complementing the space shuttle and government ELV's. The law follows by nearly a year the creation of the Office of Commercial Space Transportation at the U.S. Department of Transportation (DOT), which will coordinate applications for commercial space launches.

  1. Anchor Trial Launch

    Cancer.gov

    NCI has launched a multicenter phase III clinical trial called the ANCHOR Study -- Anal Cancer HSIL (High-grade Squamous Intraepithelial Lesion) Outcomes Research Study -- to determine if treatment of HSIL in HIV-infected individuals can prevent anal canc

  2. GPM Launch Coverage

    NASA Video Gallery

    A Japanese H-IIA rocket with the NASA-Japan Aerospace Exploration Agency (JAXA) Global Precipitation Measurement (GPM) Core Observatory aboard, launched from the Tanegashima Space Center in Japan o...

  3. Advanced launch system

    NASA Technical Reports Server (NTRS)

    Monk, Jan C.

    1991-01-01

    The Advanced Launch System (ALS) is presented. The costs, reliability, capabilities, infrastructure are briefly described. Quality approach, failure modes, structural design, technology benefits, and key facilities are outlined. This presentation is represented by viewgraphs.

  4. Expedition 27 Launch

    NASA Video Gallery

    NASA astronaut Ron Garan and Russian cosmonauts Andrey Borisenko and Alexander Samokutyaev launch in their Soyuz TMA-21 spacecraft from the Baikonur Cosmodrome in Kazakhstan on April 4, 2011 (April...

  5. Genomic Data Commons launches

    Cancer.gov

    The Genomic Data Commons (GDC), a unified data system that promotes sharing of genomic and clinical data between researchers, launched today with a visit from Vice President Joe Biden to the operations center at the University of Chicago.

  6. NASA Now: Glory Launch

    NASA Video Gallery

    In this episode of NASA Now, Dr. Hal Maring joins us to explain why the upcoming launch of the Glory satellite is so important to further our understanding of climate change. He also will speak on ...

  7. Launch of Juno!

    NASA Video Gallery

    An Atlas V rocket lofted the Juno spacecraft toward Jupiter from Space Launch Complex-41. The 4-ton Juno spacecraft will take five years to reach Jupiter on a mission to study its structure and dec...

  8. IRVE 3 Launch

    NASA Video Gallery

    The Inflatable Reentry Vehicle Experiment, or IRVE-3, launched on July 23, 2012, from NASA's Wallops Flight Facility. The purpose of the IRVE-3 test was to show that a space capsule can use an infl...

  9. Telehealth and Occupational Therapy: Integral to the Triple Aim of Health Care Reform.

    PubMed

    Cason, Jana

    2015-01-01

    Programs and concepts included in the Patient Protection and Affordable Care Act of 2010 are expected to transform health care in the United States from a volume-based health system to a value-based health system with increased emphasis on prevention and health promotion. The Triple Aim, a framework set forth by the Institute for Healthcare Improvement, focuses on improving the health care experience, the health of populations, and the affordability of care. This article describes telehealth as an integral component in achieving the Triple Aim of health care and discusses implications for occupational therapy practitioners. PMID:26122676

  10. A Patient-Centric, Provider-Assisted Diabetes Telehealth Self-management Intervention for Urban Minorities

    PubMed Central

    Carter, Ernest L; Nunlee-Bland, Gail; Callender, Clive

    2011-01-01

    This article describes the design and implementation of an online diabetes self-management intervention for a sample of inner-city African Americans with diabetes. Study participants were randomly assigned to the treatment (26) and control (21) conditions. The results indicate that treatment group participants were more likely to achieve positive outcomes in terms of lowered hemoglobin A1c and body mass index measurements than were control group members. These findings support the development of telehealth interventions to promote effective chronic disease management in medically underserved communities. PMID:21307985