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1

Telemedicine for wound management  

PubMed Central

The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process. PMID:23162242

Chittoria, Ravi K.

2012-01-01

2

Research Paper: A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus  

Microsoft Academic Search

BackgroundTelemedicine is a promising but largely unproven technology for providing case management services to patients with chronic conditions who experience barriers to access to care or a high burden of illness.MethodsThe authors conducted a randomized, controlled trial comparing telemedicine case management to usual care, with blinding of those obtaining outcome data, in 1,665 Medicare recipients with diabetes, aged 55 years

Steven Shea; Ruth S. Weinstock; Justin Starren; Jeanne A. Teresi; Walter Palmas; Lesley Field; Philip C. Morin; Robin Goland; Roberto E. Izquierdo; L. Thomas Wolff; Mohammed Ashraf; Charlyn Hilliman; Stephanie Silver; Suzanne Meyer; Douglas Holmes; Eva Petkova; Linnea Capps; Rafael A. Lantigua

2006-01-01

3

Telemedicine  

PubMed Central

As the health care industry is facing many challenges and is undergoing extensive change, telemedicine is in the position to address these challenges and be an important part of health care’s development. Telemedicine has been used for approximately a half century, in which researchers have explored the different technologies utilized, clinical outcomes, cost benefits, perceptions, and adoption challenges of its use. This paper reviews and summarizes these findings and presents possible future research endeavors. Examining what is known about telemedicine can aid in the development of innovative, sustainable and beneficial health technologies that could positively impact health care delivery and outcomes. PMID:23616832

Whitten, P.; Holtz, B.; LaPlante, C.

2010-01-01

4

Telemedicine in a Rural Memory Disorder Clinic—Remote Management of Patients with Dementia  

PubMed Central

Background There are many reasons to develop telemedicine clinics for assessment and management of dementia. Time constraints, location, and poor weather conditions can all impact on the ability of patients and providers to attend rural clinics. The utility of telemedicine in the diagnosis of dementia and subsequent follow-up appears promising in the literature, as it provides a viable means of assessing cognition in patients in remote areas with limited access to medical specialists. Methods & Results This study explored the feasibility of introducing a telemedicine memory disorder follow-up clinic in a rural community. The evaluation of 32 clinic sessions found high levels of satisfaction, with over 90% of physicians and patients indicating that they’d be willing to use video conferencing again. Physicians overwhelmingly felt the sessions provided enough information to assist in clinical decision-making (96%), and patients and CCAC Case Managers/Geriatric Assessors felt able to present the same information by video conferencing as in person (92% for both groups). The telemedicine clinic provided a number of favourable results such as: timely access to specialist care in the patient’s own community; fewer cancelled clinics; enhanced care transitions between the follow-up clinic and primary care with the support of a case manager/geriatric assessor; and enhanced follow-up for a complex patient population. In addition, the telemedicine initiative freed up spaces for “in-person” clinics. This allowed them to focus on new patient assessments. Conclusions The high satisfaction rates amongst all key stakeholders affirm that telemedicine is a viable option and worth continued efforts at shaping and developing, particularly in regions where local physician specialists are a scare resource. PMID:23259023

Azad, Nahid; Amos, Stephanie; Milne, Kelly; Power, Barbara

2012-01-01

5

A pharmacist-managed telemedicine clinic for hepatitis C care: a descriptive analysis.  

PubMed

We established a pharmacist-led telemedicine clinic to manage patients with chronic hepatitis C infection. The clinic used individual pharmacist-to-patient consultations. There was also a group hepatitis C patient education class. The hepatitis C telemedicine service began in February 2011 and was available at three remote sites (Santa Maria, Bakersfield and East Los Angeles) from the main site in West Los Angeles. A total of 96 patients were seen through telemedicine in the first nine months. A patient satisfaction survey was conducted at the end of 2011 and 18 questionnaires were returned. In comparison with visits to the clinic in West Los Angeles, all patients were at least equally satisfied with telemedicine and there were no patients who were less satisfied with telemedicine. Telemedicine reduced the travelling distance and time it took for patients to attend their clinic appointment. 82% of patients preferred their future hepatitis C clinic visits to be conducted via telemedicine and 78% would prefer any future clinic visit for any disease state management to be conducted via telemedicine. The use of telemedicine increased the opportunities for patients living in remote areas to receive care for hepatitis C management. PMID:24414398

You, Andy; Kawamoto, Jenna; Smith, Jason P

2014-03-01

6

Telemedicine as a tool for intensive management of diabetes: the DIABTel experience  

Microsoft Academic Search

This paper presents the current features of the DIABTel telemedicine system and the evaluation outcomes of its use in clinical routine. This telemedicine system is designed to complement the daily care and intensive management of diabetic patients through telemonitoring and telecare services. The system comprises a patient unit (PU) used by patients in their day-to-day activities and a Medical Workstation

Enrique J. Gómez; M. Elena Hernando; A. García; Francisco Del Pozo; J. Cermeño; R. Corcoy; Eulalia Brugués; Alberto De Leiva

2002-01-01

7

The empirical foundations of telemedicine interventions for chronic disease management.  

PubMed

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

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

2014-09-01

8

Telepresence and telemedicine in trauma and emergency care management.  

PubMed

The use of telemedicine is long-standing, but only recently has been applied to the specialties of trauma, emergency care, and surgery. Subsequently the concepts of teletrauma, telepresence, and telesurgery have evolved and are being integrated into modern care of trauma and surgical patients. This chapter will review the current applications and future endeavors of telemedicine and telepresence to trauma and emergency care as the new frontiers of telemedicine application. PMID:15747979

Latifi, Rifat; Peck, Kim; Porter, John M; Poropatich, Ron; Geare, Ted; Nassi, Richard B

2004-01-01

9

A systematic review of the efficacy of telemedicine for making diagnostic and management decisions  

Microsoft Academic Search

Summary We conducted a systematic review of the literature to evaluate the efficacy of telemedicine for making diagnostic and management decisions in three classes of application: office\\/hospital-based, store-and-forward, and home-based telemedicine. We searched the MEDLINE, EMBASE, CINAHL and HealthSTAR databases and printed resources, and interviewed investigators in the field. We excluded studies where the service did not historically require face-to-face

William Hersh; Mark Helfand; James Wallace; Dale Kraemer; Patricia Patterson; Susan Shapiro; Merwyn Greenlick

2002-01-01

10

Web-based telemedicine for management of type 2 diabetes through glucose uploads: a randomized controlled trial  

PubMed Central

Aims: To evaluate the feasibility and effectiveness of a telemedicine system based on internet in the follow-up of patients with type 2 diabetes mellitus (T2DM). Methods: A prospective randomized telemedicine study with two parallel groups was designed. 114 patients diagnosed T2DM were randomly divided into telemedicine group and traditional face-to-face visit group as control. 57 cases were included for each group. 108 patients completed the trial, in which 53 cases in telemedicine group and 55 cases in control group. Patients in telemedicine group were taught to use telemedicine software to upload their blood glucose and other metabolic information at home at least every 2 weeks, and the researchers gave proper advices according to patients’ key behaviors. The telemedicine interval is 3 months. Results: Compared to control group, telemedicine group exhibited better HbA1c and fasting blood glucose controlling (P < 0.05). Moreover, telemedicine intervention decreased hypoglycemia risk (P = 0.044), and contributed to levels of HbA1c less than 7% which is the target of our study (P = 0.049). Conclusions: Telemedicine system can provide a tighter glycemic control for the treatment of T2DM patients, especially in cases with difficulties to access to the medical centre.

Zhou, Peiru; Xu, Lingli; Liu, Xueyan; Huang, Jiewei; Xu, Wanping; Chen, Weiju

2014-01-01

11

A telemedicine support for diabetes management: the T-IDDM project  

Microsoft Academic Search

In the context of the EU funded Telematic Management of Insulin-Dependent Diabetes Mellitus (T-IDDM) project, we have designed, developed and evaluated a telemedicine system for insulin dependent diabetic patients management. The system relies on the integration of two modules, a Patient Unit (PU) and a Medical Unit (MU), able to communicate over the Internet and the Public Switched Telephone Network.

Riccardo Bellazzi; Cristiana Larizza; Stefania Montani; Alberto Riva; Mario Stefanelli; Giuseppe D'annunzio; R. Lorini; Enrique J. Gómez; M. Elena Hernando; Eulalia Brugués; J Cermeno; R Corcoy; A de Leiva; C Cobelli; G Nucci; S Del Prato; A Maran; E Kilkki; J Tuominen

2002-01-01

12

Diabetes Disease Management Program for an Indigent Population Empowered by Telemedicine Technology  

Microsoft Academic Search

Mercy Health Center in Laredo, Texas implemented a Telemedicine Diabetes Disease Man- agement Program to determine the impact of a web-based patient interface technology as part of a diabetes disease management program. The program featured the use of the Health Hero ® iCare Desktop™ and the Health Buddy ® appliance. The Mercy Health Center outcomes study aimed to assess the

Julie Cheitlin Cherry; Tracey P. Moffatt; Christine Rodriguez; Kirsten Dryden

2002-01-01

13

Telemedicine success in the United States Associated Pacific Islands (USAPI): two illustrative cases.  

PubMed

A simple technical solution to a difficult situation serves as a model for telemedicine in the developing world of the Pacific Rim. Reported here are two cases involving little girls who accidentally suffered broken legs and how they were helped. The first, a 6-year-old from Kolonia, Pohnpei State, Federated States of Micronesia, fell out of a second story window and broke her left leg. The second, a 5-year-old girl from Majuro, Republic of the Marshall Islands, was hit by an automobile and suffered a fracture of her left leg. These two cases illustrate the utility of simple-store-and-forward telemedicine technology in distance consultation, referral, and education. PMID:12699613

Person, Donald A; Hedson, Johnny S; Gunawardane, Kamal J

2003-01-01

14

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

PubMed

More than 100 stroke units have been established in Germany. In rural areas, however, acute stroke care needs to be improved. In order to advance clinical stroke therapy, two specialized stroke centers founded a telemedicine network (TEMPiS) among 12 community hospitals in eastern Bavaria. Each network hospital established specialized stroke wards where qualified teams manage acute stroke patients. Twenty-four hours daily, physicians in local hospitals are able to contact the stroke centers via videoconferencing including transmission of digital DICOM data. To study the efficacy of this network, a controlled trial will be performed. Five TEMPiS-network hospitals will be matched with five other hospitals equal in size, catchment area, and diagnostic techniques. For about 1 year, all consecutive stroke cases in the matched study hospitals will be prospectively recorded in a database. Neurological deficits will be quantified on the National Institute of Health Stroke Scale within 24 h after stroke onset. Mortality and institutional care as a combined primary endpoint will be assessed after 3 and 12 months. Furthermore, functional outcome according to the modified Rankin scale, Barthel score, and quality of life will be assessed using a standard telephone interview. Data acquisition started in July 2003, and final results are expected in 2005. PMID:14770288

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

2004-02-01

15

Telemedicine-Based Approach for Obstructive Sleep Apnea Management: Building Evidence  

PubMed Central

Background Telemedicine seems to offer reliable solutions to health care challenges, but significant contradictory results were recently found. Therefore, it is crucial to carefully select outcomes and target patients who may take advantage of this technology. Continuous positive airway pressure (CPAP) therapy compliance is essential to treat patients with obstructive sleep apnea (OSA). We believe that OSA patients could benefit greatly from a telemedicine approach for CPAP therapy management. Objective The objective of our study was to evaluate the application of a telemedicine-based approach in the CPAP therapy management, focusing on patients’ CPAP follow-up and training. Methods We performed two studies. First, (study 1) we enrolled 50 consecutive OSA patients who came to our sleep center for the CPAP follow-up visit. Patients performed a teleconsultation with a physician, and once finalized, they were asked to answer anonymously to a questionnaire regarding their opinion about the teleconsultation. In a second randomized controlled trial (RCT) (study 2), we included 40 OSA patients scheduled for CPAP training. There were 20 that received the usual face-to-face training and 20 that received the training via videoconference. After the session, they were blindly evaluated on what they learned about OSA and mask placement. Results More than 95% (49/50) of the interviewed patients were satisfied with the teleconsultation, and 66% (33/50) of them answered that the teleconsultation could replace 50%-100% of their CPAP follow-up visits. Regarding the RCT, patients who received the CPAP training via videoconference demonstrated the same knowledge about OSA and CPAP therapy as the face-to-face group (mean 93.6% of correct answers vs mean 92.1%; P=.935). Performance on practical skills (mask and headgear placement, leaks avoidance) was also similar between the two groups. Conclusions OSA patients gave a positive feedback about the use of teleconsultation for CPAP follow-up, and the CPAP training based on a telemedicine approach proved to be as effective as face-to-face training. These results support the use of this telemedicine-based approach as a valuable strategy for patients’ CPAP training and clinical follow-up. PMID:24554392

León, Carmen; Torres, Marta; Embid, Cristina; Roca, Josep; Navajas, Daniel; Farré, Ramon; Montserrat, Josep M

2014-01-01

16

Management of heart failure patients using telemedicine communication systems  

Microsoft Academic Search

Heart failure (HF) continues to place significant demands on health care resources because of the large number of hospital\\u000a admissions for HF, the growth of the elderly population with HF, and the improved survival of patients with chronic heart\\u000a disease who develop HF that requires continuous care. Because HF is best managed using a disease management approach, frequent\\u000a communication is

Abul Kashem; Robert C. Cross; William P. Santamore; Alfred A. Bove

2006-01-01

17

Telemedicine in the U.S. Army: case reports from Somalia and Croatia.  

PubMed

Recent advances in information systems technology improved the abilities of U.S. Army physicians in Somalia and Croatia to obtain clinical consults from U.S. Army Medical Centers in Germany and Washington, D.C. Through commercial satellite transmission of voice, facsimile, and high-resolution still, digital images, the Remote Clinical Communications System (RCCS) has expanded the Army Medical Department's means to provide better healthcare to our armed forces. This paper describes the RCCS technology and illustrates, through specific case reports, how this telemedicine system helped the Army Medical Department accomplish its mission during overseas deployments. PMID:10165326

Crowther, J B; Poropatich, R

1995-01-01

18

Intelligent image management in a distributed PACS and telemedicine environment  

Microsoft Academic Search

Advances in information technology in the past decade have resulted in a proliferation of clinical information systems dedicated to individual user groups and clinical functional areas. This, in turn, has led to the need for hospital-wide management and integration of information, and has triggered major efforts towards the development of integrated hospital information systems. A framework for developing an integrated

Manolis Tsiknakis; Dimitrios G. Katehakis; S. C. Orphanoudakis

1996-01-01

19

Neurotology telemedicine consultation.  

PubMed

The opportunity to treat neurotologic patients when the patient and physician are in separate locations is an important clinical delivery mechanism. The authors developed their applications of neurotologic telemedicine in the aftermath of Hurricane Katrina and found this to be an effective way to deliver clinical care, develop a clinical neurotology practice, and train residents and fellows and to manage a growing neurotologic clinical practice remotely. This article outlines the technical requirements, current uses, clinical applicability, and implementation details of the Our Lady of the Lake - LSU neurotology telemedicine program; administrative issues surrounding telemedicine; and future considerations. PMID:22032478

Arriaga, Moisés; Nuss, Daniel; Arriaga, Rebecca Y

2011-12-01

20

Effect of culture on acceptance of telemedicine in Middle Eastern countries: case study of Jordan and Syria.  

PubMed

We investigated issues that affect the use and adoption of telemedicine in Middle Eastern countries, taking the Hashemite Kingdom of Jordan and the Syrian Arab Republic as case studies. Our study is based on interviews with key stakeholders (including doctors, technicians, engineers, and decision makers) and questionnaires administered to key stakeholders (including patients), ensuring opinion was gained from people from a full range of backgrounds and roles in the healthcare system. We found doctor and patient resistance was a major issue preventing the adoption of telemedicine in both countries, followed by poor infrastructure, lack of funding, and lack of information technology training. Our research identifies that culture is a greater issue than technical matters for the adoption of telemedicine in Middle Eastern countries. Based on our preliminary results we developed a guideline framework for each country that might be applied to telemedicine projects at the pre-implementation phase. The proposed guideline framework was validated through a return visit to the stakeholders and seeking further opinion. PMID:23540280

Alajlani, Mohannad; Clarke, Malcolm

2013-04-01

21

Telemedicine and ISDN  

SciTech Connect

Telemedicine is not a new concept. Health care professionals have been using the telephone to carry out their services for years. In addition, research efforts have begun utilizing more of the telecommunication repertoire, including speech, text, data, picture, and video communication. Countries with rural areas (e.g., Australia, Canada, and Norway) have been especially active in this field. Telemedicine may be defined in several ways. The use of telecommunications and information technology is central in providing health services - regardless of locations. Thus, a goal for telemedicine has been to eliminate traveling for patients and specialist. The authors have found the following definition of telemedicine useful: The investigation, monitoring, and management of patients and the education of patients and staff using systems which allow ready access to expert advice and patient information, no matter where the patient or relevant information is located. In addition to the aspects covered by this definition they also discuss administrative information in this paper. Telemedicine involves a combination of topics from the fields of telecommunication, medicine, and informatics. In 1988, Norwegian Telecom Research (NTR) started a project on telemedicine in North Norway. This area was chosen partly because of the characteristics of the health service in this region. The region is characterized by sparsely populated communities spread over vast distances, and there is a lack of qualified personnel in certain sectors of the health service. The main objective of the project is to use telemedicine to provide equal healthcare services to each individual in Norway, regardless of geography or economic variation in the population. The project systematically explores the potentials provided by new information and communication technologies in improving health care services.

Akselsen, S.; Eidsvik, A.K.; Folkow, T. (Norwegian Telecom Research, Tromsoe (Norway))

1993-01-01

22

Telemedicine Spacebridge  

NASA Technical Reports Server (NTRS)

This video is an overview on NASA's Telemedicine Spacebridge Project, which lets US doctors consult with Russian clinicians thousands of miles away by demonstration of the feasibility of live, two-way, full-bandwidth video as a medical tool.

1994-01-01

23

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

PubMed Central

There is a gradual decline in concern of specialists who follow up the care of pregnant women with diabetes. In addition, due to the dwindling economic resources allocated to health services, access to specialized healthcare facilities is becoming more difficult. Telemedicine, or medicine practiced at a distance, is inserted in this context with applications differing for type of interaction (real-time or deferred, i.e., videoconferencing versus store-and-forward data transmission), type of monitoring (automatic versus requesting cooperation from the patient), and type of devices used (web connections and use of mobile phones or smartphones). Telemedicine can cope with the current lack of ability to ensure these patients frequent direct contact with their caregivers. This approach may have an impact not only on the classical maternal-fetal outcome, but also on some underestimated aspects of patients with diabetes in pregnancy, in this case their quality of life, the perception of “diabetes self-efficacy,” and the glycemic variability. In this paper, we will analyze the current evidence regarding the use of telemedicine in pregnancies complicated by diabetes, trying to highlight the main limitations of these studies and possible strategies to overcome them in order to improve the effectiveness of future clinical interventions with these medical applications. PMID:25295059

Chilelli, Nino Cristiano; Dalfrà, Maria Grazia; Lapolla, Annunziata

2014-01-01

24

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

PubMed

The success of telemedicine applications within health care begins with the process of implementing planned change. The attitudes of staff and their willingness to embrace new technology can be positively influenced in order to gain acceptance of new ways to perform tasks. Telemedicine applications have been designed to improve operational efficiency and obtain improved outcomes, but system designers and procurers are dependent upon the organization's leadership to effect attitudinal and behavioral changes that are essential for acceptance and usage of new technology. PMID:22948364

Rufo, Rebecca Zapatochny

2012-01-01

25

Telemedicine in vascular surgery: Feasibility of digital imaging for remote management of wounds  

Microsoft Academic Search

Purpose: Telemedicine coupled with digital photography could potentially improve the quality of outpatient wound care and decrease medical cost by allowing home care nurses to electronically transmit images of patients' wounds to treating surgeons. To determine the feasibility of this technology, we compared bedside wound examination by onsite surgeons with viewing digital images of wounds by remote surgeons. Methods: Over

Douglas J. Wirthlin; Syam Buradagunta; Roger A. Edwards; David C. Brewster; Richard P. Cambria; Jonathan P. Gertler; Glenn M. LaMuraglia; Diane E. Jordan; Joseph C. Kvedar; William M. Abbott

1998-01-01

26

Survey Determinant Factors of Telemedicine Strategic Planning from the Managers and Experts Perspective in the Health Department, Isfahan University of Medical Sciences  

PubMed Central

ABSTRACT Introduction: Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. Method: This is a descriptive–analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Results: Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. Conclusions: According to the strengths, weaknesses, opportunities and threats points determined by managers and experts, and compare it with success and failure factors, which are defined by different researchers, it seems will be fail to implement of telemedicine in the province at present. But according to the strengths identified by managers and experts, there are a lot of potential for telemedicine in the province, and may be used, in relation to telemedicine projects, with a 3 or 5 year strategic plan, and taking steps to get closer to the equity aim in health. PMID:25568581

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

2014-01-01

27

Performance improvement in telemedicine: the essential elements.  

PubMed

Performance improvement activities in telemedicine may be placed into five categories. (1) Licensing and credentialing. Telemedicine overcomes geographical boundaries, but its reach is constrained by state laws on licensing. Some states require a state license, whereas others grant "consultation exemptions" for out-of-state physicians. Simple renewable licenses do not guarantee quality. Potential solutions include a national telemedicine license or license reciprocity laws for telemedicine. (2) Data security and privacy. Telemedicine technology raises some security concerns. Differences in reporting requirements among states complicate the issue of privacy. Storage of telemedicine consultation records may help physicians document care decisions for risk management, but conventional long-term storage may not be feasible because of cost constraints and may not be required to document the encounter appropriately. (3) Informed consent. Potential failures in security and transmission are new, and should be communicated to the patient. (4) Peer review. Peer review findings encourage thorough, accurate, and legible documentation. Results should be recorded by provider and must be available during the recredentialing process. (5) Tailored performance improvement initiatives. By using established principles and techniques, performance improvement initiatives can gather, analyze, and communicate information about the cost-effectiveness of telemedicine. These performance improvement efforts are the heart of quality management and are critical to the justification of telemedicine. Walter Reed Telemedicine has put into effect a performance improvement plan in accordance with this outline. This article describes the plan and suggests it as a model for other telemedicine programs. PMID:9715616

Eliasson, A H; Poropatich, R K

1998-08-01

28

Case management.  

PubMed

Providing cost-effective high quality healthcare services ranks as the number one concern for anyone involved with the healthcare delivery system. While quality of care should always be the number one priority, controlling healthcare costs receives most of the attention. With limited healthcare dollars and providers assuming more of the financial risk for services rendered, a whole assortment of cost-containment strategies are being introduced in an effort to maintain some semblance of financial viability. Healthcare providers can approach cost control from two different angles. On the fixed-cost operational overhead side, traditional cost-containment techniques have focused on downsizing, maximizing productivity, staffing redesign, improved purchasing contracts, standardization, inventory control, and other more individualized restructured service models. On the variable-cost clinical side, cost control has been approached by introducing a variety of cost-containment strategies designed to improve efficiency and effectiveness of provider performance. While many of these strategies, previously discussed in the Journal of Healthcare Resource Management have stressed the importance of education, guidelines, pathways, and other clinical "tools for improvement," the success of many of these tools resides in the ability to provide real-time intervention. Real-time intervention rather than the more passive retrospective variance analysis has the greatest potential for producing cost savings by actually making a recommendation that prevents the unwanted event from occurring. In many institutions, the case manager bears the responsibility for monitoring and managing these programs. This article describes various case management models currently used by different institutions. PMID:10166062

Rosenstein, A H; Propotnik, T

1997-03-01

29

[Telemedicine: science or fiction?].  

PubMed

Telemedicine has been considered to be a scientific discipline midway between medicine and technology. Thus, over the last decade it has been largely influenced by the continuous development of computer and communications technologies. Now that the phase of its laboratory investigation has been completed, it can be considered to be a technique in a mature state. Hence, both from the point of view of technology suppliers and of the users of medicine -patients and professionals- there is a demand for a takeoff in the arena of its implantation, that is to say, the need for new health services based on telemedicine. This article offers an up-to-date view of the state of the art of telemedicine but without entering into an in-depth evaluation and description of the technology and its applications. On the contrary, our aim is to make it known to users and to the different health organisations, including their managers, that the conditions for its development are now available. Thus the success or failure of its implantation is a task for all of the actors involved. What is certain is that in the light of the experience and results of its application during the last decade, both in our surrounding geographical milieu and in the United States, there are unmistakable signs that telemedicine is here to stay. PMID:16421609

Monteagudo, J L; Serrano, L; Hernández Salvador, C

2005-01-01

30

Telemedicine Program  

NASA Technical Reports Server (NTRS)

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

1996-01-01

31

Telemedicine as an Innovative Model for Rebuilding Medical Systems in Developing Countries Through Multipartnership Collaboration: The Case of Albania.  

PubMed

Abstract The U.S. Government and other developed nations provide billions of dollars annually in relief assistance to countries around the world. The long-term benefits of this aid, however, are often difficult to elucidate. The aim of this article is to present a model of a multipartnership collaboration among U.S. governmental, nongovernmental organizations, and academia to rebuild medical systems using telemedicine as a sustainable model of foreign aid. The International Virtual e-Hospital implemented the "initiate-build-operate-transfer" strategy to establish an effective telemedicine system in Albania that includes the National Telemedicine Center and 12 regional telemedicine centers. This nationwide telemedicine network has active clinical programs, virtual educational programs, and an electronic library that has substantially improved the access to care while advancing medical education. We propose that telemedicine is an optimal, sustainable, low-cost model for rebuilding medical systems of developing countries when implemented through a multipartnership approach. PMID:25347524

Latifi, Rifat; Dasho, Erion; Shatri, Zhaneta; Tilley, Elizabeth; Osmani, Kalterina L; Doarn, Charles R; Dogjani, Agron; Olldashi, Fatos; Koçiraj, Agim; Merrell, Ronald C

2014-10-27

32

Case Management  

Microsoft Academic Search

The Productivity Commission’s inquiry report into ‘Waste Management’ was tabled by Government in December 2006. The Australian Government asked the Commission to identify policies that would enable Australia to address market failures and externalities associated with the generation and disposal of waste, and recommend how resource efficiencies can be optimised to improve economic, environmental and social outcomes. In the final

2009-01-01

33

Telemedicine for adolescents with type 1 diabetes.  

PubMed

Diabetes is the third most common chronic disease in the pediatric population and diabetes management in adolescents presents a unique challenge for health care providers. The purpose of this article is to define telemedicine, review a variety of telemedicine intervention studies in the adolescent population, and interpret those results in the context of the current health care climate. Clinicians and researchers will be provided with education related to adolescent needs and telemedicine interventions so that telemedicine can be used effectively to promote the health of adolescents with diabetes. Because telemedicine has yet to demonstrate consistent and significant positive outcomes in this population, further research and continued development of technology are essential to improve diabetes control in adolescents and prevent the long-term complications of this disease. PMID:24695401

Dougherty, Jennifer P; Lipman, Terri H; Hyams, Sandra; Montgomery, Kathleen A

2014-10-01

34

Patient perspectives of telemedicine quality  

PubMed Central

Background The purpose of this study was to explore the quality attributes required for effective telemedicine encounters from the perspective of the patient. Methods We used a multi-method (direct observation, focus groups, survey) field study to collect data from patients who had experienced telemedicine encounters. Multi-perspectives (researcher and provider) were used to interpret a rich set of data from both a research and practice perspective. Results The result of this field study is a taxonomy of quality attributes for telemedicine service encounters that prioritizes the attributes from the patient perspective. We identify opportunities to control the level of quality for each attribute (ie, who is responsible for control of each attribute and when control can be exerted in relation to the encounter process). This analysis reveals that many quality attributes are in the hands of various stakeholders, and all attributes can be addressed proactively to some degree before the encounter begins. Conclusion Identification of the quality attributes important to a telemedicine encounter from a patient perspective enables one to better design telemedicine encounters. This preliminary work not only identifies such attributes, but also ascertains who is best able to address quality issues prior to an encounter. For practitioners, explicit representation of the quality attributes of technology-based systems and processes and insight on controlling key attributes are essential to implementation, utilization, management, and common understanding. PMID:25565781

LeRouge, Cynthia M; Garfield, Monica J; Hevner, Alan R

2015-01-01

35

Perceptual Image Compression in Telemedicine  

NASA Technical Reports Server (NTRS)

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

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

1996-01-01

36

Telemedicine by mobile communication  

Microsoft Academic Search

We have proposed some techniques for mobile telemedicine and have verified their practical feasibility in experiments. This article presents technical considerations required to realize a practical mobile telemedicine system, techniques developed for multiple medical data transmission, and the satisfactory results of their applications to telemedicine in moving vehicles

Koichi Shimizu

1999-01-01

37

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support  

PubMed Central

The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC) or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile) unit. This integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3–12 lead ECG, SPO2, NIBP, IBP, Temp) and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunication means; in addition the system has been clinically validated in three different countries using a standardized medical protocol. PMID:12694629

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

2003-01-01

38

Assessing the Quality of Teleconsultations in a Store-And-Forward Telemedicine Network  

PubMed Central

Store-and-forward telemedicine in resource-limited settings is becoming a relatively mature activity. However, there are few published reports about quality measurement in telemedicine, except in image-based specialties, and they mainly relate to high- and middle-income countries. In 2010, Médecins Sans Frontières (MSF) began to use a store-and-forward telemedicine network to assist its field staff in obtaining specialist advice. To date, more than 1000 cases have been managed with the support of telemedicine, from a total of 40 different countries. We propose a method for assessing the overall quality of the teleconsultations provided in a store-and-forward telemedicine network. The assessment is performed at regular intervals by a panel of observers, who – independently – respond to a questionnaire relating to a randomly chosen past case. The answers to the questionnaire allow two different dimensions of quality to be assessed: the quality of the process itself and the outcome, defined as the value of the response to three of the four parties concerned, i.e., the patient, the referring doctor, and the organization. It is not practicable to estimate the value to society by this technique. The feasibility of the method was demonstrated by using it in the MSF telemedicine network, where process quality scores, and user-value scores, appeared to be stable over a 9-month trial period. This was confirmed by plotting the cusum of a portmanteau statistic (the sum of the four scores) over the study period. The proposed quality-assessment method appears feasible in practice, and will form one element of a quality assurance program for MSF’s telemedicine network in future. The method is a generally applicable one, which can be used in many forms of medical interaction. PMID:25077138

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

39

[Telemedicine applied to surgery].  

PubMed

The transmission of images, audio, video and computed data allows new possibilities in initial or continuing education/training of surgeons and new interactivities between medical or surgical specialties. In the field of surgery, telemedicine is used for teaching, diagnostic or therapeutic assistance, and even consultation of remote patients. This article reviews telemedicine technologies, national legislation current, surgical telemedicine practices and the future applications (telementoring, surgical simulator, telesurgery...). PMID:9752478

Sézeur, A

1998-01-01

40

Comparative performance of seven long-running telemedicine networks delivering humanitarian services.  

PubMed

Seven long-running telemedicine networks were surveyed. The networks provided humanitarian services (clinical and educational) in developing countries, and had been in operation for periods of 5-15 years. The number of experts serving each network ranged from 15 to 513. The smallest network had a total of 10 requesters and the largest one had more than 500 requesters. The networks operated in nearly 60 countries. The seven networks managed a total of 1857 cases in 2011, i.e. an average of 265 cases per year per network. There was a significant growth in total activity, amounting to 100.3 cases per year during the 15 year study period. In 2011, network activity was 50-700 teleconsultations per network. There were clear differences in the patterns of activity, with some networks managing an increasing caseload, and others managing a slowly reducing caseload. The seven networks had published a total of 44 papers listed in Medline which summarized the evidence resulting from the delivery of services by telemedicine. There was a dearth of information about clinical and cost-effectiveness. Nevertheless, the services were widely appreciated by referring doctors, considered to be clinically useful, and there were indications that clinical outcomes for telemedicine patients were often improved. Despite a lack of formal evidence, the present study suggests that telemedicine can provide clinically useful services in developing countries. PMID:22869822

Wootton, Richard; Geissbuhler, Antoine; Jethwani, Kamal; Kovarik, Carrie; Person, Donald A; Vladzymyrskyy, Anton; Zanaboni, Paolo; Zolfo, Maria

2012-09-01

41

Telemedicine and the delivery of health services to veterans with multiple sclerosis  

Microsoft Academic Search

Telemedicine involves the provision of health care and sharing of medical knowledge using telecommunications technologies. Preventive, diagnostic, and therapeutic services, as well as patient education and assistance with self-manage- ment of health, can be provided via telemedicine. The Veterans Health Administration (VHA) has a wide range of telemedi- cine capabilities. Given limitations on studying its effective- ness, telemedicine is often

Michael Hatzakis; Jodie Haselkorn; Rhonda Williams; Aaron Turner; Paul Nichol

2003-01-01

42

TELEMEDICINE TO ASSIST PATIENT UNDERSTANDING OF ATMOSPHERIC INFLUENCE ON LUNG FUNCTION AND IMPROVE  

E-print Network

TELEMEDICINE TO ASSIST PATIENT UNDERSTANDING OF ATMOSPHERIC INFLUENCE ON LUNG FUNCTION AND IMPROVE-time generic telemedicine system is presented. It is discussed in the context of self- management for people as influencing lung function, we have used data collected during a feasibility study of the telemedicine system

McSharry, Patrick E.

43

Security and privacy in RFID and applications in telemedicine  

Microsoft Academic Search

Radio frequency identification systems have many applications in manufacturing, supply chain management, inventory control, and telemedicine. In an RFID system, products and objects are given RFID tags to identify themselves. However, security and privacy issues pose significant challenges on these systems. In this article we first briefly introduce RFID systems. Then two RFID applications in telemedicine are proposed: studying supply

Yang Xiao; Xuemin Shen; BO Sun; Lin Cai

2006-01-01

44

Telemedicine Usage and Potentials  

Microsoft Academic Search

Telemedicine has been in use for many years and it is the use of telecommunications technologies to consult with remote physician. In this paper, we shed light on telemedicine in terms of the common usage and the future potentials of the technology with some examples.

Yang Xiao; Daisuke Takahashi; Fei Hu

2007-01-01

45

Telemedicine infrastructure development  

Microsoft Academic Search

While there are significant technical and regulatory barriers to developing an adequate infrastructure for telemedicine, even more fundamental organizational and financial infrastructure issues must be addressed if this technology is to realize its potential. The lack of good evaluative data on telemedicine consultations has been a further major stumbling block to its acceptance by both practitioners and policy-makers. This paper

Dena S. Puskin; Jay H. Sanders

1995-01-01

46

Telemedicine: The Up Side, and . . .  

ERIC Educational Resources Information Center

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

Risser, Joseph

1998-01-01

47

"Tuberculosis Case Management" Training.  

ERIC Educational Resources Information Center

The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to practice acquired skills in a simulated…

Knebel, Elisa; Kolodner, Jennifer

2001-01-01

48

Error-resilient video coding and application to telemedicine  

Microsoft Academic Search

Digital imagery and video are a vital part of medical consultation and diagnosis. A telemedicine program linking international hospitals improves patient care, promotes more rapid diagnosis, and may hasten improved survival rates for children with cancer. However, in many developing countries and in rural and remote areas, reliable wired communications lines are not available, in which case telemedicine needs to

Zhen Liu; Lana Karam; Glen P. Abousleman; B. Razzouk

2000-01-01

49

Rural trauma telemedicine.  

PubMed

Telemedicine is the ability to provide remote health care to patients with the use of a consultant and 2-way interactive technology and telecommunication. Traumatic injuries occurring in rural areas frequently carry a greater risk of mortality than those same injuries occurring in the urban settings. The purpose of this article was to increase practitioner awareness of the potential for improved outcomes as a result of the use of telemedicine in rural trauma care. The use of trauma telemedicine will help decrease the overall mortality and morbidity, length of stay at the urban trauma centers, patient care cost, and transfer time. PMID:24305081

Wesson, James Bryan; Kupperschmidt, Betty

2013-01-01

50

Assessing the Quality of Teleconsultations in a Store-And-Forward Telemedicine Network – Long-Term Monitoring Taking into Account Differences between Cases  

PubMed Central

We have previously proposed a method for assessing the quality of individual teleconsultation cases; this paper proposes an additional step to allow the long-term monitoring of quality. The basic scenario is a teleconsultation system (aka an e-referral system or a tele-expertise system) where the referrer posts a question about a clinical case, the question is relayed to an appropriate expert, and the chosen expert provides an answer. The people running this system want assurances that it is stable, i.e., they want routine quality assurance information about the “output” from the “process.” This requires two things. It needs a method of assessing the quality of individual patient consultations. And it needs a method for taking into account differences between patients, so that these quality assessments can be compared longitudinally. Building on the previously proposed methodology, the present paper proposes two techniques for measuring the difficulty posed by a particular teleconsultation. The first is an indirect method, similar to a willingness to pay economic estimation. The second is a direct method. Using these two methods with real data from a telemedicine network showed that the first method was feasible, but did not produce useful results in a pilot trial. The second method, while more laborious, was also feasible and did produce useful results. Thus, when output quality is measured, an allowance can be made for the characteristics of the case submitted. This means that fluctuations in output quality can be attributed to variations in the process (network) or to variations in the raw materials (queries submitted to the network). Long-term quality assurance should assist those providing telemedicine services in low-resource settings to ensure that the services are operated effectively and efficiently, despite the constraints and complexities of the environment. PMID:25389525

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

51

Telemedicine and European law.  

PubMed

A Directive of the European Union was first published in 2000, which dealt with telemedicine as part of its provisions. This E-Commerce Directive, as it became known, was subjected to further study which revealed some problems relative to the practice of telemedicine. Among the subjects discussed in this paper are those of privacy, data protection, free movement of services, the impact of electronic communication and ethical issues. PMID:15074761

Callens, Stefaan

2003-01-01

52

Telemedicine in Gastroenterohepatology  

PubMed Central

Telemedicine itself is not the medical profession, it is not a medical specialty, but the way in which the medical profession conduct its activity. Therefore we are talking about tele otorhinolaryngology, tele cardiology or tele pathology. In the definition of a multitude of telemedicine that can be found in the literature is the following: Telemedicine is a system that supports the process of health care by providing ways and means for more efficient exchange of information that allows multitude of activities related to health care, including health care and health personnel, including education, administration and treatment. Telemedicine applications include tele diagnosis, tele consultation, tele monitoring, tele-care, tele consultations and remote access to information contained in one or more databases. It turned out that telemedicine is an important factor in technological, professional, financial and organizational uniformity of development of the health system. Telemedicine, although a new area, to a large extent already changed the ways of providing health care, and even more influence on the ways of designing the future of medicine. PMID:25395732

Zildzic, Muharem; Salihefendic, Nizama; Krupic, Ferid; Beganovic, Emina; Zunic, Lejla; Masic, Izet

2014-01-01

53

[Telemedicine and wireless devices in heart failure].  

PubMed

Telemedicine has the potential to constitute the central element of the future primary care and become an effective means of prevention and early warning of acute exacerbation of chronic diseases. Up to now, the application of telemedicine has found a variety of difficulties, regarding the types and methods of acquisition and transmission of biological signals, the acceptance and cooperation of the patient, etc. The latest technological developments involve the combined use of wireless technologies and smartphones, for the collection and the transmission of data, and specific softwares for their automatic analysis. This paper examines some of the critical aspects in the application of new technologies for heart failure remote management. PMID:24873944

Billeci, Lucia; Guerriero, Lorenzo; L'Abbate, Antonio; Pioggia, Giovanni; Tartarisco, Gennaro; Trivella, Maria Giovanna

2014-05-01

54

Case Management Directors  

PubMed Central

Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role. We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Findings/Conclusions: Case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. Implications for Case Management: As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time. To operate most effectively, case management directors must understand the full range of their responsibilities and impact. They must find opportunities for themselves and their departments to learn and stay current as the regulatory environment continues to change. Providing a list of functions for which they are responsible, practical strategies for carrying them out, and places to go for help and information can help hospital case management directors operate with the confidence and knowledge they need to influence the quality and safety of patient care for the entire care team and to provide the best possible interactions with patients and family members. PMID:25629731

Bankston-White, Cheri; Birmingham, Jackie

2015-01-01

55

Design of a centralized telemedicine model in Palestine.  

PubMed

To provide patients with easy-access telemedicine services in Palestine, a simple and low-cost telemedicine system has been established. The system is based on a star topology network between local hospitals and a main telemedicine centre. In a pilot trial, a computerized tomography image was transmitted from a local hospital connected to the telemedicine service centre by ISDN (128 kbit/s). A videoconferencing discussion between the two ends was held. The performance of the system was satisfactory. The transmission time for a 1 MByte image was about 60 s. A conference was conducted to discuss this real clinical case by use of interactive sharing of the medical record. The session lasted 20 min. Encouraging results were obtained. The pilot study suggests that telemedicine can overcome existing isolation problems of cities and villages and the difficulties of transferring patients from one location to another. PMID:12217155

Zatari, Daoud I

2002-01-01

56

Telemedicine for Access to Quality Care on Medical Practice and Continuing Medical Education in a Global Arena  

ERIC Educational Resources Information Center

Health care practices continue to evolve with technological advances integrating computer applications and patient information management into telemedicine systems. Telemedicine can be broadly defined as the use of information technology to provide patient care and share clinical information from one geographic location to another. Telemedicine…

Rafiq, Azhar; Merrell, Ronald C.

2005-01-01

57

Telemedicine: the slow revolution.  

PubMed

The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas. That project had 6 connected telemedicine sites: 3 in Austin, Texas, and 3 in Giddings, Texas (a small community 55 miles to the southeast of Austin). The sites in Giddings included a chronic outpatient dialysis facility, an inpatient psychiatric hospital, and the emergency department at Giddings Hospital. Patient contact began in April 1991 and continued through March 1993. During that period, data on the 1500 patient contacts made were recorded. After termination of the Texas Telemedicine Project, AT&T continued to provide the transmission lines, and between 1993 and 1996, another 12,000 patient contacts were made. Approximately 80% were dialysis evaluations and 20% were non-dialysis primary care contacts. The original cost of materials and equipment in the Texas Telemedicine Project exceeded $50,000 per site. Today, a secure Internet connection with full-motion video and wireless data transfer to almost any location in the world is achievable with an iPad. Multiple inexpensive applications with connections for electrocardiogram, otoscope, and stethoscope, among others, make this technology extremely inexpensive and user-friendly. The revolution now is rapidly moving forward, with Medicare reimbursing telemedicine contacts in medically underserved areas. Multiple bills are before Congress to expand Medicare and therefore private insurance payment for this service. PMID:25338434

Moncrief, Jack W

2014-01-01

58

Telemedicine, virtual reality, and surgery  

NASA Technical Reports Server (NTRS)

Two types of synthetic experience are covered: virtual reality (VR) and surgery, and telemedicine. The topics are presented in viewgraph form and include the following: geometric models; physiological sensors; surgical applications; virtual cadaver; VR surgical simulation; telesurgery; VR Surgical Trainer; abdominal surgery pilot study; advanced abdominal simulator; examples of telemedicine; and telemedicine spacebridge.

Mccormack, Percival D.; Charles, Steve

1994-01-01

59

Current status of domestic telemedicine  

Microsoft Academic Search

This manuscript addresses several aspects of the current status of telemedicine in the United States. Telemedicine programs have been in existence since the 1960s, but only in the last 2 or 3 years have they begun to proliferate. Teleradiology has grown rapidly, both in the number of systems and the volume of images transmitted. Clinical telemedicine consultation, using video-conferencing, has

Jim Grigsby

1995-01-01

60

Managing Requirement Volatility in an Ontology-Driven Clinical LIMS Using Category Theory. International Journal of Telemedicine and Applications  

E-print Network

Requirement volatility is an issue in software engineering in general, and in Web-based clinical applications in particular, which often originates from an incomplete knowledge of the domain of interest. With advances in the health science, many features and functionalities need to be added to, or removed from, existing software applications in the biomedical domain. At the same time, the increasing complexity of biomedical systems makes them more difficult to understand, and consequently it is more difficult to define their requirements, which contributes considerably to their volatility. In this paper, we present a novel agent-based approach for analyzing and managing volatile and dynamic requirements in an ontology-driven laboratory information management system (LIMS) designed for Web-based case reporting in medical mycology. The proposed framework is empowered with ontologies and formalized using category theory to provide a deep and common understanding of the functional and nonfunctional requirement hi...

Shaban-Nejad, Arash; Kassab, Mohamad; Haarslev, Volker; 10.1155/2009/917826

2009-01-01

61

Case Management: A Resource Manual.  

ERIC Educational Resources Information Center

This resource manual has been developed to assist both case managers and management staff in implementing a case management system as an infrastructure for delivering services that will facilitate the positive growth and development of youth and the achievement of individual and organizational performance goals. (The goal of case managers is to…

Adams, Anne Thomas; Franklin, Sundra; Taylor, Rebecca

62

Mobile telemedicine: a survey study.  

PubMed

Telemedicine involves the use of advanced and reliable communication techniques to deliver biomedical signals over long distances. In such systems, biomedical information is transmitted using wireline or wireless communication systems. Mobile telemedicine is an improved form of telemedicine, in which advanced wireless communication systems are used to deliver the biomedical signals of patients at any place and any time. Mobile telemedicine employs advanced concepts and techniques from the fields of electrical engineering, computer science, biomedical engineering, and medicine to overcome the restrictions involved in conventional telemedicine and realize an improvement in the quality of service of medicine. In this paper, we study several mobile telemedicine systems, and it is important to gain a good understanding of mobile telemedicine systems because in the further, such systems are expected to become ubiquitous for the delivery of biomedical signals for medicine. PMID:20703699

Lin, Chin-Feng

2012-04-01

63

Telemedicine in the 'Hood.  

ERIC Educational Resources Information Center

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

Elgrably, Jordan

1998-01-01

64

Telemedicine for evaluation of retinopathy of prematurity.  

PubMed

Retinopathy of prematurity (ROP) remains a significant threat to vision for extremely premature infants despite the availability of therapeutic modalities capable, in most cases, of managing this disorder. It has been shown in many controlled trials that application of therapies at the appropriate time is essential to successful outcomes in premature infants affected by ROP. Bedside binocular indirect ophthalmoscopy has been the standard technique for diagnosis and monitoring of ROP in these patients. However, implementation of routine use of this screening method for at-risk premature infants has presented challenges within our existing care systems, including relative local scarcity of qualified ophthalmologist examiners in some locations and the remote location of some NICUs. Modern technology, including the development of wide-angle ocular digital fundus photography, coupled with the ability to send digital images electronically to remote locations, has led to the development of telemedicine-based remote digital fundus imaging (RDFI-TM) evaluation techniques. These techniques have the potential to allow the diagnosis and monitoring of ROP to occur in lieu of the necessity for some repeated on-site examinations in NICUs. This report reviews the currently available literature on RDFI-TM evaluations for ROP and outlines pertinent practical and risk management considerations that should be used when including RDFI-TM in any new or existing ROP care structure. PMID:25548330

Fierson, Walter M; Capone, Antonio

2015-01-01

65

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

PubMed Central

The right person in the right place and at the right time is not always possible; telemedicine offers the potential to give audio and visual access to the appropriate clinician for patients. Advances in information and communication technology (ICT) in the area of video-to-video communication have led to growth in telemedicine applications in recent years. For these advances to be properly integrated into healthcare delivery, a regulatory framework, supported by definitive high-quality research, should be developed. Telemedicine is well suited to extending the reach of specialist services particularly in the pre-hospital care of acute emergencies where treatment delays may affect clinical outcome. The exponential growth in research and development in telemedicine has led to improvements in clinical outcomes in emergency medical care. This review is part of the LiveCity project to examine the history and existing applications of telemedicine in the pre-hospital environment. A search of electronic databases including Medline, Excerpta Medica Database (EMBASE), Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant papers was performed. All studies addressing the use of telemedicine in emergency medical or pre-hospital care setting were included. Out of a total of 1,279 articles reviewed, 39 met the inclusion criteria and were critically analysed. A majority of the studies were on stroke management. The studies suggested that overall, telemedicine had a positive impact on emergency medical care. It improved the pre-hospital diagnosis of stroke and myocardial infarction and enhanced the supervision of delivery of tissue thromboplasminogen activator in acute ischaemic stroke. Telemedicine presents an opportunity to enhance patient management. There are as yet few definitive studies that have demonstrated whether it had an effect on clinical outcome. PMID:25635190

2014-01-01

66

Arizona Telemedicine Program  

PubMed Central

The Arizona Telemedicine Program was established in July 1996 by the Arizona state legislature. The organizational center for the program is the Arizona Health Sciences Center in Tucson. Key goals for the program include increased access to specialty services for rural, underserved populations; development of cost-effective telemedicine services; and expansion of opportunities for education of health professionals in rural areas. The program provides several levels of services based on both store-and-forward and real-time interactive applications. The telecommunication infrastructure is provided by two methods: The first is a private asynchronous transfer mode network established and operated by program personnel. The second is dial-up access via the public switched telephone network. After an extensive period of organization and vendor evaluations, most of the private network was implemented between June and December 1997. This paper describes experiences establishing the asynchronous transfer mode network. PMID:9760392

McNeill, Kevin M.; Weinstein, Ronald S.; Holcomb, Michael J.

1998-01-01

67

Telemedicine and anaesthesia  

PubMed Central

Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article. PMID:20885864

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

2010-01-01

68

Emerging Technologies for Telemedicine  

PubMed Central

This paper focuses on new technologies that are practically useful for telemedicine. Three representative systems are introduced: a Digital Video Transport System (DVTS), an H.323 compatible videoconferencing system, and Vidyo. Based on some of our experiences, we highlight the advantages and disadvantages of each technology, and point out technologies that are especially targeted at doctors and technicians, so that those interested in using similar technologies can make appropriate choices and achieve their own goals depending on their specific conditions. PMID:22563284

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

2012-01-01

69

Telemedicine for patient education  

Microsoft Academic Search

A telemedicine project was conducted to explore the delivery of childbirth preparation classes originating at a large regional hospital to a remote site at a small rural hospital. Over six months, three series of classes were included in the project, with twenty?four participants at the originating site and twenty participants at the remote site. A two?way, audio\\/video teleconferencing system with

David L. Byers Jr; Cheryl Hilgenberg; Dent M. Rhodes

1999-01-01

70

Wireless technologies for telemedicine  

Microsoft Academic Search

Wireless telemedicine is a new and evolving area in telemedical and telecare systems. Healthcare personnel require realtime\\u000a access to accurate patient data, including clinical histories, treatments, medication, tests, laboratory results and insurance\\u000a information. With large-scale wireless networks and mobile computing solutions, such as cellular 3G, Wi-Fi mesh and WiMAX,\\u000a healthcare personnal can tap into vital information anywhere and at any

H. S. Ng; M. L. Sim; C. M. Tan; C. C. Wong

2006-01-01

71

Emerging technologies for telemedicine.  

PubMed

This paper focuses on new technologies that are practically useful for telemedicine. Three representative systems are introduced: a Digital Video Transport System (DVTS), an H.323 compatible videoconferencing system, and Vidyo. Based on some of our experiences, we highlight the advantages and disadvantages of each technology, and point out technologies that are especially targeted at doctors and technicians, so that those interested in using similar technologies can make appropriate choices and achieve their own goals depending on their specific conditions. PMID:22563284

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

2012-01-01

72

Expert Advice Provided through Telemedicine Improves Healing of Chronic Wounds: Prospective Cluster Controlled Study.  

PubMed

Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds. PMID:25290685

Zarchi, Kian; Haugaard, Vibeke B; Dufour, Deirdre N; Jemec, Gregor B E

2015-03-01

73

Quality Assurance of Teleconsultations in a Store-and-Forward Telemedicine Network – Obtaining Patient Follow-up Data and User Feedback  

PubMed Central

User surveys in telemedicine networks confirm that follow-up data are essential, both for the specialists who provide advice and for those running the system. We have examined the feasibility of a method for obtaining follow-up data automatically in a store-and-forward network. We distinguish between follow-up, which is information about the progress of a patient and is based on outcomes, and user feedback, which is more general information about the telemedicine system itself, including user satisfaction and the benefits resulting from the use of telemedicine. In the present study, we were able to obtain both kinds of information using a single questionnaire. During a 9-month pilot trial in the Médecins Sans Frontières telemedicine network, an email request for information was sent automatically by the telemedicine system to each referrer exactly 21?days after the initial submission of the case. A total of 201 requests for information were issued by the system and these elicited 41 responses from referrers (a response rate of 20%). The responses were largely positive. For example, 95% of referrers found the advice helpful, 90% said that it clarified their diagnosis, 94% said that it assisted with management of the patient, and 95% said that the telemedicine response was of educational benefit to them. Analysis of the characteristics of the referrers who did not respond, and their cases, did not suggest anything different about them in comparison with referrers who did respond. We were not able to identify obvious factors associated with a failure to respond. Obtaining data by automatic request is feasible. It provides useful information for specialists and for those running the network. Since obtaining follow-up data is essential to best practice, one proposal to improve the response rate is to simplify the automatic requests so that only patient follow-up information is asked for, and to restrict user feedback requests to the cases being assessed each month by the quality assurance panel. PMID:25505782

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

74

Population-based case management.  

PubMed

Harris Methodist Health System is an integrated health system that has developed and implemented integrated health management (IHM) as a new care delivery model. IHM provides a focused, differentiated approach to case management based on the concept of population-based care. Unlike traditional case management, IHM goes beyond managing acute care across clinical settings to provide health care across a continuum that includes health promotion and illness prevention. PMID:10163107

Qudah, F J; Brannon, M

1996-01-01

75

Telemedicine: socio-ethical considerations in the Indian milieu.  

PubMed

Telemedicine is the rapidly developing application of clinical medicine by telephone, the internet or other networks for the purpose of consulting, and on occasions carrying out examinations or medical procedures. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries. Telemedicine offers real benefits in a country as vast as India where the majority of the population lives in remote areas with no access to even the most basic healthcare. As the practice of telemedicine spreads, maintaining standards, security and privacy, will be a challenge especially with regard to legal and regulatory measures and who will be held responsible if telemedicine-assisted surgery fails due to failure in connectivity? Is it the surgeon, the satellite provider or the software/hardware engineer? What is the legal status of telemedicine-based diagnosis and treatment? Other legal issues involve conflicting national laws and information piracy, the dangers of prescription drugs that are banned in one country but not in another and quacks who offer medical advice and prescribe drugs over the internet. This paper discusses some of the legal, ethical and social considerations in the Indian context. PMID:19731480

Sharma, Luv K; Rajput, Meena

2009-01-01

76

Internet technologies and requirements for telemedicine  

NASA Technical Reports Server (NTRS)

Internet technologies are briefly introduced and those applicable for telemedicine are reviewed. Multicast internet technologies are described. The National Aeronautics and Space Administration (NASA) 'Telemedicine Space-bridge to Russia' project is described and used to derive requirements for internet telemedicine. Telemedicine privacy and Quality of Service (QoS) requirements are described.

Lamaster, H.; Meylor, J.; Meylor, F.

1997-01-01

77

Telemedicine in Alentejo  

PubMed Central

Abstract Alentejo covers a third of Portugal, yet it is home to only 5% of the population. Residents of the region are poorer, older, and less educated than the rest of the country. There is a shortage of physicians in several specialties. The low population density, a concentration of specialized services, and a poor public transportation network all create barriers to access. Telemedicine was introduced in 1998 to help address these challenges. In this article, we provide an overview of the program and its current status, focusing on infrastructure, services, and activity volume. We also discuss the impact the program has had from the perspectives of patients and healthcare professionals. From 1998 to 2011, there were 132,546 episodes of service using telemedicine, including real-time teleconsultations, teleradiology, teleultrasound, and telepathology. At present, the network includes 20 primary care units and five hospitals, covering almost 30,000 km2 and 500,000 people. Units have high-resolution videoconferencing equipment, access to patients' clinical records, an image archive, and peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are available in 15 medical specialties and areas, ranging from neurology to pediatric surgery. In 2008, regional health authorities started a tele-education program, and by the end of 2011, 876 healthcare professionals, across 52 locations, had participated in remote learning sessions. More than a decade since telemedicine was introduced in Alentejo, it is now an integral part of everyday service provision. A comprehensive assessment of the costs and consequences of the program is currently underway. PMID:24180419

Bayer, Steffen; Gonçalves, Luís; Barlow, James

2014-01-01

78

Case Management: Service or Symptom?  

ERIC Educational Resources Information Center

Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

Netting, F. Ellen

1992-01-01

79

CLINICAL EVALUATION OF A MOBILE PHONE TELEMEDICINE SYSTEM FOR THE SELF-MANAGEMENT OF TYPE 1 DIABETES  

E-print Network

DIABETES O. J. Gibson1 , L. Tarassenko1 , P. E. McSharry1 , P. M. Hayton1 , A. J. Farmer2 , H. A. W. Neil2 and Primary Health Care, University of Oxford, Oxford, UK 3 Oxford Centre for Diabetes Endocrinology- management of Type 1 diabetes was tested in a clinical randomized controlled trial. Both intervention

McSharry, Patrick E.

80

Towards technical interoperability in telemedicine.  

SciTech Connect

For telemedicine to realize the vision of anywhere, anytime access to care, the question of how to create a fully interoperable technical infrastructure must be addressed. After briefly discussing how 'technical interoperability' compares with other types of interoperability being addressed in the telemedicine community today, this paper describes reasons for pursuing technical interoperability, presents a proposed framework for realizing technical interoperability, identifies key issues that will need to be addressed if technical interoperability is to be achieved, and suggests a course of action that the telemedicine community might follow to accomplish this goal.

Craft, Richard Layne, II

2004-05-01

81

Clinical outcomes resulting from telemedicine interventions: a systematic review  

PubMed Central

Background The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. Methods Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis). All included articles were abstracted and graded for quality and direction of the evidence. Results A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. Conclusions Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective. PMID:11737882

2001-01-01

82

Telemedicine Security: A Systematic Review  

PubMed Central

Telemedicine is a technology-based alternative to traditional health care delivery. However, poor security measures in telemedicine services can have an adverse impact on the quality of care provided, regardless of the chronic condition being studied. We undertook a systematic review of 58 journal articles pertaining to telemedicine security. These articles were selected based on a keyword search on 14 relevant journals. The articles were coded to evaluate the methodology and to identify the key areas of research in security that are being reviewed. Seventy-six percent of the articles defined the security problem they were addressing, and only 47% formulated a research question pertaining to security. Sixty-one percent proposed a solution, and 20% of these tested the security solutions that they proposed. Prior research indicates inadequate reporting of methodology in telemedicine research. We found that to be true for security research as well. We also identified other issues such as using outdated security standards. PMID:21722592

Garg, Vaibhav; Brewer, Jeffrey

2011-01-01

83

Barriers, legal issues, limitations and ongoing questions in telemedicine applied to stroke.  

PubMed

The use of telemedicine services, such as telestroke, is still highly fragmented and its deployment in an integrative healthcare system is challenging. Factors impeding the growth of telemedicine include confidence and malpractice issues, technical advances, reimbursement, licensing, credentialing costs, cost effectiveness, and legal issues. These barriers, limitations and requirements in the routine use of telemedicine are reviewed, in addition to medical activities, the objectives of telestroke, technical aspects, funding, legal issues, evaluation and quality management. As telemedicine induces a new form of interrelationship between health care providers, mutual trust and acceptance need to be developed in telemedicine services. Furthermore, education and training will be crucial in order to facilitate the use of telestroke over the next decade. PMID:19546540

de Bustos, Elisabeth Medeiros; Moulin, Thierry; Audebert, Heinrich J

2009-01-01

84

New technology applied to telemedicine  

NASA Technical Reports Server (NTRS)

Satellite communications technology was used for establishing international telemedicine communications links in a number of instances, (e.g., Telemedicine SpaceBridge between Armenia and the United States in 1989, and the proposed linkages shown, for demonstration during this conference and during 1992 and 1993). In the current example, geostationary satellites are used to provide intercontinental communications links between the two countries and also for distribution within each country.

Miller, Edward F.

1991-01-01

85

Information issues in telemedicine systems.  

PubMed

This paper examines the use of the Integrated Services Digital Network (ISDN) for telemedicine from the computer scientist's point of view. As increased bandwidth becomes available at reasonable cost, it becomes possible to employ graphical user interfaces in telemedicine systems. This means that human-computer interaction (HCI) techniques can be applied to the interface design. This paper describes some of these as applied to telemedicine by other authors. HCI techniques can be considered to be part of the development process of telemedicine systems. An integrated, multimedia-based telemedicine system which emulated the concept of a hospital information system would have many benefits, such as a consistent user interface with appropriate clinical metaphors, integrated patient records with facilities to store graphical information, and remote access. Telemedicine has much to offer in terms of providing higher standards of patient care through improved response times by clinicians who have the required information immediately available. The patient also benefits from convenience factors, such as being able to consult locally a remote specialist. PMID:9375112

McClelland, I; Adamson, K; Black, N D

1995-01-01

86

Telemedicine: lessons remain unheeded.  

PubMed Central

Telemedicine, the delivery of health care with the patient and health professional at different locations, has been around for over 30 years. Its driving force has been developments in communications technology, and as new communications systems are developed health applications are proposed such as supporting the delivery of primary health care to geographically remote areas or regions underserved through the maldistribution of professional expertise. Despite rapid technological advances, evaluations of such systems have been largely superficial, and more thorough evaluations have failed to show significant advantages for more advanced and expensive technology over older technology such as the telephone. Methods for evaluating the impact of particular technologies on the health care system need to be developed and clearer benefits shown in terms of improved standards of care. Images p1391-a PMID:7787547

McLaren, P.; Ball, C. J.

1995-01-01

87

Rural telemedicine project in northern New Mexico  

SciTech Connect

A virtual electronic medical record system is being deployed over the Internet with security in northern New Mexico using TeleMed, a multimedia medical records management system that uses CORBA-based client-server technology and distributed database architecture. The goal of the NNM Rural Telemedicine Project is to implement TeleMed into fifteen rural clinics and two hospitals within a 25,000 square mile area of northern New Mexico. Evaluation of the project consists of three components: job task analysis, audit of immunized children, and time motion studies. Preliminary results of the evaluation components are presented.

Zink, S.; Hahn, H.; Rudnick, J.; Snell, J.; Forslund, D. [Los Alamos National Lab., NM (United States); Martinez, P. [Northern New Mexico Community Coll., Espanola, NM (United States)

1998-12-31

88

Valuation of Online Continuing Medical Education and Telemedicine in Taiwan  

ERIC Educational Resources Information Center

Physicians have acknowledged information technology (IT) efficiency and now utilize it in their professional practice and patient management. The benefits of IT within the health care environment has received academic attention, however existing literature currently pertains to limited areas, including the financial effects of telemedicine…

Wang, Fuhmei

2008-01-01

89

Chapter 1 Introduction 1.1 Telemedicine  

E-print Network

1 Chapter 1 Introduction 1.1 Telemedicine The trend in medical imaging is increasing toward direct that telemedicine and digital image processing will eventually completely replace conventional film (hard copy) imaging in medicine. Telemedicine is the provision of health care services via electronic transmission

Qi, Xiaojun

90

Telemedicine effects: Cost, quality, and access  

Microsoft Academic Search

Following a brief review of lessons learned from first generation telemedicine projects, an analytical framework for assessing the potential effects of telemedicine on cost, quality, and accessibility of health care is provided. It is proposed that the effects of telemedicine on cost, quality, and accessibility are interconnected, and a comprehensive assessment should incorporate all three aspects, each considered from the

Rashid L. Bashshur

1995-01-01

91

A model driven ontology-based architecture for supporting the quality of services in pervasive telemedicine applications  

Microsoft Academic Search

Advanced telemedicine systems based on ubiquitous computing need to be designed in order to deliver high quality of services at anytime and anywhere. The optimal management of the telemedical assistance process in emergency situations, taking into consideration different communication and material resources availability, is still a major problem in telemedicine. In this paper we propose an ontology-based architecture model enabling

Ebrahim Nageba; J. Fayn; P. Rubel

2009-01-01

92

Opportunities and challenges to telemedicine in rural America  

Microsoft Academic Search

Rural communities have chronically suffered from a lack of adequate health care resources. Too few primary care practitioners and the need to travel long distances for specialty care have made it difficult for many rural residents to receive the care they need when they need it. Telemedicine provides one tool for improving this situation. As is often the case, however,

Dena S. Puskin

1995-01-01

93

A multimedia telemedicine system.  

PubMed

A multimedia telemedicine system (MTS) using Transfer Control Protocol and Internet Protocol (TCP/IP) over the Internet is developed. Doctor with patient and doctor can communicate each other using this system. Real-time data, including audio, video and instant message (IM), and non-real-time data, including vital sign signals, radiological images with DICOM 3.0, file, bio-signal, bio-data and so on, can be exchanged on the system. This system's architecture is client/server mode. All data are encoded/compressed before transferring through Internet/Intranet. The real-time audio is encoded and decoded by MPEG (Moving Picture Experts Group) audio layer 3 algorithm and real-time video is encoded and decoded by MPEG-4. The software implementation of needed functionality without any externally attached hardware CODEC (Coder/Decoder) units enables the compact design with low cost. The real-time video has 25 frames per second at Local Area Network (LAN) and more than 20 frames per second at ADSL. PMID:17281043

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

2005-01-01

94

Telemedicine and spaceflight.  

PubMed

Medical assessment and treatment of crews during spaceflight is primarily perfomed by the Earth-based medical staff analyzing information received by telemetry and onboard preventive and medical treatment facilities. In the coming decades, the building of the International Space Station (ISS) will be the most important near-Earth space exploration project. Remote monitoring and distance support of the crewmembers by the Earth-based clinical medicine specialists will become increasely important. The international nature of the ISS will require integrating medical support systems of the participating countries. Consideration must also be given to biomedical ethics and the confidentiality of the medical information exchanged. In Russia, the construction of the telemedicine network for the Russian node of the ISS has been completed. It is evident that during interplanetary flight biomedical problems will be much more difficult than during orbital flights of the same duration. Such a long-duration flight will require development of a special telemedical support system, as well as onboard facilities, which will present many new challenges. This new system will involve the integration of information technologies with biology, as well as physics and chemistry, representing a new interdisciplinary technological breakthrough. PMID:12137107

Grigoriev, Anatoly I; Orlov, Oleg I

2002-07-01

95

What's funny about case management?  

PubMed

Humor is an effective tool to prevent and resolve burnout, a common problem associated with the practice of case management. Easily accessed by almost everyone, humor has many physiological and psychological benefits. The conscious use of humor in an organization requires a commitment at all levels in order for the organization to benefit as a whole. Offering formal seminars, using humor in company newsletters, and encouraging cartoon or joke sharing impacts on the physical and mental health of the employees. Techniques for bringing laughter to the workplace are outlined, as well as examples from the practice of case management. PMID:9335722

Saxton, S E

1997-01-01

96

Telemedicine applications in occupational medicine.  

PubMed

Telemedicine combines telecommunication technology and medicine to increase access to health care services for patients living in remote areas and enhance the efficiency of delivering that care. This article describes the results of a Mayo Clinic pilot study on the use of telemedicine in an occupational medicine clinic for Mayo Clinic employees and their dependents. The study involved 21 patients who came for initial evaluations for work-related problems or injuries, follow-up visits, visits for acute problems such as low-back pain, and periodic health evaluations. It found that patients and providers were comfortable with the technology after a short training session and satisfied with the outcomes of the visits. More rigorous research evaluating the applications of telemedicine in occupational health care is needed. PMID:17153904

Varkey, Prathibha; Hagen, Philip T; Wimsett, William; Buchta, William

2006-11-01

97

A Computational framework for telemedicine.  

SciTech Connect

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

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

1998-07-01

98

Telemedicine experience in the Brazilian Amazon  

PubMed Central

Introduction The development of telecommunication technologies and the diffusion of its eHealth applicability have enabled the implementation of a wide range of telemedicine systems, supporting clinical practices in different regions of the world. Distant and poorer areas of the globe, often characterized by difficult access and hazardous environments, are those that can most benefit from availability of remote consultations. This is due to the high costs associated with the transportation of specialized health teams and medical equipment between major cities and small villages, sometimes essential for the provision of adequate health care. Brazil is a country of continental dimensions with socioeconomic inequalities and uneven distribution of specialized health care, making it an ideal environment for establishment of eHealth initiatives. Objective The main objectives were (1) to develop an efficient method for acquiring and delivering patient medical information in remote areas using local Internet and (2) to assist urban and Indian populations in the Brazilian Amazon presenting with skin lesions and cardiovascular diseases. Methodology Ethical approval was granted by the research and Ethics Committees of PUCRS, Porto Alegre, Brazil. The project comprised: (1) triage and patient interview; (2) digital ECG and skin picture acquisition; (3) data management, storage and transmission; (4) delivery of expert second opinion based on development of a secure and confidential communication system between the receiving and delivering sites. Upon internet availability, the system was programmed to connect to the Microgravity Centre’s main server and to synchronise all collected data. Specialist health professionals accessed this server and the electronic patient records via a secure application installed on personal computers. Patient information, images, and exams were analysed by health specialists at the delivering site, and an opinion and treatment suggestion was offered. Cases that proved inconclusive were due to a lack of available information or the need for further laboratory exams. The opinions were secured in an encrypted PDF envelope and returned to the receiving site, where final diagnosis and treatment remained the responsibility of the local health team. Results Telecardiology (n=98): 59 (60.2%) normal ECGs, whilst 39 (39.8%) were altered, showing arrhythmias, conductive alterations and signs of ventricular hypertrophy. No patients presented signs of acute ischemia. In teledermatology (n=110): 57 (51.8%) patients did not present any skin disease. Among the patients with dermatological problems (n=53; 48.2%), the most common diagnoses were eczema, pityriasis versicolor, tinea, onychomycosis, and superficial mycosis. In five patients, the dermatologist suspected a cancerous lesion and recommended further investigation. Conclusion The telemedicine tools and the telecommunication system developed for this project proved to have a great applicability for diagnosis of dermatological skin conditions and for assessment of patient cardiovascular diseases. It was possible to remotely diagnose dermatological and cardiovascular conditions in a short period of time, at low cost and without the need for transportation of patients to other locations. It is believed that the eHealth assistance model applied in this project can be transferred to other places that have access to an Internet connection.

Jones, Christopher Robert; Cardoso, Ricardo Bertoglio; Oliveira, Helena Willhelm; Lopes, Maria Helena Itaqui; Huttner, Edison; Huttner, Eder; Wiehe, Mario; Celia2, Sergio Antonio Curcio; Russomano, Thais

2012-01-01

99

Multimedia systems for telemedicine and their communications requirements  

Microsoft Academic Search

Telemedicine is much more than just teleconferencing. ISDN could be used in some low-end applications, but many telemedicine applications will require the higher bandwidth and guaranteed qualities of service supported by ATM. We discuss the design of multimedia systems for telemedicine. First, various applications of telemedicine are presented, and their multimedia and communications requirements are discussed. A telemedicine prototype is

Yongmin Kim

1996-01-01

100

Clinical aspects of telemedicine  

NASA Technical Reports Server (NTRS)

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

Merrell, Ronald C.

1991-01-01

101

[Telemedicine in clinics and practice].  

PubMed

As a result of modern techniques of fast and flexible transmission of pictures and sound, new chances for a use in medicine are presented. In this article the pro's and con's of telemedicine are discussed and the technical prerequisites described. PMID:10756606

Manss, V

2000-01-01

102

7 Virtual Reality in telemedicine  

Microsoft Academic Search

Virtual Reality (VR) can be considered as the leading edge of a general evolution of present communication interfaces involving the television, computer and telephone. Main characteristic of this evolution is the full immersion of the human sensorimotor channels into a vivid and global communication experience. Since telemedicine is principally focusing on transmitting medical information, VR has the potential to enhance

Giuseppe RIVA; Lucio GAMBERINI

2001-01-01

103

Arizona TeleMedicine Project.  

ERIC Educational Resources Information Center

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

Arizona Univ., Tucson. Coll. of Medicine.

104

A pilot study of telemedicine for post-operative urological care in children.  

PubMed

We conducted a retrospective study of paediatric urological surgery patients over a 12-month period. We compared patients followed up by telemedicine with those who had post-operative follow-up on site at the Arkansas Children's Hospital (ACH) in Little Rock. All pre-operative patients living in northwest Arkansas were given the opportunity to use telemedicine from a satellite clinic at Lowell, 328?km from the hospital. Of 61 patients, 10 chose telemedicine and 51 chose to be evaluated at the ACH clinic. All telemedicine visits were completed successfully, but in four cases, the video clarity of the telemedicine images was not sufficient for decision-making, and a digital photograph was sent by email to the physician at the ACH. There were no post-operative surgical complications in either patient group. In the telemedicine group, the median distance to the ACH was 330?km, and the median distance to the remote clinic was 35?km. In the on-site group, the median distance to the ACH was 293?km, which was significantly less (P?=?0.03). In the on-site group, the median travel time to the ACH was 174?min. If the telemedicine group had driven to the hospital, the median travel time would have been 192?min. Logistic regression showed that for every 37?km increase in distance to ACH, patients had a 111% increase in the odds of receiving telemedicine compared to receiving on-site care (OR?=?2.1, 95% CI: 1.0, 4.4). The pilot study supports the use of telemedicine for the post-operative evaluation of paediatric urology surgery patients and suggests that substantial travel distance and time savings can be made. PMID:25316038

Canon, Stephen; Shera, Annashia; Patel, Ashay; Zamilpa, Ismael; Paddack, John; Fisher, Paige L; Smith, Jacob; Hurtt, Robbie

2014-12-01

105

Supervision of thrombolysis of acute myocardial infarction using telemedicine.  

PubMed

The treatment of acute myocardial infarction (MI) constitutes a significant problem in remote geographical areas of Greece. Furthermore, thrombolysis, the treatment of choice in the early phase of acute MI, requires the supervision of an expert. We have used thrombolytic treatment, using telemedicine, in remote medical centres. The Onassis Cardiac Surgery Centre was linked to six remote Aegean islands via telemedicine systems which permitted the transmission of 12-lead electrocardiograms (ECGs). The thrombolytic agent anistreplase was administered to patients with acute MI. Supervision, including consultation for treatment of complications, was achieved using the telemedicine system. One hundred and fifty-two ECGs were transmitted during 24 months, of which 108 (71%) indicated specific treatment of a cardiac condition. Ten cases were diagnosed as having acute MI and eight of these were treated with anistreplase. All patients survived acute MI and complications were treated locally. The application of thrombolytic treatment in acute MI is feasible in remote areas, with the use of a telemedicine system. PMID:10824393

Mavrogeni, S I; Tsirintani, M; Kleanthous, C; Vranakis, K; Secheta, E; Mihelakis, D; Sotiriou, D; Gatzonis, M; Tsolas, C; Kontaratos, A N; Cokkinos, D V

2000-01-01

106

A review of telemedicine business models.  

PubMed

Telemedicine has become an increasingly popular option for long-distance/virtual medical care and education, but many telemedicine ventures fail to grow beyond the initial pilot stage. Studying the business models of successful telemedicine ventures can help develop business strategies for upcoming ventures. This article describes business models of eight telemedicine ventures from different regions of the world using Osterwalder's "Business Model Canvas." The ventures are chosen on the basis of their apparent success and their diverse value chains. The business models are compared to draw inferences and lessons regarding their business strategy and contextual factors that influenced it. Key differences between telemedicine business practices in developing and developed countries are also discussed. The purpose of this article is to inform and inspire the business strategy of the next generation of telemedicine ventures to be economically sustainable and to successfully address local healthcare challenges. PMID:23540278

Chen, Shengnan; Cheng, Alice; Mehta, Khanjan

2013-04-01

107

Telemedicine for acute plastic surgical trauma and burns.  

PubMed

Visual images can enhance communication over a distance. In the UK, plastic surgery provides services over large distances by a 'hub and spoke' model. Telemedicine could help to increase the efficiency of service for plastic surgery patients. Telemedicine, along with the impending Electronic Patient Record system could combine to improve communication, patient triage, record keeping, audit and could lead to a better quality of clinical care. Another benefit could be significant cost savings. We report our experience of the introduction of telemedicine to a Regional Plastic Surgery Service. Our first study compared assessments from images and patient examinations, which gave us confidence in the use of images [Jones SM, Milroy C, Pickford MA. Telemedicine in acute plastic surgical trauma and burns. Ann R Coll Surg Engl 2004;86:239-42]. We proceeded to a 10-week evaluation of all 973 referrals to our unit. We found that the system was used for a wide variety of injuries and for 42% of the 452 patients where the system was available. Initial resistance was overcome by the ease of use of the system, with both receiving and referring clinicians reporting benefits. The third phase was a 12-week prospective cohort study of 996 patients comparing the referrals with and without the telemedicine system. The system was available for 389 patients, and used for 243 patients (63%). The groups were analysed by a chi squared test and confidence interval calculation. We demonstrated a significant difference in the initial management of patients, with 10% more being booked directly to our Day Surgery Unit. There was a decrease in number of occasions when we were unable to accept a patient due to a lack of capacity. We found no change in the patients being managed with telephone only advice. We found that telemedicine is a valuable method of providing useful preliminary information in the referral process for injured patients and often significantly modifies their treatment and/or management plan. This has implications for the use of Information Technology resources and potentially the delivery of healthcare in relation to the management of injured patients. PMID:18068653

Wallace, D L; Jones, S M; Milroy, C; Pickford, M A

2008-01-01

108

Case Management with At-Risk Youth.  

ERIC Educational Resources Information Center

This issue attempts to provide some initial answers to questions about the use of case management in serving disadvantaged youth. "Case Management with At-Risk Youth" presents some basic lessons synthesized from a review of case management in employment programs and in services for teenage parents, the elderly, and the developmentally disabled. It…

Youth Programs, 1988

1988-01-01

109

The Research Agenda in ICU Telemedicine  

PubMed Central

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

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

2011-01-01

110

[Telemedicine, a medical social network for humanitarian aid between Spain and Cameroon].  

PubMed

The application of information technologies and telecommunications in healthcare in southern countries can improve the health of millions of people living in poverty without access to high-quality health services. Specifically, telemedicine not synchronized with internet platforms is a very efficient option for international cooperation projects. Since its inception, the project Health 2.0: professionals from Africa-Spain connected, of the Spanish organization, Foundation Recover, Hospitals for Africa, has managed to connect health professionals from both continents with the goal of improving health in Cameroon. Thanks to a social network with the scientific format of case management and clinical updates, Spanish physicians collaborate through volunteer e-health in the training of their African colleagues to improve the quality of care provided to residents and also create sources of knowledge and research. PMID:25175358

Pérez-Manchón, David

2015-01-01

111

Alaska telemedicine: growth through collaboration.  

PubMed

The last thirty years have brought the introduction and expansion of telecommunications to rural and remote Alaska. The intellectual and financial investment of earlier projects, the more recent AFHCAN Project and the Universal Service Administrative Company Rural Health Care Division (RHCD) has sparked a new era in telemedicine and telecommunication across Alaska. This spark has been flamed by the dedication and collaboration of leaders at he highest levels of organizations such as: AFHCAN member organizations, AFHCAN Office, Alaska Clinical Engineering Services, Alaska Federal Health Care Partnership, Alaska Federal Health Care Partnership Office, Alaska Native health Board, Alaska Native Tribal health Consortium, Alaska Telehealth Advisory Council, AT&T Alascom, GCI Inc., Health care providers throughout the state of Alaska, Indian Health Service, U.S. Department of Health and Human Services, Office of U.S. Senator Ted Steens, State of Alaska, U.S. Department of Homeland Security--United States Coast Guard, United States Department of Agriculture, United States Department of Defense--Air Force and Army, United States Department of Veterans Affairs, University of Alaska, and University of Alaska Anchorage. Alaska now has one of the largest telemedicine programs in the world. As Alaska moves system now in place become self-sustaining, and 2) collaborating with all stakeholders in promoting the growth of an integrated, state-wide telemedicine network. PMID:15709313

Patricoski, Chris

2004-12-01

112

Telemedicine standardization in the NATO environment.  

PubMed

As the North Atlantic Treaty Organization (NATO) has evolved its doctrine from that of strictly national medical support during operations to that of multinational medical support, the importance of, and the need for, telemedicine standardization has become apparent. This article describes the efforts made by NATO in recent years to begin the process of telemedicine (TMED) standardization within the Alliance. PMID:15689651

Lam, David M; Poropatich, Ronald K; Gilbert, Gary R

2004-01-01

113

Telemedicine: Health Care for Isolated Areas.  

ERIC Educational Resources Information Center

The lead article discusses the results of a series of experiments in rural Alaska in which telemedicine was used to improve the delivery of health care to isolated populations. The author, Dennis Foote, also discusses the implications of these experiments for planning telemedicine systems in other areas. Satellite communication and a centralized…

Development Communication Report, 1977

1977-01-01

114

Telemedicine evaluation of cutaneous diseases: A blinded comparative study  

Microsoft Academic Search

Background: Numerous telemedicine programs have been created in the United States, but studies documenting the fidelity and effectiveness of telemedicine for evaluation of skin diseases are lacking. Objective: We attempted to determine the percentage of encounters in which two different dermatologists, one using telemedicine and one on-site, could independently arrive at the same primary diagnosis. Methods: Two clinical telemedicine sites

Loretta S. Davis; Frederick W. Gourdin; Debra English; William O. Thompson

1998-01-01

115

Telemedicine needs for multimedia and integrated services digital network (ISDN)  

Microsoft Academic Search

Telemedicine applications are based on multimedia systems and a variety of networks. Multimedia and transmission technology are very necessary to telemedicine applications. Since the delay is the enemy for patients, so the integrated and high-speed telecommunication is an optimal option for telemedicine systems. For that, ISDN is chosen as an infrastructure for many telemedicine applications. The objective of this paper

M. H. A. Al-Taei

2005-01-01

116

Advanced telemedicine development  

SciTech Connect

This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The objective of this project was to develop a Java-based, electronic, medical-record system that can handle multimedia data and work over a wide-area network based on open standards, and that can utilize an existing database back end. The physician is to be totally unaware that there is a database behind the scenes and is only aware that he/she can access and manage the relevant information to treat the patient.

Forslund, D.W.; George, J.E.; Gavrilov, E.M.

1998-12-31

117

Teaching public management: the case for (and against) cases  

Microsoft Academic Search

This article calls for an increased and more rigorous use of the case method in public administration education. Cases yield generalizations, cases help students take ownership of knowledge, and cases can further repetition of behavioral characteristics important to students such as empathy and self-confidence.The gradual expansion of public policy training into the area of public management has brought with it

Dorothy Robyn

1998-01-01

118

Telemedicine in inflammatory bowel disease: opportunities and approaches.  

PubMed

: This review article summarizes the evidence about telemedicine applications (e.g., telemonitoring, teleconsulting, and tele-education) in the management of patients with inflammatory bowel disease (IBD), and we aim to give an overview of the acceptance and impact of these interventions on health outcomes. Based on the literature search on "inflammatory bowel disease," "Crohn's disease" and "ulcerative colitis" in combination with "e-health," "telemedicine," and "telemanagement," we selected 58 titles and abstracts published up to June 2014 and searched in PubMed, EMBASE, MEDLINE, Cochrane Database, Web of Science and Conference Proceedings. Titles and abstracts were screened for a set of inclusion criteria: e-health intervention, IBD as the main disease, and a primary study performed. Finally, 16 were included for full reading, data extraction, and critical appraisal of the evaluation. Most studies use telemonitoring (home telemanagement system or web portal) and telecare (real-time telephone and image) as telemedicine applications and assessed the feasibility and acceptance of these systems, adherence to treatment, quality of life, and patient knowledge, particularly in patients with ulcerative colitis. Furthermore, some of these studies evaluated the patients' empowerment, health care costs, and safety of telemonitoring in IBD. In conclusion, the health outcomes of telemedicine applications in IBD suggest that these could be implemented in clinical practice because they are safe and feasible applications that are well accepted by the patient and improve adherence, quality of life, and disease knowledge. Further studies with large sample sizes and complex diseases are needed to confirm these results. PMID:25437818

Aguas Peris, Mariam; Del Hoyo, Javier; Bebia, Paloma; Faubel, Raquel; Barrios, Alejandra; Bastida, Guillermo; Valdivieso, Bernardo; Nos, Pilar

2015-02-01

119

Telemedicine in Iran: Chances and Challenges  

PubMed Central

BACKGROUND Technology is likely to transform the way care is delivered at home and in the community. Telemedicine, the child of IT and Medicine sciences is the use of telecommunication equipment and information technology to provide clinical care to individuals at distant sites and the transmission of medical and surgical information and images needed to provide that care. Undoubtedly, the advantages outweight its disadvantages, but just like any other innovations, it has some drawbacks. The present study outlines telemedicine strong and weak points. In this regard a survey has been done in Tehran University of Medical Sciences in Iran. METHODS Between 14th May and 14th August 2012, 90 medical specialist men and 42 women from different hospitals of Tehran Medical Sciences University, Iran were enrolled by a simple ran- dom sampling method. They all completed a questionnaire to consider what are telemedicine chances and challenges. RESULTS Making use of telemedicine was a profitable alternative in remote, rural/urban places especially in new project of “family physician” presented by Iran Ministry of Health. The results also highlighted that security considerations was an inevitable challenge of telemedicine, while shorter hospital stays and reduced warm ischemic time, and reduced morbidity and mortality rates were telemedicine merits. Despite most previous studies results, telemedicine has been recognised as a cost-effective alternative. Cultural, language distinctions as well as the level of literacy were barriers on deploying tele- medicine. There was no strong evidence showing that using telemedicine caused a decrease in tactile feedback. CONCLUSION We need to fully understand and consider various outcomes and challenges of telemedicine before applying it. PMID:25489500

Salehahmadi, Zeinab; Hajialiasghari, Fatemeh

2013-01-01

120

Case Study -- Improving Management Performance  

ERIC Educational Resources Information Center

The Knitting, Lace, and Net Industry Training Board in Great Britain is beginning to work with management training, using three firms for experimental pilot projects. The Board plans to introduce this management system throughout the industry. (MF)

Stait, Norman

1970-01-01

121

Two cases of placenta accreta managed conservatively  

Microsoft Academic Search

Placenta accreta is a rare complication of pregnancy. Traditionally treatment has been operative, commonly total abdominal hysterectomy, in order to prevent serious haemorrhage or infection. Reproductive function can, however, be presered by conservative management which is possible in carefully selected cases without risking maternal welfare. We report two cases of placenta accreta managed conservatively — both women delivered after this

Marja H. Komulainen; Martti A. Väyrynen; Minna L. Kauko; Seppo Saarikoski

1995-01-01

122

Iowa Case Management for Rural Drug Abuse  

ERIC Educational Resources Information Center

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

2009-01-01

123

Case Studies in Middle Management Supervision  

ERIC Educational Resources Information Center

This chapter presents a series of supervision-related case studies of situations that midlevel managers might face. Individuals enrolled in a midlevel management professional development course recommended the topics selected for this chapter. Drawing upon her experience teaching the course, the author selected four case studies that individuals…

White, Lori S.

2011-01-01

124

The telemedicine and teleconsultation system application in clinical medicine.  

PubMed

Telemedicine and teleconsultation are the application and development of the telecommunication networks. Health experts can solve problems by using the electronic and communication technologies without distance limitation. In this study, we try to develop the telemedicine and teleconsultation system between local site and consulting expert site. Two applications of this system in clinical medicine are discussed. The system at each site has a workstation including a cable modem or ADSL connection, a monitor, a web camera, speakers, a microphone for communication, and NetMeeting application software. The first application in this study is to develop a school-based intervention program by using this system for high-risk school-age children in one of the earthquake-struck areas. The preliminary result of this study is that the telemedicine and teleconsultation system is more effective than traditional consultation and supervision. Moreover, we can apply this system in training local volunteers, educators, and welfare workers. Meanwhile, we can save lots of cost and time since we don't need to travel between the local site and the expert site. In the end of this study, the second application of this system in SARS case treatment was also discussed. PMID:17271012

Chang, T; Lee, J; Wu, S

2004-01-01

125

Paying for telemedicine.  

PubMed

Objectives We used the 2003-2009 Medical Expenditure Panel Survey to evaluate average annual total and out-of-pocket expenditures by nonelderly adults with asthma. Study Design We divided patients diagnosed with asthma into 4 groups, based on whether or not they had had an asthma attack in the previous year (a crude marker for disease severity) and whether or not they reported using treatment for their asthma. Methods For each group we calculated total and out-of-pocket average annual spending for hospital inpatient, hospital outpatient, emergency department, and physician office care, as well as for prescription drugs. These averages were adjusted to account for differences in respondents' overall health (presence of other co-morbidities, self-reported health status, and self-reported activity limitations), sociodemographic characteristics (age, sex, race/ethnicity, income), and insurance status. Results We found that among the 4 groups, those who were receiving treatment but continued to experience asthma attacks had the highest total and out-of-pocket expenditures in all categories, consistent with their likely higher illness severity. However, patients who reported receiving treatment and did not experience attacks also reported relatively high adjusted total and out-of-pocket expenditures-most notably $536 per year out of pocket for prescription medications and $231 per year out of pocket for physician office visits. After adjustment, about the same proportion of patients in these 2 groups (13.5% who did not get treated and had attacks, and 13.8% who did get treated and avoided attacks) reported high financial burden. Conclusions Patients may experience financial challenges to appropriate self-management of asthma, even when they are able to avoid exacerbations. PMID:25526386

Rudin, Robert S; Auerbach, David; Zaydman, Mikhail; Mehrotra, Ateev

2014-12-01

126

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2010 CFR

...Indicate in the plan that case management services provided in accordance...Prohibit providers of case management services from exercising...maintain case records that document for all individuals receiving case management as follows: (i)...

2010-10-01

127

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

PubMed Central

Background Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation. Methods A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ?18 years) transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis. Results Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%). The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high. Conclusions Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and development, especially with regard to high speed broadband access, is needed before this approach can be implemented in daily practice. PMID:25343246

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

2014-01-01

128

Towards grid-enabled telemedicine in Africa  

E-print Network

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

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

2006-01-01

129

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

PubMed Central

Background: In Iran, burns are the second most common cause of death, after traffic accidents in individuals under the age of 15 years. Many burned patients die or suffer injury due to lack of immediate care, so we need to use an alternative resuscitations to cure them immediately. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status and care. The aim of this study was to express the advantages of Telemedicine to resuscitate and care burn patients. Materials and Methods: This study was a narrative review. The literature was searched on fast resuscitation and care of the patients’ burn by telemedicine with the help of libraries, databases, and also searches engines available at Google, Google scholar, books and conference proceedings. In our searches, we employed the following keywords and their combinations: Telemedicine, Telecare, Burn, Burn patient, Air transport, Triage and Health Information Management in the searching areas of titles, keywords, abstracts and full texts. Results: In this study, more than 78 articles and reports were collected and 30 of them were selected based on their relevancy. Conclusion: Acute evaluation of burn patients can be performed by the telemedicine and it plays an important role in improving access to the required expertise, and raises physician confidence in treating burn patients. This can reduce under-triage or over-triage for air transport and finally lead to saving time and cost. PMID:25197300

Ajami, Sima; Arzani-Birgani, Arezo

2014-01-01

130

An economic analysis of the EHAS telemedicine system in Alto Amazonas.  

PubMed

Telemedicine systems providing voice communication and email by radio were installed at seven health centres (HCs) and 32 health posts (HPs) in the Alto Amazonas province of Peru during 2001. A cost analysis was performed to estimate the net effect on direct resource consumption from the perspective of society. Prior to the availability of the EHAS telemedicine system, there was a mean of 11.1 urgent patient referrals per year from the HPs and 14.0 referrals per year from the HCs. After the implementation of telemedicine, patient referrals fell to 2.5 per year from the HPs (P = 0.03) and to 8.4 per year from the HCs (P = 0.17). The net economic effect of the telemedicine programme over a four-year period was clearly positive, amounting to annual net savings of US$320,126 (using a 5% discounting rate). A one-way sensitivity analysis using a range of values for the discounting rate, and the number of urgent referrals, confirms that the programme was efficient (i.e. it made net financial savings) in all cases. From the restricted budgetary perspective of the health network, the results also demonstrate that the additional operational costs (telephone and maintenance) introduced by the telemedicine system were lower than the direct cost-savings produced for the health-care network. PMID:17288652

Martínez, Andrés; Villarroel, Valentín; Puig-Junoy, Jaume; Seoane, Joaquín; del Pozo, Francisco

2007-01-01

131

Multimedia case management system implemented in Java  

NASA Astrophysics Data System (ADS)

Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau (CIB) of the state of Idaho, created a Northwest testbed to develop and integrate a multimedia case management system. A system was developed to assist investigators in tracking and maintaining investigative cases and improving access to internal and external data resources. In this paper, we discuss the results of our case management system development and the ability to present state and federal information incorporating object oriented and multimedia techniques. We then outline our plans for future research and development.

Stewart, Howard D.; Davis, Midge L.; Handy, Dale L.; Kvarfordt, Kent B.; Ford, Glenn

1999-01-01

132

Multimedia case management system implemented in Java  

Microsoft Academic Search

Managing the timely access of information is a major challenge facing law enforcement agencies. One of the areas of greatest need is that of the case management process. During the course of FY98, the Office of National Drug Control Policy (ONDCP), the Counterdrug Technology Assessment Center (CTAC), the Idaho National Engineering and Environmental Laboratory (INEEL), and the Criminal Investigative Bureau

Howard D. Stewart; Midge L. Davis; Dale L. Handy; Kent B. Kvarfordt; Glenn Ford

1999-01-01

133

Meeting the need for educational standards in the practice of telemedicine and telehealth.  

PubMed

The first telemedicine standard to be developed, documented and adopted widely was the radiology standard, which includes technical and image transmission standards as well as requirements and qualifications needed for teleradiology practice. But many other health professionals engaged either full time or part time in telemedicine and telehealth--for example, telepsychiatry, telepathology, teletriage and tele-ophthalmology--also need and use special skills and knowledge. At present, they acquire these skills on the job and their skills may not be recognized. There should be performance standards and telepractice guidelines for professionals operating in the fields of telemedicine and telehealth. Furthermore, there is a case for the development and implementation of education and training standards, enabling professionals who practise in the field to obtain suitable skills, knowledge and recognition for telepractice. PMID:10975105

Picot, J

2000-01-01

134

Clinical and Educational Support for Space Flight via Telemedicine  

NASA Technical Reports Server (NTRS)

Session MP3 includes short reports on: (1) Telemedicine: A User's Perspective; (2) Health Care in Extreme Environments; (3) Integration of Emerging Technologies in Information and Telecommunications in Health Care Systems for Space; (4) Telemedicine and Environmental Medicine in Russia: A First Step in Basic Medical Education; and (5) Clinical Utility of Internet Telemedicine.

1997-01-01

135

TELEMEDICINE AND e-HEALTH Volume 13, Number 4, 2007  

E-print Network

369 TELEMEDICINE AND e-HEALTH Volume 13, Number 4, 2007 © Mary Ann Liebert, Inc. DOI: 10.1089/tmj of Washington, Seattle, WA. 5Deputy Director, Advanced Center for Telemedicine and Surgical Innovation perspective. It has been said that telemedicine and telesurgery AU1 #12;were, in fact, first used on Early

136

Telemedicine in the context of the National Broadband Network  

E-print Network

Telemedicine in the context of the National Broadband Network June 2010 Report by NICTA for Department of Broadband, Communications and the Digital Economy #12;Australian telemedicine opportunities://creativecommons.org/licenses/by/2.5/au/legalcode). The document should be attributed as `Telemedicine in the context of the National

Heiser, Gernot

137

Differential measurements selection for evaluation of telemedicine applications  

E-print Network

Differential measurements selection for evaluation of telemedicine applications Shuai Zhang, Sally a quantitative measure of patient satisfaction with telemedicine in three classes of SAF, RTC and CARE, during the period 1999-2009. Cost measurement selection for economic analysis of telemedicine applications

Oakley, Jeremy

138

Towards grid-enabled telemedicine in Florence JACQ1  

E-print Network

Towards grid-enabled telemedicine in Africa Florence JACQ1 , Frank BACIN2 , Nonfounikoun MEDA3.fr 6 Centre Médical Schiphra, Ouagadougou, BurkinaFaso Abstract: Telemedicine services are very relevant tools to train local physicians and to improve diagnosis by exchanging medical data. Telemedicine

Paris-Sud XI, Université de

139

TELEMEDICINE AND e-HEALTH Volume 13, Number 4, 2007  

E-print Network

369 TELEMEDICINE AND e-HEALTH Volume 13, Number 4, 2007 © Mary Ann Liebert, Inc. DOI: 10.1089/tmj for Telemedicine and Surgical Innovation, University of Cincinnati, Cincinnati, OH. 2SRI International, Menlo Park, WA. TELEMEDICINE AND E-HEALTH faces many chal- lenges and opportunities. Many of us in the various

Rosen, Jacob

140

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems  

E-print Network

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems Dimitrios I. Kosmopoulos dkosmo for automated pressure ulcer stage classification can be integrated into an asynchronous telemedicine system, telemedicine I. Introduction A pressure ulcer is a lesion caused by unrelieved pressure resulting in damage

Kosmopoulos, Dimitrios I.

141

Telemedicine in India: the Apollo story.  

PubMed

The challenges faced and the methods implemented by the Apollo Hospitals Group in introducing telemedicine in the Indian setting are discussed in this article. Using Information and Communication Technology (ICT) to make available secondary and tertiary medical expertise to suburban and rural India was thought of as early as 1997. In March 2000, the world's first Very Small Aperture Terminal (VSAT)-enabled village hospital was commissioned. Today, with 115 centers including 9 overseas, the Apollo Telemedicine Networking Foundation (ATNF) is the oldest and largest multispecialty telemedicine network. More than 57,000 teleconsultations in various disciplines, ranging from sexual medicine to neurosurgery, have been provided. Patients have been evaluated from distances ranging from 120 to 4,500 miles. A majority (85%) of these teleconsults were reviews. The successful proof of concept validation studies, carried out from 2000 to 2001 by Apollo, were instrumental in the Indian Space Research Organization (ISRO) including telemedicine as a major thrust area. The pioneering role played by Apollo is also discussed in using VSAT-enabled Hospitals on Wheels. The paper reviews the significant role played by ATNF in the growth and development of telemedicine in South Asia. Academic activities are also highlighted. The pioneering efforts in the field of m-health, home telecare, the Pan African e-Network Project, starting the first formal educational course in telehealth and various other e-initiatives are elaborated. PMID:19659414

Ganapathy, Krishnan; Ravindra, Aditi

2009-01-01

142

The Telemedicine Information Exchange: 10 years' experience.  

PubMed

The Telemedicine Information Exchange (TIE) Website has provided information on telemedicine since 1995. The site could be considered successful from its longevity alone; however, it can also be considered a success using other measures. The usage of the site has grown steadily over the years, to more than 20,000 visitors per month by 2005. The Bibliographic database has over 16,000 telemedicine-related citations, more than found anywhere else, and is the most visited section of the Website. The second most visited database, Active Telemedicine Programs, is the result of 10 years of tracking activity and growth using a voluntary online survey. This continuous monitoring of telemedicine literature and activity has allowed TIE research staff to anticipate user needs and interests. For instance, a Home Telehealth section was initiated after it became apparent that interest in the subject was increasing. Longevity also provides a perspective about the best ways of maintaining a content-heavy online resource. Efforts to augment federal funding (the TIE's sole source of support) by selling packaged information products have taught us that online users will not pay for information. Our raison d'être for the past 10 years has been the provision of credible, up-to-date information, and our reward has been positive feedback from thousands of TIE users. PMID:16375783

Brown, Nancy A

2005-01-01

143

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

PubMed

Abstract Background: The effectiveness of telemedicine for the management of chronic diseases is unclear. This study examined the effectiveness of telemedicine in relieving asthma symptoms. Materials and Methods: A systematic review of the Medline, Cochrane, EMBASE, and Google Scholar databases was conducted until December 31, 2013 using the following key words: "asthma," "telemedicine," "telehealth," "e-health," "mobile health," "Internet," "telecommunication," "telemanagement," "remote," and "short message service." Inclusion criteria were randomized controlled trial, a diagnosis of asthma, the majority of the patients were ?18 years of age, and intervention involved any format of telemedicine. A meta-analysis of eligible studies was conducted with the primary outcome being change of asthma symptoms. Results: Of 813 articles identified, 11 were included in the qualitative synthesis, and 6 were included in the meta-analysis. Among the 11 studies, there were 1,460 patients in the intervention groups and 1,349 in the control groups, and the total numbers of participants ranged from 12 to 481 in the intervention groups and from 12 to 487 in the control groups. The mean age of patients ranged in the intervention groups from 34.4 to 54.6 years and in the control groups from 30.7 to 56.4 years. The treatment duration ranged from 0.5 to 12 months. The meta-analysis of six eligible studies revealed no significant difference in asthma symptom score change between the telemedicine and control groups (pooled Hedges's g=0.34, 95% confidence interval=-0.05 to 0.74, Z=1.69, p=0.090). Conclusions: Telemedicine interventions do not appear to improve asthma function scores, but other benefits may be present. PMID:25393915

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

2014-11-13

144

NATIONAL ROLLOUT OF A WEB BASED TELEMEDICINE STROKE CARE SERVICE: REACH 2.0  

Microsoft Academic Search

Stroke care in the US and in the world is fragmented and mostly unavailable in rural areas. The primary reason for poor stroke care is the lack of neurological expertise in rural hospitals. While existing point-to-point telemedicine systems work in some cases, there is an overwhelming need to remove the geographic penalty associated with acute stroke care and make it

David C. Hess; Sandeep J. Agate

145

Telemedicine: An Application in Search of Users  

NASA Technical Reports Server (NTRS)

Telemedicine involves the use of telecommunication technologies as a medium for the provision of medical information and services to consumers at sites that are at a distance from the provider. The concept encompasses everything from the telephone system to high-speed, wide-bandwidth transmission with use of fiberoptics, satellites, or a combination of terrestrial and satellite-communication technologies. The peripheral software could be as simple as a typewriter used to type a letter requesting an opinion or as complex as high-capacity parallel processing computers and imaging devices. Although the definition includes telephone, facsimile, and distance learning, the term "Telemedicine" is currently used as a generic label for remote consultation and diagnosis. Telemedicine is not a medical subspecialty but a facilitator of all medical and surgical specialties.

Khandheria, Bijoy K.

1996-01-01

146

Telemedicine: history, applications, and impact on librarianship.  

PubMed Central

This paper traces the uses of telecommunications in health care from the Civil War era to the present. Topics include the National Aeronautics and Space Administration's involvement in the origins of current telemedicine systems and the impact of television. Applications of telemedicine discussed include remote consultation and diagnosis, specialty clinical care (including examples from anesthesia, dermatology, cardiology, psychiatry, radiology, critical care, and oncology), and others (including examples of patient education, home monitoring, and continuing education). The concluding section highlights how telemedicine affects health sciences librarianship, beginning with the development of online computerized literature searching. This section also discusses the medical resources available to health sciences librarians as a result of the Internet. PMID:8938332

Zundel, K M

1996-01-01

147

Design and Customization of Telemedicine Systems  

PubMed Central

In recent years, the advances in information and communication technology (ICT) have resulted in the development of systems and applications aimed at supporting rehabilitation therapy that contributes to enrich patients' life quality. This work is focused on the improvement of the telemedicine systems with the purpose of customizing therapies according to the profile and disability of patients. For doing this, as salient contribution, this work proposes the adoption of user-centered design (UCD) methodology for the design and development of telemedicine systems in order to support the rehabilitation of patients with neurological disorders. Finally, some applications of the UCD methodology in the telemedicine field are presented as a proof of concept. PMID:23762191

Martínez-Alcalá, Claudia I.; Muñoz, Mirna; Monguet-Fierro, Josep

2013-01-01

148

Disaster case management and individuals with disabilities  

E-print Network

management in the United States has been provided through donated funds and primarily delivered by faith-based organizations, many of which are members of National Voluntary Organizations Active in Disaster (NVOAD). Until re- cently, the case management... not necessarily reflect those of the above-named organizations. The authors gratefully acknowledge the contributions of J. Aaron Resch, Chris- tina Knight, and Amy Heath to this research. Correspondence concerning this article should be addressed to Laura M...

Stough, Laura

2010-01-01

149

Applicability of Telemedicine in Bangladesh: Current Status and Future Prospects  

E-print Network

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

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

2009-01-01

150

Towards a methodology for developing and implementing best practices in telehealth and telemedicine.  

PubMed

One objective of the growing telehealth and telemedicine literature base is to inform potential adopters and raise their awareness through pilot projects. However, pilot studies often fail to create sustainable solutions because certain conditions are needed for long term success: (1) matching needs to appropriate solutions: while needs assessment can identify needs, adopters must view, test, and experience potential solutions under a number of circumstances; (2) change and new technology: technological implementation brings both foreseen and unforeseen changes, difficult to forecast, and pilot projects can create artificial expectations; (3) awareness of context: there has been a pervasive tendency to treat telemedicine or telehealth as separate from the context of health care delivery, but telemedicine is only a communication and information tool, and should not be considered as separate from other health care delivery activities; (4) availability of long term funding; while loans, government grants and private sector partnering can bridge gaps temporarily, sustainable solutions require that savings from existing systems can be applied to pay for telehealth and telemedicine installations. This paper makes a case for adopting best practices by proposing that a data base of case studies documenting best practices and success factors be developed and made widely available. PMID:10747542

Picot, J

1999-01-01

151

The implementation of telemedicine within a community cancer network.  

PubMed

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

London, J W; Morton, D E; Marinucci, D; Catalano, R; Comis, R L

1997-01-01

152

"Managing after the Merger" Case Analysis.  

ERIC Educational Resources Information Center

Responds to a case study for management communication classes (presented in this same issue) that focuses on issues of performance appraisals and employee feedback after a merger. Notes cultural differences between the companies; examines the supervisor's differential evaluations of his employees and his communicative dynamics; examines the…

Cusella, Louis P.

2000-01-01

153

Gardening waste management - case study: Tehran - Iran  

Microsoft Academic Search

Wastes are unwanted products in human life as well as inseparable part of every process resulted in various sectors such as agriculture and gardening. Agriculture in Iran produces more than 80% of the country's food supply; therefore, it is one of the main producers of the wastes. This shows the importance of agricultural Losses and waste management. Consequently, a case

H. F. Ahmadi; A. Rezaee; Q. Miraki

2010-01-01

154

Anesthesic Management for Escobar Syndrome: Case Report  

PubMed Central

Escobar syndrome is a rare autosomal recessive disorder which is characterized by growth retardation, axillary, antecubital, popliteal digital, and intercrural joint flexion contracture, pterygium in the eyes, cleft palate, decreased lung capacity, genital abnormalities, and spinal deformity. In this case, we presented the anesthesic management of a 2-year-old child undergoing frontal sling operation for ptosis and amblyopia etiology exploration. PMID:21541234

Arpaci, Ayse Hande; Bozkirli, Fusun; Konuk, Onur

2011-01-01

155

The role of medical informatics in telemedicine  

Microsoft Academic Search

The role of medical informatics in telemedicine is dependent on using the power of the computerized database to not only feed patient specific information to the health care providers, but to use the epidemiological and statistical information in the data base to improve decision making and ultimately care. The computer is also a powerful tool to facilitate standardizing and monitoring

Terry P. Clemmer

1995-01-01

156

Telepointer technology in telemedicine: a review.  

PubMed

Telepointer is a powerful tool in the telemedicine system that enhances the effectiveness of long-distance communication. Telepointer has been tested in telemedicine, and has potential to a big influence in improving quality of health care, especially in the rural area. A telepointer system works by sending additional information in the form of gesture that can convey more accurate instruction or information. It leads to more effective communication, precise diagnosis, and better decision by means of discussion and consultation between the expert and the junior clinicians. However, there is no review paper yet on the state of the art of the telepointer in telemedicine. This paper is intended to give the readers an overview of recent advancement of telepointer technology as a support tool in telemedicine. There are four most popular modes of telepointer system, namely cursor, hand, laser and sketching pointer. The result shows that telepointer technology has a huge potential for wider acceptance in real life applications, there are needs for more improvement in the real time positioning accuracy. More results from actual test (real patient) need to be reported. We believe that by addressing these two issues, telepointer technology will be embraced widely by researchers and practitioners. PMID:23496940

Abdul Karim, Rohana; Zakaria, Nor Farizan; Zulkifley, Mohd Asyraf; Mustafa, Mohd Marzuki; Sagap, Ismail; Md Latar, Nani Harlina

2013-01-01

157

Using Telemedicine to Conduct Behavioral Assessments  

ERIC Educational Resources Information Center

We describe the use of telemedicine by the Biobehavioral Service at the University of Iowa Hospitals and Clinics to conduct brief functional analyses for children with developmental and behavioral disorders who live in rural areas of Iowa. Instead of being served at our outpatient facility, participants received initial behavioral assessments in…

Barretto, Anjali; Wacker, David P.; Harding, Jay; Lee, John; Berg, Wendy K.

2006-01-01

158

Using JPEG image compression to facilitate telemedicine  

Microsoft Academic Search

Economical applications of teleradiology and telemedicine are limited to the existing telephone network infrastructure, which greatly limits the speed of digital information transfer. Telephone lines are inherently slow, requiring image transmission times to be unacceptably long for large, complex, or numerous images. JPEG (Joint Photographic Experts Group) image transmission has been shown to compress images to 10% of the original

Loren G Yamamoto

1995-01-01

159

Fundamentals of modern telemedicine in Africa.  

PubMed

The FOMTA (Fundamentals of Modern Telemedicine in Africa) project aims to promote the development of indigenous regional networks between R&D centres and universities of the Developing Countries (DCs) and their European counterparts. While FOMTA prepares the way for the use of broadband technology in Africa, it will also associate the DCs with the generation of knowledge, innovative and appropriate technologies needed to solve some of the specific problems, in order to achieve a sustainable economic development. Designed to eliminate the time-delaying lack of infrastructure, FOMTA will embark on the simulation of the integrated Service Digital Network infrastructure. FOMTA will adopt measures to increase the awareness and stimulate the participation of the DCs in the telemedicine and health care telematics projects through demonstrations, pilot projects, workshops, training and exchange activities. This will demonstrate the feasibility of telemedicine services in the DCs, including trial of services in real-life circumstances, and will provide training possibilities for researchers in the use of methods and tools for advanced communication technologies and telematics. Undoubtedly, telediagnosis, teleconsultation and other areas of telemedicine would thrive in Africa both as remote testing grounds and fields of practical applications. PMID:9242003

Adeyinka, M B

1997-02-01

160

Telemedicine in Western Africa: lessons learned from a pilot project in Mali, perspectives and recommendations  

PubMed Central

Objective to evaluate the feasibility, potential and risks of an internet-based telemedicine network in developing countries of Western Africa. Methods a project for the development of a national telemedicine network in Mali was initiated in 2001, using internet-based technologies for distance learning and teleconsultations. Results the telemedicine network has been in productive use for 18 months and has enabled various collaboration channels, including North-South, South-South, and South-North distance learning and teleconsultations. It also unveiled a set of potential problems: a) limited pertinence of North-South collaborations when there are major differences in available resources or socio-cultural contexts between the collaborating parties; b) risk of induced digital divide if the periphery of the health system is not involved in the development of the network, and c) need for the development of local medical contents management skills. Conclusion the identified risks must be taken into account when desiging large-scale telemedicine projects in developing countries and can be mitigated by the fostering of South-South collaboration channels, the use of satellite-based internet connectivity in remote areas, and the valorization of local knowledge and its publication on-line. PMID:14728172

Geissbuhler, Antoine; Ly, Ousmane; Lovis, Christian; L’Haire, Jean-François

2003-01-01

161

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

PubMed

In the face of the information age, Internet and telecommunication technologies have been widely applied in various settings. These innovational technologies have been used in the areas of e-commerce, long distance learning programs, entertainment, e-government, and so on. In recent years, the evolution of Internet technology is also pervading the health care industry. This dramatic trend may significantly alter traditional medical practice as well as the means of delivery of health care. The idea of telemedicine is to use modern information technology as a means or platform to deliver health care service in remote areas and to manage medical information in digitalized forms. The progress of developing telemedicine, however, is rather slow. The main reason for this slow progress is not technological but rather legal. Health care providers are reluctant to promote this innovation in medical service mainly due to uncertain legal consequences and ethical concerns. Although there are many legal challenges surrounding telemedicine, this note will examine major legal issues including licensure, malpractice liability, and privacy protection. Furthermore, I will discuss the potential of applying telemedicine programs in Taiwan's National Health Insurance Program (hereinafter referred to as NHI). PMID:19202856

Wu, Hsing-Hao

2008-12-01

162

[Case managers experience improved trajectories for cancer patients after implementation of the case manager function.  

PubMed

Case managers are increasingly used to optimize trajectories for patients. This study is based on a questionnaire among case managers in cancer care, aiming at the clarification of the function and its impact on especially patient safety, when handing over the responsibility. The results show a major variation in how the function is organized, the level of competence and the task to be handled. The responsibility has in general been narrowed to department level. Overall, the case managers believe that the function has optimized pathways for cancer patients and improved safety, but barriers persist. PMID:25316364

Axelsen, Karina Rahbek; Nafei, Hanne; Jakobsen, Stine Finne; Gandrup, Per; Knudsen, Janne Lehmann

2014-10-13

163

Provision of Telemedicine Services by Community Health Centers  

PubMed Central

The objective of this study was to assess the use of telemedicine services at community health centers. A national survey was distributed to all federally qualified health centers to gather data on their use of health information technology, including telemedicine services. Over a third of responding health centers (37%) provided some type of telemedicine service while 63% provided no telemedicine services. A further analysis that employed ANOVA and chi-square tests to assess differences by the provision of telemedicine services (provided no telemedicine services, provided one telemedicine service, and provided two or more telemedicine services) found that the groups differed by Meaningful Use compliance, location, percentage of elderly patients, mid-level provider, medical, and mental health staffing ratios, the percentage of patients with diabetes with good blood sugar control, and state and local funds per patient and per uninsured patient. This article presents the first national estimate of the use of telemedicine services at community health centers. Further study is needed to determine how to address factors, such as reimbursement and provider shortages, that may serve as obstacles to further expansion of telemedicine services use by community health centers. PMID:25422721

Sharac, Jessica; Jacobs, Feygele

2014-01-01

164

Provision of telemedicine services by community health centers.  

PubMed

The objective of this study was to assess the use of telemedicine services at community health centers. A national survey was distributed to all federally qualified health centers to gather data on their use of health information technology, including telemedicine services. Over a third of responding health centers (37%) provided some type of telemedicine service while 63% provided no telemedicine services. A further analysis that employed ANOVA and chi-square tests to assess differences by the provision of telemedicine services (provided no telemedicine services, provided one telemedicine service, and provided two or more telemedicine services) found that the groups differed by Meaningful Use compliance, location, percentage of elderly patients, mid-level provider, medical, and mental health staffing ratios, the percentage of patients with diabetes with good blood sugar control, and state and local funds per patient and per uninsured patient. This article presents the first national estimate of the use of telemedicine services at community health centers. Further study is needed to determine how to address factors, such as reimbursement and provider shortages, that may serve as obstacles to further expansion of telemedicine services use by community health centers. PMID:25422721

Shin, Peter; Sharac, Jessica; Jacobs, Feygele

2014-01-01

165

Adoption of routine telemedicine in Norway: the current picture  

PubMed Central

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

Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

2014-01-01

166

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

...2014-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.31...1700.31 Distance Learning and Telemedicine Loan and Grant Program. RUS...grants and loans to furnish and improve telemedicine services and distance learning...

2014-01-01

167

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

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.31...1700.31 Distance Learning and Telemedicine Loan and Grant Program. RUS...grants and loans to furnish and improve telemedicine services and distance learning...

2010-01-01

168

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

Code of Federal Regulations, 2012 CFR

...2012-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.31...1700.31 Distance Learning and Telemedicine Loan and Grant Program. RUS...grants and loans to furnish and improve telemedicine services and distance learning...

2012-01-01

169

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

Code of Federal Regulations, 2011 CFR

...2011-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.31...1700.31 Distance Learning and Telemedicine Loan and Grant Program. RUS...grants and loans to furnish and improve telemedicine services and distance learning...

2011-01-01

170

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

Code of Federal Regulations, 2013 CFR

...2013-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.31...1700.31 Distance Learning and Telemedicine Loan and Grant Program. RUS...grants and loans to furnish and improve telemedicine services and distance learning...

2013-01-01

171

Disaster case management: Disaster case management and individuals with disabilities following Hurricane Katrina  

E-print Network

was the largest single coordinated case management pro- gram used in the U.S. in response to disaster and had as its goal to provide case management to 100,000 families affected by Hurri- cane Katrina. Nine member organizations were part of the original... BRAIN INJURY PROFESSIONAL18 This article, submitted for inclusion in an upcoming issue of Re- habilitation Psychology, investigates the long-term recovery of in- dividuals with disabilities following Hurricane Katrina through data collected from...

Stough, Laura

2011-01-01

172

The Science Manager's Guide to Case Studies  

SciTech Connect

This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.; Vallario, Robert W.

2001-09-24

173

Design and Implementation of Telemedicine based on Java Media Framework  

NASA Astrophysics Data System (ADS)

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

Xiong, Fengguang; Jia, Zhiyan

174

HOPE, an open platform for medical data management on the grid  

E-print Network

for telemedicine and built upon the EGEE gLite middleware and particularly the metadata catalogue AMGA as well in Europe and Asia and is being customized for applications in the field of telemedicine and medical physics. Keywords. Grid, telemedicine, medical data, data management 1 ­ Introduction The application of grid

Boyer, Edmond

175

In what circumstances is telemedicine appropriate in the developing world?  

PubMed Central

Objectives To review papers reporting actual experience with telemedicine in developing countries and to summarize their findings, including the strength of the evidence. Design A retrospective review was conducted. Study quality was assessed. Setting Four commonly-used electronic databases. Main outcome measures Study quality scores. Results From a total of 202 potential articles, 38 relevant papers were identified. Thirty-four articles (89%) reported clinical experience and 14 articles (37%) reported the use of telemedicine for educational purposes. The quality of the reports was rather weak (median quality-score 3, on a scale 0–9); only one study, rated at 7, fell into the high quality score band. The fact that almost all studies reported positively in favour of telemedicine suggests a publication bias. Of the 38 articles, 15 (39%) reported the use of real-time telemedicine and 25 (66%) reported the use of asynchronous, or store-and-forward, telemedicine. Email was the most commonly reported modality (half of all studies). Conclusion Some of the longer established telemedicine operations have developed into substantial networks. The review suggests that great potential exists for telemedicine in the developing world. However, some caution is required in future telemedicine work if telemedicine exemplars are to be produced which can be widely copied. PMID:21103129

Wootton, Richard; Bonnardot, Laurent

2010-01-01

176

New telemedicine approach to the dynamic ECG and other biological signals ambulatory monitoring  

Microsoft Academic Search

Telemedicine is an emerging field that can potentially affect health management, according to the present technological progress, combining medical expertise and communication technology. In this field, three main trials have been up to now experimented; teleconference, tele-intervention, telemonitoring. Teleconference applications are today a true reality, even in the medical field (i.e. consulting), while tele-intervention (i.e. tele-surgery) and telemonitoring remain at

D. Franchi; A. Belardinelli; G. Palagi; A. Ripoli; R. Bedini

1998-01-01

177

Comparative study of connectivity in telemedicine.  

PubMed

Communication links are the lifelines for telemedicine practice. Various terrestrial and satellite media can be used; however, each has its own plus and minus side. The current study was designed to evaluate three types of telecommunication media used for telemedical videoconference at the Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow Telemedicine program over a period of 20 months. The evaluation was based on analysis of technical parameters recorded in a prescribed proforma designed for the study purpose and maintained prospectively after completion of each event. Only technical issues were addressed. At the end of the study period, analysis of data revealed that leased line-based terrestrial Internet Protocol (IP) was better than Sky IP. Integrated Services Digital Network media were found technically less acceptable for telemedical videoconference. PMID:18954256

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

2008-10-01

178

42 CFR 440.169 - Case management services.  

Code of Federal Regulations, 2010 CFR

...identifying needs and supports to assist the eligible individual in obtaining services, providing case managers with useful feedback, and alerting case managers to changes in the eligible individual's needs. [72 FR 68091, Dec. 4, 2007, as...

2010-10-01

179

10 CFR 2.332 - General case scheduling and management.  

Code of Federal Regulations, 2010 CFR

...case scheduling and management. 2.332 Section...Intervene, Availability of Documents, Selection of Specific...and General Hearing Management for NRC Adjudicatory...because of lack of management; (3) Discouraging...publication of the pertinent document will not...

2010-01-01

180

Virtual doctor's office telemedicine delivery system  

E-print Network

communities, applicable to one of two scenarios ? with the presence of a healthcare provider and without (homecare). The objectives of the project were to: (a) Design a "Telemedicine Delivery System", constituting three basic components ? the Virtual... Instrument to acquire and pre-process the patient information, an application to retrieve this information and relay it via the Internet to the Doctor's Office and an application on the doctor's side to obtain the relayed information and present...

Sainath, Paavana

2002-01-01

181

[Telemedicine experiences in an urology educational institute].  

PubMed

The Telemedicine (TM) it is a viable alternative to improve the quality of the attention to the patient; in order to obtain the suitable efficiency is convenient that specialists must handle with naturalness the technical concepts related to the installation and operation of the equipment required in a TM session. In this work results on telemedicine teaching at the Center of Image Processing, are presented, showing the development of this medical-technology project. The objective of the course was to upgrade the academic formation of the students in the area of the TM, showing its versatility through varied experiences and medical practice. The experimental phase of telemedicine course was made for the Master Degree Program in Urology of Carabobo University. This activity was carried out at the Urology Teaching Institute (IDU). This article describes the experience and explains details of the videoconference equipment's configuration, the medical peripherals used in TM, the telecommunications services installation, the medical ambient in TM and the course programming. The course was twelve (12) weeks long. Some tutorials were given to make level the doctor's knowledge and soon teleconsulting were made which are explained later. Courses of this category have been made in several countries. This it is the first formal experience in TM in Venezuela having didactic goals. This course allowed us to observe the interaction between doctors and TM equipment's, related to teleradiology (RX and ultrasound) and telecitoscopy. PMID:14515767

Pérez, Egilda; Montilla, Guillermo; Villegas, Hyxia

2003-01-01

182

Case histories in pharmaceutical risk management.  

PubMed

The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS). PMID:19767156

McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

2009-12-01

183

MBA Supply Chain Case Competition Center for Supply Chain Management  

E-print Network

MBA Supply Chain Case Competition Center for Supply Chain Management February 1, 2013 1:00 ­ 4:00 p their skills in analyzing a real-world supply chain management case. Provide a chance for sponsoring companies of the Rutgers Center for Supply Chain Management to get to know top talent from RBS. The Schedule The case

Lin, Xiaodong

184

Private payer reimbursement for telemedicine services in the United States.  

PubMed

Telemedicine has garnered significant attention over the past decade as a solution to cost and access challenges facing healthcare. Yet, utilization rates have not reached their full potential. One major barrier to the adoption of telemedicine cited in the literature is the lack of universal reimbursement from private payers. The purpose of this investigation was to capture a current picture of private reimbursement for telemedicine services in the United States. This investigation was a follow-up to a 2003 survey conducted by the American Telemedicine Association (ATA) and AMD Telemedicine. Representatives from 116 telemedicine programs were contacted between September and November 2005 via telephone and/or e-mail to participate in this survey. Of those contacted, we received responses from 64 organizations, a 55% response rate. To provide answers to our research questions, descriptive statistics were used for data analysis. Data indicate that the United States is progressing toward expanded private reimbursement for telemedicine services with 58% of responding organizations who provide potentially billable telemedicine services receiving private reimbursement (up 5% from 2003). In addition, it was found that 81% of those who receive private pay reported no differences between reimbursement for telemedicine services as compared to traditional faceto-face consults. Finally, of those who receive private pay, data indicated that telemedicine programs are submitting on average approximately 40% of consults for private reimbursement. While this investigation does suggest that we are making small improvements in private payer reimbursement, the change appears to lag behind a pace needed to optimize telemedicine deployment. PMID:17309350

Whitten, Pamela; Buis, Lorraine

2007-02-01

185

Mobimed: a telemedicine system for mobile monitoring of physiological parameters  

NASA Astrophysics Data System (ADS)

The project Mobimed started in 1988. The purpose of the project was to develop a telemedicine system where patient information text as well as data reflecting the status of various physiological parameters could be transmitted from a mobile terminal to a resident terminal at a hospital or similar place. The information transmitted was to be so comprehensive that a physician at the hospital together with the personnel attending the patient could make a diagnosis and suggest therapy. At the hospital all transmitted data should be stored automatically. Since September 1989 a prototype system is running in Sweden with one ambulance connected to two hospitals. This system is using the Mobitex* and speech transmission system for data transmission. As a first step the project is oriented towards ECG-monitoring. Mobimed has also been developed for laptop computers using the ordinary telephone network. In this case Mobimed can be used at home or anyplace where wireless transmission is not required. 1.

Thorborg, Sten; Sjoqvist, Bengt A.

1990-06-01

186

Proceedings of Student-Faculty Research Day, CSIS, Pace University, May 3rd A Tele-Weight Management System  

E-print Network

endeavors to demonstrate how telemedicine can address the prevalence of weight-related health problems long-term resulting wellness and health. 1. Introduction Telemedicine is the use of medical information]. A manifestation of telemedicine is in the area of Tele-Weight management. Currently, the rate of obesity in the U

Tappert, Charles

187

Assessing telemedicine: a systematic review of the literature  

Microsoft Academic Search

Background: To clarify the current status of telemedicine, we carried out a systematic review of the literature. We identified controlled assessment studies of telemedicine that reported patient outcomes, administrative changes or economic assessments and assessed the quality of that literature. Methods: We carried out a systematic electronic search for articles published from 1966 to early 2000 using the MEDLINE (1966-April

Risto Roine; Arto Ohinmaa; David Hailey

2001-01-01

188

Telemedicine in the United Kingdom: current status and future prospects  

Microsoft Academic Search

The objective of this correspondence is to present an overview of some of the current development and some of the ongoing telemedicine programs in the United Kingdom. The issues of the future integration of telemedicine activities within the National Health Service that promises better access to healthcare with higher efficiency, mobility, and lower cost are also discussed.

Robert S. H. Istepanian; H. Istepanian

1999-01-01

189

Cost Analysis in Telemedicine: Empirical Evidence From Sites in Arizona  

ERIC Educational Resources Information Center

Support of telemedicine for largely rural and ethnically diverse populations is premised on expectations that it increases opportunities for appropriate and timely medical services, and that it improves cost-effective service delivery. To understand the cost-effectiveness of telemedicine in 8 small and/or rural sites in Arizona. A cost analysis…

de la Torre, Adela; Hernandez-Rodriguez, Clemente; Garcia, Lorena

2004-01-01

190

A telemedicine system for remote cooperative medical imaging diagnosis  

Microsoft Academic Search

Telemedicine is changing the classical form of health care delivery, by providing efficient solutions to an increasing number of new situations: here we consider those which require some type of computer-supported cooperative work (CSCW) between health care professionals located in different clinical sites. This paper presents the design and development of a telemedicine system for remote computer-supported cooperative medical imaging

E. J. Go´mez; F. del Pozo; J. A. Quiles; M. T. Arredondo; H. Rahms; M. Sanz; P. Cano

1996-01-01

191

Successful Adoption of a School-Based Telemedicine System  

ERIC Educational Resources Information Center

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

Mackert, Michael; Whitten, Pamela

2007-01-01

192

Telemedicine: a new frontier for effective healthcare services  

Microsoft Academic Search

Telemedicine: a new frontier for effective healthcare services. S. Scalvini, M.Vitacca, L. Paletta, A. Giordano, B. Balbi. Telemedicine can be defined as the delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication tech- nologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and

S. Scalvini; M. Vitacca; L. Paletta; A. Giordano; B. Balbi

193

Karnataka State Telemedicine Project: Utilization Pattern, Current, and Future Challenges  

PubMed Central

Background: The Telemedicine Network Project in the state of Karnataka was introduced in the year 2001. This is a value added service from the health department of the government of Karnataka. There is no data on its utilization pattern or its future challenges. This study was conducted from a nodal center in order to understand the above two issues. Materials and Methods: We used a 51-item survey questionnaire that captured data on infrastructure, technical aspects, and connectivity parameters, tele-consultations including emergency services, human resources, and coordination aspects both at the client as well as the nodal centers. Results: Services are operational in 25 district hospitals across the state for the past 3.3 (2.1) years. Space was ear-marked across all the client centers. Back-up power supply was present only in 10 (40%) of the client centers. Quality of satellite connection was acceptable in 18 (72%) centers. Approximately, 3.0 (1.8) phone calls had to be made to the nodal centers to obtain one appointment. Monthly maximum and minimum cases done over the past 2 year period were reported as 58.2 (66.2) and 13.5 (16.2) respectively. Each consultation lasted for 26.1 (13.9) min. Tele-consultation advices from nodal centers were carried out completely in only 9 (36%) centers. Only in 13 (52%) client centers, did doctors keep up with appointment regularly. All technicians reported that the training they received was inadequate. 16 (64%) technicians were asked to do works that were not pertaining to telemedicine. 19 (76%) technicians had frequently felt insecurities about their jobs. Conclusions: The telemedicine service has been largely under-utilized and has failed to deliver the promise in Karnataka state. At present, the obstacles reflect both inherent limitations in the technology and also improper use of human resources. Successful implementation of the given recommendations may in the long run help optimal utilization and reach all end-users. PMID:24249931

Holla, Bharath; Viswanath, Biju; Neelaveni, Shanthaveeranna; Harish, T.; Kumar, Channaveerachari Naveen; Math, Suresh Bada

2013-01-01

194

What is "telemedicine" and what does it mean for a pediatric surgeon?  

PubMed

Telemedicine is a broad term and has recently become a household term in the medical field. However, there are many interpretations as to what the term "telemedicine" means. There are many facets to telemedicine and here we describe all of the elements of telemedicine, a glossary of terms, and how they relate to pediatric surgery. PMID:25111277

Nalugo, Margaret; Craner, Domenic R; Schwachter, Marc; Ponsky, Todd A

2014-08-01

195

Quick management of accidental tritium exposure cases.  

PubMed

Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ?100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies. PMID:22349318

Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R

2012-07-01

196

Teleradiology Usage and User Satisfaction with the Telemedicine System Operated by Médecins Sans Frontières  

PubMed Central

Médecins Sans Frontières (MSF) began a pilot trial of store-and-forward telemedicine in 2010, initially operating separate networks in English, French, and Spanish; these were merged into a single, multilingual platform in 2013. We reviewed the pattern of teleradiology usage on the MSF telemedicine platform in the 4-year period from April 2010. In total, 564 teleradiology cases were submitted from 22 different countries. A total of 1114 files were uploaded with the 564 cases, the majority being of type JPEG (n?=?1081, 97%). The median file size was 938?kb (interquartile range, IQR 163–1659). A panel of 14 radiologists was available to report cases, but most (90%) were reported by only 4 radiologists. The median radiologist response time was 6.1?h (IQR 3.0–20). A user satisfaction survey was sent to 29 users in the last 6?months of the study. There was a 28% response rate. Most respondents found the radiologist’s advice helpful and all of them stated that the advice assisted in clarification of a diagnosis. Although some MSF sites made substantial use of the system for teleradiology, there is considerable potential for expansion. More promotion of telemedicine may be needed at different levels of the organization to increase engagement of staff. PMID:25389524

Halton, Jarred; Kosack, Cara; Spijker, Saskia; Joekes, Elizabeth; Andronikou, Savvas; Chetcuti, Karen; Brant, William E.; Bonnardot, Laurent; Wootton, Richard

2014-01-01

197

Service Design Attributes Affecting Diabetic Patient Preferences of Telemedicine in South Korea  

PubMed Central

Abstract Objective Attempts to introduce telemedicine in South Korea have failed mostly, leaving critical questions for service developers and providers about whether patients would be willing to pay for the service and how the service should be designed to encourage patient buy-in. In this study, we explore patients' valuations and preferences for each attribute of telemedicine service for diabetes management and evaluate patient willingness to pay for specific service attributes. Materials and Methods We conducted a conjoint survey to collect data on patients' stated preferences among telemedicine service alternatives. The alternatives for diabetes-related service differed in 10 attributes, including those related to price, type of service provider, and service scope. To estimate the relative importance of attributes, patients' willingness to pay for each attribute, and their probable choice of specific alternatives, we used a rank-ordered logit model. A total of 118 respondents participated in the survey. Results All 10 attributes significantly affected patients' valuations and preferences, and demographic and disease characteristics, such as existence of complications and comorbidities, significantly affected patients' valuations of the attributes. Price was the most important attribute, followed by comprehensive scope of service, the availability of mobile phone-based delivery, and large general-hospital provided services. Conclusions The study findings have significant implications for adoption policy and strategy of telemedicine in diabetes management care. Further, the methodology presented in this study can be used to draw knowledge needed to formulate effective policy for adoption of the necessary technology and for the design of services that attract potential beneficiaries. PMID:21631382

Chon, YuCheong; Lee, Jongsu; Choi, Ie-Jung; Yoon, Kun-Ho

2011-01-01

198

Intensive case management for severe mental illness  

PubMed Central

Background Intensive Case Management (ICM) is a community based package of care, aiming to provide long term care for severely mentally ill people who do not require immediate admission. ICM evolved from two original community models of care, Assertive Community Treatment (ACT) and Case Management (CM), where ICM emphasises the importance of small caseload (less than 20) and high intensity input. Objectives To assess the effects of Intensive Case Management (caseload <20) in comparison with non-Intensive Case Management (caseload > 20) and with standard community care in people with severe mental illness. To evaluate whether the effect of ICM on hospitalisation depends on its fidelity to the ACT model and on the setting. Search methods For the current update of this review we searched the Cochrane Schizophrenia Group Trials Register (February 2009), which is compiled by systematic searches of major databases, hand searches and conference proceedings. Selection criteria All relevant randomised clinical trials focusing on people with severe mental illness, aged 18 to 65 years and treated in the community-care setting, where Intensive Case Management, non-Intensive Case Management or standard care were compared. Outcomes such as service use, adverse effects, global state, social functioning, mental state, behaviour, quality of life, satisfaction and costs were sought. Data collection and analysis We extracted data independently. For binary outcomes we calculated relative risk (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data we estimated mean difference (MD) between groups and its 95% confidence interval (CI). We employed a random-effects model for analyses. We performed a random-effects meta-regression analysis to examine the association of the intervention’s fidelity to the ACT model and the rate of hospital use in the setting where the trial was conducted with the treatment effect. Main results We included 38 trials (7328 participants) in this review. The trials provided data for two comparisons: 1. ICM versus standard care, 2. ICM versus non-ICM. 1. ICM versus standard care Twenty-four trials provided data on length of hospitalisation, and results favoured Intensive Case Management (n=3595, 24 RCTs, MD ?0.86 CI ?1.37 to ?0.34). There was a high level of heterogeneity, but this significance still remained when the outlier studies were excluded from the analysis (n=3143, 20 RCTs, MD ?0.62 CI ?1.00 to ?0.23). Nine studies found participants in the ICM group were less likely to be lost to psychiatric services (n=1633, 9 RCTs, RR 0.43 CI 0.30 to 0.61, I2=49%, p=0.05). One global state scale did show an Improvement in global state for those receiving ICM, the GAF scale (n=818, 5 RCTs, MD 3.41 CI 1.66 to 5.16). Results for mental state as measured through various rating scales, however, were equivocal, with no compelling evidence that ICM was really any better than standard care in improving mental state. No differences in mortality between ICM and standard care groups occurred, either due to ’all causes’ (n=1456, 9 RCTs, RR 0.84 CI 0.48 to 1.47) or to ’suicide’ (n=1456, 9 RCTs, RR 0.68 CI 0.31 to 1.51). Social functioning results varied, no differences were found in terms of contact with the legal system and with employment status, whereas significant improvement in accommodation status was found, as was the incidence of not living independently, which was lower in the ICM group (n=1185, 4 RCTs, RR 0.65 CI 0.49 to 0.88). Quality of life data found no significant difference between groups, but data were weak. CSQ scores showed a greater participant satisfaction in the ICM group (n=423, 2 RCTs, MD 3.23 CI 2.31 to 4.14). 2. ICM versus non-ICM The included studies failed to show a significant advantage of ICM in reducing the average length of hospitalisation (n=2220, 21 RCTs, MD ?0.08 CI ?0.37 to 0.21). They did find ICM to be more advantageous than non-ICM in reducing rate of lost to follo

Dieterich, Marina; Irving, Claire B; Park, Bert; Marshall, Max

2014-01-01

199

Case management insider. The 2-midnight rule--a game-changer for case management.  

PubMed

As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions. Having a case management presence in the emergency department will help to ensure a sound review process at this important route of entry to the hospital. A working team should be created to review the cases that fall outside of the rule, and these cases should also be presented to the utilization review committee so that the hospital can continue to learn and move forward. Finally, listen to the CMS National Provider Calls (www.cms. gov/NPC) to gain additional and updated information as it becomes available! For additional information on the two-midnight rule go to www.cms.gov and search for CMS-1599-F. PMID:24697139

Cesta, Toni

2014-04-01

200

The role of CORBA in enabling telemedicine  

SciTech Connect

One of the most powerful tools available for telemedicine is a multimedia medical record accessible over a wide area and simultaneously editable by multiple physicians. The ability to do this through an intuitive interface linking multiple distributed data repositories while maintaining full data integrity is a fundamental enabling technology in healthcare. The author discusses the role of distributed object technology using CORBA in providing this capability including an example of such a system (TeleMed) which can be accessed through the World Wide Web. Issues of security, scalability, data integrity, and useability are emphasized.

Forslund, D.W.

1997-07-01

201

Telemedicine optoelectronic biomedical data processing system  

NASA Astrophysics Data System (ADS)

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

Prosolovska, Vita V.

2010-08-01

202

[Hospital without borders--visions of telemedicine].  

PubMed

Transfer the expertise rather than the patient! With the help of a screen and a videocamera the general practitioner requiring expert help in diagnosis is able to consult the specialists directly via the broadband ISDN (Integrated Services Digital Network), and referrals complemented with audio-visual material can also be transmitted via the network. Modern telemedicine technology enables hospitals to be linked up, advanced information to be transmitted, interpreter services to be enlisted, and continuous postgraduate training to be developed. Thus, time and money can be saved, the patients given better and faster service, and the quality of health care enhanced. PMID:7478969

Brismar, B

1995-01-01

203

Global excellence in management systems: a Diamond Offshore Drilling case  

Microsoft Academic Search

How do managers, in their role as decision makers, design and implement systems for management of quality? Proposes that there is no one, definitive answer to this question, given various industrial environments and their operating constraints, diverse market conditions and numerous management philosophies. Attempts to address quality management issues in the business-to-business industrial service industry by presenting a case study

Denis Graham; Vipul K. Gupta

1996-01-01

204

Case Studies for Management Development in Bangladesh. Second Book.  

ERIC Educational Resources Information Center

These 15 case studies developed by faculty at institutions in Bangladesh are appropriate for use in a course in management development. The typical case describes a real business situation in which a real manager had to reach a decision. The case gives quantitative and qualitative information that is, or may be, relevant to that decision.…

McLean, Gary N.

205

Perinatal management of major congenital heart disease.  

PubMed

Congenital heart disease (CHD) is the most common form of congenital anomaly. Prenatal diagnosis of CHD has been associated with decreased morbidity and mortality for some forms of major CHD. As most cases of major CHD are not identified prenatally, clinical examination of the newborn and pulse oximetry are also important means of identifying more cases. Clinicians must suspect CHD as a diagnosis in a cyanosed or shocked neonate and be familiar with appropriate management, namely the commencement of prostaglandin if a duct dependent cardiac lesion is suspected. Telemedicine can aid prompt diagnosis of CHD and therefore direct appropriate management. PMID:25484461

McGovern, Eiméar; Sands, Andrew J

2014-09-01

206

Supporting Hospital Doctors in the Middle East by Email Telemedicine: Something the Industrialized World Can Do to Help  

PubMed Central

Background Since 1999, the Swinfen Charitable Trust has operated an email referral system between doctors in the developing world and specialists in the industrialized world. Since 2001, it has expanded its operation into the Middle East, in particular Iraq, an area of considerable conflict. Objectives The aim was to compare referral patterns to the Trust from the Middle East with those received from the rest of the developing world and to look for qualitative evidence of health gain. Methods We analyzed referrals to the Swinfen Charitable Trust between July 2004 and June 2007 and compared these by speciality with those received from elsewhere during the same 3-year period. We asked two referring doctors for their views of the process, and we analyzed the total Middle Eastern referrals made to a single specialty (neurology). Results Between July 2004 and June 2007, 283 referrals were received from four countries in the Middle East (Iraq, Afghanistan, Pakistan, Kuwait) and 500 cases were received from 22 other countries. The 283 cases resulted in 522 separate queries to specialists. The median time to specialist reply for the queries relating to the 283 Middle Eastern cases was 24.3 hours (interquartile range 6.1-63.3). There was a significant difference in case mix between the Middle East and the rest of the world (P < .001), with more obstetric referrals and fewer referrals in medical specialties and radiology. The referring doctors were helped greatly by the service. The neurologist was confident of the diagnosis in 20 of 26 referrals received (77%). Both referring doctors and the specialist were able to cite referred cases where management was improved as a result of the service. Conclusions Email telemedicine can be used in areas of conflict such as the Middle East. Perhaps surprisingly, trauma referrals are not increased but obstetric referrals are. Supporting individual doctor-patient encounters in this way is therefore often beneficial and is easily expandable. As well as improving care for individuals, email telemedicine provides effective case-based learning for local doctors, leading to improved care for subsequent similar patients. PMID:17951214

Patterson, Victor; Swinfen, Pat; Swinfen, Roger; Azzo, Emil; Taha, Husen

2007-01-01

207

General practitioners' perceptions of asynchronous telemedicine in a randomized controlled trial of teledermatology.  

PubMed

We studied the perceptions of general practitioners (GPs) towards teledermatology, before and after its introduction into eight general practices for the purposes of a randomized controlled trial. A postal questionnaire was distributed before the trial and again one year later. Thirty-six of the 42 GPs responded on each occasion (a response rate of 86%). In the second survey, only 21% of respondents indicated that they were satisfied with teledermatology in their practice, while 47% said that they were dissatisfied. Thirty-one per cent said that they felt confident about diagnosis and management of care through teledermatology, and 28% reported that they were unconfident. Only 23% of respondents said that they would consider using a telemedicine system in the future, while 34% said they would not (43% were unsure). There were no significant findings to suggest that the GPs' perceptions changed over time. Less favourable responses to telemedicine were found than has been observed in previous studies, which suggests that the model of telemedicine described in this study would not be widely acceptable to GPs. PMID:15068645

Collins, Karen; Bowns, Ian; Walters, Stephen

2004-01-01

208

Changes in the job situation due to telemedicine.  

PubMed

Little is known either about how telemedicine changes the job situation or about how the working environment might be improved for those involved in telemedicine. To investigate these issues, qualitative interviews were carried out with 30 people in Norway working with telepsychiatry (12 respondents), teledermatology (six respondents), a telepathology frozen-section service (10 respondents) and tele-otolaryngology (two respondents). The median annual number of remote consultations in telepsychiatry was nine, in teledermatology 81 and in the telepathology frozen-section service nine. The positive aspects of working with telemedicine included less travelling, which gave more time for other work, less need to travel in poor weather, new contacts, an increased sense of professional security (because support was readily available) and the satisfaction of seeing partners in communication. At its present volume, telemedicine generally fits into daily work patterns quite well. Problems do occur, but they can be solved by appropriate organizational measures. Long-term scheduling of telemedical sessions may be important. Many telemedicine workers want to have the equipment in their own office. Working with telemedicine can be tiring and those interviewed wanted to limit the number of hours per week. A solution may be to use large clinics, such as university clinics, where the telemedical work could be distributed between several specialists. Large telemedicine clinics with a full-time dedicated staff would need careful consideration of working practices. PMID:11809084

Aas, I H Monrad

2002-01-01

209

Narrative review of telemedicine consultation in medical practice  

PubMed Central

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

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

2015-01-01

210

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

PubMed

Since the creation of the NATO Telemedicine Expert Panel (now renamed the TMED Expert Team) in 2000, when few nations had deployed telemedicine systems to support military field operations, this group has been encouraging the nations to deploy telemedicine (TMED) in support of their forces, and to write the use of TMED into NATO doctrine. This has been a relatively successful effort, and TMED is increasingly being used within the military medical structures of some NATO and Partnership for Peace nations to provide medical care to deployed military personnel. We report the results of a multinational survey of current and projected availability of various telemedicine modalities within the NATO medical services that are participating in the work of the TMED expert team (ET). Though only a "snapshot in time," and not representing all NATO nations, this is the first attempt to identify both current and planned TMED utilization within the multinational military medical community. Participating nations report that communication systems now in place at the lowest levels of medical support increasingly enable the routine use of Web-based teleconsultation modalities. Teleradiology is now being seen as the de facto standard for imaging support. While a number of nations report they have deployed capabilities for obtaining clinical consultations at a distance, most responding nations do not have a formal organizational structure to control and manage remote consultation and rely on informal clinical relationships (e.g., requesting consults from the deployed clinician's home hospital or from friends). Military electronic health records are in use by only a minority of nations and fewer still are capable of civilian interface. Less common TMED capabilities (e.g., tele-microbiology, tele-pathology, tele-medical maintenance) are being increasingly used, but are still rarely deployed. As a result of the findings of this survey, specific recommendations for expanding the use of TMED in the NATO multinational medical setting have been made to appropriate NATO bodies. PMID:19035805

Lam, David M; Poropatich, Ronald K

2008-11-01

211

Case management as a tool for clinical integration.  

PubMed

Case management has evolved to meet the challenges of contemporary health care. As an effective strategy to promote clinical integration within health care systems, case management brings together population and individual approaches to development and coordination of evidence-based, outcome-focused health, disease, and illness management programs and services. A three-level prevention-focused model for health care management across the continuum of care is presented. PMID:9874932

Weiss, M E

1998-01-01

212

Telemedicine for the care of children in the hospital setting.  

PubMed

Telemedicine is by no means a new technology, given that audio-video telecommunication links have been utilized for the provision of medical services since the 1950s. Nonetheless, telemedicine is currently in a phase of rapid growth and evolution. The combination of increasingly affordable and powerful networking, computing, and communication technology, along with the continued nationwide crisis in health care access and costs, has created a "tipping point," whereby telemedicine has progressed from a novel means of practicing medicine to practical tool to help address our nation's health care needs. Telemedicine has also evolved beyond a means of providing care to remote communities to becoming a versatile tool in the delivery of health care in a variety of non-rural settings. Although no one can be everywhere at once, telemedicine allows us to be in more places at once than we've ever been before. The problems of disparities and access to care are even more evident in pediatrics, where subspecialists are fewer in number and more regionalized than adult providers. Numerous successful telemedicine programs across the country have demonstrated the impact that these technologies can have in pediatrics, with many more programs in development. As a versatile means of delivering care, telemedicine can be used at any point during the course of a health care encounter as not only a means of expanding our reach, but also as a means of increasing efficiency. Using telemedicine to provide consultations to community hospitals has been shown to improve quality of care, strengthen the referral base for the consulting facilities, facilitate cost savings, and improve the financial bottom line for both referring and consulting facilities. This review highlights some of the ways in which telemedicine is being used to facilitate timely and effective pediatric care in a variety of hospital settings. PMID:24512161

McSwain, S David; Marcin, James P

2014-02-01

213

A telemedicine health care delivery system  

NASA Technical Reports Server (NTRS)

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

Sanders, Jay H.

1991-01-01

214

Telemedicine in Anesthesiology and Reanimatology  

PubMed Central

Review SUMMARY In recent years impressive progress is happening in information and telecommunication technologies. The application of computers in medicine allows permanent data storage, data transfer from one place to another, retrieving and data processing, data availability at all times, monitoring of patients over time, etc. This can significantly improve the medical profession. Medicine is one of the most intensive users of all types of information and telecommunication technology. Quickly and reliably store and transfer data (text, images, sounds, etc.) provides significant assistance and improvement in almost all medical procedures. In addition, data in locations far from medical centers can be of invaluable benefit, especially in emergency cases in which the decisive role has anesthesiologists. PMID:24222933

Tafro, Lejla; Masic, Izet

2010-01-01

215

Store-and-forward telemedicine for doctors working in remote areas.  

PubMed

For doctors working in remote areas, access to medical specialists is crucial in order to provide patients with the best possible health care. Telemedicine is now widely used to obtain second opinions from consultants and is a mainstay of the organization of health care in Antarctica. Taking advantage of our extreme geographical isolation on a polar station, we tested the possibilities for obtaining specialist advice by telemedicine based on email. Two virtual case reports with one question each were sent to six correspondents: two non-governmental organizations (NGOs), two personal acquaintances and two institutions. Initial email replies were received between 13 hours and 7 days later. There were three kinds of reply: well argued and well adapted to our situation (one NGO); argued but not well adapted to our situation (one NGO, one acquaintance and one institution); and a short reply without argument (one acquaintance). Contacting personal acquaintances was not as reliable as we had expected. The best support was provided by one of the NGOs whose efficiency was based on the use of an automatic message-handling system and a team of specialists well trained in giving advice to isolated doctors. This NGO demonstrated how a store-and-forward telemedicine system can be efficient and reliable; the study also highlighted some limitations in other methods of obtaining specialist advice. PMID:19139214

Bonnardot, Laurent; Rainis, Roberto

2009-01-01

216

Tavarua : a mobile telemedicine system using WWAN striping  

E-print Network

Tavarua is a platform designed to support mobile telemedicine systems over wireless wide area networks, WWANs. It utilizes network striping and other complementary techniques to send uni-directional near real time video ...

Carlisle, Jennifer (Jennifer Nicole)

2007-01-01

217

Arogyasree: An Enhanced Grid-Based Approach to Mobile Telemedicine  

PubMed Central

A typical telemedicine system involves a small set of hospitals providing remote healthcare services to a small section of the society using dedicated nodal centers. However, in developing nations like India where majority live in rural areas that lack specialist care, we envision the need for much larger Internet-based telemedicine systems that would enable a large pool of doctors and hospitals to collectively provide healthcare services to entire populations. We propose a scalable, Internet-based P2P architecture for telemedicine integrating multiple hospitals, mobile medical specialists, and rural mobile units. This system, based on the store and forward model, features a distributed context-aware scheduler for providing timely and location-aware telemedicine services. Other features like zone-based overlay structure and persistent object space abstraction make the system efficient and easy to use. Lastly, the system uses the existing internet infrastructure and supports mobility at doctor and patient ends. PMID:20467560

Kailasam, Sriram; Kumar, Santosh; Dharanipragada, Janakiram

2010-01-01

218

MediaStation 5000: a multimedia workstation for telemedicine  

NASA Astrophysics Data System (ADS)

Building on the success of the MediaStation 5000 (MS5000) multimedia system which was developed in our laboratory in 1994, we have developed a prototype telemedicine workstation which is programmable and supports high-bandwidth telecommunications links to connect together many medical treatment facilities. The system can support various telemedicine and consultation functions to collaboratively transfer, manipulate, and view radiological images, image sequences, audio, and video. The requirements for a telemedicine workstation include high performance, flexibility, and upgradability. The unique components of our workstation include an advanced parallel processor, highly integrated multimedia support circuitry, high- speed network interface, and a graphical user interface. Each of these is a key ingredient to a successful telemedicine system.

Parsons, David M.; Cabral, James E., Jr.; Kim, Yongmin; Lipski, Gregory L.; Frank, Mark S.

1995-04-01

219

Problems in Office Management: Cases in Practice  

ERIC Educational Resources Information Center

Office managers face an increasing array of job responsibilities in today's business environment. To prepare new office administration employees and managers, educational institutions must maintain a progressive curriculum to meet position demands. Using a population of members of the Association of Professional Office Managers, this study was…

Hemby, K. Virginia; Smith, Vincent W.

2006-01-01

220

Clinical outcomes resulting from telemedicine interventions: a systematic review  

Microsoft Academic Search

BACKGROUND: The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office\\/hospital-based. METHODS: Data sources for the study included deports of studies

William R Hersh; Mark Helfand; James Wallace; Dale Kraemer; Patricia Patterson; Susan Shapiro; Merwyn Greenlick

2001-01-01

221

Cost-Effectiveness of Case Management in Substance Abuse Treatment  

ERIC Educational Resources Information Center

Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

2006-01-01

222

 psychological distress in australian case managers working with the unemployed  

Microsoft Academic Search

This study reports levels of psychological distress found in a sample of Australian case managers who work with the unemployed. Using a longitudinal survey method- ology, 86 case managers employed throughout Australia completed the 12-item General Health Questionnaire (GHQ-12; D. P. Goldberg, 1978) on 2 occasions during 1999. In comparison with other studies investigating psychological well- being of both employed

Richard Goddard; Wendy Patton; Peter Creed

223

Quantitative 3-D imaging topogrammetry for telemedicine applications  

NASA Technical Reports Server (NTRS)

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

Altschuler, Bruce R.

1994-01-01

224

Telemedicine Networks of EHAS Foundation in Latin America  

PubMed Central

Rural areas in developing countries are characterized by lack of resources, low population density, and scarcity of communications infrastructure. These circumstances make it difficult to provide appropriate health-care services. This paper explains research results achieved by Enlace Hispano Americano de Salud – Hispano American Health Link (EHAS) and how they have contributed to improve healthcare in isolated areas of developing countries through the use of information and communication technologies (ICT). As the first step, EHAS always collaborates with public health systems to identify its communication and information needs. Based on the analysis of needs, EHAS does research on appropriate technologies to provide communication in each context and on information systems suited to needs of health personnel. In parallel, EHAS has worked to provide applications that, making use of the communications services installed, could improve the health-care services in these remote areas. In this line, solutions to improve epidemiological surveillance or to provide telemedicine services (like a digital stethoscope or a tele-microscopy system) have been developed. EHAS has also performed several researches trying to ensure the sustainability of their solutions and has summarized them in a Management Framework for Sustainable e-Healthcare Provision. Finally, the effort to spread acquired knowledge has crystallized in a book that details all the technologies and procedures previously mentioned. PMID:25360436

Prieto-Egido, Ignacio; Simó-Reigadas, Javier; Liñán-Benítez, Leopoldo; García-Giganto, Víctor; Martínez-Fernández, Andrés

2014-01-01

225

Telemedicine Networks of EHAS Foundation in Latin America.  

PubMed

Rural areas in developing countries are characterized by lack of resources, low population density, and scarcity of communications infrastructure. These circumstances make it difficult to provide appropriate health-care services. This paper explains research results achieved by Enlace Hispano Americano de Salud - Hispano American Health Link (EHAS) and how they have contributed to improve healthcare in isolated areas of developing countries through the use of information and communication technologies (ICT). As the first step, EHAS always collaborates with public health systems to identify its communication and information needs. Based on the analysis of needs, EHAS does research on appropriate technologies to provide communication in each context and on information systems suited to needs of health personnel. In parallel, EHAS has worked to provide applications that, making use of the communications services installed, could improve the health-care services in these remote areas. In this line, solutions to improve epidemiological surveillance or to provide telemedicine services (like a digital stethoscope or a tele-microscopy system) have been developed. EHAS has also performed several researches trying to ensure the sustainability of their solutions and has summarized them in a Management Framework for Sustainable e-Healthcare Provision. Finally, the effort to spread acquired knowledge has crystallized in a book that details all the technologies and procedures previously mentioned. PMID:25360436

Prieto-Egido, Ignacio; Simó-Reigadas, Javier; Liñán-Benítez, Leopoldo; García-Giganto, Víctor; Martínez-Fernández, Andrés

2014-01-01

226

Using a Telemedicine System to Decrease Cardiovascular Disease Risk in an Underserved Population: Design, Use, and Interim Results  

Microsoft Academic Search

Cardiovascular disease is the leading cause of morbidity and mortality in the USA. Disease management programs, while successful, are intensive and expensive. Follow-up is often inadequate, incomplete, and inconsistent. To address these problems, we developed an Internet- Telemedicine system. Patients send\\/receive data to\\/from their care provider via the Internet. The system optimizes function and minimizes cost (all hardware is off

William P. Santamore; Carol J. Homko; Abul Kashem; Timothy R. McConnell; A. A. Bove

2007-01-01

227

IEEE 802.16\\/WiMAX-based broadband wireless access and its application for telemedicine\\/e-health services  

Microsoft Academic Search

In this article we investigate the application of IEEE 802.16-based broadband wireless access (BWA) technology to telemedicine services and the related protocol engineering issues. An overview of the different evolutions of the IEEE 802.16 standard is presented and some open research issues are identified. A survey on radio resource management, traffic scheduling, and admission control mechanisms proposed for IEEE 802.16\\/WiMAX

D. Niyato; E. Hossain; J. Diamond

2007-01-01

228

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

PubMed Central

Objective Practice Based Collaborative Care is a complex evidence-based practice that is difficult to implement in smaller primary care practices lacking on-site mental health staff. Telemedicine Based Collaborative Care virtually co-locates and integrates mental health providers into primary care settings. The objective of this multi-site randomized pragmatic comparative effectiveness trial was to compare the outcomes of patients randomized to Practice Based versus Telemedicine Based Collaborative Care. Method From 2007–2009, patients at Federally Qualified Health Centers serving medically underserved populations were screened for depression, and 364 patients screening positive were enrolled and followed for 18 months. Those randomized to Practice Based Collaborative Care received evidence-based care from an on-site primary care provider and nurse care manager. Those randomized to Telemedicine Based Collaborative Care received evidence-based care from an on-site primary care provider and off-site telephone nurse care manager, telephone pharmacist, tele-psychologist and tele-psychiatrist. The primary clinical outcomes were treatment response, remission and changes in depression severity Results There were significant group main effects for both response (OR=7.74, CI95=3.94–15.20, p<0.0001) and remission (OR=12.69, CI95=4.81–33.46, p<0.0001) and a significant overall group by time interaction effect for Hopkins Symptom Checklist depression severity (?23=40.51, p<0.0001) with greater reductions in depression severity observed over time for those randomized to Telemedicine Based Collaborative Care. Improvements in outcomes appeared to be attributable to higher fidelity to the collaborative care evidence-base in the Telemedicine Based group. Conclusions Contracting with an off-site Telemedicine Based Collaborative Care team yields better outcomes than implementing Practice Based Collaborative Care with locally available staff. PMID:23429924

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

2013-01-01

229

Public Management of Science Case Studies.  

ERIC Educational Resources Information Center

Presented are six papers pertaining to the management of science, research, and development by federal agencies. The papers were prepared by students in a management of science course offered at the American University, Washington, D.C. Federal agencies reviewed include: National Aeronautics and Space Administration (NASA); Department of…

American Univ., Washington, DC. Coll. of Public Affairs.

230

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

PubMed

Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine. PMID:24267440

Mars, Maurice

2013-01-01

231

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

...2014-01-01 2014-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section 1700.57...Approval Authorities § 1700.57 Distance Learning and Telemedicine Loan and Grant Program. (a) Administrator:...

2014-01-01

232

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

Code of Federal Regulations, 2013 CFR

...2013-01-01 2013-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section 1700.57...Approval Authorities § 1700.57 Distance Learning and Telemedicine Loan and Grant Program. (a) Administrator:...

2013-01-01

233

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

Code of Federal Regulations, 2011 CFR

...2011-01-01 2011-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section 1700.57...Approval Authorities § 1700.57 Distance Learning and Telemedicine Loan and Grant Program. (a) Administrator:...

2011-01-01

234

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

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section 1700.57...Approval Authorities § 1700.57 Distance Learning and Telemedicine Loan and Grant Program. (a) Administrator:...

2010-01-01

235

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

Code of Federal Regulations, 2012 CFR

...2012-01-01 2012-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section 1700.57...Approval Authorities § 1700.57 Distance Learning and Telemedicine Loan and Grant Program. (a) Administrator:...

2012-01-01

236

The RAFT Telemedicine Network: Lessons Learnt and Perspectives from a Decade of Educational and Clinical Services in Low- and Middle-Incomes Countries  

PubMed Central

Background: The objectives of this paper are to (i) provide an overview of the educational and clinical experiences of the Réseau en Afrique Francophone pour la Télémédecine (RAFT) network, (ii) analyze key challenges and lessons learnt throughout a decade of activity, and (iii) draw a vision and perspectives of its sustainability. Methods: The study was carried out following three main stages: (i) a literature review, (ii) the analysis of key documents, and (iii) discussions with key collaborators of the RAFT. Results: Réseau en Afrique Francophone pour la Télémédecine has been offering an important quantity of educational, clinical, and public health activities during the last decade. The educational activities include the weekly delivery of video-lectures for continuing and post-graduate medical education, the use of virtual patients for training in clinical decision making, research training activities using ICTs and other e-learning activities. The clinical and public health activities include tele-expertise to support health professionals in the management of difficult clinical cases, the implementation of clinical information systems in African hospitals, the deployment of mHealth projects, etc. Since 2010, the RAFT has been extended to the Altiplano in Bolivia and Nepal (in progress). Lessons Learnt and Perspectives: Important lessons have been learnt from the accumulated experiences throughout these years. These lessons concern: social and organization, human resources, technologies and data security, policy and legislation, and economy and financing. Also, given the increase of the activities and the integration of eHealth and telemedicine in the health system of most of the countries, the RAFT network faces many other challenges and perspectives such as learning throughout life, recognition, and valorization of teaching or learning activities, the impact evaluation of interventions, and the scaling up and transferability out of Africa of RAFT activities. Based on the RAFT experience, effective integration and optimum use of eHealth and telemedicine in low- and middle-income countries (LMICs) health systems should take into account the context (resources, infrastructure, and funding), the needs of key stakeholders, and the results derived from theoretical and practical experience. The relevant items highlighted to illustrate the sustainability of the RAFT network and the analyses performed in this study, should serve as discussion basis for the development of eHealth and telemedicine in LMICs. PMID:25340048

Bediang, Georges; Perrin, Caroline; Ruiz de Castañeda, Rafael; Kamga, Yannick; Sawadogo, Alexandre; Bagayoko, Cheick Oumar; Geissbuhler, Antoine

2014-01-01

237

Telemedicine in the State of Maine: A Model for Growth Driven by Rural Needs  

Microsoft Academic Search

As of mid-2002, Maine had one of the largest state-wide telemedicine systems, comprising over 150 facilities among 90 health, mental health, and social service provider organizations in two collaborative networks. The rapid growth of telemedicine in this rural, economically disadvantaged state is largely attributable to collaborative development and the service ac- tivities of the Maine Telemedicine Services division of a

Michael A. Edwards; Arvind C. Patel

2003-01-01

238

MODELLING AND FORMAL SPECIFICATION OF A MULTIAGENT TELEMEDICINE SYSTEM FOR DIABETES  

E-print Network

MODELLING AND FORMAL SPECIFICATION OF A MULTIAGENT TELEMEDICINE SYSTEM FOR DIABETES CARE Iñaki@gbt.tfo.upm.es Keywords: Software agents, MAS Formal Specification, Modelling, Diabetes Care, Telemonitoring, Telemedicine Abstract: This paper presents the modelling and formal specification of a telemedicine system for diabetes

Zhu, Hong

239

Factors Affecting the Adoption of Telemedicine: A Three-Country Empirical Investigation  

ERIC Educational Resources Information Center

Telemedicine improves access to information and healthcare services. Not only more cost effective and more efficient method of providing health care than the traditional methods, telemedicine is the most convenient method of delivering healthcare. However, the adoption of telemedicine has been challenging. The purpose of this dissertation is to…

Mansouri-Rad, Parand

2012-01-01

240

TELEMEDICINE IN PRACTICE From operating theatre to operating studio visualising surgery in the age of  

E-print Network

1 TELEMEDICINE IN PRACTICE From operating theatre to operating studio ­ visualising surgery in the age of telemedicine Margunn Aanestad1 , Jan Sigurd Røtnes1 , Bjørn Edwin1 and Trond Buanes2 1 a telemedicine project between two of Norway's largest hospitals (Rikshospitalet and Ullevaal hospital

Sahay, Sundeep

241

Quality of Service consideration for the wireless telemedicine and e-health services  

E-print Network

Quality of Service consideration for the wireless telemedicine and e-health services PhD Anna the application of IEEE 802.11 wireless standard to QoS (Quality of Service) support within wireless e-health/telemedicine-health technologies and wireless telemedicine systems are presented and some open research problems are identified

Mihaylova, Lyudmila

242

Leveraging Mobile Cloud for Telemedicine: A Performance Study in Medical Monitoring  

E-print Network

Leveraging Mobile Cloud for Telemedicine: A Performance Study in Medical Monitoring Xiaoliang Wang1, NY, United States E-mail: {xwang90, qgui1, bliu11, ychen, zjin}@binghamton.edu Abstract--Telemedicine cloud telemedicine framework and discuss its potential performance by taking advantage of the real

Chen, Yu

243

Secured and progressive transmission of compressed images on the Internet: application to telemedicine  

E-print Network

to telemedicine Marie Babela, Beno^it Parreinb, Olivier D´eforgesa, Nicolas Normandb, Jean-Pierre Gu ABSTRACT Within the framework of telemedicine, the amount of images leads first to use efficient lossless in the domain of telemedicine: several bitstreams representing the complete coded image, and each of them

Paris-Sud XI, Université de

244

Mobile Telemedicine Sensor Networks with Low-Energy Data Query and  

E-print Network

Mobile Telemedicine Sensor Networks with Low-Energy Data Query and Network Lifetime Considerations admission control scheme in terms of meeting the multimedia telemedicine QoS requirements. Index Terms-- Mobile telemedicine, ad hoc networks, sensor networks, 3G wireless cellular networks. æ 1 INTRODUCTION

Wu, Hongyi

245

Survey of Current Efforts and Potentials in Application of Telemedicine in Ethiopia  

E-print Network

Survey of Current Efforts and Potentials in Application of Telemedicine in Ethiopia Fikreyohannes. Telemedicine ­ delivery of health services through the use of ICT ­ that has met wide success in alleviating. To study the past and current effort on the application of telemedicine in Ethiopia, a survey of government

Kassegne, Samuel Kinde

246

A Cost-Effective Portable Telemedicine Kit for Use in Developing Countries Ari T. Adler  

E-print Network

A Cost-Effective Portable Telemedicine Kit for Use in Developing Countries by Ari T. Adler B Telemedicine Kit for Use in Developing Countries by Ari T. Adler Submitted to the Department of Mechanical in Mechanical Engineering Abstract Telemedicine is currently being used to bridge the physical distance between

247

Design of Architecture for a Terrestrial LAN & VSAT-based National Telemedicine Network in Ethiopia  

E-print Network

1 Design of Architecture for a Terrestrial LAN & VSAT- based National Telemedicine Network-doctor ratios anywhere in the world (almost 30,000 to 1), telemedicine offers a cost-effective health and implementation stage. Looking forward, however, we argue that telemedicine should play a more prominent role

Kassegne, Samuel Kinde

248

Models to Extend the Scope of Usability Testing for Telemedicine Systems  

E-print Network

Models to Extend the Scope of Usability Testing for Telemedicine Systems [Extended Abstract.Stevens@ed.ac.uk ABSTRACT Some of the changes brought about by the introduction of telemedicine into healthcare organisations can be partly ad- dressed by a better consideration of usability in telemedicine system design

Stevens, Perdita

249

Telemedicine using VoIP combined with a Store and Forward Approach  

E-print Network

Telemedicine using VoIP combined with a Store and Forward Approach M Chetty, W Tucker, Prof E Blake developed a telemedicine application for a rural village in the Eastern Cape. This paper describes how weIP) combined with a store and forward approach to achieve our telemedicine goals. We present an overview

Blake, Edwin

250

REPETE2: A Next Generation Home Telemedicine Architecture Albert M. Lai, PhD,1  

E-print Network

REPETE2: A Next Generation Home Telemedicine Architecture Albert M. Lai, PhD,1 Jason Nieh, PhD,2 of home broadband in- creases, there is an increasing need for a broadband- based home telemedicine. Background: Due to low availability of broadband in the home, home telemedicine projects have typically

Yang, Junfeng

251

Telemedicine and Dialysis Pierre-Yves Durand*, Jacques Chanliau*, Agnes Mariot*, Michle Kessler*, Jean-Pierre  

E-print Network

Telemedicine and Dialysis Pierre-Yves Durand*, Jacques Chanliau*, Agnes Mariot*, Michèle Kessler in the literature presents only marginal experiences concerning telemedicine in regards to peritoneal dialysis (PD. This article presents a new and innovative application of telemedicine in the field of PD and describes its

Paris-Sud XI, Université de

252

QoS Considerations in Wireless Sensor Networks for Telemedicine Sunil Kumar b **  

E-print Network

QoS Considerations in Wireless Sensor Networks for Telemedicine Fei Hu a * Sunil Kumar b Engineering, Clarkson University, Potsdam, NY 13699-5720 ABSTRACT The integration of telemedicine with medical micro sensor technology (Mobile Sensor Networks for Telemedicine applications -- MSNT) provides

Kumar, Sunil

253

Communications infrastructure requirements for telemedicine/telehealth in the context of planning for and responding to natural disasters: Considering the need for shared regional networks  

NASA Technical Reports Server (NTRS)

During the course of recent years the frequency and magnitude of major disasters - of natural, technological, or ecological origin - have made the world community dramatically aware of the immense losses of human life and economic resources that are caused regularly by such calamities. Particularly hard hit are developing countries, for whom the magnitude of disasters frequently outstrips the ability of the society to cope with them. In many cases this situation can be prevented, and the recent trend in disaster management has been to emphasize the importance of preparedness and mitigation as a means of prevention. In cases of disaster, a system is needed to respond to relief requirements, particularly the delivery of medical care. There is no generic telecommunications infrastructure appropriate for the variety of applications in medical care and disaster management. The need to integrate telemedicine/telehealth into shared regional disaster management telecommunications networks is discussed. Focus is on the development of infrastructure designed to serve the needs of disaster prone regions of the developing world.

Scott, John Carver

1991-01-01

254

Evolution of telemedicine in the space program and earth applications.  

PubMed

Remote monitoring of crew, spacecraft, and environmental health has always been an integral part of the National Aeronautics and Space Administration's (NASA's) operations. Crew safety and mission success face a number of challenges in outerspace, including physiological adaptations to microgravity, radiation exposure, extreme temperatures and vacuum, and psychosocial reactions to space flight. The NASA effort to monitor and maintain crew health, system performance, and environmental integrity in space flight is a sophisticated and coordinated program of telemedicine combining cutting-edge engineering with medical expertise. As missions have increased in complexity, NASA telemedicine capabilities have grown apace, underlying its role in the field. At the same time, the terrestrial validation of telemedicine technologies to bring healthcare to remote locations provides feedback, improvement, and enhancement of the space program. As NASA progresses in its space exploration program, astronauts will join missions lasting months, even years, that take them millions of miles from home. These long-duration missions necessitate further technological breakthroughs in tele-operations and autonomous technology. Earth-based monitoring will no longer be real-time, requiring telemedicine capabilities to advance with future explorers as they travel deeper into space. The International Space Station will serve as a testbed for the telemedicine technologies to enable future missions as well as improve the quality of healthcare delivery on Earth. PMID:11321704

Nicogossian, A E; Pober, D F; Roy, S A

2001-01-01

255

Evolution of telemedicine in the space program and earth applications  

NASA Technical Reports Server (NTRS)

Remote monitoring of crew, spacecraft, and environmental health has always been an integral part of the National Aeronautics and Space Administration's (NASA's) operations. Crew safety and mission success face a number of challenges in outerspace, including physiological adaptations to microgravity, radiation exposure, extreme temperatures and vacuum, and psychosocial reactions to space flight. The NASA effort to monitor and maintain crew health, system performance, and environmental integrity in space flight is a sophisticated and coordinated program of telemedicine combining cutting-edge engineering with medical expertise. As missions have increased in complexity, NASA telemedicine capabilities have grown apace, underlying its role in the field. At the same time, the terrestrial validation of telemedicine technologies to bring healthcare to remote locations provides feedback, improvement, and enhancement of the space program. As NASA progresses in its space exploration program, astronauts will join missions lasting months, even years, that take them millions of miles from home. These long-duration missions necessitate further technological breakthroughs in tele-operations and autonomous technology. Earth-based monitoring will no longer be real-time, requiring telemedicine capabilities to advance with future explorers as they travel deeper into space. The International Space Station will serve as a testbed for the telemedicine technologies to enable future missions as well as improve the quality of healthcare delivery on Earth.

Nicogossian, A. E.; Pober, D. F.; Roy, S. A.

2001-01-01

256

Groundwater Management Tools: Analytical Procedure and Case Studies  

E-print Network

Groundwater Management Tools: Analytical Procedure and Case Studies MAF Technical Paper No: 2003 and Forestry #12;i Contents Page Executive Summary v Introduction 1 Section A ­ Groundwater Management: Best 2 2.2. Groundwater Budgets 2 2.3. Dynamic Storage 2 3. Scale of Abstraction Effects 3 4. Limitations

Hickman, Mark

257

Teacher classroom management communication: A qualitative case study  

Microsoft Academic Search

This study considers the effectiveness of using Albert Scheflen's context analysis as a descriptive framework for the analysis of teacher classroom management communication. The case study focusses upon the orientations, movements, or “positions”; that teachers use in managing classroom interaction in an alternative high school class. Four positional sequences are described. The Scheflen methodology is shown to provide data for

William Foster Owen

1984-01-01

258

30 CFR 250.518 - What are the requirements for casing pressure management?  

Code of Federal Regulations, 2011 CFR

...What are the requirements for casing pressure management? 250.518 Section...Well-Completion Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install...

2011-07-01

259

30 CFR 250.519 - What are the requirements for casing pressure management?  

...What are the requirements for casing pressure management? 250.519 Section...Well-Completion Operations Casing Pressure Management § 250.519 What are the requirements for casing pressure management? Once you install...

2014-07-01

260

30 CFR 250.519 - What are the requirements for casing pressure management?  

Code of Federal Regulations, 2013 CFR

...What are the requirements for casing pressure management? 250.519 Section...Well-Completion Operations Casing Pressure Management § 250.519 What are the requirements for casing pressure management? Once you install...

2013-07-01

261

30 CFR 250.518 - What are the requirements for casing pressure management?  

Code of Federal Regulations, 2012 CFR

...What are the requirements for casing pressure management? 250.518 Section...Well-Completion Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install...

2012-07-01

262

30 CFR 250.518 - What are the requirements for casing pressure management?  

Code of Federal Regulations, 2010 CFR

...What are the requirements for casing pressure management? 250.518 Section...Well-Completion Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install...

2010-07-01

263

Blake's Illness A Case of "Wildlife Management"  

NSDL National Science Digital Library

Blake is sick. With his background in the sciences and a little help from the Internet, he should be able to do a self-diagnosis. Or can he? As this case study unfolds, we follow the course of Blake’s illness and the eventual diagnosis of his disorder. The case works well as an interrupted case that can be assigned to individual students or student teams. It was written for a School of Pharmacy microbiology course, but could easily be used in a medical microbiology or infectious diseases course.

Cathy R. Santanello

2009-01-01

264

Telemedicine in the Indian context: an overview.  

PubMed

One sixth of humanity accounting for 1100 million people live in India. India is generally considered to be a developing country and certainly there is considerable scope for improving the per capita income and the average standard of life. India however is a paradox. We now produce and launch our own satellites. Information is being gathered regarding the feasibility of launching a HEALTHSAT - a satellite exclusively for purposes of health care. There has been an unprecedented growth and development in Information Technology. Satellite transmission, fiber optic cables, increasing band width, fall in computer prices, licensing of private internet service providers, internet thro' cable etc have become the buzz words even in suburban and rural India. Theoretically, it is easier to set up an excellent telecommunication infrastructure in suburban and rural India, to increase the reach of the limited number of urban specialists, than to place hundreds of specialists in places devoid of specialists. Telemedicine therefore is the answer. It is universally acknowledged that Indians have made enormous contributions in the field of information technology. We no longer have to follow or piggy back. We now leap frog!! PMID:15747977

Ganapathy, K

2004-01-01

265

Adapters, strugglers, and case managers: a typology of spouse caregivers.  

PubMed

Although family home care problems are frequently described in the health care literature, the ways in which families and other informal caregivers manage those problems are not often addressed. We conducted a descriptive analysis of interviews in which spouses caring for a partner with Alzheimer's or Parkinson's disease were asked to describe difficult home care problems and how they managed those problems. Analysis of these interviews indicated three recurring management styles. Adapters told stories about applying pre-existing skills to manage home care problems. Strugglers told stories of reoccurring home care problems for which they had few or no management strategies. Case managers' interview stories focused on the challenges of finding and coordinating home care services. These findings suggest that caregiving burden might be influenced more by the caregiver's management style than the demands of the care situation. Suggestions for tailoring support programs for the three types of caregivers are proposed. PMID:25189535

Davis, Linda Lindsey; Chestnutt, Deborah; Molloy, Margory; Deshefy-Longhi, Tess; Shim, Bomin; Gilliss, Catherine L

2014-11-01

266

Case Management after Long-term Absence from Work in China: A Case Report  

Microsoft Academic Search

Introduction Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play\\u000a a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice.\\u000a Objectives This case report describes Mr. H’s RTW process for illustrating the work of a case management team in China. Suggestions

Dan TangIgnatius; Ignatius Tak Sun Yu; Xiaoyuan Luo; Youxin Liang; Yonghua He

2011-01-01

267

ACUTE MANAGEMENT CONCEPTS OF THE ACROMIOCLAVICULAR JOINT: A CASE REPORT  

PubMed Central

Acromioclavicular injuries are quite common and approaches to early management of those that are described as a Type III are controversial. The Rockwood Type III classification implies complete disruption of the acromioclavicular and coracoclavicular ligaments, resulting in inferior positioning of the scapula and, thus, the glenohumeral complex while the clavicle appears more superiorly prominent. Clinical management can include surgical or conservative techniques. This case report outlines the decision making process related to this type of injury, as applied in the diagnosis and management of 61 year?old recreational athlete. Level of Evidence 5 (Single Case report) PMID:23091789

2012-01-01

268

Ranking Taiwanese management journals: A case study  

Microsoft Academic Search

To improve the quality of journals in Taiwan, the National Science Council (NSC) of the Republic of China evaluates journals\\u000a in the fields of humanities and social sciences periodically. This paper describes the evaluation of 46 management journals\\u000a conducted by the authors, as authorized by the NSC. Both a subjective approach, with judgments solicited from 345 experts,\\u000a and an objective

Chiang Kao; Hsiou-Wei Lin; San-Lin Chung; Wei-Chi Tsai; Jyh-Shen Chiou; Yen-Liang Chen; Liang-Hsuan Chen; Shih-Chieh Fang; Hwei-Lan Pao

2008-01-01

269

75 FR 23582 - Annular Casing Pressure Management for Offshore Wells  

Federal Register 2010, 2011, 2012, 2013

...develop the industry standard. Offshore Operators Committee (OOC...Casing Pressure Management for Offshore Wells (74 FR 38147, July...annular casing pressure in offshore wells. (4) This final rule...Gas Extraction, and 213111, Drilling Oil and Gas Wells. For...

2010-05-04

270

Hydroxychloroquine overdose: case report and recommendations for management.  

PubMed

Hydroxychloroquine poisoning has rarely been reported in the literature, with only 18 cases being found on searching the literature. In this paper, we report a case that occurred in Hong Kong, and we make recommendations for emergency management of hydroxychloroquine overdose based on our and other's experience. PMID:18180661

Ling Ngan Wong, Anna; Tsz Fung Cheung, Ian; Graham, Colin A

2008-02-01

271

Laparoscopic management in a rare case of bilateral perirenal lymphangiomatosis.  

PubMed

Lymphangiomas are lymphatic malformations commonly seen around the neck, axillary region and the mediastinum. Perirenal lymphangiomatosis is very rare with only a few cases being reported in literature. We present a case of symptomatic perirenal lymphangiomatosis in a female of childbearing age, managed laparoscopically by deroofing and marsupialization. PMID:23671373

Meyyappan, R M; Ravikumar, S; Gopinath, M

2013-01-01

272

Laparoscopic management in a rare case of bilateral perirenal lymphangiomatosis  

PubMed Central

Lymphangiomas are lymphatic malformations commonly seen around the neck, axillary region and the mediastinum. Perirenal lymphangiomatosis is very rare with only a few cases being reported in literature. We present a case of symptomatic perirenal lymphangiomatosis in a female of childbearing age, managed laparoscopically by deroofing and marsupialization. PMID:23671373

Meyyappan, R. M.; Ravikumar, S.; Gopinath, M.

2013-01-01

273

Telemedicine in Space Flight - Summary of a NASA Workshop  

NASA Technical Reports Server (NTRS)

The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

Barsten, K. N.; Watkins, S. D.; Otto, C.; Baumann, D. K.

2011-01-01

274

A strategy for the development of secure telemedicine applications.  

PubMed Central

Healthcare applications based on computer-supported collaboration technologies have the potential to improve the quality of care delivered to patients. Such applications can help overcome barriers to quality healthcare in the small, scattered populations of rural areas enabling telemedicine to be a part of the practice of medicine. However the growing concern about the potential for abuse through disclosure of personal health information to unauthorized parties has restricted the deployment and adoption of these potentially valuable tools. The authors, who built ARTEMIS--an Intranet healthcare collaboration facility, now describe their approach to develop secure telemedicine applications for rural healthcare practitioners. PMID:9357645

Raman, R. S.; Reddy, R.; Jagannathan, V.; Reddy, S.; Cleetus, K. J.; Srinivas, K.

1997-01-01

275

Telemedicine: interventional decentralised blood pressure telemonitoring (idTBPM).  

PubMed

Telemedicine comprises different methods of bridging a spatial distance between doctor, medical and care services and patients. These include mere data transmissions as well as alarm functionalities, consultations and therapy recommendations. A special form of telemedicine application is the interventional decentralised telemonitoring (idTM). Here the patient-practitioner relationship forms the basis for therapy control and optimisation using telemetrical medical data. To identify areas of indication of idTM, a detailed definition of transferred parameters, alarm conditions and intervention algorithms is required as a well as cost efficiency and feasibility studies. The quality of the telemedical application is determined by the medical quality of the derived actions. PMID:25587892

Schulz, Egbert G; Stahmann, Alexander; Neumann, Claas Lennart

2015-01-01

276

Stroke care using a hub and spoke model with telemedicine.  

PubMed

Stroke is the fourth leading cause of death in the United States. On average, someone has a stroke every 40 seconds. The gaps for patients diagnosed with a stroke are the availability of physicians who specialize in stroke care and access to evidence-based stroke care. Telemedicine has assisted in bridging this gap to provide effective stroke treatment. The purpose of this article is to describe how the implementation of a hub and spoke model using telemedicine has assisted in increasing patient access to neurology expertise and receiving evidence-based treatment of recombinant tissue plasminogen activator, thereby improving patient outcomes. PMID:25438889

Huddleston, Penny; Zimmermann, Mary Beth

2014-12-01

277

A CASE STUDY OF ENVIRONMENTAL DATA MANAGEMENT  

EPA Science Inventory

In order to support our ongoing research in watershed ecology and global climate change, we gather and analyze environmental data from several government agencies. This case study demonstrates a researcher’s approach to accessing, organizing, and using intersectoral data. T...

278

Management case study: Tampa Bay, Florida  

USGS Publications Warehouse

Tampa Bay, Florida,USA, is a shallow,subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of sea grasses and other selected habitat types, to support estuarine-dependent faunal guilds.

Morrison, G.; Greening, H.S.; Yates, K.K.

2012-01-01

279

Effect of telemedicine follow-up care of leg and foot ulcers: a systematic review.  

PubMed

BackgroundLeg ulcers and diabetes-related foot ulcers are frequent and costly complications of their underlying diseases and thus represent a critical issue for public health. Since the population is aging, the prevalence of these conditions will probably increase considerably and require more resources. Treatment of leg and foot ulcers often demands frequent contact with the health care system, may pose great burden on the patient, and involves follow-up in both primary and specialist care. Telemedicine provides potential for more effective care management of leg and foot ulcers. The objective of this systematic review of the literature was to assess the effect of telemedicine follow-up care on clinical, behavioral or organizational outcomes among patients with leg and foot ulcers.MethodsWe searched Ovid MEDLINE (1980¿), Ovid EMBASE (1980¿), Clinical Trials in the Cochrane Library (via Wiley), Ebsco CINAHL with Fulltext (1981¿) and SveMed¿+¿(1977¿) up to May 2014 for relevant articles. We considered randomized controlled trials, non-randomized trials, controlled before-after studies and prospective cohort studies for inclusion and selected studies according to predefined criteria. Three reviewers independently assessed the included studies using the Cochrane Collaboration risk-of-bias tool. We performed a narrative synthesis of results and assessed the strength of evidence for each outcome using GRADE (grading of recommendations, assessment, development and evaluation).ResultsOnly one non-randomized study was included. The study (n =140) measured the effect of real-time interactive video consultation compared with face-to-face follow-up on healing time, adjusted healing ratio and the number of ulcers at 12 weeks among patients with neuropathic forefoot ulcerations. There were no statistically significant differences in results of the different outcomes between patients receiving telemedicine and traditional follow-up. We assessed the study to have a high risk of bias.ConclusionsThere is insufficient evidence available to unambiguously determine whether telemedicine consultation of leg and foot ulcers is as effective as traditional follow-up. PMID:25373875

Nordheim, Lena; Haavind, Marianne; Iversen, Marjolein M

2014-11-01

280

The Costs of Critical Care Telemedicine Programs  

PubMed Central

Background: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. Methods: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Results: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. Conclusions: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology. PMID:22797291

Falk, Derik M.; Bonello, Robert S.; Kahn, Jeremy M.; Perencevich, Eli; Cram, Peter

2013-01-01

281

[Prenatal telemedicine and teledidactic networking. A report on the TOCOMAT project].  

PubMed

Telemedicine originates with the combined use of electromedical equipment, information technologies and telecommunication systems designed to improve healthcare by overcoming the limitations of time and space. Moreover, telemedicine also possesses greater didactic potential than instruction by traditional means. Teledidactic networking, both as e-learning and e-teaching, represents a new integrated system of computer-aided education for the development and management of distance learning programs. Our study evaluated the effectiveness of teledidactic applications in the first Italian project in conventional and computerized telecardiotocography (TOCOMAT). Five cardiotocography outpatient monitoring facilities were linked telematically to a university central operating unit to obtain computerized analysis of telecardiotocographic (CTG) tracings and specialist consulting. The peripheral site operators received theoretical-practical training in the function and use of the system, the guidelines for CTG tracing interpretation and the diagnostic-therapeutic protocols. Improvement in learning progress was observed in the reduction of technical errors in CTG recording and in the increased ability of the outpatient clinic staff to select, analyze and interpret test RESULTS. Results from the feedback questionnaires on the didactic impact of the project indicated objective improvement in the specific skills acquired by the physicians at these facilities. The findings also show that a well-structured distance learning course can improve clinical, technical and managerial skills and behavior of healthcare operators by promoting the kind of professional continuing education a modern medical school should provide. PMID:12364892

Di Lieto, A; Scaramellino, M; Campanile, M; Iannotti, F; De Falco, M; Pontillo, M; Pollio, F

2002-10-01

282

Management of Multiple Impacted Teeth: A Case Report and Review  

PubMed Central

Interdisciplinary care for the management of impacted teeth provides a holistic method of treating patients. Careful planning is necessary to reach the desired treatment goals. This article attempts to highlight the importance of diagnosis and adequate treatment planning for successful eruption of impacted teeth. The concept of forced eruption to improve the bone morphology of the impacted teeth has been used to treat a case of multiple impacted teeth. This paper reviews the diagnosis and management of impacted teeth. A case report of multiple impacted maxillary anterior teeth of a 13-year-old female patient has been presented. How to cite the article: Ajith SD, Shetty S, Hussain H, Nagaraj T, Srinath M. Management of multiple impacted teeth: A case report and review. J Int Oral Health 2014;6(3):93-8. PMID:25083041

Ajith, Sreedevi D; Shetty, Smitha; Hussain, Huma; Nagaraj, Tejavathy; Srinath, M

2014-01-01

283

Management of multiple impacted teeth: a case report and review.  

PubMed

Interdisciplinary care for the management of impacted teeth provides a holistic method of treating patients. Careful planning is necessary to reach the desired treatment goals. This article attempts to highlight the importance of diagnosis and adequate treatment planning for successful eruption of impacted teeth. The concept of forced eruption to improve the bone morphology of the impacted teeth has been used to treat a case of multiple impacted teeth. This paper reviews the diagnosis and management of impacted teeth. A case report of multiple impacted maxillary anterior teeth of a 13-year-old female patient has been presented. How to cite the article: Ajith SD, Shetty S, Hussain H, Nagaraj T, Srinath M. Management of multiple impacted teeth: A case report and review. J Int Oral Health 2014;6(3):93-8. PMID:25083041

Ajith, Sreedevi D; Shetty, Smitha; Hussain, Huma; Nagaraj, Tejavathy; Srinath, M

2014-06-01

284

A brief survey of Department of Defense Telemedicine.  

PubMed

This paper describes current telemedical projects sponsored by the Department of Defense (DoD) and provides points of contact for further communication. The scope and scale of these projects demonstrate the DoD commitment to the development and deployment of telemedicine and advanced medical information technologies in health care delivery. PMID:10165547

Zimnik, P R

1996-01-01

285

Hindawi Publishing Corporation International Journal of Telemedicine and Applications  

E-print Network

cardiac patients. This represents the evolution of e-health systems from traditional desktop telemedicine Cardiac Patient Monitoring: A Survey Sunil Kumar,1 Kashyap Kambhatla,1, 2 Fei Hu,3 Mark Lifson,4 and Yang hardware/software platforms for wireless cardiac monitoring. The design methodology and challenges

Kumar, Sunil

286

Arizona TeleMedicine Network: System Procurement Specifications.  

ERIC Educational Resources Information Center

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

Atlantic Research Corp., Alexandria, VA.

287

Arizona TeleMedicine Network: Engineering Master Plan.  

ERIC Educational Resources Information Center

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

Atlantic Research Corp., Alexandria, VA.

288

STARPAHC space-oriented medical evaluation. [telemedicine system  

NASA Technical Reports Server (NTRS)

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

1979-01-01

289

Mobile e-Health: The Unwired Evolution of Telemedicine  

Microsoft Academic Search

The movement of telemedicine from desktop platforms to wireless and mobile configurations may have a significant impact on future health care. This paper reviews some of the latest technologies in wireless communication and their application in health care. The new tech- nologies can make the remote medical monitoring, consulting, and health care more flexible and convenient. But, there are challenges

Sapal Tachakra; X. H. Wang; Robert S. H. Istepanian; Y. H. Song

2003-01-01

290

Telemedicine: The Assessment of an Evolving Health Care Technology.  

ERIC Educational Resources Information Center

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

Reich, Joel J.

291

Case management training needs to support vocational rehabilitation for case managers and general practitioners: a survey study  

PubMed Central

Background The use of the biopsychosocial model of health and case management for effective vocational rehabilitation (VR) has been confirmed for many health conditions. While Case and Condition Managers (CCMPs) use this approach in their everyday work, little is known about their views on training needs. A review of the training curriculum for General Practitioners’ (GPs) revealed little training in VR and the biopsychosocial model of care. This study aims to identify Case and Condition Managers and GPs perceptions of their training needs in relation to employability and VR. Methods 80 Case and Condition Managers and 304 GPs working in NHS Lanarkshire, providing a comparison group, were invited to participate in this study. A self-completion questionnaire was developed and circulated for online completion with a second round of hardcopy questionnaires distributed. Results In total 45 responses were obtained from CCMPs, 5 from occupational health nurses (62% response rate) and 60 from GPs (20% response rate). CCMPs and the nursing group expressed a need for training but to a lesser extent than GP’s. The GP responses demonstrated a need for high levels of training in case/condition management, the biopsychosocial model, legal and ethical issues associated with employment and VR, and management training. Conclusions This survey confirms a need for further training of CCMPs and that respondent GPs in one health board are not fully equipped to deal with patients employability and vocational needs. GPs also reported a lack of understanding about the role of Case and Condition managers. Training for these professional groups and others involved in multidisciplinary VR could improve competencies and mutual understanding among those advising patients on return-to-work. PMID:24884477

2014-01-01

292

A remote real-time PACS-based platform for medical imaging telemedicine  

NASA Astrophysics Data System (ADS)

This paper describes a remote real-time PACS-based telemedicine platform for clinical and diagnostic services delivered at different care settings where the physicians, specialists and scientists may attend. In fact, the platform aims to provide a PACS-based telemedicine framework for different medical image services such as segmentation, registration and specifically high-quality 3D visualization. The proposed approach offers services which are not only widely accessible and real-time, but are also secure and cost-effective. In addition, the proposed platform has the ability to bring in a realtime, ubiquitous, collaborative, interactive meeting environment supporting 3D visualization for consultations, which has not been well addressed with the current PACS-based applications. Using this ability, physicians and specialists can consult with each other at separate places and it is especially helpful for settings, where there is no specialist or the number of specialists is not enough to handle all the available cases. Furthermore, the proposed platform can be used as a rich resource for clinical research studies as well as for academic purposes.

Maani, Rouzbeh; Camorlinga, Sergio; Eskicioglu, Rasit

2009-02-01

293

Case management of childhood tuberculosis in children's hospitals in Khartoum.  

PubMed

No published information is available on the case management of childhood tuberculosis (TB) in Sudan. The aim of this study was to describe the case management of childhood TB in 4 children's hospitals in Khartoum State, Sudan. Data on 467 children aged 0-14 years registered in 2009 were collected from patient records; 52.9% males and 53.0% aged 5-14 years. Most cases were registered as new cases (89.5%) and most had pulmonary TB (72.4%). Of all cases, 31.0% had sputum smear microscopy done, 35.8% had X-ray and none had a record of being culture confirmed. Category III regimen was given to 58.5%. Reported outcomes were: cured (1.5%), completed treatment (14.6%), transferred out (13.1%), default (17.3%), death (4.3%) and treatment failure (0.6%). Age was significantly associated with treatment outcome, while sex, type of patient, site of TB and treatment category were not significant. Case management of childhood TB is suboptimal in this region. PMID:25023771

Osman, T; El Sony, A

2014-07-01

294

Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey  

ERIC Educational Resources Information Center

Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

2012-01-01

295

Impact of School Nurse Case Management on Students with Asthma  

ERIC Educational Resources Information Center

This project determined asthma prevalence in a large school district, absentee rates, and potential effects of school nurse case management for student asthma over three years. Data were derived from an asthma tracking tool used by nurses in one school district for every student reported as having asthma by their parent. School nurses began…

Taras, Howard; Wright, Sandra; Brennan, Jesse; Campana, Jack; Lofgren, RoseMarie

2004-01-01

296

Advanced Cogeneration Control, Optimization, and Management: A Case Study  

E-print Network

ADVANCED COGENERATION CONTROL, OPTIMIZATION, AND MANAGEMENT: A CASE STUDY Fletcher Hinson Senior Applications Engineer Bailey Controls Company Wickliffe, Ohio ABSTRACT The performance of cogeneration power plants can now be assessed... on line in real time using a distributed microprocessor based data acquisition and control system. A representative implementation is described for cogeneration power in a food processing plant. The COPA (COgeneration Performance Assessment) package...

Hinson, F.; Curtin, D.

297

The Management of Training in Multinational Corporations: Comparative Case Studies.  

ERIC Educational Resources Information Center

Case studies of British and Australian multinational corporations in the food and drink industry investigated how training and development are managed. Competency-based education and industry boards are important elements in both countries. Lack of a training culture in the industry and little innovation in training were observed. (SK)

Noble, Charles

1997-01-01

298

Management Science in Higher Education Institutions: Case Studies from Greece  

ERIC Educational Resources Information Center

Regardless of the source of funding, university quality is based on knowledge, teaching, and research, and hence cannot be run like private enterprises as they are expert organisations that provide solely a public service. The purpose of this paper is to investigate, through the analysis of case studies, whether or not management theory,…

Saiti, Anna

2010-01-01

299

Medical Training Skills Curriculum for Case Management Assistants.  

ERIC Educational Resources Information Center

This manual helps service care providers working with HIV-infected people learn how HIV affects the body's major systems, emphasizing the structure and functions of each system and direct and indirect effects of HIV on each system. The curriculum was developed for case management assistants (CMAs) who work in homes of HIV-infected people. Lessons…

Family Planning Council of Southeastern Pennsylvania, Philadelphia.

300

Customer relationship management: the case of a European bank  

Microsoft Academic Search

Purpose – To convert the principle of customer relationship management (CRM) into practical guidelines for best practice in the implementation of a CRM programme in the real world. Design\\/methodology\\/approach – The findings of an extensive review of the literature provide the foundations for a general CRM paradigm, which is applied to a case study of a large European bank's specification,

Adam Lindgreen; Michael Antioco

2005-01-01

301

Case Study Report: Agile Product Management at Planon  

E-print Network

Case Study Report: Agile Product Management at Planon K. Vlaanderen S. Brinkkemper T. Cheng S Abstract With the advent of agile development methods such as SCRUM, the unpredictable and dynamic process that these devel- opments have resulted in an increased interest in the expansion of agile principles to other

Utrecht, Universiteit

302

Coplink: a case of intelligent analysis and knowledge management  

Microsoft Academic Search

Law enforcement agencies across the United States have begun to focus on innovative knowledge management technologies to aid in the analysis of criminal information. The use of such technologies can serve as intelligence tools to combat criminal activity by aiding in case investigation or even by predicting criminal activity. Funded by the National Institute of Justice, the University of Arizona's

Roslin V. Hauck; Hsinchun Chen

1999-01-01

303

Managing educational change: a case of two leadership approaches  

Microsoft Academic Search

This article reports a case study that investigated the ways in which heads of subject departments managed the development and application of new assessment strategies in one secondary school in Hong Kong. The data of the study were gathered through participant observation and interviews with 12 teachers who participated in an assessment for learning project in the school. The results

Alice Chow

2012-01-01

304

A Systematic Approach to Safety Case Management Dr Tim Kelly  

E-print Network

04AE-149 A Systematic Approach to Safety Case Management Dr Tim Kelly University of York, UK in the regulatory approach to ensuring system safety. Whereas compliance with prescriptive safety codes to construct and present well reasoned arguments that their systems achieve acceptable levels of safety

Kelly, Tim

305

School Asthma Screening and Case Management: Attendance and Learning Outcomes  

ERIC Educational Resources Information Center

Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided…

Moricca, Michelle L.; Grasska, Merry A.; BMarthaler, Marcia; Morphew, Tricia; Weismuller, Penny C.; Galant, Stanley P.

2013-01-01

306

The Case for Managed International Cooperation in Space Exploration  

E-print Network

to the International Space Station (ISS) to maintain its diplomatic credibility for future exploration endeavorsThe Case for Managed International Cooperation in Space Exploration By D. A. Broniatowski, G. Ryan Faith, and Vincent G. Sabathier Introduction International cooperation in space exploration has

de Weck, Olivier L.

307

Translating childhood tuberculosis case management research into operational policies.  

PubMed

The control of childhood tuberculosis (TB) has been of low priority in TB programmes in high-burden settings. The objective of this paper was to describe the development and testing of tools for the management of childhood TB. The Pakistan National TB Control Programme embarked on a number of activities, including the establishment of policy guidelines for the management of childhood TB and later a guidance document, 'Case Management Desk Guide and Structured Monitoring', to demonstrate the implementation of childhood TB interventions in a programme context. Initial results showed improved case finding and treatment outcome in implementation sites compared with control districts. However, further programme attention is required to improve quality. PMID:21740680

Safdar, N; Hinderaker, S G; Baloch, N A; Enarson, D A; Khan, M A; Morkve, O

2011-08-01

308

Evaluation method for determining management priorities for special case waste  

SciTech Connect

The U.S. Department of Energy (DOE) Radioactive Waste Technical Support Program (TSP) began the Special Case Waste (SCW) Inventory and Characterization Project in April 1989. The collection of data has been completed and a final draft report, Department of Energy Special Case Radioactive Waste Inventory and Characterization Data Report (DOE/LLW-96), was submitted in May 1990. A second final draft report, Supplemental Data Report to the Department of Energy Special Case Radioactive Waste Inventory and Characterization Data Report (DOE/LLW-95), containing additional and more detailed data and graphical presentations, was completed in July 1990. These two reports contain details on the special case waste categories and summaries of the total volumes and curies associated with each category of waste. It is anticipated that some version or combination of these two reports will be included in the final version of this report, which will describe an evaluation method for determining management priorities for special case waste. Preliminary analysis of the inventory data indicates that approximately 1,000,000 m{sup 3} of special case waste exist in the DOE system with possible insufficient treatment/storage/disposal capability or capacity. To help DOE prioritize the actions required to manage this large volume of special case waste, an evaluation method is required.

Kudera, D.E.; Wickland, C.E.

1990-08-01

309

"Managing after the Merger": Feedback at BAS Case Analysis. Response to "Managing after the Merger" Case Analysis.  

ERIC Educational Resources Information Center

Offers two responses to the case study for management communication classes (presented in this same issue) examining issues of performance appraisals and employee feedback in a company after a recent merger. Outlines advice for coaching the supervisor on the performance appraisal process and in his understanding of cultural mergers. Examines…

DeWine, Sue; Eicholtz, Mary M.; Walker, Juanie N.; Walker, Michael G.

2000-01-01

310

Features for a B-ISDN telemedicine system and its application.  

PubMed

Telemedicine technology is emerging as a new way of medical practice. It will provide more cooperative activity between departments and more comfortable access for disabled patients home. We developed two types of telemedicine system: a telediagnosis system and a home care system. Our telemedicine application is aimed to be run on the broadband-integrated services digital network (B-ISDN). The legacy network is also considered. The user interface is designed to help doctors to communicate easily. The key elements of telemedicine systems are user friendly interface, medical multimedia database design highly refined display technique. PMID:10384468

Choi, J; Kim, Y; Lee, S; Lee, J; Woo, J; Seo, J; Yoo, T; Cho, H

1998-01-01

311

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

PubMed

Over the last decade various international Information and Communications Technology networks have been created for a global access to high-level medical care. OP 2000 has designed and validated the high-end interactive video communication system WinVicos especially for telemedical applications, training of the physician in a distributed environment, teleconsultation and second opinion. WinVicos is operated on a workstation (WoTeSa) using standard hardware components and offers a superior image quality at a moderate transmission bandwidth of up to 2 Mbps. WoTeSa / WinVicos have been applied for IP-based communication in different satellite-based telemedical networks. In the DELTASS-project a disaster scenario was analysed and an appropriate telecommunication system for effective rescue measures for the victims was set up and evaluated. In the MEDASHIP project an integrated system for telemedical services (teleconsultation, teleelectro-cardiography, telesonography) on board of cruise ships and ferries has been set up. EMISPHER offers an equal access for most of the countries of the Euro-Mediterranean area to on-line services for health care in the required quality of service. E-learning applications, real-time telemedicine and shared management of medical assistance have been realized. The innovative developments in ICT with the aim of realizing a ubiquitous access to medical resources for everyone at any time and anywhere (u-Health) bear the risk of creating and amplifying a digital divide in the world. Therefore we have analyzed how the objective needs of the heterogeneous partners can be joined with the result that there is a need for real integration of the various platforms and services. A virtual combination of applications serves as the basic idea for the Virtual Hospital. The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre-operative planning, intra-operative navigation and minimally-invasive surgery require a digital and virtual environment supporting the perception of the physician. As data and computing resources in a virtual hospital are distributed over many sites the concept of the Grid should be integrated with other communication networks and platforms. PMID:18305324

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

2008-01-01

312

Telemedicine for rural and remote child and youth mental health services.  

PubMed

The E-Child and Youth Mental Health Service was designed to provide children and adolescents in Queensland with access to specialist mental health consultations using telemedicine. A project officer provided a single point of contact for referral management and clinic coordination, thereby reducing barriers of access to the service. Over a six-month period from November 2004, 42 point-to-point videoconferences were conducted to nine sites in Queensland. Three multipoint conferences were also conducted. Eleven videoconferences (24%) were arranged for administrative purposes, and 34 (76%) were conducted for the delivery of clinical services (30 patients). The referral and consultation activity suggests an improvement in the capacity of rural and remote mental health service providers to deliver specialist services for children and adolescents. PMID:16375806

Ryan, Ven-nice; Stathis, Stephen; Smith, Anthony C; Best, Denisse; Wootton, Richard

2005-01-01

313

Design of an SHD-distributed database over IP to support telemedicine.  

PubMed

We have conducted tests utilizing superhigh-definition CRTs (hereafter, referred to as a "super high-definition image system," or "SHD ": 2,048 x 2,048 pixels, 24-bit RGB gradation, noninterlace system) for autonomous and distributed medical image database systems. The system is capable of providing six times the image definition of a hi-vision television (HDTV). The aim in designing and testing the system is to enable gigabit network connectivity while displaying images on a DOS- V machine. This paper discusses how we devised an integrated environment for managing and operating distributed an SHD image database to support Telemedicine linking with ATM, with INS-1500, and with dial-up IP connection. PMID:11508902

Juzoji, H; Nakajima, I; Hata, M; Tanabe, K

2001-10-01

314

Assessing Need for Intensive Case Management in Long-Term Care  

Microsoft Academic Search

This article presents a brief screening tool to help case managers identify clients in a home- and community- based services (HCBS) program who need more intensive social work case management (CM). Using existing data from a case management time study ( N ? 242) and a content analysis of 70 cases in a Medicaid waiver- funded HCBS program, this study

Sadhna Diwan; Catherine Ivy; D'Anna Merino; Theresa Brower

2001-01-01

315

High quality image oriented telemedicine with multimedia technology  

Microsoft Academic Search

Researchers at Osaka and Kyoto University hospital performed three experiments, beginning in 1995, which looked at high quality-oriented telemedicine. This paper describes the system design for the three projects. Experiment 1 applied high-definition TV images and B-ISDN for distance learning and medical information exchange. Experiment 2 developed a super high-definition medical image filing system and the images were transmitted via

Hiroshi Takeda; Kotaro Minato; Takashi Takahasi

1999-01-01

316

3G Mobile Phone Applications in Telemedicine - A Survey  

Microsoft Academic Search

In this paper, we review current 3G mobile phone applications in telemedicine. Mobile phones are the backbone of mobile communications and have experienced explosive growth. 3G mobiles provide a next generation mobile phone service that aims to offer high-speed 2Mb\\/s communication using high transmission efficiency in the high frequency 2GHz band. This offers a groundbreaking way to use mobile phones.

Kazuaki Yamauchi; Wenxi Chen; Daming Wei

2005-01-01

317

Abstract--Compression of biomedical signals is of great interest in telemedicine applications for a fast and reliable  

E-print Network

Abstract-- Compression of biomedical signals is of great interest in telemedicine applications in telemedicine applications [1-4]. These studies were mainly focused on the applications of wavelet transforms

Moussavi, Zahra M. K.

318

The simulation model of teleradiology in telemedicine project.  

PubMed

Telemedicine projects are aimed at offering medical services to people who do not have access to direct diagnosis and treatment services. As a powerful tool for analyzing the performance of complex systems and taking probable events into consideration, systemic simulation can facilitate the analysis of implementation processes of telemedicine projects in real-life-like situations. The aim of the present study was to propose a model for planning resource capacities and allocating human and operational resources to promote the efficiency of telemedicine project by investigating the process of teleradiology. In this article, after verification of the conceptual model by the experts of this field, the computerized simulation model is developed using simulation software Arena. After specifying the required data, different improvement scenarios are run using the computerized model by feeding the data into the software and validation and verification of the model. Fixing input data of the system such as the number of patients, their waiting time, and process time of each function, for example, magnetic resonance imaging or scan, has been compared with the current radiology process. Implementing the teleradiology model resulted in reduction of time of patients in the system (current: 1.84 ± 0.00, tele: 0.81 ± 0.00). Furthermore, through this process, they can allocate the lower resources to perform better functions of staff. The use of computerized simulation is essential for designing processes, optimal allocation of resources, planning, and making appropriate decisions for providing timely services to patients. PMID:25627857

Goodini, Azadeh; Torabi, Mashallah; Goodarzi, Maryam; Safdari, Reza; Darayi, Mohamad; Tavassoli, Mahdieh; Shabani, MohammadMehdi

2015-01-01

319

A generic telemedicine infrastructure for monitoring an artificial pancreas trial.  

PubMed

Telemedicine systems are seen as a possible solution for the remote monitoring of physiological parameters and can be particularly useful for chronic patients treated at home. Implementing those systems however has always required spending a great effort on the underlying infrastructure instead of focusing on the application cores as perceived by their users. This paper proposes an abstract unifying infrastructure for telemedicine services which is loosely based on the multi-agent paradigm. It provides the capability of transferring to the clinic any remotely acquired information, and possibly sending back updates to the patient. The infrastructure is a layered one, with the bottom layer acting at the data level and implemented in terms of a software library targeting a wide set of hardware devices. On top of this infrastructure several services can be written shaping the functionality of the telemedicine application while at the highest level, adhering to a simple agent model, it is possible to reuse those functional components porting the application to different platforms. The infrastructure has been successfully used for implementing a telemonitoring service for a randomized controlled study aimed at testing the effectiveness of the artificial pancreas as a treatment within the AP@home project funded by the European Union. PMID:23415079

Capozzi, Davide; Lanzola, Giordano

2013-06-01

320

Successful Management of a Recurrent Supralevator Abscess: A Case Report  

PubMed Central

Anorectal abscesses are commonly encountered in clinical surgical practice. These abscesses require surgical management. Supralevator abscesses are thought to originate either from an ischiorectal or intersphincteric abscess extension or from an intraperitoneal source. These abscesses are quite uncommon and present a difficult surgical problem. We present a case here of a 42-year-old female with a recurrent supralevator abscess requiring multiple surgical procedures for adequate drainage and care of her abscess. PMID:22649747

Sanyal, S.; Khan, F.; Ramachandra, Prashanth

2012-01-01

321

Oral bullous lichen planus: Case report and review of management  

PubMed Central

A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus. PMID:23293497

Patil, Archana; Prasad, Shiva; Ashok, L.; Sujatha, G. P.

2012-01-01

322

Utilization of the American Telemedicine Association's Clinical Practice Guidelines  

PubMed Central

Abstract Background: The American Telemedicine Association (ATA) Standards and Guidelines Committee develops practice standards and guidelines. Key to the Committee's mission is dissemination so the standards can be used in the practice of telemedicine. Over a 2-year period, when a standards document was accessed from the ATA Web site, a short survey was completed, but it did not assess how the documents were used once downloaded. A more formal survey was conducted to determine the impact ATA standards and guidelines are having on healthcare delivery via telemedicine. Materials and Methods: A survey was developed and distributed via SurveyMonkey to 13,177 ATA members and nonmembers in November 2011. Results were compiled and analyzed after a 90-day open period for responses to be submitted. Results: The majority of respondents (96%) believe the practice of telemedicine/telehealth should have standards and guidelines and that the ATA and other professional societies/associations should be responsible for developing them. The top uses of guidelines include guidance for clinical practice, training, gaining reimbursement, and research. Respondents indicating a need for standards and guidelines said the ATA (78.7%) and other professional societies/associations (74.5%) should be responsible for development. When asked to list specific practice guidelines or standards they are using for telehealth, the majority (21.5%) are using in-house (e.g., hospital, company)-developed guidelines, followed by those from professional associations/societies (20.4%) and those developed by the ATA (18.2%). Conclusions: Overall, the survey results indicate guidelines documents developed by the ATA and other professional societies and those developed in-house are being regularly accessed and used in both public and private sectors. Practitioners of telemedicine believe that standards and guidelines are needed for guidance for clinical practice, training, gaining reimbursement, and research, and they are to use those developed by professional organization such as the ATA as well as those developed by their own institutions. PMID:24050615

Antoniotti, Nina; Bernard, Jordana

2013-01-01

323

A meta-analysis of telemedicine success in Africa  

PubMed Central

The use of information and communication technologies (ICT) tools to improve the efficiency of professionalism at work is increasing every time under the dynamic digital environment. Tools such as telemedicine, tele-education, and health informatics have of late been incorporated in the health sector to enable easy access to essential services, for example, in medical areas from referral centers by the patients on one hand and enabling the doctor to doctor consultations for the benefit of patients. Unfortunately, observations indicate dearth efforts and commitment to optimize use of the tools in the majority of the countries south of the Sahara. Sub-Saharan Africa has been left almost behind the rest of the world in terms of development going through decades of economic exploitation by especially the west through its natural and human resources. These factors, ethnic conflicts and endless wars have continued to ruin sub-Saharan Africa’s socio-economic development. Information was obtained through a network of telemedicine practitioners in different African countries using internet communication, through E-mail and reviewing existing literature of their activities. This information was compiled from representative countries in each African region and the previous authors’experiences as telemedicine practioners. Most of these countries have inadequate ICT infrastructure, which yet creates sub-optimal application. Sub-Saharan Africa, made up of 33 of the 48 global poorest countries has to extend its ICT diffusion and policy to match the ever developing global economy. In some countries such as Ethiopia and South Africa there is significant progress in Telemedicine while in countries such as Burkina Faso and Nigeria the progress is slow because of lack of political support. Almost all reference to Africa is made in due respect to sub-Saharan Africa, one with big social, economic, and political problems with resultant high morbidity and mortality rates. This also highlights the under-representation of African researchers in the global whelm of information system research. Telemedicine in Africa though has not attracted enough political support is potentially a very useful conduit of health-care given the fact that the continent is resource limited and still enduring the effects of scarce human resource especially in health. PMID:23858382

Wamala, Dan S.; Augustine, Kaddu

2013-01-01

324

A meta-analysis of telemedicine success in Africa.  

PubMed

The use of information and communication technologies (ICT) tools to improve the efficiency of professionalism at work is increasing every time under the dynamic digital environment. Tools such as telemedicine, tele-education, and health informatics have of late been incorporated in the health sector to enable easy access to essential services, for example, in medical areas from referral centers by the patients on one hand and enabling the doctor to doctor consultations for the benefit of patients. Unfortunately, observations indicate dearth efforts and commitment to optimize use of the tools in the majority of the countries south of the Sahara. Sub-Saharan Africa has been left almost behind the rest of the world in terms of development going through decades of economic exploitation by especially the west through its natural and human resources. These factors, ethnic conflicts and endless wars have continued to ruin sub-Saharan Africa's socio-economic development. Information was obtained through a network of telemedicine practitioners in different African countries using internet communication, through E-mail and reviewing existing literature of their activities. This information was compiled from representative countries in each African region and the previous authors'experiences as telemedicine practioners. Most of these countries have inadequate ICT infrastructure, which yet creates sub-optimal application. Sub-Saharan Africa, made up of 33 of the 48 global poorest countries has to extend its ICT diffusion and policy to match the ever developing global economy. In some countries such as Ethiopia and South Africa there is significant progress in Telemedicine while in countries such as Burkina Faso and Nigeria the progress is slow because of lack of political support. Almost all reference to Africa is made in due respect to sub-Saharan Africa, one with big social, economic, and political problems with resultant high morbidity and mortality rates. This also highlights the under-representation of African researchers in the global whelm of information system research. Telemedicine in Africa though has not attracted enough political support is potentially a very useful conduit of health-care given the fact that the continent is resource limited and still enduring the effects of scarce human resource especially in health. PMID:23858382

Wamala, Dan S; Augustine, Kaddu

2013-01-01

325

Proceedings of Student/Faculty Research Day, CSIS, Pace University, May 7th, 2004 Pervasive Telemedicine System  

E-print Network

Telemedicine System David Pazmino, Michael Filippone, Pavan Mundra, and Savitha Iyengar Abstract The Pervasive Telemedicine System focuses on providing medical support to the Pace community at remote campus locations telemedicine systems that were initiated in other Universities and are being used to provide healthcare

Tappert, Charles

326

25 CFR 20.318 - What case management responsibilities does the social services worker have?  

Code of Federal Regulations, 2011 CFR

...case management responsibilities does the social services worker have? 20.318 Section...HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance...case management responsibilities does the social services worker have? In working...

2011-04-01

327

25 CFR 20.318 - What case management responsibilities does the social services worker have?  

Code of Federal Regulations, 2010 CFR

...case management responsibilities does the social services worker have? 20.318 Section...HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance...case management responsibilities does the social services worker have? In working...

2010-04-01

328

Cumulative environmental impacts and integrated coastal management: the case of Xiamen, China  

E-print Network

Cumulative environmental impacts and integrated coastal management: the case of Xiamen, China, successful `integrated' management in a coastal area requires an understanding of the environmental impacts, Environmental Science Research Center, Xiamen University, Xiamen, China b Management Science/Environmental

Charles, Anthony

329

Training older adults to work as psychiatric case management aides.  

PubMed

Adults who were age 55 and over were trained to work as case management aides for individuals with serious and persistent mental illness. The training program was a cooperative effort of several state, academic, and private agencies in the New Orleans area, including the department of psychiatry at a state university medical center, the State Office of Mental Health, a consortium of colleges and universities providing educational opportunities for older adults, and the American Association of Retired Persons. The program curriculum included ten weeks of classroom instruction and a four-month field practicum. Of the 14 participants in the initial group of trainees, 13 sought and received employment as case aides. At follow-up three months after employment, supervisors of the case aides rated their job performance as excellent. PMID:8132188

Simon, P M; Morse, E V; Speier, T; Osofsky, H J

1993-12-01

330

Management of Two Cases of Recurrent Anal Carcinoma  

PubMed Central

Due to the low incidence of anal cancer and generally high cure rates, few second-line treatment options have been evaluated in the setting of formal clinical trials. We briefly report two cases that were both found to have wild-type K-RAS, with no epidermal growth factor receptor amplification or evidence of prior persistent human papilloma virus infection. Both cases were treated with irinotecan and cetuximab with evidence of clinical benefit in the setting of a third recurrence, as well as evidence of response to other strategies employed in their management. These cases provide support for the suggestion that treatment planning in conjunction with molecular profiling may be beneficial in such uncommon clinical settings. PMID:24163660

Klimant, Eiko; Markman, Maurie

2013-01-01

331

Management strategy after diagnosis of Abernethy malformation: a case report  

PubMed Central

Introduction The Abernethy malformation is a rare anomaly with a widely variable clinical presentation. Many diagnostic dilemmas have been reported. Nowadays, with the evolution of medical imaging, diagnosis can be made more easily, but management of patients with an Abernethy malformation is still open for discussion. Case presentation In this case study, we describe a 34-year-old Caucasian man who presented with a large hepatocellular carcinoma in the presence of an Abernethy malformation, which was complicated by the development of pulmonary arterial hypertension. Conclusion This case underlines the importance of regular examination of patients with an Abernethy malformation, even in older patients, to prevent complications and to detect liver lesions at an early stage. PMID:22742057

2012-01-01

332

Chiropractic management of breast-feeding difficulties: a case report  

PubMed Central

Objective The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties. Clinical Features The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic. Intervention and Outcome Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days. Conclusion The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently. PMID:22014911

Holleman, Annique C.; Nee, John; Knaap, Simone F.C.

2011-01-01

333

EU-TeleInViVo: an integrated portable telemedicine workstation featuring acquisition, processing and transmission over low-bandwidth lines of 3D ultrasound volume images  

Microsoft Academic Search

A transportable telemedicine workstation has been designed, developed and evaluated for use in isolated areas such as islands, rural areas and crisis situation areas. The EU-TeleInViVo is a custom-made device integrating in one solid case: a portable PC with telecommunication capabilities and a light, portable 3D ultrasound station. The system developed has low price, low weight, is transportable and non-radiating.

George Kontaxakis; Stefan Walter; Georgios Sakas

2000-01-01

334

Primary Care Providers' Perceptions of Home Diabetes Telemedicine Care in the IDEATel Project  

ERIC Educational Resources Information Center

Context: Few telemedicine projects have systematically examined provider satisfaction and attitudes. Purpose: To determine the acceptability and perceived impact on primary care providers' (PCP) practices of a randomized clinical trial of the use of telemedicine to electronically deliver health care services to Medicare patients with diabetes in…

Tudiver, Fred; Wolff, L. Thomas; Morin, Philip C.; Teresi, Jeanne; Palmas, Walter; Starren, Justin; Shea, Steven; Weinstock, Ruth S.

2007-01-01

335

A Comparison of Diabetes Education Administered Through Telemedicine Versus in Person  

Microsoft Academic Search

OBJECTIVE — To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators. RESEARCH DESIGN AND METHODS — A total of 56 adults with diabetes were randomized to receive diabetes education in person (control group) or via telemedicine (tele- medicine group) and were followed prospectively. The education consisted

ROBERTO E. IZQUIERDO; PAUL E. KNUDSON; SUZANNE MEYER; JOANN KEARNS; ROBERT PLOUTZ-SNYDER; RUTH S. WEINSTOCK

2003-01-01

336

Designing Web-based Telemedicine Training for Military Health Care Providers.  

ERIC Educational Resources Information Center

Interviews with 48 military health care professionals identified 20 objectives and 4 learning clusters for a telemedicine training curriculum. From these clusters, web-based modules were developed addressing clinical learning, technology, organizational issues, and introduction to telemedicine. (Contains 19 references.) (SK)

Bangert, David; Doktor, Boert; Johnson, Erik

2001-01-01

337

Study quality and evidence of benefit in recent assessments of telemedicine  

Microsoft Academic Search

Summary We carried out a systematic review of recent telemedicine assessments to identify scientifically credible studies that included comparison with a non-telemedicine alternative and that reported administrative changes, patient outcomes or the results of an economic assessment. From 605 publications identified in the literature search, 44 papers met the selection criteria and were included in the review. Four other publications

David Hailey; Arto Ohinmaa; Risto Roine

2004-01-01

338

Web-based telemedicine systems for home-care: technical issues and experiences  

Microsoft Academic Search

The use of the Web for telemedicine applications seems nowadays a compulsory solution: the Web has become a standardized infrastructure for giving access to sophisticated telemedicine applications from virtually any machine and operating system. Such standardized communication platform guarantees accessibility and usability advantages to both customers and providers (patients and physicians). However, there are several issues that should be discussed

Riccardo Bellazzi; Stefania Montani; Alberto Riva; Mario Stefanelli

2001-01-01

339

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support  

Microsoft Academic Search

The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC) or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to

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

2003-01-01

340

Professional Opinions of the Use of Telemedicine in Child & Adolescent Psychiatry  

Microsoft Academic Search

The Telemedicine project at Yorkhill Hospital, Glasgow was set up in 2004 to aid in the rapid diagnosis of children at a distant location. The Child and Adolescent Mental Health Services (CAMHS) are now the largest users. CAMHS use this service for clinical work, service development and to aid research. Twenty four CAMHS professionals with experience of the telemedicine facility

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

2009-01-01

341

Suitability of Coded Orthogonal Frequency Division Multiplexing (COFDM) for Multimedia Data Transmission in Wireless Telemedicine Applications  

Microsoft Academic Search

Telemedicine is the process of using latest telecommunication and computer technology to enhance the performance of medicine, particularly in the area of delivery of medical care. Wireless telemedicine is a new and evolving area in telemedical and telecare systems. It involves the use of mobile communication and multimedia technologies and their integration for new mobile healthcare delivery systems. In wireless

K. Thenmozhi; V. Prithiviraj

2007-01-01

342

Empowerment and change management in Aboriginal organisations: a case study.  

PubMed

The social organisation of work, management styles and social relationships in the workplace all matter for health. It is now well recognised that people who have control over their work have better health and that stress in the workplace increases the level of disease. In the context of organisational change, the potential benefits of empowerment strategies are two-fold: a positive impact on the organisation's effectiveness and enhancements in staff health, wellbeing and sense of control. This case study describes the University of Queensland Empowerment Research Program's experience working with the Apunipima Cape York Health Council in a change management process. Participatory action research and empowerment strategies were utilised to facilitate shifts in work culture and group cohesion towards achieving Apunipima's vision of being an effective lead agency for Indigenous health reform in Cape York. As part of the project, staff morale and confidence were monitored using a pictorial tool, Change Curve, which outlined the phases of organisational change. The project findings indicated that organisational change did not follow a clear linear trajectory. In some ways the dynamics mapped over a period of 18 months mirror the type of struggles individuals commonly encounter as a part of personal growth and development. In this case, one of the factors which influenced the program's success was the willingness of executive employees to actively support and participate in the change management process. PMID:20797370

McEwan, Alexandra B; Tsey, Komla; McCalman, Janya; Travers, Helen J

2010-08-01

343

Case Managers' Attitudes toward the Use of Homework for People Diagnosed with a Severe Psychiatric Disability  

ERIC Educational Resources Information Center

The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework administration practices. A survey examining attitudes toward the use of homework was completed by 122 Australian mental health case managers. Case managers who held more positive…

Kelly, Peter J.; Deane, Frank P.; Kazantzis, Nikolaos; Crowe, Trevor P.

2007-01-01

344

Roadmap: Human Development and Family Studies Case Management for Individuals and Families -Bachelor of Science  

E-print Network

Roadmap: Human Development and Family Studies ­ Case Management for Individuals and Families (upper division) 3 #12;Roadmap: Human Development and Family Studies ­ Case Management for Individuals Development and Family Studies: Case Management I 3-6 Offered in fall only; fulfills experiential learning

Sheridan, Scott

345

SUGGESTED THREE-YEAR GRADUATION PLAN Human Development and Family Studies Case Management  

E-print Network

SUGGESTED THREE-YEAR GRADUATION PLAN Human Development and Family Studies ­Case Management Internship in Human Development and Family Studies: Case Management I 3-6 Offered in fall only; fulfills THREE-YEAR GRADUATION PLAN Human Development and Family Studies ­Case Management for Individuals

Sheridan, Scott

346

SUGGESTED THREE-YEAR GRADUATION PLAN Human Development and Family Studies Case Management  

E-print Network

SUGGESTED THREE-YEAR GRADUATION PLAN Human Development and Family Studies ­Case Management HDFS 44192 Internship in Human Development and Family Studies: Case Management I 3-6 Offered in fall below #12;SUGGESTED THREE-YEAR GRADUATION PLAN Human Development and Family Studies ­Case Management

Sheridan, Scott

347

Roadmap: Human Development and Family Studies Case Management for Individuals and Families -Bachelor of Science  

E-print Network

Roadmap: Human Development and Family Studies ­ Case Management for Individuals and Families only HDFS 44192 Internship in Human Development and Family Studies: Case Management I 3-6 Offered Internship in Human Development and Family Studies: Case Management II 3-6 Offered in spring only; fulfills

Sheridan, Scott

348

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

PubMed

The telemedicine system aims at monitoring patients remotely without limit in time and space. However the existing telemedicine systems exchange medical information simply in a specified location. Due to increasing speed in processing data and expanding bandwidth of wireless networks, it is possible to perform telemedicine services on personal digital assistants (PDA). In this paper, a telemedicine system on PDA was developed using wideband mobile networks such as Wi-Fi, HSDPA, and WiBro for high speed bandwidths. This system enables to utilize and exchange variety and reliable patient information of video, biosignals, chatting messages, and triage data. By measuring bandwidths of individual data of the system over wireless networks, and evaluating the performance of this system using PDA, we demonstrated the feasibility of the designed portable emergency telemedicine system. PMID:19964507

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

2009-01-01

349

A telemedicine instrument for Internet-based home monitoring of thoracoabdominal motion in patients with respiratory diseases  

NASA Astrophysics Data System (ADS)

Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol/Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p < 0.0001) and the reduction in thoracic movement during abnormal abdominal breathing (p < 0.005). Simulated asynchrony in thoracoabdominal motion was also adequately detected by the system (p < 0.0001). The experimental results obtained for patients with respiratory diseases were in close agreement with the expected values, providing evidence that this instrument can be a useful tool for the evaluation of thoracoabdominal motion. The Internet transmission tests showed that the acquisition and analysis of the thoracoabdominal motion signals can be performed remotely. The user can also receive medical recommendations. The proposed system can be used in a spectrum of telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.

da Silva Junior, Evert Pereira; Esteves, Guilherme Pompeu; Dames, Karla Kristine; Melo, Pedro Lopes de

2011-01-01

350

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

PubMed Central

Background Telemedicine is defined as the use of electronic information and communication technologies to provide health care between distant people. Many activities in transfusion medicine could benefit from the application of telemedicine. To map the spread of the use of telemedicine in transfusion medicine in Italy, the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) performed a nationwide survey: the results are presented in this paper. Materials and methods A survey, dealing with different aspects of the use of telemedicine, was performed by sending a questionnaire to 280 Italian Blood Centres. The survey was designed to evaluate the diffusion of telemedicine and the features of the systems, with special attention to the systems’ safety and legal adequacy. One section of the questionnaire was designed to identify the features of the systems considered essential by the respondents. Results Out of 280 Blood Services contacted, 196 (70%) filled in at least one of the questions of the online questionnaire. Globally the use of some form of telemedicine was reported by 70% of the respondents. Telemedicine is used for remote validation of laboratory tests by 32% of the Centres that responded, for remote biological validation of blood units by 34% and for assignment of blood components by 29%. Less frequently, telemedicine is used to control electronic refrigerators, for electronic blood requests and for bed-side identification of patients. Discussion The use of telemedicine is widespread in Italian Blood Services. There appears to be some heterogeneity between structures with regards to the evaluation of the systems’ safety and their legal adequacy. No telemedicine system should be introduced into practice until it has proven to have the same standards of safety as the corresponding “on site” activity. PMID:23149141

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

2014-01-01

351

[Management of onychocryptosis in primary care: A clinical case].  

PubMed

Onychocryptosis (ingrown toenail) is a condition commonly seen in Primary Care clinics. It is uncomfortable and restrictive for patients and has a high incidence in males between second and third decades of life. It is of unknown origin, with a number of predisposing triggering factors being involved. Treatment depends on the stage of the ingrown nail and the procedures may range from conservative to minor surgery that can be performed by the Primary Care physician in the health centre. We report the case of a 25-year onychocryptosis that did not respond to conservative management, and was extracted with partial matricectomy of the nail. PMID:24034767

Zavala Aguilar, K; Gutiérrez Pineda, F; Bozalongo de Aragón, E

2013-09-01

352

A Case of Error Disclosure: A Communication Privacy Management Analysis  

PubMed Central

To better understand the process of disclosing medical errors to patients, this research offers a case analysis using Petronios’s theoretical frame of Communication Privacy Management (CPM). Given the resistance clinicians often feel about error disclosure, insights into the way choices are made by the clinicians in telling patients about the mistake has the potential to address reasons for resistance. Applying the evidenced-based CPM theory, developed over the last 35 years and dedicated to studying disclosure phenomenon, to disclosing medical mistakes potentially has the ability to reshape thinking about the error disclosure process. Using a composite case representing a surgical mistake, analysis based on CPM theory is offered to gain insights into conversational routines and disclosure management choices of revealing a medical error. The results of this analysis show that an underlying assumption of health information ownership by the patient and family can be at odds with the way the clinician tends to control disclosure about the error. In addition, the case analysis illustrates that there are embedded patterns of disclosure that emerge out of conversations the clinician has with the patient and the patient’s family members. These patterns unfold privacy management decisions on the part of the clinician that impact how the patient is told about the error and the way that patients interpret the meaning of the disclosure. These findings suggest the need for a better understanding of how patients manage their private health information in relationship to their expectations for the way they see the clinician caring for or controlling their health information about errors. Significance for public health Much of the mission central to public health sits squarely on the ability to communicate effectively. This case analysis offers an in-depth assessment of how error disclosure is complicated by misunderstandings, assuming ownership and control over information, unwittingly following conversational scripts that convey misleading messages, and the difficulty in regulating privacy boundaries in the stressful circumstances that occur with error disclosures. As a consequence, the potential contribution to public health is the ability to more clearly see the significance of the disclosure process that has implications for many public health issues. PMID:25170501

Petronio, Sandra; Helft, Paul R.; Child, Jeffrey T.

2013-01-01

353

Anaesthetic management of a case of idiopathic intracranial hypertension  

PubMed Central

Idiopathic intracranial hypertension (IIH) is a rare headache syndrome characterized by prolonged elevation of intracranial pressure without related pathology in either the brain or the composition of cerebrospinal fluid. Herein, we provide a brief review of the clinical presentation of IIH and the anaesthetic considerations in a female posted for transcervical resection of the endometrium and right nephrectomy with the disorder. Most of patients with IIH are reported during pregnancy and came for management of labour and delivery. To our knowledge no such case has been described previously. PMID:24163458

Butala, Bina P; Shah, Veena R

2013-01-01

354

Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report  

PubMed Central

ABSTRACT Failure of eruption of primary teeth can be considered rare, especially in maxillary anterior teeth. The problem can be either mechanical obstruction of eruption or a failure of the eruption mechanism. This case report presents failure of eruption of the maxillary right deciduous central incisor in a 4-year-old girl. The unerupted primary tooth was removed surgically. The histological finding revealed fibroma with reactive giant cells. Periodic follow-up visits were advised to monitor the developing dentition and to ensure enough space for the permanent incisor. How to cite this article: Shakra KA. Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report. Int J Clin Pediatr Dent 2014;7(1):58-60. PMID:25206241

2014-01-01

355

Adrenal insufficiency secondary to tuberculosis: the value of telemedicine in the remote diagnosis of Addison's disease in Ebeye, Republic of the Marshall Islands.  

PubMed

A young Marshallese woman presented with the insidious development of fever, cough, fatigue, profound weakness, massive weight loss, cachexia, alopecia, amenorrhea, and periumbilical hyperpigmentation. Limited laboratory studies revealed anemia, leukocytosis, and hyponatremia. Imaging studies, as well as digital photographs, transmitted over the Internet, using the secure Pacific Island Health Care Project (PIHCP), store-and-forward telemedicine system, suggested the diagnosis of disseminated tuberculosis, and antimycobacterial antibiotics were begun. Sputum cultures eventually grew Mycobacterium tuberculosis. Based on the constellation of clinical signs and symptoms, the transmitted images, and limited laboratory data, adrenal tuberculosis (Addison's disease) with adrenal insufficiency was diagnosed and corticosteroids were initiated. The patient responded dramatically This case underscores the utility of telemedicine in the diagnosis and treatment of patients with unusual conditions, rarely seen today in the United States, from remote sites in the Developing World. PMID:19365922

Bush, Lisabeth A; Ruess, Lynne; Jack, Tom; Person, Donald A

2009-01-01

356

Diagnostic ultrasound and telemedicine utilization in the international space station  

NASA Astrophysics Data System (ADS)

Clinical diagnostic ultrasound (US) is experiencing an expanding role that is well suited to application on the International Space Station (ISS). Diagnostic US can be used to reduce the risks associated with long duration human space flight by providing a non-invasive tool with head-to-toe diagnostic capability in both biomedical research and crew health care. General health care of the astronauts will be diagnosed with US, e.g., kidney stones, gall bladder disease, appendicitis, etc. Initial studies will focus on detection of ``ureteral jets'' in the bladder. This is a non-invasive test to rule out obstructive uropathy from kidney stones with minimal requirements for crew training. Biomedical research experiments, focusing on the effects of the microgravity environment, will be performed using both the HHU and the HDI 5000. US will be used to evaluate bone density and muscle mass in this environment. Prolonged or emergency EVAs may occur with the ISS. The hand-held ultrasound unit (HHU) and its telemedicine capability will be used in EVA settings to monitor events such as decompression sickness (DCS) microbubble formation in the cardiovascular system. There will be telemetry links between the HHU and the ATL/Lockheed Martin rack mounted HDI 5000 in the ISS Human Research Facility (HRF), as well as between the HRF and medical expertise on the ground. These links will provide the ISS with both real-time and store-and-forward telemedicine capabilities. The HHU can also be used with the existing telemedicine instrument pack (TIP).

Carter, Stephen J.; Stewart, Brent K.; Kushmerick, Martin J.; Langer, Steve G.; Schmiedl, Udo P.; Winter, Thomas C.; Conley, Kevin E.; Jubrias, Sharon A.

1999-01-01

357

The Portable Dynamic Fundus Instrument: Uses in telemedicine and research  

NASA Technical Reports Server (NTRS)

For years ophthalmic photographs have been used to track the progression of many ocular diseases such as macular degeneration and glaucoma as well as the ocular manifestations of diabetes, hypertension, and hypoxia. In 1987 a project was initiated at the Johnson Space Center (JSC) to develop a means of monitoring retinal vascular caliber and intracranial pressure during space flight. To conduct telemedicine during space flight operations, retinal images would require real-time transmissions from space. Film-based images would not be useful during in-flight operations. Video technology is beneficial in flight because the images may be acquired, recorded, and transmitted to the ground for rapid computer digital image processing and analysis. The computer analysis techniques developed for this project detected vessel caliber changes as small as 3 percent. In the field of telemedicine, the Portable Dynamic Fundus Instrument demonstrates the concept and utility of a small, self-contained video funduscope. It was used to record retinal images during the Gulf War and to transmit retinal images from the Space Shuttle Columbia during STS-50. There are plans to utilize this device to provide a mobile ophthalmic screening service in rural Texas. In the fall of 1993 a medical team in Boulder, Colorado, will transmit real-time images of the retina during remote consultation and diagnosis. The research applications of this device include the capability of operating in remote locations or small, confined test areas. There has been interest shown utilizing retinal imaging during high-G centrifuge tests, high-altitude chamber tests, and aircraft flight tests. A new design plan has been developed to incorporate the video instrumentation into face-mounted goggle. This design would eliminate head restraint devices, thus allowing full maneuverability to the subjects. Further development of software programs will broaden the application of the Portable Dynamic Fundus Instrument in telemedicine and medical research.

Hunter, Norwood; Caputo, Michael; Billica, Roger; Taylor, Gerald; Gibson, C. Robert; Manuel, F. Keith; Mader, Thomas; Meehan, Richard

1994-01-01

358

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases  

PubMed Central

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

Rusnak, James E.

1987-01-01

359

Meta-case based realization of design rationale management systems  

SciTech Connect

System design is an iterative, creative, and cooperative process where informal ideas are transformed into a detailed definition of how a system can be implemented. Design rationale aims at capturing and preserving the why underlying the what, the argument behind the artifact in the design process. Recording deliberations of the design process therefore promises benefits for the overall system engineering life cycle. Providing adequate computer support for design rationale is an interesting issue and a real need for effective application. A design rationale management system (DRMS) supports the capturing, storing and retrieval of interaction rationale in a shared corporate knowledge base and allows organizational learning through long-term and inter-project reuse. The intent of meta-CASE systems is to capture the specification of a required CASE tool and then generate the tool for actual production from the specification. In this paper we identify the requirements for a DRMS and investigate the applicability of meta-CASE tools for the implementation of DRMS`s. Furthermore we describe the experiences gained in the development of two DRMS`s adopting the meta CASE tools MaestroII GED/TCI and Hardy.

Paul, G. [Johannes Kepler Univ., Linz (Austria)

1996-12-31

360

Management of ovarian cysts in pregnancy: a case report.  

PubMed

According to recent epidemiological studies on ovarian cysts during pregnancy one out of 600 are, in most cases, benign neoformations. The most frequent histological type reported is mature cystic teratoma (50% of the cases), followed by functional cysts (13%), benign cystadenomas (20%) and ovarian cancer (0.6%). Most adnexal masses are asymptomatic and spontaneously resolve before the 16th week of amenorrhoea. On the other hand, some cases are persistent forms which can cause complications for the mother and fetus. The objective of this work was to review the existing literature from an epidemiological point of view, with an emphasis on diagnostic and therapeutic management. We have paid particular attention in our review to the use of diagnostic techniques and non surgical therapies such as laparoscopy, which in expert hands and adopting particular skills, can be considered as on approach to ovarian cysts in pregnancy. We present the case of a patient with an ovarian cyst during pregnancy that was a successfully treated with laparoscopy. PMID:16398230

Patacchiola, F; Collevecchio, N; Di Ferdinando, A; Palermo, P; Di Stefano, L; Mascaretti, G

2005-01-01

361

Conservative management of a case of tarsal tunnel syndrome  

PubMed Central

Objective: This case study was conducted to evaluate the treatment and management of a patient presenting with chronic foot pain, diagnosed as tarsal tunnel syndrome. Case: 61 year old female presenting with plantar and dorsal foot pain and burning sensation of 6 months duration. Treatment: Treatment was initiated using custom orthotics only for the first ten weeks of care as the patient did not follow up or initially respond to follow up calls placed by the practitioner. A course of high-velocity, low-amplitude adjustments using a toggle board to the cuboid and the talonavicular joint and fascial stripping was added upon report from the patient that the orthotic therapy alone did not resolve the symptoms. Improvement of pain reported on the Verbal Rating Scale was noted with a complete resolution of the condition at the conclusion of treatment. No pain was reported on a ten month follow up with the patient. Conclusion: Conservative management, including orthotics, manipulation, and fascial stripping may be beneficial in the treatment of tarsal tunnel syndrome. PMID:20520754

Hudes, Karen

2010-01-01

362

'Management multiple myeloma during pregnancy: a case report and review'  

PubMed

Multiple myeloma (MM) is a hematologic neoplasm characterized by plasma tumor cell proliferation in the bone marrow. It's a rare malignancy before a 40-year-old and it is extremely uncommon during pregnancy. We report the case of a 37-year-old woman with a newly diagnosed IgG ? MM (Durie-Salmon stage IIIA, International Staging System II and good prognosis cytogenetic) at the 27th week of her pregnancy. Our management during pregnancy, the delivery, and initiation of anti-myeloma treatment with bortezomib, lenalidomide, and dexamethasone are published. There are a few reviews reporting the most common features and management of MM during pregnancy. We perform a comprehensive review of all 32 cases reported between 1965 and 2014 in which a MM was diagnosed during pregnancy including score, cytogenetic results, labor characteristics, and response to therapy. About 53% of pregnant women did not start treatment before partum. Cesarean section was the most common form of delivery (82%). About 88% of newborns were healthy, although most of them were premature (73%). Management of a MM diagnosed during pregnancy should be based on the presence of myeloma-related organ damage to secure survival of the mother without fetal adverse effects related to treatment. Serial fetal ultrasound may be helpful in order to avoid complications. The cesarean section may be preferred depending on maternal and fetus prognosis. Whole-body diffusion-weighted imaging minimal response could be an appropriate technique to discard plasmacytomas during pregnancy in critical situations such as the appearance of symptoms of spinal cord compression. Therapeutic choices should be agreed with the pregnant after a thorough discussion of the prognostic factors of the disease and the potential risk for the fetus and the patient. While awaiting partum, dexamethasone is a non-toxic treatment. Triple therapy including a proteasome inhibitor should be started quickly after delivery. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25491088

Cabañas-Perianes, Valentin; Macizo, Maribel; Salido, Eduardo; Blanquer, Miguel; Araico, Fernando; Melero-Amor, Antonia; Garcia-Candel, Faustino; Muñoz-Garcia, Maria Isabel; Martinez-Villanueva, Miriam; Muñoz-Esparza, Carmen; Guzmán-Aroca, Florentina; Pérez-López, Raúl; Moraleda, Jose Maria

2014-12-10

363

Get Them Talking: Managing Change through Case Studies and Case Study Discussion. RUSA Occasional Paper, Number 25.  

ERIC Educational Resources Information Center

Since 1989, the Reference and User Services Association/Management and Operation of User Services Section's Management of Reference Committee has successfully used case studies to foster structured discussions among public service librarians on a wide variety of issues relating to managing change in reference services. The information offered in…

Arthur, Gwen, Ed.

364

Health information management using optical storage technology: case studies.  

PubMed

All the health care facilities examined in the case studies addressed several important organizational issues before and during the installation of their systems. All the facilities examined employee commitment. The prudent managers considered how easily their employees adapt to changes in their jobs and work environment. They considered how enthusiastic cooperation can be fostered in the creation of a liberated and reengineered office. This was determined not only by each individual's reaction to change, but also by the health care facility's track record with other system installations. For example, document image, diagnostic image, and coded data processing systems allow the integration of divergent health care information systems within complex institutions. Unfortunately, many institutions are currently struggling with how to create an information management architecture that will integrate their mature systems, such as their patient care and financial systems. Information managers must realize that if optical storage technology-based systems are used in a strategic and planned fashion, these systems can act as focal points for systems integration, not as promises to further confuse the issue. Another issue that needed attention in all the examples was the work environment. The managers considered how the work environment was going to affect the ability to integrate optical image and data systems into the institution. For example, many of these medical centers have created alliances with clinics, HMOs, and large corporate users of medical services. This created a demand for all or part of the health information outside the confines of the original institution. Since the work environment is composed of a handful of factors such as merged medical services, as many work environment factors as possible were addressed before application of the optical storage technology solution in the institutions. And finally, the third critical issue was the organization of work. "Organizations that understand their business processes are having no trouble whatsoever justifying the cost of optical storage-based information management systems," said Thornton May, director of imaging research at Nolan Norton Institute. "It is only confusing to organizations that do not have a feel for what is happening in the flow of work in the company. If an organization has on-line performance measurements with regard to time, cost, quality, error rates, and customer service, the move to optical image and data management technology is a no-brainer."(ABSTRACT TRUNCATED AT 400 WORDS) PMID:10119028

Kohn, D

1992-05-01

365

Impact of telemedicine on the quality of forensic sexual abuse examinations in rural communities.  

PubMed

To assess the quality and diagnostic accuracy of pediatric sexual abuse forensic examinations conducted at rural hospitals with access to telemedicine compared with examinations conducted at similar hospitals without telemedicine support. Medical records of children less than 18 years of age referred for sexual abuse forensic examinations were reviewed at five rural hospitals with access to telemedicine consultations and three comparison hospitals with existing sexual abuse programs without telemedicine. Forensic examination quality and accuracy were independently evaluated by expert review of state mandated forensic reporting forms, photo/video documentation, and medical records using two structured implicit review instruments. Among the 183 patients included in the study, 101 (55.2%) children were evaluated at telemedicine hospitals and 82 (44.8%) were evaluated at comparison hospitals. Evaluation of state mandatory sexual abuse examination reporting forms demonstrated that hospitals with telemedicine had significantly higher quality scores in several domains including the general exam, the genital exam, documentation of examination findings, the overall assessment, and the summed total quality score (p<0.05 for each). Evaluation of the photos/videos and medical records documenting the completeness and accuracy of the examinations demonstrated that hospitals with telemedicine also had significantly higher scores in several domains including photo/video quality, completeness of the examination, and the summed total completeness and accuracy score (p<0.05 for each). Rural hospitals using telemedicine for pediatric sexual abuse forensic examination consultations provided significantly higher quality evaluations, more complete examinations, and more accurate diagnoses than similar hospitals conducting examinations without telemedicine support. PMID:24841062

Miyamoto, Sheridan; Dharmar, Madan; Boyle, Cathy; Yang, Nikki H; MacLeod, Kristen; Rogers, Kristen; Nesbitt, Thomas; Marcin, James P

2014-09-01

366

Provider satisfaction and patient outcomes associated with a statewide prison telemedicine program in Louisiana.  

PubMed

Health information technology including telemedicine offers potential to improve patient care outcomes. As part of the response to Hurricanes Katrina and Rita in 2005, the Louisiana State University Health Care Services Division expanded its statewide telemedicine program. The aim of this study was to evaluate provider satisfaction and patient outcomes associated with telemedicine when used for the administration of prisoner medical care. Providers completed a survey following each patient encounter in real-time; questions were adapted from standard satisfaction indices. Statistical methods included uni-, bi-, and multivariable including ordinal regression methods to characterize unadjusted and adjusted factors associated with telemedicine use and provider satisfaction, and patient outcomes. Data were collected between December 2007 and May 2008 and were analyzed using SAS and Stata. Out of 737 patient visits, the majority of patients were African American (68.6%), men (92.9%), seen for either infectious disease or mental health (46.2% and 50.2%), with most surveys completed by a physician (63.1%). Most telemedicine encounters were completed (92.8%), a treatment plan was established (97.0%), the provider perceived that the technology was adequate to conduct visit (93.4%), and a follow-up telemedicine appointment was requested (90.8%). Most providers were satisfied with telemedicine for the visit overall (87.0%), believed that telemedicine improved patient prognosis (88.2%), and perceived that the patient was satisfied (83.0%). This study suggests that telemedicine was an effective and accepted method of healthcare provision. PMID:20438385

Glaser, Michelle; Winchell, Tom; Plant, Patty; Wilbright, Wayne; Kaiser, Michael; Butler, Michael K; Goldshore, Matthew; Magnus, Manya

2010-05-01

367

A Case Study of Enterprise Identity Management System Adoption in an Insurance Organization  

E-print Network

A Case Study of Enterprise Identity Management System Adoption in an Insurance Organization Pooya--Collaborative Computing Keywords Identity management, Qualitative Research, Security Tools, Organizational Factors, Case Study 1. INTRODUCTION Identity management (IdM) comprises the processes and in- frastructure

368

Scheduling in Sensor Grid Middleware for Telemedicine Using ABC Algorithm.  

PubMed

Advances in microelectromechanical systems (MEMS) and nanotechnology have enabled design of low power wireless sensor nodes capable of sensing different vital signs in our body. These nodes can communicate with each other to aggregate data and transmit vital parameters to a base station (BS). The data collected in the base station can be used to monitor health in real time. The patient wearing sensors may be mobile leading to aggregation of data from different BS for processing. Processing real time data is compute-intensive and telemedicine facilities may not have appropriate hardware to process the real time data effectively. To overcome this, sensor grid has been proposed in literature wherein sensor data is integrated to the grid for processing. This work proposes a scheduling algorithm to efficiently process telemedicine data in the grid. The proposed algorithm uses the popular swarm intelligence algorithm for scheduling to overcome the NP complete problem of grid scheduling. Results compared with other heuristic scheduling algorithms show the effectiveness of the proposed algorithm. PMID:25548557

Vigneswari, T; Mohamed, M A Maluk

2014-01-01

369

Scheduling in Sensor Grid Middleware for Telemedicine Using ABC Algorithm  

PubMed Central

Advances in microelectromechanical systems (MEMS) and nanotechnology have enabled design of low power wireless sensor nodes capable of sensing different vital signs in our body. These nodes can communicate with each other to aggregate data and transmit vital parameters to a base station (BS). The data collected in the base station can be used to monitor health in real time. The patient wearing sensors may be mobile leading to aggregation of data from different BS for processing. Processing real time data is compute-intensive and telemedicine facilities may not have appropriate hardware to process the real time data effectively. To overcome this, sensor grid has been proposed in literature wherein sensor data is integrated to the grid for processing. This work proposes a scheduling algorithm to efficiently process telemedicine data in the grid. The proposed algorithm uses the popular swarm intelligence algorithm for scheduling to overcome the NP complete problem of grid scheduling. Results compared with other heuristic scheduling algorithms show the effectiveness of the proposed algorithm. PMID:25548557

Vigneswari, T.; Mohamed, M. A. Maluk

2014-01-01

370

Practical Considerations for Optic Nerve Estimation in Telemedicine  

SciTech Connect

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

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

2009-01-01

371

Design and deployment of hybrid-telemedicine applications  

NASA Astrophysics Data System (ADS)

With advances and availability of information and communication technology infrastructures in some nations and institutions, patients are now able to receive healthcare services from doctors and healthcare centers even when they are physically separated. The availability and transfer of patient data which often include medical images for specialist opinion is invaluable both to the patient and the medical practitioner in a telemedicine session. Two existing approaches to telemedicine are real-time and stored-and-forward. The real-time requires the availability or development of video-conferencing infrastructures which are expensive especially for most developing nations of the world while stored-and-forward could allow data transmission between any hospital with computer and telephone by landline link which is less expensive but with delays. We therefore propose a hybrid design of applications using hypermedia database capable of harnessing the features of real-time and stored-and-forward deployed over a wireless Virtual Private Network for the participating centers and healthcare providers.

Ikhu-Omoregbe, N. A.; Atayero, A. A.; Ayo, C. K.; Olugbara, O. O.

2004-12-01

372

Design and deployment of hybrid-telemedicine applications  

NASA Astrophysics Data System (ADS)

With advances and availability of information and communication technology infrastructures in some nations and institutions, patients are now able to receive healthcare services from doctors and healthcare centers even when they are physically separated. The availability and transfer of patient data which often include medical images for specialist opinion is invaluable both to the patient and the medical practitioner in a telemedicine session. Two existing approaches to telemedicine are real-time and stored-and-forward. The real-time requires the availability or development of video-conferencing infrastructures which are expensive especially for most developing nations of the world while stored-and-forward could allow data transmission between any hospital with computer and telephone by landline link which is less expensive but with delays. We therefore propose a hybrid design of applications using hypermedia database capable of harnessing the features of real-time and stored-and-forward deployed over a wireless Virtual Private Network for the participating centers and healthcare providers.

Ikhu-Omoregbe, N. A.; Atayero, A. A.; Ayo, C. K.; Olugbara, O. O.

2005-01-01

373

Project RavenCare: global multimedia telemedicine in Alaska  

NASA Astrophysics Data System (ADS)

Project RavenCare is a testbed for assessing the utility of teleradiology, telemedicine and electronic patient records systems for delivering health care to Native Alaskans in remote villages. It is being established as a joint project between the department of radiology at Georgetown University Medical Center and the Southeast Alaska Regional Health Corporation (SEARHC) in Sitka, Alaska. This initiative will establish a sustained routine clinical multimedia telemedicine support for a village clinic in Hoonah, Alaska and a regional hospital in Sitka. It will link the village clinic in Hoonah to Mt. Edgecumbe Hospital in Sitka. This regional hospital will in turn be linked to Georgetown University Hospital through the T1- VSAT (very small aperture terminal) of the NASA-ACTS (Advanced Communication Technology Satellite). Regional physicians in Hoonah lack support in providing relatively routine care in areas such as radiology and pathology. This project is an initial step in a general plan to upgrade telecommunications in the health care system of the Southeast Alaska region and will address aspects of two problems; limited communication between the village health clinics and the hospital and lack of subspecialty support for hospital-based physicians in Sitka.

Tohme, Walid G.; Collmann, Jeff R.; Mun, Seong K.; Vastola, David J.

1995-05-01

374

Projection-Based Medical Image Compression for Telemedicine Applications.  

PubMed

Recent years have seen great development in the field of medical imaging and telemedicine. Despite the developments in storage and communication technologies, compression of medical data remains challenging. This paper proposes an efficient medical image compression method for telemedicine. The proposed method takes advantage of Radon transform whose basis functions are effective in representing the directional information. The periodic re-ordering of the elements of Radon projections requires minimal interpolation and preserves all of the original image pixel intensities. The dimension-reducing property allows the conversion of 2D processing task to a set of simple 1D task independently on each of the projections. The resultant Radon coefficients are then encoded using set partitioning in hierarchical trees (SPIHT) encoder. Experimental results obtained on a set of medical images demonstrate that the proposed method provides competing performance compared with conventional and state-of-the art compression methods in terms of compression ratio, peak signal-to-noise ratio (PSNR), and computational time. PMID:25236913

Juliet, Sujitha; Rajsingh, Elijah Blessing; Ezra, Kirubakaran

2014-09-19

375

Telemedicine Cardiovascular Risk Reduction in Veterans  

PubMed Central

Background Patients with co-occurrence of hypertension, hyperlipidemia, and diabetes have an increased risk of cardiovascular disease (CVD) events. Comprehensive programs addressing both tailored patient self-management and pharmacotherapy are needed to address barriers to optimal cardiovascular risk reduction. We are examining a Clinical Pharmacy Specialist (CPS), telephone administered intervention, relying on home monitoring, with a goal of providing tailored medication and behavioral intervention to Veterans with CVD risk. Methods Randomized controlled trial including patients with hypertension (blood pressure (BP) > 150/100 mmHg) or elevated low density liporotein (LDL) (> 130 mg/dl). Longitudinal changes in CVD risk profile and improvement in health behaviors over time will be examined. Conclusion Given the national prevalence of CVD and the dismal rates of risk factor control; intensive, but easily disseminated interventions are required to treat this epidemic. This study will be an important step in testing the effectiveness of a behavioral and medication intervention to improve CVD control among Veterans. PMID:23537965

Melnyk, S. Dee; Zullig, Leah L.; McCant, Felicia; Danus, Susanne; Oddone, Eugene; Bastian, Lori; Olsen, Maren; Stechuchak, Karen M.; Edelman, David; Rakley, Susan; Morey, Miriam; Bosworth, Hayden B

2013-01-01

376

Conservation markets for wildlife management with case studies from whaling.  

PubMed

Although market-based incentives have helped resolve many environmental challenges, conservation markets still play a relatively minor role in wildlife management. Establishing property rights for environmental goods and allowing trade between resource extractors and resource conservationists may offer a path forward in conserving charismatic species like whales, wolves, turtles, and sharks. In this paper, we provide a conceptual model for implementing a conservation market for wildlife and evaluate how such a market could be applied to three case studies for whales (minke [Balaenoptera acutorostrata], bowhead [Balaena mysticetus], and gray [Eschrictius robustus]). We show that, if designed and operated properly, such a market could ensure persistence of imperiled populations, while simultaneously improving the welfare of resource harvesters. PMID:24640529

Gerber, Leah R; Costello, Christopher; Gaines, Steven D

2014-01-01

377

Management of extra oral sinus cases: a clinical dilemma.  

PubMed

The cutaneous sinus tract of dental origin is an uncommon but well documented condition. Its diagnosis is not always easy unless the treating clinician considers the possibility of its dental origin. Such patients may undergo multiple surgical excisions, biopsies, and antibiotic regimens, but all of them fail with the recurrence of the sinus tract. This is because the primary etiology is incorrectly diagnosed. This case report describes the treatment of four patients presenting with variable complaints of pain and purulent or hemorrhagic discharge from lesions of the face. Clinical and radiographic examination revealed carious teeth with radiolucent areas indicating chronic periradicular abscess. The teeth were restorable, so nonsurgical endodontic therapy was performed in all of them. No systemic antibiotic therapy was provided. The patients responded well, and the cutaneous lesions healed uneventfully. Improper diagnosis can lead to needless loss of teeth that can be otherwise maintained through timely and proper management. PMID:15220655

Mittal, Neelam; Gupta, Pooja

2004-07-01

378

Water resources management: case study of Sharkia governorate, Egypt  

NASA Astrophysics Data System (ADS)

Ministry of water resources and irrigation in Egypt is currently implementing projects that expand new cultivated area, and accordingly the supplies of Nile River to the Nile Delta will be negatively affected. So, Enormous interest toward water resources management has been taken in the Egyptian water sector. Conveyance infrastructure and irrigation technology has been gradually improved to ensure efficient distribution and utilization of scarce water resources. The present study is focused on the optimum utilization of water resources in Sharkia governorate, Egypt. Operational and planning distribution model is implemented on the selected case study (Sharkia governorate) to develop appropriate water plan. The gross revenue of all crops is correlated to surface water discharge, ground water discharge, surface water salinity, and ground water salinity. In addition, the effect of varying both surface and groundwater quantities and qualities on the gross revenue has been investigated. Moreover, the effect of limiting rice production on the gross revenue is allocated.

Mohamed, Y. A.; Rashad, M.

2012-06-01

379

Epidermolysis Bullosa, Dental and Anesthetic Management: A Case Report  

PubMed Central

Epidermolysis bullosa (EB) is a group of rare inherited skin and mucous membrane disorders in which blister formation may arise spontaneously or following a minor friction. Various patterns of inheritance are explicated for the disease. The disease has a profound effect on oral mucosa and may result in high prevalence of dental caries. General anesthesia is sometimes the only choice for dental treatments in patients with EB. The following case report describes the dental and anesthetic management of an 12.5 -year-old girl with dystrophic type of EB. The patient was followed up every 6 months. New carious lesions were detected one year after the treatment, on the last visit. Presenting a perfect dental care to children with this disorder can be challenging for the in charge specialist, both pediatric dentist and anesthesiologist. PMID:25191665

Esfahanizade, Katayoun; Mahdavi, Ali Reza; Ansari, Ghassem; Fallahinejad Ghajari, Masoud; Esfahanizadeh, Abdolreza

2014-01-01

380

Case Management Reduces Drinking During Pregnancy among High Risk Women  

PubMed Central

Aim Estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD). Design Women were recruited from antenatal clinics and engaged in 18 months of CM. Setting A South African community with a subculture of heavy, regular, weekend, recreational drinking and high documented rates of FASD. Participants Forty-one women who were high risk for bearing a child with FASD. Measures Statistical analysis of trends in drinking and other risk factors. Findings At intake 87.8% were pregnant, most had previous alcohol-exposed pregnancies, most/all of their friends drink alcohol (67.5%), and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p < .001) and 18 months (p < .001). For participants completing 18 months of CM, AUDIT scores improved significantly by 6-month follow-up (from 19.8 to 9.7, p = .000), and even though rising at 12 and 18 months, AUDIT scores indicate that problematic drinking remained statistically significantly lower than baseline throughout CM. Happiness scale scores correlated significantly with reduced drinking in most time periods. Conclusions An enduring change in drinking behavior is difficult in this social setting. Yet, CM provided by skilled and empathic case managers reduced maternal drinking at critical times, and therefore, alcohol exposure levels to the fetus. PMID:24729823

May, Philip A.; Marais, Anna-Susan; Gossage, J. Phillip; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Hendricks, Natalie; Roux, Sumien; Blom, Annalien; Steenekamp, Jeanetta; Alexander, Theresa; Andreas, Romena; Human, Suzanne; Snell, Cudore; Seedat, Soraya; Parry, Charles C.; Kalberg, Wendy O.; Buckley, David; Blankenship, Jason

2014-01-01

381

Telemedicine technology and applications for home hemodialysis.  

PubMed

Home hemodialysis (HD) for the treatment of patients with end-stage renal disease (ESRD) was first put into practice about 30 years ago. In this paper we describe the application of telematics monitoring services (TMS) for supporting patients who need home or satellite HD (SHD). For the clinical trials two modified HD machines were located in the renal unit and a central control station (UNIX workstation with multimedia PC-terminal) was located in another room of the hospital. Bi-directional communication between modified HD machines and central control station was managed via ISDN (Integrated Services Digital Network) links. Using these HD-machines 150 HD sessions were performed in nine patients over a period of five months. This system enabled on-line remote supervision of the HD machine-related functions (air in the blood, leak of blood, low conductivity etc.) and the clinical condition of patients through measurement of blood pressure (BP), pulse rate, PO2 (pulse oxymetry) and electrocardiogram (ECG) from the central control station (CCS). The user checked the type of alarm/warning, its appearance on HD machines and multimedia terminal units (MTU), the action of the protective system and the appearance of consultative messages from CCS on the remote terminal unit RTU. According to the data collected, the disturbances of HD machine function were visible and audible in the CCS and the user messages were always observed on the RTU. No unusual dialysis-associated complications were observed, all data and alarms/warnings were transmitted correctly and patients had adequate HD treatment. PMID:10585132

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

1999-10-01

382

Case Management Models for Persons Who Are Homeless and Mentally Ill: The ACCESS Demonstration Project  

Microsoft Academic Search

Persons who are homeless and mentally illpresent unique challenges to service providers and humanservice systems. In vivo case management approaches suchas assertive community treatment (ACT) have shown promise in engaging this population. This paperexplores case management models employed within theACCESS program, a five year, 18-site demonstrationprogram enriching services for homeless persons with serious mental illness. We describe theimplementation of case

Matthew Johnsen; Laura Samberg; Robert Calsyn; Margaret Blasinsky; Wendy Landow; Howard Goldman

1999-01-01

383

HIV/AIDS Case Managers and Client HIV Status Disclosure: Perceived Client Needs, Practices, and Services  

ERIC Educational Resources Information Center

People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/AIDS in New York State. The survey was conducted anonymously, and case…

Kalichman, Seth C.; Klein, Susan J.; Kalichman, Moira O.; O'Connell, Daniel A.; Freedman, Jay A.; Eaton, Lisa; Cain, Demetria

2007-01-01

384

Process and impact of mergers of NHS trusts: multicentre case study and management cost analysis  

Microsoft Academic Search

Objective To study the processes involved in and impact of mergers between NHS trusts, including the effect on management costs. Design Cross sectional study involving in depth interviews and documentary analysis; case study to compare savings in management costs between case trusts and control trusts. Setting Nine trusts (cross sectional study) and four trusts (case study) in London. Participants 96

Naomi Fulop; Gerasimos Protopsaltis; Andrew Hutchings; Annette King; Pauline Allen; Charles Normand; Rhiannon Walters

2002-01-01

385

DOI: 10.1089/tmj.2007.0087 MARY ANN LIEBERT, INC. VOL. 14 NO. 6 JULY/AUGUST 2008 TELEMEDICINE and e-HEALTH 539 Brett M. Harnett, M.S.I.S.,1  

E-print Network

DOI: 10.1089/tmj.2007.0087 © MARY ANN LIEBERT, INC. · VOL. 14 NO. 6 · JULY/AUGUST 2008 TELEMEDICINE- ment of telemedicine, which has seen a global expansion.1 Surgical teleconsultation is effective;540 TELEMEDICINE

Rosen, Jacob

386

Combining Image and Non-Image Data for Automatic Detection of Retina Disease in a Telemedicine Network  

SciTech Connect

A telemedicine network with retina cameras and automated quality control, physiological feature location, and lesion/anomaly detection is a low-cost way of achieving broad-based screening for diabetic retinopathy (DR) and other eye diseases. In the process of a routine eye-screening examination, other non-image data is often available which may be useful in automated diagnosis of disease. In this work, we report on the results of combining this non-image data with image data, using the protocol and processing steps of a prototype system for automated disease diagnosis of retina examinations from a telemedicine network. The system includes quality assessments, automated physiology detection, and automated lesion detection to create an archive of known cases. Non-image data such as diabetes onset date and hemoglobin A1c (HgA1c) for each patient examination are included as well, and the system is used to create a content-based image retrieval engine capable of automated diagnosis of disease into 'normal' and 'abnormal' categories. The system achieves a sensitivity and specificity of 91.2% and 71.6% using hold-one-out validation testing.

Aykac, Deniz [ORNL; Chaum, Edward [University of Tennessee, Knoxville (UTK); Fox, Karen [Delta Health Alliance; Garg, Seema [University of North Carolina; Giancardo, Luca [ORNL; Karnowski, Thomas Paul [ORNL; Li, Yaquin [University of Tennessee, Knoxville (UTK); Nichols, Trent L [ORNL; Tobin Jr, Kenneth William [ORNL

2011-01-01

387

Radiation-related myocardial injury. Management of two cases.  

PubMed

Pericardial effusion and trifascicular block developed 5 years following mediastinal irradiation for Hodgkin's disease in a 19-year-old patient. Another 24-year-old patients had an acute myocardial infarction followed by severe angina pectoris 5 years following mediastinal irradiation for the same disease. A pericardial window and a permanent demand pacemaker were used in the first case; an aorto-coronary vein grafting was utilized in the second patient. Both patients responded to treatment and are well. Five other previously reported cases of myocardial injury that occurred 2 months to 8 years following mediastinal irradiation in young patients were reviewed. To our knowledge, successful surgical treatment of this disease entity has not been reported before. Close, long-term follow-up of patients who have received mediastinal irradiation should be helpful in the early recognition and successful management of these serious cardiac complications. The systematic clinical and radiographic surveilance of these patients should be supplemented by a routine 12-lead electrocardiogram. PMID:1086710

Ali, M K; Kahlil, K G; Fuller, L M; Leachman, R D; Sullivan, M P; Loh, K K; Gamble, J F; Shullenberger, C C

1976-11-01

388

Chiropractic management of essential tremor and migraine: a case report  

PubMed Central

Objective The purpose of this case report is to describe the chiropractic management of a 39-year-old woman with essential tremors and migraine headaches. Clinical Features A 39-year-old woman presented with essential tremors and migraine headaches, which occurred 2 to 3 times per week. The essential tremor was diagnosed in 2000, and migraine headaches with aura were diagnosed when she was 10. Both diagnoses were made by her general medical practitioner. Previous treatments for migraine included propranolol, isometheptene, dichloralphenazone, acetaminophen, sumatriptan, and over-the-counter pain relievers. Intervention and Outcome The patient received high-velocity, low-amplitude chiropractic spinal manipulation to her upper cervical spine using the Blair Upper Cervical chiropractic technique protocol. There was improvement in her tremors and migraine headaches following her initial chiropractic treatment, with a sustained improvement after 4 months of care. Conclusion This case study demonstrated improvement in a woman with essential tremors and migraine headaches. This suggests the need for more research to examine how upper cervical specific chiropractic care may help mitigate tremors and migraine headaches. PMID:23204956

Hubbard, Todd A.; Kane, Janice D.

2012-01-01

389

75 FR 82053 - Notification of a New Privacy Act System of Records, Effort to Outcomes-Case Management System...  

Federal Register 2010, 2011, 2012, 2013

...Act System of Records, Effort to Outcomes--Case Management System for the...new system of records. The new system...the Office of Management and Budget (OMB...including case management. CATEGORIES OF RECORDS IN THE...

2010-12-29

390

Interactive modelling with stakeholders in two cases in flood management  

NASA Astrophysics Data System (ADS)

New policies on flood management called Multi-Level Safety (MLS), demand for an integral and collaborative approach. The goal of MLS is to minimize flood risks by a coherent package of protection measures, crisis management and flood resilience measures. To achieve this, various stakeholders, such as water boards, municipalities and provinces, have to collaborate in composing these measures. Besides the many advances this integral and collaborative approach gives, the decision-making environment becomes also more complex. Participants have to consider more criteria than they used to do and have to take a wide network of participants into account, all with specific perspectives, cultures and preferences. In response, sophisticated models are developed to support decision-makers in grasping this complexity. These models provide predictions of flood events and offer the opportunity to test the effectiveness of various measures under different criteria. Recent model advances in computation speed and model flexibility allow stakeholders to directly interact with a hydrological hydraulic model during meetings. Besides a better understanding of the decision content, these interactive models are supposed to support the incorporation of stakeholder knowledge in modelling and to support mutual understanding of different perspectives of stakeholders To explore the support of interactive modelling in integral and collaborate policies, such as MLS, we tested a prototype of an interactive flood model (3Di) with respect to a conventional model (Sobek) in two cases. The two cases included the designing of flood protection measures in Amsterdam and a flood event exercise in Delft. These case studies yielded two main results. First, we observed that in the exploration phase of a decision-making process, stakeholders participated actively in interactive modelling sessions. This increased the technical understanding of complex problems and the insight in the effectiveness of various integral measures. Second, when measures became more concrete, the model played a minor role, as stakeholders were still bounded to goals, responsibilities and budgets of their own organization. Model results in this phase are mainly used in a political way to maximize the goals of particular organizations.

Leskens, Johannes; Brugnach, Marcela

2013-04-01

391

Cognitive Behavioral Case Management for Depressed Low-income Older Adults  

Microsoft Academic Search

The purpose of this chapter is to introduce the reader to cognitive behavioral case management (CB case management) for low-income\\u000a elderly patients. This intervention was developed at San Francisco General Hospital and has been researched by the Over-60\\u000a Team at UCSF. CB case management arose out of the recognition that older adults living in financial distress often have difficulty\\u000a utilizing

Patricia A. Areán; George Alexopoulos; Joyce P. Chu

392

Comprehensive case management for substance abuse clients who have mood or anxiety disorders  

Microsoft Academic Search

Background: The Iowa Case Management Project (ICMP) was developed to evaluate the effectiveness of a comprehensive, solution-focused model of case management with rural clients in substance use disorder treatment.Aims: To evaluate the effectiveness of a strengths-based case management model to help clients with and without co-occurring psychiatric disorders reduce substance use and improve psychiatric functioning.Method: Clients admitted to residential or

James A. Hall; Mary Vaughan-Sarrazin; Amanda R. Reedy; Diane L. Huber

2008-01-01

393

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

ERIC Educational Resources Information Center

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

Reed, Philip A.

2003-01-01

394

Barriers to the adoption of telemedicine as explained by the disruptive innovation framework  

E-print Network

Despite its development and suitability to many specialties of medicine for the past forty years and the driving demands of an aging population, telemedicine has not made significant progress in deployment or commercialization. ...

Malik, Shaheen, 1974-

2003-01-01

395

Digital diffusion in the clinical trenches : findings from a Telemedicine Needs Assessment  

E-print Network

Broadly stated, this dissertation focuses on how practitioners and provider organizations integrate the computer and web into healthcare delivery. The opportunity that afforded this research was a Telemedicine Needs ...

Harrop, Verlé M. (Verlé Margaret), 1952-

2002-01-01

396

Talent management versus strategic human resources management a case of evolution or revolution?.  

E-print Network

??Includes abstract. The objective is to investigate the theoretical and practical differences between Talent Management and Strategic Human Resource Management and whether Talent Management in… (more)

Harry, Jaqueline.

2012-01-01

397

Knowledge Management in Preserving Ecosystems: The Case of Seoul  

ERIC Educational Resources Information Center

This study explores the utility of employing knowledge management as a framework for understanding how public managers perform ecosystem management. It applies the grounded theory method to build a model. The model is generated by applying the concept of knowledge process to an investigation of how the urban ecosystem is publicly managed by civil…

Lee, Jeongseok

2009-01-01

398

Management Styles: A Case Study of Women in TAFE.  

ERIC Educational Resources Information Center

Female managers in Australian technical and further education (TAFE) use a predominantly feminine management style in comparison to traditional masculine style. They use a people-oriented style to get tasks done. Managers interviewed felt the climate of TAFE did not support proactive management. (Contains 68 references.)

Rice, Ann

2000-01-01

399

HOW EMPLOYABLE ARE PEOPLE WITH SERIOUS MENTAL ILLNESS? CASE MANAGERS’ AND UNDERGRADUATES’ EXPECTATIONS.  

E-print Network

??This study examines 107 case managers' and 159 undergraduates' employment-related expectations for adults with serious mental illness. The psychometric properties of Expectations about Employment for… (more)

Abraham, Kristen M

2007-01-01

400

The U.S. Army telemedicine program: general overview and current status in Southwest Asia.  

PubMed

This paper presents and discusses the U.S. Army telemedicine support systems currently available to our deployed forces in Southwest Asia. Organization and structure of the support system are discussed, along with some of the business rules and policies developed for its use. Some of the lessons learned are directly applicable to any type of large-scale telemedicine deployment, civilian or military. PMID:16942411

Poropatich, Ronald K; DeTreville, Robert; Lappan, Charles; Barrigan, Cynthia R

2006-08-01

401

TeleMedMail: free software to facilitate telemedicine in developing countries.  

PubMed

Telemedicine offers the potential to alleviate the severe shortage of medical specialists in developing countries. However lack of equipment and poor network connections usually rule out video-conferencing systems. This paper describes a software application to facilitate store-and-forward telemedicine by email of images from digital cameras. TeleMedMail is written in Java and allows structured text entry, image processing, image and data compression, and data encryption. The design, implementation, and initial evaluation are described. PMID:11604848

Fraser, H S; Jazayeri, D; Bannach, L; Szolovits, P; McGrath, S J

2001-01-01

402

Construction waste management based on industrial management models: a Swedish case study.  

PubMed

This paper describes a methodology for estimating the true internal costs of construction waste, aimed at promoting environmentally friendly waste management. The study employs cost-benefit analysis, contribution margin analysis, the polluter-pays principle and a mathematical model: the model for Efficient Use of Resources for Optimal Production Economy (EUROPE), which has been introduced previously by the author for assigning industrial costs to waste. The calculations are performed on construction waste created in a case study of a building project. Moreover, waste is regarded as, in a business sense, having the same basic status as any normal industrial product, namely the 'equality principle'. Application of the methodology is suggested to create incentives for environmental and profitability improvement in construction companies and other types of industrial sectors. The results of the case study show the generation of construction waste to substantially decrease the final operating income, due to the internal shadow price cost it creates. This paper is intended to reduce the gap between the choice of waste management procedures and their economic impact, the overall objective being to accomplish an improved industrial environmental situation. PMID:15751391

Stenis, Jan

2005-02-01

403

The Telemedicine benchmark--a general tool to measure and compare the performance of video conferencing equipment in the telemedicine area.  

PubMed

In this paper, we describe the 'Telemedicine Benchmark' (TMB), which is a set of standard procedures, protocols and measurements to test reliability and levels of performance of data exchange in a telemedicine session. We have put special emphasis on medical imaging, i.e. digital image transfer, joint viewing and editing and 3D manipulation. With the TMB, we can compare the aptitude of different video conferencing software systems for telemedicine issues and the effect of different network technologies (ISDN, xDSL, ATM, Ethernet). The evaluation criteria used are length of delays and functionality. For the application of the TMB, a data set containing radiological images and medical reports was set up. Considering the Benchmark protocol, this data set has to be exchanged between the partners of the session. The Benchmark covers file transfer, whiteboard usage, application sharing and volume data analysis and compression. The TMB has proven to be a useful tool in several evaluation issues. PMID:10505968

Klutke, P J; Mattioli, P; Baruffaldi, F; Toni, A; Englmeier, K H

1999-09-01

404

A strategic vision for telemedicine and medical informatics in space flight  

NASA Technical Reports Server (NTRS)

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

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

2000-01-01

405

Delivering kidney cancer care in rural Central and Southern Illinois: a telemedicine approach.  

PubMed

There is a growing body of experience and research suggesting that telemedicine (video conferencing, smart phones and online patient portals) could be the solution to addressing gaps in the provision of specialised healthcare in rural areas. The proposed role of telemedicine in providing needed services in hard to reach areas is not new. The United States Telecommunication Act of 1996 provided the initial traction for telemedicine by removing important economic and legal obstacles regarding the use of technology in healthcare delivery. This initial ruling has been supplemented by the availability of federal funding to support efforts aimed at developing telemedicine in underserved areas. In this paper, we explore one aspect of disease disparity pertinent to rural Illinois (kidney cancer incidence and mortality) and describe how we are planning to use an existing telemedicine program at Southern Illinois University School of Medicine (SIUSOM) to improve kidney cancer (Kca) care in rural Illinois. This represents an example of the possible role of telemedicine in addressing healthcare disparities in rural areas/communities and provides a description of general challenges and barriers to the implementation and maintenance of such systems. PMID:25286964

Alanee, S; Dynda, D; LeVault, K; Mueller, G; Sadowski, D; Wilber, A; Jenkins, W D; Dynda, M

2014-11-01

406

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

PubMed

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond. PMID:11242553

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

2000-01-01

407

Changes in Service Delivery Patterns After Introduction of Telemedicine Provision of Medical Abortion in Iowa  

PubMed Central

Objectives. We assessed the effect of a telemedicine model providing medical abortion on service delivery in a clinic system in Iowa. Methods. We reviewed Iowa vital statistic data and billing data from the clinic system for all abortion encounters during the 2 years prior to and after the introduction of telemedicine in June 2008 (n?=?17?956 encounters). We calculated the distance from the patient’s residential zip code to the clinic and to the closest clinic providing surgical abortion. Results. The abortion rate decreased in Iowa after telemedicine introduction, and the proportion of abortions in the clinics that were medical increased from 46% to 54%. After telemedicine was introduced, and with adjustment for other factors, clinic patients had increased odds of obtaining both medical abortion and abortion before 13 weeks’ gestation. Although distance traveled to the clinic decreased only slightly, women living farther than 50 miles from the nearest clinic offering surgical abortion were more likely to obtain an abortion after telemedicine introduction. Conclusions. Telemedicine could improve access to medical abortion, especially for women living in remote areas, and reduce second-trimester abortion. PMID:23153158

Grindlay, Kate; Buchacker, Todd; Potter, Joseph E.; Schmertmann, Carl P.

2013-01-01

408

Evaluating a Web-Based Interface for Internet Telemedicine  

NASA Technical Reports Server (NTRS)

The objective is to introduce the usability engineering methodology, heuristic evaluation, to the design and development of a web-based telemedicine system. Using a set of usability criteria, or heuristics, one evaluator examined the Spacebridge to Russia web-site for usability problems. Thirty-four usability problems were found in this preliminary study and all were assigned a severity rating. The value of heuristic analysis in the iterative design of a system is shown because the problems can be fixed before deployment of a system and the problems are of a different nature than those found by actual users of the system. It was therefore determined that there is potential value of heuristic evaluation paired with user testing as a strategy for optimal system performance design.

Lathan, Corinna E.; Newman, Dava J.; Sebrechts, Marc M.; Doarn, Charles R.

1997-01-01

409

Robust tissue classification for reproducible wound assessment in telemedicine environments  

NASA Astrophysics Data System (ADS)

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

Wannous, Hazem; Treuillet, Sylvie; Lucas, Yves

2010-04-01

410

Remote Measurements of Heart and Respiration Rates for Telemedicine  

PubMed Central

Non-contact and low-cost measurements of heart and respiration rates are highly desirable for telemedicine. Here, we describe a novel technique to extract blood volume pulse and respiratory wave from a single channel images captured by a video camera for both day and night conditions. The principle of our technique is to uncover the temporal dynamics of heart beat and breathing rate through delay-coordinate transformation and independent component analysis-based deconstruction of the single channel images. Our method further achieves robust elimination of false positives via applying ratio-variation probability distributions filtering approaches. Moreover, it enables a much needed low-cost means for preventing sudden infant death syndrome in new born infants and detecting stroke and heart attack in elderly population in home environments. This noncontact-based method can also be applied to a variety of animal model organisms for biomedical research. PMID:24115996

Qian, Yi; Tsien, Joe Z.

2013-01-01

411

US-USSR telemedicine consultation spacebridge to Armenia and Ufa  

NASA Technical Reports Server (NTRS)

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

1991-01-01

412

Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France  

PubMed Central

Background The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. Methods We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Results Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. Conclusions The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency. PMID:24708721

2014-01-01

413

The opening phase of telemedicine consultations: an analysis of interaction.  

PubMed

This paper describes communication in the opening phases of real-time, video-mediated telemedicine consultations, using the method of conversation analysis, in three NHS settings in the UK. The literature on interaction analysis in face-to-face medical consultations indicates that physicians' capacity to determine topics in consultations is established in the opening phases of the encounter. This is because patients concede the communicative floor to physicians who claim it for themselves by using well-established patterns of interaction. Drawing on 10 teleconsultations, the analysis shows that, for health care professionals and patients, video-mediated telemedicine is unfamiliar terrain, where communication requires constant negotiation of skills and roles, this complexity being added to by the fact that more than one professional participates in the encounter. Analysis of the opening phases of teleconsultations shows them to involve 'floor negotiation' between professionals and between professionals and patients in which they experience discrepancies between suggested 'frames', a term coined by Goffman [Goffman, E. (1974). Frame analysis. New York: Harper and Row.] to indicate interpretive schemas that allow people to understand the meaning of events in interactions in which they participate. Frame attunement is achieved during floor negotiation through various interruptions, interjections and attachments that professionals produce to defend their agenda. The novelty of the setting also made participants negotiate the physical space in which the encounter took place. We make tentative suggestions for the training of participants, based on the limited evidence of this study, which requires extending by further studies based on direct observation. PMID:19201514

Pappas, Yannis; Seale, Clive

2009-04-01

414

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

PubMed

Specialized stroke units offer optimal treatment of patients with an acute stroke. Unfortunately, their installation is limited by an acute lack of experienced neurologists and the small number of stroke patients in sparsely populated rural areas. This problem is increasingly being solved by the use of telemedicine, so that neurological expertise is made available to basic and regular care. It has been demonstrated by national and international pilot studies that solidly based and rapid decisions can be made by telemedicine regrading the use of thrombolysis, as the most important acute treatment, but also of other interventions. So far studies have only evaluated improvement in the quality of care achieved by networking, but not of any lasting effect on any economic benefit. Complementary to a medical evaluation, the qualitative economic assessment presented here of German and American concepts of telemetric care indicate no difference in efficacy between various ways of networking. Most noteworthy, when comparing two large American and German studies, is the difference in their priorities. While the American networks achieved targeted improvements in efficacy of care that go beyond the immediate wishes of the doctors involved, this was of only secondary importance in the German studies. Also, in contrast to several American networks, the German telemetry networks have not tended to be organized for future growth. In terms of economic benefits, decentralized organized networks offer a greater potential of efficacy than purely local ones. Furthermore, the integration of inducements into the design of business models is a fundamental factor for achieving successful and lasting existence, especially within a highly competitive market. PMID:20077382

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

2010-05-01

415

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

PubMed

The health care system is undergoing major reform, characterized by organized delivery systems (regionalization, decentralization, devolution, etc); shifts in care delivery sites; changing health provider roles; increasing consumer responsibilities; and accountability. Rapid advances in information technology and telecommunications have led to a new type of information infrastructure which can play a major role in this reform. Compatible health information systems are now being integrated and connected across institutional, regional, and sectorial boundaries. In the near future, these information systems will readily be accessed and shared by health providers, researchers, policy makers, health consumers, and the public. SECURITY is a critical characteristic of any health information system. This paper will address three fields associated with SECURITY: confidentiality, integrity, and availability. These will be defined and examined as they relate to specific aspects of Telemedicine, such as electronic integrated records and clinical databases; electronic transfer of documents; as well as data storage and disposal. The guiding principles, standards, and safeguards being considered and put in place to ensure that telemedicine information intrastructures can protect and benefit all stakeholders' rights and needs in both primary and secondary uses of information will be reviewed. Implemented, proposed, and tested institutional, System, and Network solutions will be discussed; for example, encryption-decryption methods; data transfer standards; individual and terminal access and entry I.D. and password levels; smart card access and PIN number control; data loss prevention strategies; interference alerts; information access keys; algorithm safeguards; and active marketing to users of standards and principles. Issues such as policy, implementation, and ownership will be addressed. PMID:10163762

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

1996-01-01

416

The U.S. Army Telemedicine and m-Health Program: making a difference at home and abroad.  

PubMed

This article highlights the deployment of telemedicine by the U.S. Army through the various echelons of care and in overseas locations, including range and scope of health services provided by telemedicine in a challenging environment. This is followed by a discussion of technological developments advances in mobile communications likely to change the practice of telemedicine in the military from limited fixed-point access to a highly mobile individual with handheld communication devices. PMID:23537383

Poropatich, Ronald; Lai, Eva; McVeigh, Francis; Bashshur, Rashid

2013-05-01

417

Effectively managing partnership evolution: a case study from Chicago.  

PubMed

Given the continued proliferation of public/ private partnerships as vehicles for sharing best practices, lessons learned and actionable information, the keys to their success become more important to identify. Effective partnerships enhance the resilience of their respective members, which, in turn, improves community resilience. Thus, identifying the attributes of a successful partnership should be a high priority for those looking to foster collaboration between the public and private sectors. This paper will illustrate with two case studies how successful partnerships creatively leverage opportunities and manage the evolution of public/private relationships, while always seeking to institutionalise these collaborative efforts. The first will discuss briefly the development of the most important national partnership within the financial sector. The other focuses on a public/private task force in Chicago, composed of public safety agencies and representatives of critical infrastructure, which owes its existence to an unexpected research project and that needed to be restructured in light of experience. The manner in which the task force formed and evolved yields many lessons for partnerships interested in remaining relevant and effective. PMID:23315246

Tishuk, Brian S

418

Endoscopic surgery and telemedicine in microgravity: developing contingency procedures for exploratory class spaceflight  

NASA Technical Reports Server (NTRS)

OBJECTIVES: The risk of a urinary calculus during an extended duration mission into the reduced gravity environment of space is significant. For medical operations to develop a comprehensive strategy for the spaceflight stone risk, both preventive countermeasures and contingency management (CM) plans must be included. METHODS: A feasibility study was conducted to demonstrate the potential CM technique of endoscopic ureteral stenting with ultrasound guidance for the possible in-flight urinary calculus contingency. The procedure employed the International Space Station/Human Research Facility ultrasound unit for guide wire and stent localization, a flexible cystoscope for visual guidance, and banded, biocompatible soft ureteral stents to successfully stent porcine ureters bilaterally in zero gravity (0g). RESULTS: The study demonstrated that downlinked endoscopic surgical and ultrasound images obtained in 0g are comparable in quality to 1g images, and therefore are useful for diagnostic clinical utility via telemedicine transmission. CONCLUSIONS: In order to be successful, surgical procedures in 0g require excellent positional stability of the operating surgeon, assistant, and patient, relative to one another. The technological development of medical procedures for long-duration spaceflight contingencies may lead to improved terrestrial patient care methodology and subsequently reduced morbidity.

Jones, J. A.; Johnston, S.; Campbell, M.; Miles, B.; Billica, R.

1999-01-01

419

Content and Workflow Management for Library Websites: Case Studies  

ERIC Educational Resources Information Center

Using database-driven web pages or web content management (WCM) systems to manage increasingly diverse web content and to streamline workflows is a commonly practiced solution recognized in libraries today. However, limited library web content management models and funding constraints prevent many libraries from purchasing commercially available…

Yu, Holly, Ed.

2005-01-01

420

MULTICHANNEL CUSTOMER MANAGEMENT: A CASE STUDY IN EGYPT  

Microsoft Academic Search

Channel management is one CRM systems component much influenced by the behaviour of customers in relation to the implementation and use of channel management CRM component. The consumers' behaviours, preferences, perceptions and expectations are crucial for the implementation and use of channel management. Customers' contact with the organization's multi-channels can occur at several touch points through out customer lifecycle. Customers'

Maged Ali; Laurence Brooks

421

Safety management system in university: case study KMUTT, Thailand  

Microsoft Academic Search

To maintain safety for all students and staff in the university, King Mongkuts University of Technology Thonburi (KMUTT) is committed to the proper management of safety and provides safety management service through the Energy Environment Safety and Health Office. Safety management system has been developed according to standard practice and focused on laboratory and workshop safety including chemical and biological

S Chaisawadi; S Suwanyuen

2010-01-01

422

Pakistan-Specific Cases for the Advanced Management Course in Public Administration.  

ERIC Educational Resources Information Center

A compilation of management case studies concerning public administration in Pakistan and accompanying teaching notes, this document is intended to foster discussion in classes such as the advanced management course in public administration at the National Institute of Public Administration in Lahore, Pakistan. Included are case studies entitled…

McLean, Gary N., Ed.

423

Louisiana's Ventilator Assisted Care Program: Case Management Services to Link Tertiary with Community-Based Care.  

ERIC Educational Resources Information Center

The Ventilator Assisted Care Program provides centralized case management services to ventilator-using youths and their families in Louisiana. Case managers develop individualized, comprehensive plans to be implemented locally using community resources; plans are based on needs identified by tertiary care providers and family members and are…

Kirkhart, Kathryn A.; And Others

1988-01-01

424

Models of Community Care for Severe Mental Illness: A Review of Research on Case Management  

Microsoft Academic Search

We describe different models of community care for persons with severe mental illness and review the research literature on case management, including the results of 75 studies. Most research has been conducted on the assertive community treatment (ACT) or intensive case management (ICM) models. Controlled research on ACT and ICM indicates that these models reduce time in the hospital and

Kim T. Mueser; Gary R. Bond; Robert E. Drake; Sandra G. Resnick

1998-01-01

425

y Models of Community Care for Severe Mental Illness: A Review of Research on Case Management  

Microsoft Academic Search

We describe different models of community care for persons with severe mental illness and review the research literature on case management, including the results of 75 studies. Most research has been con- ducted on the assertive community treatment (ACT) or intensive case management (ICM) models. Controlled research on ACT and ICM indicates that these models reduce time in the hospital

Kim T. Mueser; Qary R. Bond; Robert E. Drake; Sandra Q. Resnick

426

Effectiveness of Different Models of Case Management for Substance-Abusing Populations  

Microsoft Academic Search

Case management has been implemented in substance abuse treatment to improve (cost-) effectiveness, but controversy exists about its potential to realize this objective. A systematic and comprehensive review of peer-reviewed articles (n = 48) published between 1993 and 2003 is presented, focusing on the effects of different models of case management among various substance-abusing populations. Results show that several studies

Wouter Vanderplasschen; Judith Wolf; Richard C. Rapp; Eric Broekaert

2007-01-01

427

Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 27.  

ERIC Educational Resources Information Center

This TIP contains information on the best practice guidelines on case management for substance abuse treatment providers. It serves to educate program coordinators and facilitators about the factors to consider as they decide to modify or implement case management activities. Many substance abuse clients arrive for treatment with a number of other…

Cook, Paddy; Dogoloff, Mary Lou; Harteker, Linda; Nelson, Anne E.; Paul, Michelle M.; Shuman, Deborah J.; Mjoseth, Marcia; Vitzthum, Virginia; Hayes, Elizabeth; Gilbert, Max; Smith, Cara; Nguyen, Y-Lang

428

Case Studies, Ethics, Philosophy, and Liberal Learning for the Management Profession  

ERIC Educational Resources Information Center

Case studies can be an important methodology for ethics and philosophy in humanistic management and liberal education as well as in the social sciences because they integrate a deeper, reflective, philosophical, and ethical understanding of the organization. A case study approach based on philosophy of management contributes to putting into…

Rendtorff, Jacob Dahl

2015-01-01

429

Resource Training Manual for Family Advocacy Case Management with Adolescents with Emotional Disabilities.  

ERIC Educational Resources Information Center

This training manual for social work practitioners is based on the Family Advocacy Model of Case Management, which states that case management with adolescents contains two important elements: work with the adolescent and work with those responsible for his/her care. This manual deals with the first of two elements and is designed to be used in…

Ronnau, John; And Others

430

The benefits of electronic records management systems: a general review of published and some unpublished cases  

Microsoft Academic Search

Purpose – To review published case studies, and some unpublished results, to identify the benefits actually achieved by implementing an electronic records management system or an electronic document management system (ERMS, or EDMS). Design\\/methodology\\/approach – Draws on the literature and unpublished results of work undertaken by the authors’ organisation. Findings – Few case studies were found in which clear, quantitative

Gary P. Johnston; David V. Bowen

2005-01-01

431

Group Dynamics in a Security Risk Management Team Context: A Teaching Case Study  

E-print Network

Group Dynamics in a Security Risk Management Team Context: A Teaching Case Study Rostyslav-up of security risk management teams and their performance. Three different models were used to construct team security risk management tasks. The study has shown that there is a possible correlation between the teams

Paris-Sud XI, Université de

432

Searching for the Right Fit: A Case Study of IT Security Management Model Tradeoffs  

E-print Network

Searching for the Right Fit: A Case Study of IT Security Management Model Tradeoffs Kirstie Hawkey systems within an organization is impacted not only by tool interfaces but also by the security management their diverse perspectives of the realities of managing security in a decentralized post-secondary organization

433

Reflections on Case Management in Youth Support Using a Program Example  

ERIC Educational Resources Information Center

Using Moxley's (1997) program development framework as an agenda for a dialogue that juxtaposes an academic perspective with that of a seasoned youth program manager, this paper focuses on the relatively unexplored terrain of case management programs. In doing so, it exposes the convergences and divergences between academic and program manager…

Kennedy, Rosemary; Kennedy, Barry

2010-01-01

434

On the Common Information Service Platform Based Supply Chain Management, a Case Study  

Microsoft Academic Search

A case of supply chain management based on common information service platform has been studied on the background of tobacco industry of China in this paper. Under the system architecture of the platform, the problem of key data integration has been solved by integration of the digitalization management system of distribution centers and the information management system of logistics on

Liwei Bao; Yuchi Huang; Jijiong Song; Yingguang Yang

2009-01-01

435

Using Role-Play and Case Studies to Improve Preservice Teacher Attitudes toward Classroom Management  

ERIC Educational Resources Information Center

Classroom management is a concern for preservice teachers (Charles, 2008). Teacher educators struggle to find the most effective ways to teach preservice teachers classroom management. Role-playing, combined with classroom management content, may offer a productive approach. As such, this study focused on the use of role-play with case studies to…

Rudolph, Amanda

2008-01-01

436

Instituting a case management system for the lead-poisoned child: the Maine experience.  

PubMed

This article details the origin and implementation of a state-level case management system for children with elevated blood lead levels. This includes a thorough accounting of the methods utilized to create the system. The article closes with data derived from the case management reporting system showing the system's effectiveness and with a description of how this design parallels the case management recommendations by the Centers for Disease Control and Prevention made at a later date. The article offers suggestions for designers of such systems. In general, the authors advise building on existing systems, creating written protocols for both case managers and health care personnel, developing a support system for case managers, tracking activities through data, and giving recognition to field personnel. PMID:15112375

Hubley, Teresa A; Amrich, MaryAnn

2003-01-01

437

Ethical issues in the introduction of case management for elderly people.  

PubMed

As case management is under development in France for elderly people, this study sets out to identify and analyse key situations responsible for ethical dilemmas for French case managers. We based our study on the analyses of individual interviews made with case managers and focus-group discussions, bringing together all case managers working in local organisations running for at least a year. We identified three situations giving rise to ethical dilemmas: in the order of importance, the refusals of care, the practicalities of collecting and sharing personal data and the allocation of resources. These three situations can lead to conflict between the principle of beneficence and those of respect for autonomy, non-maleficence and justice. We describe here how French case managers practically deal with these situations. PMID:22918055

Corvol, Aline; Moutel, Grégoire; Gagnon, Dominique; Nugue, Mathilde; Saint-Jean, Olivier; Somme, Dominique

2013-02-01

438

Managing complexity: An integration of ethics, management, and technology viewed through the Dow Corning silicone implant case  

Microsoft Academic Search

This dissertation is a contextual examination of an ethical organizational dilemma complicated by elaborate and interrelated systems or soft technologies. Dow Corning's silicone breast implant case is analyzed by example, to show the usefulness of a more varied, flexible, and multi-faceted approach to ethics and management in the midst of a rapidly expanding technological society. This case represents an ongoing

Patricia Jane Tod

1999-01-01

439

Case Studies for School Administrators: Managing Change in Education.  

ERIC Educational Resources Information Center

This book examines case-based learning in educational leadership courses, discusses case-based learning as an educational tool, exemplifies methods of writing a case study, and contains 14 case-studies by teachers and administrators. "Stakeholders in a House of Cards," by Audrey Burgher, discusses integrating technology with innovation. "Reforming…

Benham, Maenette K. P. Ah Nee

440

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

PubMed

We studied maritime telemedicine and its potential for improvement. Twenty-four people representing 13 different shipping companies and maritime public authorities were interviewed. They covered all areas of the Norwegian maritime sector except for offshore installations. The morbidity pattern reported differed between the groups: on cruise liners and ferries the major problems were due to coronary heart disease, while on merchant ships, navy vessels and in the fishing fleet the major problems were accidents. Voice and fax systems were available in all cases. However, the Emergency Medical Dispatch Centres did not offer an email service and did not use faxes in the maritime setting. Radio Medico Norway was the only assistance provider offering two-way transfer of digital pictures. The interviewees suggested a number of areas for improvement; these included having a single emergency telephone number to call for help, email systems with the possibility of digital picture attachments, wireless communication systems on board and a standard CD-ROM reference work for medical guidance/education. PMID:12396854

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

2002-01-01

441

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

PubMed

The purpose was to design and implement a Web-based telemedicine system for diabetic retinopathy screening using digital fundus cameras and to make the software publicly available through Open Source release. The process of retinal imaging and case reviewing was modeled to optimize workflow and implement use of computer system. The Web-based system was built on Java Servlet and Java Server Pages (JSP) technologies. Apache Tomcat was chosen as the JSP engine, while MySQL was used as the main database and Laboratory of Neuro Imaging (LONI) Image Storage Architecture, from the LONI-UCLA, as the platform for image storage. For security, all data transmissions were carried over encrypted Internet connections such as Secure Socket Layer (SSL) and HyperText Transfer Protocol over SSL (HTTPS). User logins were required and access to patient data was logged for auditing. The system was deployed at Hubert H. Humphrey Comprehensive Health Center and Martin Luther King/Drew Medical Center of Los Angeles County Department of Health Services. Within 4 months, 1500 images of more than 650 patients were taken at Humphrey's Eye Clinic and successfully transferred to King/Drew's Department of Ophthalmology. This study demonstrates an effective architecture for remote diabetic retinopathy screening. PMID:16478413

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

2006-02-01

442

Case Study of American Healthways' Diabetes Disease Management Program  

PubMed Central

Disease management has been defined as a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant (Disease Management Association of America, 2005). The purpose of this article is to provide an overview of the diabetes disease management program offered by American Healthways (AMHC) and highlight recently reported results of this program (Villagra, 2004a; Espinet et al., 2005). PMID:17288077

Pope, James E.; Hudson, Laurel R.; Orr, Patty M.

2005-01-01

443

Sonographic localization and management of metallic fragments: a report of five cases.  

PubMed

Ultrasound was used as adjunct to radiographic imaging in the assessment and management of metallic fragments in five cases encountered in forward-deployed military facilities. Although metallic fragments are usually seen well on radiographs, ultrasound can add details of the surrounding soft-tissue structures and clarify location. Portable handheld units are well suited for studies when probe selection and equipment adjustments are correct. In selected cases, ultrasound information can favorably influence case management. PMID:22934382

Harcke, H Theodore; Rooks, Veronica J

2012-08-01

444

Reconceptualizing the Case Management Relationship in Intensive Treatment: A Study of Staff Perceptions and Experiences  

Microsoft Academic Search

The helping relationship or alliance is theorized to be an important process variable in case management services for people\\u000a with serious mental illness. Previous studies of the case management relationship borrow concepts and measures from psychotherapy\\u000a research and therefore may overlook important differences in tasks, settings, and clinical roles across settings. A study\\u000a of client–provider relationships as perceived by case

Beth Angell; Colleen Mahoney

2007-01-01

445

Supplier Relationship Management in Health Care Practice - A Case Study  

Microsoft Academic Search

Structural changes and increasing market dynamics in the health care sector intensify the hospitals' need for cost-savings and process optimization. One source to generate not only short-term savings but also sustainable benefits is the active and sophisticated management of the relationship with different suppliers, also known as supplier relationship management (SRM). As in the health care sector material cost continuously

Tobias Mettler; Peter Rohner

2008-01-01

446

Integrated approach to healthcare quality management: a case study  

Microsoft Academic Search

Purpose – The purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically. Design\\/methodology\\/approach – This paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare

Prasanta Kumar Dey; Seetharaman Hariharan

2006-01-01

447

Manufacturing logistics management Using RFID: Dynamic and case study  

Microsoft Academic Search

Manufacturing logistics management consists of complex interconnections among manufacturing processes, facilities, warehouses, quality controlling, packaging and logistics. In recent years, RFID (Radio Frequency Identification) technology has become so matured that it has been widely applied on manufacturing logistics management. Firstly, this paper presents the significant potential of RFID application in manufacturing logistics, and aims to investigate the dynamic of manufacturing

Tan Jinrong; Chen Haiquan

2010-01-01

448

Telemedicine system for the care of patients with neuromuscular disease and chronic respiratory failure  

PubMed Central

Introduction Neuromuscular diseases cause a number of limitations which may be improved by using a telemedicine system. These include functional impairment and dependence associated with muscle weakness, the insidious development of respiratory failure and episodes of exacerbation. Material and methods The present study involved three patients with severe neuromuscular disease, chronic respiratory failure and long-term mechanical ventilation, who were followed up using a telemedicine platform. The telemedicine system is based on videoconferencing and telemonitoring of cardiorespiratory variables (oxygen saturation, heart rate, blood pressure and electrocardiogram). Two different protocols were followed depending on whether the patient condition was stable or unstable. Results Over a period of 5 years, we analyzed a series of variables including use of the system, patient satisfaction and clinical impact. Overall we performed 290 videoconference sessions, 269 short monitoring oximetry measurements and 110 blood pressure measurements. With respect to the clinical impact, after enrolment in the telemedicine program, the total number of hospital admissions fell from 18 to 3. Conclusions Our findings indicate that the system was user friendly for patients and care givers. Patient satisfaction scores were acceptable. The telemedicine system was effective for the home treatment of three patients with severe neuromuscular diseases and reduced the need for hospital admissions. PMID:25395959

Morete, Emilio; González, Francisco

2014-01-01

449

Telemedicine licensure in the United States: the need for a cooperative regional approach.  

PubMed

The extraordinary successes and refinement of modern telemedicine applications in recent years have been diminished somewhat by the anachronistic licensure laws of the 50 state jurisdictions that limit the practice of medicine to specific state geographic boundaries. This approach is deficient when applied to telemedicine because, with the advent of the Internet and modern technological advances, differences in space and time are rendered nearly meaningless. It is recommended in this paper that the practice of telemedicine be handled differently than the practice of face-to-face medicine, as related to licensure. Although it may be argued persuasively that a national licensure model for telemedicine should be advanced, the political and constitutional hurdles may be too great to overcome. It is therefore recommended that a voluntary, regional geographic approach be instituted by jurisdictions already demonstrating a commonality of interests, such as through the Southern Governors' Association or the Western Governors' Association. The benefits to be derived from this approach would include improving access to healthcare and medical specialists, enhancing the quality and timeliness of care, cutting medical costs by moving information instead of people, securing patients' access to medical records and information, and facilitating commercial export of American telemedicine services. PMID:17489700

Cwiek, Mark A; Rafiq, Azhar; Qamar, Aamna; Tobey, Charles; Merrell, Ronald C

2007-04-01

450

Use of telemedicine for haemodialysis: perceptions of patients and health-care providers, and clinical effects.  

PubMed

In Michigan, the use of telemedicine for dialysis patients began in three centres in 2005. A total of 747 clinical consultations was conducted in the following 22 months. Telephone surveys were conducted with 34 patients and four providers. The patients and providers all had positive perceptions of the telemedicine system and the care that was delivered. Most of the clinical measures of the patients met or exceeded the recommendations made by Renal Network 11. In addition to the clinical work, the telemedicine equipment was used for educational events. Twenty-six professional educational events were provided with a total audience of 105 individuals, and 35 administrative meetings were provided with 286 staff members in attendance. The study showed that patients and providers could participate in educational events that might not be available locally. Despite the success of dialysis telemedicine, the Marquette General Health System discontinued its use in 2007 when the Center for Medicare and Medicaid Services re-affirmed that dialysis centres were not approved sites for telemedicine. PMID:18348752

Whitten, Pamela; Buis, Lorraine

2008-01-01

451

Telemedicine-guided remote enrollment of patients into an acute stroke trial  

PubMed Central

Background and Purpose Enrollment into acute stroke clinical trials is limited to experienced tertiary centers with emergency research infrastructure. Feasibility of remote enrollment via telemedicine into an acute thrombolytic clinical trial has never been demonstrated. Methods Using telemedicine, our hub stroke research center partnered with two spoke community hospitals to jointly participate in a randomized, phase III adjunctive thrombolysis clinical trial in the first 3 h after symptom onset to expand recruitment of the trial. Eligible patients were successfully identified, consented, randomized, and received therapy/placebo at the spoke hospitals under real-time direction by hub trialists via telemedicine. Results Ten patients were identified from May 2013 to July 2014, and six were enrolled via telemedicine. No study procedure delays, safety events, or major protocol violations occurred. Conclusions It is feasible to randomize and enroll stroke patients via remote telemedicine into an acute thrombolytic clinical trial. This novel approach could expand access and accelerate completion of clinical trials if widely implemented. PMID:25642433

Wu, Tzu-Ching; Sarraj, Amrou; Jacobs, Amber; Shen, Loren; Indupuru, Hari; Biscamp, Donna; Ho, Victor; Ankrom, Christy; Grotta, James C; Savitz, Sean I; Barreto, Andrew D

2015-01-01

452

Alignment of Misuse Cases with Security Risk Management  

Microsoft Academic Search

It is recognised that security has to be addressed through the whole system development process. However current practices address security only in late stages, i.e., development or maintenance. Due to the success of UML use cases, misuse cases have been accepted by industry as a means to tackle security. However misuse cases, firstly, lack a precise application process, secondly, are

Raimundas Matulevicius; Nicolas Mayer; Patrick Heymans

2008-01-01

453

The Use of Telemedicine Technology and Restructured Referral Patterns to Reduce Health Care Costs in a Juvenile Justice System  

Microsoft Academic Search

The study objective was to examine the cost-effectiveness and cost savings of a telemedicine program in four adolescent detention facilities in Tennessee. The facilities, in rural communities with limited access to specialty health care resources, implemented a telemedicine and referral program that obtained care from an academic medical center. The study measured costs for specialty outpatient, emergency department, and inpatient

Karen C. Fox; Grant Somes; Teresa M. Waters

2006-01-01

454

77 FR 41986 - Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services  

Federal Register 2010, 2011, 2012, 2013

...HUMAN SERVICES Indian Health Service Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services...OCPS), Community Based Model of Public Health Nursing Case Management Services. This program is...

2012-07-17

455

Case Management: Steadfast Resource for Addressing Linkage to Care and Prevention with Hospitalized HIV-Infected Crack Users  

PubMed Central

Interviews were conducted among HIV-positive inpatients in Miami, Florida and Atlanta, Georgia to examine whether having a case manager was associated with improved outcomes. We explored whether current use of a case manager was associated with unprotected sex, HIV care, use of antiretroviral medications, and referral to case management at time of diagnosis. Outcomes among patients who received case management were compared to those without a case manager. Participants with a current case manager were significantly more likely to take HIV medications, have obtained HIV care within the past six months, and have been referred to case management when first diagnosed. They were also significantly less likely to engage in unprotected sex within the last six months. Interventions that link HIV positive patients with a case manager may improve HIV health-seeking behaviors and reduce sexual risk engagement which may lead to improved clinical results.

Kenya, Sonjia; Chida, Natasha; Cardenas, Gabriel; Pereyra, Margaret; Del Rio, Carlos; Rodriguez, Allan; Metsch, Lisa

2015-01-01

456

Telemedicine and the patient-centered medical home.  

PubMed

Imagine an environment where health care coordination is seamless; where the pediatricians and their care teams could significantly reduce the time it takes to communicate and transfer the information between physicians, patients, and their families. Imagine a situation where unnecessary referrals and investigations are avoided, saving costs and anxieties for the patients. Welcome to the world of telemedicine and a patient-centered medical home (PCMH). Comprehensive health care delivered in the most efficient manner with the least expense is the cornerstone of these concepts. The concept of PCMH was first introduced in 1967 by the American Academy of Pediatrics (AAP) Council on Pediatric Practice in the book, Standards of Child Health Care. The medical home concept originally referred to one central source of medical records for children with special health care needs. During the past 4 decades, this concept has transformed beyond data entry to methods of delivering the best quality of care for all children. In 2007, a joint statement by the AAP, the American Academy of Family Physicians, the American College of Physicians, and the American Osteopathic Association endorsed the PCMH concept. PMID:24512158

Herendeen, Neil; Deshpande, Prashant

2014-02-01

457

Transmission of olfactory information for tele-medicine  

SciTech Connect

While the inclusion of visual, aural, and tactile senses into virtual reality systems is widespread, the sense of smell has been largely ignored. We have developed a chemical vapor sensing system for the automated identification of chemical vapors (smells). Our prototype chemical vapor sensing system is composed of an array of tin-oxide vapor sensors coupled to an artificial neural net-work. The artificial neural network is used in the recognition of different smells and is constructed as a standard multilayer feed-forward network trained with the backpropagation algorithm. When a chemical sensor array is combined with an automated pattern identifier, it is often referred to as an electronic or artificial nose. Applications of electronic noses include monitoring food and beverage odors, automated flavor control, analyzing fuel mixtures, and quantifying individual components in gas mixtures. Our prototype electronic nose has been used to identify odors from common household chemicals. An electronic nose will potentially be a key component in an olfactory input to a telepresent virtual reality system. The identified odor would be electronically transmitted from the electronic nose at one site to an odor generation system at another site. This combination would function as a mechanism for transmitting olfactory information for telepresence. This would have direct applicability in the area of telemedicine since the sense of smell is an important sense to the physician and surgeon. In this paper, our chemical sensing system (electronic nose) is presented along with a proposed method for regenerating the transmitted olfactory information.

Keller, P.E.; Kouzes, R.T.; Kangas, L.J.; Hashem, S.

1995-01-01

458

Development of a portable vital sensing system for home telemedicine.  

PubMed

For safe and effective home medical care, a network system for observing one's vital signs noninvasively and evaluating one's health conditions is highly desirable. In this paper, we described a portable vital sensing system and a home medical server to establish a home telemedicine system. In order to develop a portable vital sensing system, physiological sensing circuit, digital signal processor and wireless communication device are integrated into a small electrical circuit, called "smart telecom unit" with a size of 25mm * 37mm. By using a smart telecom unit, noninvasive vital sensing units including blood pressure, electrocardiograph, pulse wave and body temperature were developed. These sensing units are able to communicate vital records to a home medical server, which consists of a small computer and virtual physiological model to estimate health conditions and can seamlessly connect to the Internet. The accuracy and stability were evaluated in the system performance test. As a result of a performance test of a portable vital sensing system, these vital data could be measured easily and noninvasively. In addition, vital sensing system is able to communicate vital records to home medical server. Hence, it could be confirmed that it was useful to analyze daily health condition in order to prevent a lifestyle disease like hypertension, hyperlipidemia and diabetes. PMID:18003350

Ichihashi, F; Sankai, Y

2007-01-01

459

Ecological approaches to self-management: the case of diabetes.  

PubMed

In the Diabetes Initiative of The Robert Wood Johnson Foundation, an ecological perspective helped identify the following key resources and supports for self-management (RSSM): individualized assessment, collaborative goal setting, skills enhancement, follow-up and support, access to resources, and continuity of quality clinical care. These RSSM reflect the grounding of diabetes self-management in the context of social and environmental influences. Research supports the value of each of these key resources and supports. Differences among self-management interventions may be seen as complementary, rather than conflicting, ways of providing RSSM. This way of understanding differences among interventions may aid development of varied programs to reach diverse audiences. In contrast to the "5 A's" model of key provider services (Assess, Advise, Agree, Assist, and Arrange), RSSM articulate self-management from the perspective of individuals' needs. Both approaches emphasize identification of goals, teaching of skills, and facilitation and reinforcement of the use of those skills. PMID:16051929

Fisher, Edwin B; Brownson, Carol A; O'Toole, Mary L; Shetty, Gowri; Anwuri, Victoria V; Glasgow, Russell E

2005-09-01

460

Telemedicine for genetic and neurologic evaluation in the Neonatal Intensive Care Unit  

PubMed Central

Objectives Evaluate whether telemedicine can be used to perform dysmorphology and neurologic examinations in the neonatal intensive care unit (NICU) by determining the examination accuracy, limitations, and optimized procedures. Study design Prospective evaluation of NICU patients referred for subspecialty consultation for dysmorphic features (n=10) or encephalopathy (n=10). A physician at bedside (bedside clinician) performed an in-person examination which was viewed in real-time by a remote physician (remote consultant). Standardized examinations were recorded and compared. Subsequently, a qualitative approach established technique adjustments and optimization procedures necessary to improve visualization. Results Telemedicine examinations identified 81 of 87 (93%) dysmorphology examination abnormalities and 37 of 39 (92%) neurologic examination abnormalities. Optimization of remote consultant visualization required an active bedside clinician assisting in camera and patient adjustments. Conclusions Telemedicine can be used to accurately perform many components of the dysmorphology or neurologic examinations in NICU patients, but physicians must be mindful of specific limitations. PMID:24406740

Wenger, Tara L.; Gerdes, Jeffrey; Taub, Katherine; Swarr, Daniel T.; Deardorff, Matthew A.; Abend, Nicholas S.

2013-01-01

461

A Review on Telemedicine-Based WBAN Framework for Patient Monitoring  

PubMed Central

Abstract Objective: In this article, we describe the important aspects like major characteristics, research issues, and challenges with body area sensor networks in telemedicine systems for patient monitoring in different scenarios. Present and emerging developments in communications integrated with the developments in microelectronics and embedded system technologies will have a dramatic impact on future patient monitoring and health information delivery systems. The important challenges are bandwidth limitations, power consumption, and skin or tissue protection. Materials and Methods: This article presents a detailed survey on wireless body area networks (WBANs). Results and Conclusions: We have designed the framework for integrating body area networks on telemedicine systems. Recent trends, overall WBAN-telemedicine framework, and future research scope have also been addressed in this article. PMID:23841489

Gupta, Bharat; Ghosh, Soumya K.

2013-01-01

462

Environmental management accounting in local government : A case of waste management  

Microsoft Academic Search

Purpose – This study aims to explore the state of environmental management accounting practice and the motivations for its use with a view to improving waste and recycling management by local government. The focus is on practice in local governments situated in the state of New South Wales (NSW), Australia. Prior studies suggest the need for environmental management accounting as

Wei Qian; Roger Burritt; Gary Monroe

2011-01-01

463

Can economic evaluation in telemedicine be trusted? A systematic review of the literature  

PubMed Central

Background Telemedicine has been advocated as an effective means to provide health care services over a distance. Systematic information on costs and consequences has been called for to support decision-making in this field. This paper provides a review of the quality, validity and generalisability of economic evaluations in telemedicine. Methods A systematic literature search in all relevant databases was conducted and forms the basis for addressing these issues. Only articles published in peer-reviewed journals and written in English in the period from 1990 to 2007 were analysed. The literature search identified 33 economic evaluations where both costs (resource use) and outcomes (non-resource consequences) were measured. Results This review shows that economic evaluations in telemedicine are highly diverse in terms of both the study context and the methods applied. The articles covered several medical specialities ranging from cardiology and dermatology to psychiatry. The studies analysed telemedicine in home care, and in primary and secondary care settings using a variety of different technologies including videoconferencing, still-images and monitoring (store-and-forward telemedicine). Most studies used multiple outcome measures and analysed the effects using disaggregated cost-consequence frameworks. Objectives, study design, and choice of comparators were mostly well reported. The majority of the studies lacked information on perspective and costing method, few used general statistics and sensitivity analysis to assess validity, and even fewer used marginal analysis. Conclusion As this paper demonstrates, the majority of the economic evaluations reviewed were not in accordance with standard evaluation techniques. Further research is needed to explore the reasons for this and to address how economic evaluation in telemedicine best can take advantage of local constraints and at the same time produce valid and generalisable results. PMID:19852828

Bergmo, Trine S

2009-01-01

464