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Sample records for telemedicine case management

  1. Telemedicine for wound management

    PubMed Central

    Chittoria, Ravi K.

    2012-01-01

    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

  2. Telemedicine utilization to support the management of the burns treatment involving patient pathways in both developed and developing countries: a case study.

    PubMed

    Syed-Abdul, Shabbir; Scholl, Jeremiah; Chen, Chiehfeng Cliff; Santos, Martinho D P S; Jian, Wen-Shan; Liou, Der-Ming; Li, Yu-Chuan

    2012-01-01

    This case study reports on the utilization of telemedicine to support the management of the burns treatment in the islands of Sao Tome and Principe by Taipei Medical University-affiliated hospital in Taiwan. The authors share experiences about usage of telemedicine to support treatment of the burn victims in a low-income country that receive reconstructive surgery in a developed country. Throughout the entire care process, telemedicine has been used not only to provide an expert advice from distance but also to help establish and maintain the doctor-patient relationship, to keep patients in contact with their families, and to help educate and consult the medical personal physically present in Sao Tome and Principe. This case study presents the details of how this process has been conducted to date, on what were learned from this process, and on issues that should be considered to improve this process in the future. The authors plan to create instructional videos and post them on YouTube to aid clinical workers providing similar treatment during the acute care and rehabilitation process and also to support eLearning in many situations where it otherwise is not possible to use videoconferencing to establish real-time contact between doctors at the local site and remote specialists. PMID:22249104

  3. Telemedicine

    PubMed Central

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

    2010-01-01

    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

  4. Telemedicine framework using case-based reasoning with evidences.

    PubMed

    Sene, A; Kamsu-Foguem, B; Rumeau, P

    2015-08-01

    Telemedicine is the medical practice of information exchanged from one location to another through electronic communications to improve the delivery of health care services. This research article describes a telemedicine framework with knowledge engineering using taxonomic reasoning of ontology modeling and semantic similarity. In addition to being a precious support in the procedure of medical decision-making, this framework can be used to strengthen significant collaborations and traceability that are important for the development of official deployment of telemedicine applications. Adequate mechanisms for information management with traceability of the reasoning process are also essential in the fields of epidemiology and public health. In this paper we enrich the case-based reasoning process by taking into account former evidence-based knowledge. We use the regular four steps approach and implement an additional (iii) step: (i) establish diagnosis, (ii) retrieve treatment, (iii) apply evidence, (iv) adaptation, (v) retain. Each step is performed using tools from knowledge engineering and information processing (natural language processing, ontology, indexation, algorithm, etc.). The case representation is done by the taxonomy component of a medical ontology model. The proposed approach is illustrated with an example from the oncology domain. Medical ontology allows a good and efficient modeling of the patient and his treatment. We are pointing up the role of evidences and specialist's opinions in effectiveness and safety of care. PMID:26001421

  5. Dynamic biosignal management and transmission during telemedicine incidents handled by Mobile Units over diverse network types.

    PubMed

    Mandellos, George J; Koutelakis, George V; Panagiotakopoulos, Theodor C; Koukias, Andreas M; Koukias, Mixalis N; Lymberopoulos, Dimitrios K

    2008-01-01

    Early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. This paper focuses on the design and implementation of a telemedicine system that supports diverse types of endpoints including moving transports (MT) (ambulances, ships, planes, etc.), handheld devices and fixed units, using diverse communication networks. Target of the above telemedicine system is the pre-hospital patient treatment. While vital sign transmission is prior to other services provided by the telemedicine system (videoconference, remote management, voice calls etc.), a predefined algorithm controls provision and quality of the other services. A distributed database system controlled by a central server, aims to manage patient attributes, exams and incidents handled by different Telemedicine Coordination Centers (TCC). PMID:19163300

  6. Telemedicine.

    PubMed

    Dorman, T

    2000-09-01

    Telemedicine began from the humble beginnings of the first telephone call from Alexander Graham Bell to his associate, Watson. These systems already have been used for educational programs, consultative care, image transfer, second opinions, and direct acute patient care. Most of the original programs failed because of several reasons, primarily because of lack of funding when a grant ended. The major lesson of these programs is that a solid business plan is needed initially for long-term survival. The reliability of telemedical examinations has been demonstrated superficially, but more conclusive work in this area is needed. Studies that evaluate clinical, financial, and satisfaction outcomes are required simultaneously. Further integration of medical informatics into telemedicine systems is needed before these systems can achieve more acceptance. Twenty years ago, few people predicted this technologic revolution. Innovations arise almost daily. The future seems promising for telemedical systems, but much work is required. Partnerships with industry must move beyond niche projects, and regulatory and medicolegal issues must be resolved. Anesthesiologists can expect their practice to be affected directly by technology, and should embrace it, evaluate it, and help lead its use in this millennium. PMID:10989714

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

    PubMed

    McCue, Michael J; Palsbo, Susan E

    2006-04-01

    The objective of this study was to demonstrate the business case for telemedicine in nonrural areas. We developed an interactive spreadsheet to conduct multiple financial analyses under different capital investment, revenue, and expense scenarios. We applied the spreadsheet to the specific case of poststroke rehabilitation in urban settings. The setting involved outpatient clinics associated with a freestanding rehabilitation hospital in Oklahoma. Our baseline scenario used historical financial data from face-to-face encounters as the baseline for payer and volume mix. We assumed a cost of capital of 10% to finance the project. The outcome measures were financial breakeven points and internal rate of return. A total of 340 telemedicine visits will generate a positive net cash flow each year. The project is expected to recoup the initial investment by the fourth year, produce a positive present value dollar return of more than $2,000, and earn rate of return of 20%, which exceeds the hospital's cost of capital. The business case is demonstrated for this scenario. Urban telemedicine programs can be financially self-sustaining without accounting for reductions in travel time by providers or patients. Urban telemedicine programs can be a sound business investment and not depend on grants or subsidies for start-up funding. There are several key decision points that affect breakeven points and return on investment. The best business strategy is to approach the decision as whether or not to build a new clinic. PMID:16620163

  8. Telemedicine diffusion in a developing country: The case of India (March 2004)

    USGS Publications Warehouse

    Pal, A.; Mbarika, V.W.A.; Cobb-Payton, F.; Datta, P.; McCoy, S.

    2005-01-01

    Telemedicine (health-care delivery where physicians examine distant patients using telecommunications technologies) has been heralded as one of several possible solutions to some of the medical dilemmas that face many developing countries. In this study, we examine the current state of telemedicine in a developing country, India. Telemedicine has brought a plethora of benefits to the populace of India, especially those living in rural and remote areas (constituting about 70% of India's population). We discuss three Indian telemedicine implementation cases, consolidate lessons learned from the cases, and culminate with potential researchable critical success factors that account for the growth and modest successes of telemedicine in India. ?? 2005 IEEE.

  9. Evaluating the impact of a mobile oral telemedicine system on medical management and clinical outcomes of patients with complicated oral lesions in Botswana.

    PubMed

    Tesfalul, Martha; Littman-Quinn, Ryan; Antwi, Cynthia; Ndlovu, Siphiwo; Motsepe, Didintle; Phuthego, Motsholathebe; Tau, Boitumelo; Mohutsiwa-Dibe, Neo; Kovarik, Carrie

    2013-01-01

    Mobile telemedicine, which involves the use of cellular phone telecommunications to facilitate exchange of information between parties in different locations to assist in the management of patients, has become increasingly popular, particularly in resource-limited settings. In Botswana, small studies of mobile telemedicine programs suggest access to these services positively affect patients, but these programs' impact is difficult to capture given limitations of baseline and comparative data. Our observational study uses each patient receiving mobile oral telemedicine services in Botswana as his/her own control to assess the impact of these services on his/her diagnosis and management plan. At month 5 of 12 total, preliminary analysis of eligible cases (n = 27) reveals management plan discordance between clinicians submitting cases and the specialist was 68.0% (17/25), suggesting that telemedicine can result in significant changes in management of patients. PMID:23920848

  10. The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

    PubMed Central

    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

    2014-01-01

    Abstract 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

  11. The use of telemedicine in the management of acute stroke.

    PubMed

    Rubin, Mark N; Demaerschalk, Bart M

    2014-01-01

    Cerebrovascular disease, including acute ischemic stroke, remains a major public health problem in the US and throughout the world. There has been a concerted effort to apply evidence-based practices to stroke care to improve primary and secondary prevention as well as poststroke outcomes. Geography and workforce shortages contribute to a disparity in stroke care, however, among the substantial proportion of the US population that lives outside the reach of an acute stroke-ready hospital or a primary or comprehensive stroke center. In an attempt to combat the rural-to-urban disparity and expand the availability of best stroke practices, Levine and Gorman proposed the development of telemedical outreach for acute stroke evaluation and management, which they called "telestroke." Since then, the practice of telestroke has been found to have a high interrater agreement with a bedside assessment of the National Institutes of Health Stroke Scale score, to enhance correct thrombolysis decision making as compared with telephone-only consultation, and to be cost-effective. In light of these findings and the perception of benefit by acute stroke providers and patients, there has been growing interest in and a rapid expansion of telestroke networks in the US and internationally. There are legal and financial barriers to more widespread use of telemedicine in general, including telestroke. Further research is needed to understand the potential merits of telestroke infrastructure for the many phases of stroke care including poststroke hospitalization, prevention of complications, enhancing secondary prevention, and education of patients and providers. PMID:24380481

  12. Telemedicine as a special case of machine translation.

    PubMed

    Wo?k, Krzysztof; Marasek, Krzysztof; Glinkowski, Wojciech

    2015-12-01

    Machine translation is evolving quite rapidly in terms of quality. Nowadays, we have several machine translation systems available in the web, which provide reasonable translations. However, these systems are not perfect, and their quality may decrease in some specific domains. This paper examines the effects of different training methods when it comes to Polish-English Statistical Machine Translation system used for the medical data. Numerous elements of the EMEA parallel text corpora and not related OPUS Open Subtitles project were used as the ground for creation of phrase tables and different language models including the development, tuning and testing of these translation systems. The BLEU, NIST, METEOR, and TER metrics have been used in order to evaluate the results of various systems. Our experiments deal with the systems that include POS tagging, factored phrase models, hierarchical models, syntactic taggers, and other alignment methods. We also executed a deep analysis of Polish data as preparatory work before automatized data processing such as true casing or punctuation normalization phase. Normalized metrics was used to compare results. Scores lower than 15% mean that Machine Translation engine is unable to provide satisfying quality, scores greater than 30% mean that translations should be understandable without problems and scores over 50 reflect adequate translations. The average results of Polish to English translations scores for BLEU, NIST, METEOR, and TER were relatively high and ranged from 7058 to 8272. The lowest score was 6438. The average results ranges for English to Polish translations were little lower (6758-7897). The real-life implementations of presented high quality Machine Translation Systems are anticipated in general medical practice and telemedicine. PMID:26617328

  13. Telemedicine in Acute-Phase Injury Management: A Review of Practice and Advancements

    PubMed Central

    Lewis, Erin R.; Thomas, Carlos A.; Mbarika, Victor W.A.

    2012-01-01

    Abstract Objectives: To offer a systematic review of the body of literature in the emerging field of telemedicine in the management of acute-phase injuries. Materials and Methods: We conducted a literature review. Results: Telemedicine has only recently been applied to the specialties of trauma, emergency care, and surgery. The potential benefits of telemedicine include a decrease in travel expenses, enhanced continuity of care, and increased access to specialized consultants in medically underserved and rural areas. Conclusions: There still exist barriers to the use of teletechnologies in medicine that limit their wider adoption. Poor infrastructure, limited equipment availability, and insufficient access to training and education for medical personnel have prevented wider use. PMID:22694296

  14. Twenty years of telemedicine in chronic disease management--an evidence synthesis.

    PubMed

    Wootton, Richard

    2012-06-01

    A literature review was conducted to obtain a high-level view of the value of telemedicine in the management of five common chronic diseases (asthma, COPD, diabetes, heart failure, hypertension). A total of 141 randomised controlled trials (RCTs) was identified, in which 148 telemedicine interventions of various kinds had been tested in a total of 37,695 patients. The value of each intervention was categorised in terms of the outcomes specified by the investigators in that trial, i.e. no attempt was made to extract a common outcome from all studies, as would be required for a conventional meta-analysis. Summarizing the value of these interventions shows, first, that most studies have reported positive effects (n = 108), and almost none have reported negative effects (n = 2). This suggests publication bias. Second, there were no significant differences between the chronic diseases, i.e. telemedicine seems equally effective (or ineffective) in the diseases studied. Third, most studies have been relatively short-term (median duration 6 months). It seems unlikely that in a chronic disease, any intervention can have much effect unless applied for a long period. Finally, there have been very few studies of cost-effectiveness. Thus the evidence base for the value of telemedicine in managing chronic diseases is on the whole weak and contradictory. PMID:22674020

  15. Management of Type 2 Diabetes Mellitus through Telemedicine

    PubMed Central

    Cipolla, Maurizio; Merante, Valentina; Medaglia, Valeria; Irace, Concetta; Gnasso, Agostino

    2015-01-01

    Background Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence. Methods "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period. Results The mean number of accesses to the Consultants during the study was 0.6±0.9 for Cases, and 1.3±1.5 for Controls (p<0.0001). At follow-up, glycated hemoglobin (HbA1c) significantly decreased from 58±6 to 54±8 mmol/mol in Cases only (p=0.01); LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0±4.8 to 30.5±4.6 kg/m2 (p=0.03). Conclusions The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM. PMID:25974092

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

    PubMed Central

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

    2014-01-01

    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

  17. Telemedicine in the intensive care unit: its role in emergencies and disaster management.

    PubMed

    Rolston, Daniel M; Meltzer, Joseph S

    2015-04-01

    Disasters and emergencies lead to an overburdened health care system after the event, so additional telemedicine support can improve patient outcomes. If telemedicine is going to become an integral part of disaster response, there needs to be improved preparation for the use of telemedicine technologies. Telemedicine can improve patient triage, monitoring, access to specialists, health care provider burnout, and disaster recovery. However, the evidence for telemedicine and tele-intensive care in the disaster setting is limited, and it should be further studied to identify situations in which it is the most clinically effective and cost-effective. PMID:25814452

  18. Theory and applications of telemedicine.

    PubMed

    Güler, Nihal Fatma; Ubeyli, Elif Derya

    2002-06-01

    In this study, telemedicine and the use of advanced telemedicine technologies are explained. Telemedicine is the use of modern telecommunications and information technologies for the provision of clinical care to individuals at a distance, and transmission of information to provide that care. Telemedicine can be used for decision making, remote sensing, and collaborative arrangements for the real-time management of patients at a distance. The use of telecommunications and information technologies in providing health services is determined. Telemedicine is described as combination of topics from the fields of telecommunication, medicine, and informatics. The medical systems infrastructure consisting of the equipment and processes used to acquire and present clinical information and to store and retrieve data are explained in details. The challenges existing in telemedicine development in different countries are given. Technological, political, and professional barriers in applications of telemedicine are defined. An investigation of telemedicine applications in various fields is presented, and enormous impact of telemedicine systems on the future of medicine is determined. PMID:12018607

  19. Use of telemedicine to manage severe ischaemic strokes in a rural area with an elderly population.

    PubMed

    Richard, Sébastien; Lavandier, K; Zioueche, Y; Pelletier, S; Vezain, A; Ducrocq, X

    2014-05-01

    The rural district of the Meuse (East France) has a high number of elderly patients for whom prognosis of ischaemic strokes is poor with high-haemorrhagic transformation risk of intravenous tissue plasminogen activator (rt-PA). This disadvantage is made worse by the distances a patient has to travel to the nearest stroke unit. We set out to assess the effectiveness of a telestroke system implemented in this area. Between October 2010 and February 2012, data from each "tele-expertised" patient were collected. 53 patients were examined. Diagnosis of ischaemic stroke was confirmed in 43 cases (81 %), and intravenous rt-PA treatment performed in 21 cases (40 %). In the treated patient group, median age was 73 years, with 29 % of octogenarians. Baseline National Institutes of Health Stroke Scale (NIHSS) was 16, with 29 % ? 20. The median onset to needle time was 169 min, and the median door to needle time was 69 min. Intracranial haemorrhage occurred in 3 cases (14 %), and was symptomatic in two (10 %). At 3 months, median NIHSS was 6, 6 patients (29 %) presented a favourable outcome (modified Rankin scale ? 1) and 3 (14 %) had died. In rural areas, for elderly patients with severe ischaemic strokes, telemedicine appears to be a way of improving accessibility and benefits of rt-PA treatment. PMID:24277200

  20. Telemedicine and ISDN

    SciTech Connect

    Akselsen, S.; Eidsvik, A.K.; Folkow, T. )

    1993-01-01

    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.

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

    PubMed

    Rufo, Rebecca Zapatochny

    2012-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

  3. Relationship between the Quality of Service Provided through Store-and-Forward Telemedicine Consultations and the Difficulty of the Cases – Implications for Long-Term Quality Assurance

    PubMed Central

    Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

    2015-01-01

    We examined the difficulty of telemedicine cases and the quality of the resultant consultation in a mature store-and-forward telemedicine network. A random sample of 10 telemedicine cases was selected from those occurring over a 3-month period (5% of the workload) and they were scored by three experienced observers. Inter-observer agreement on the difficulty scores was poor (Fleiss’s kappa?=?0.18) and it was also poor on the consultation quality scores (Fleiss’s kappa?=?0.11). Differences between observers were minimized by consensus scoring, and the cases were re-assessed jointly by two observers. Based on the consensus scores, there was a weak negative relation between output quality and case difficulty, i.e., the more difficult cases tended to result in lower quality consultations. However, the effect was non-significant (P?=?0.59) and a larger study might be helpful. In the meantime, routine monitoring of telemedicine service quality will continue in the interests of quality assurance. As yet, there is no evidence on which to base a correction for case difficulty. PMID:26442244

  4. Applications of Telemedicine and Telecommunications to Disaster Medicine

    PubMed Central

    Garshnek, Victoria; Burkle, Frederick M.

    1999-01-01

    Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. Appropriate new telemedicine applications can improve future disaster medicine outcomes, based on lessons learned from a decade of civilian and military disaster (wide-area) telemedicine deployments. This manuscript reviews the history of telemedicine activities in actual disasters and similar scenarios as well as ongoing telemedicine innovations that may be applicable to disaster situations. Emergency care providers must begin to plan effectively to utilize disaster-specific telemedicine applications to improve future outcomes. PMID:9925226

  5. Telemedicine as an innovative model for rebuilding medical systems in developing countries through multipartnership collaboration: the case of Albania.

    PubMed

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

    2015-06-01

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

  6. Telemedicine Program

    NASA Technical Reports Server (NTRS)

    1996-01-01

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

  7. Stroke Telemedicine

    PubMed Central

    Demaerschalk, Bart M.; Miley, Madeline L.; Kiernan, Terri-Ellen J.; Bobrow, Bentley J.; Corday, Doren A.; Wellik, Kay E.; Aguilar, Maria I.; Ingall, Timothy J.; Dodick, David W.; Brazdys, Karina; Koch, Tiffany C.; Ward, Michael P.; Richemont, Phillip C.

    2009-01-01

    Stroke telemedicine is a consultative modality that facilitates care of patients with acute stroke at underserviced hospitals by specialists at stroke centers. The design and implementation of a hub-and-spoke telestroke network are complex. This review describes the technology that makes stroke telemedicine possible, the members that should be included in a telestroke team, the hub-and-spoke characteristics of a telestroke network, and the format of a typical consultation. Common obstacles to the practice of telestroke medicine are explored, such as medicolegal, economic, and market issues. An example of a state-based telestroke network is thoroughly described, and established international telestroke networks are presented and compared. The opportunities for future advances in telestroke practice, research, and education are considered. PMID:19121244

  8. A store-forward ophthalmic telemedicine case report from deployed U. S. Army forces in Kuwait.

    PubMed

    Lattimore, M R

    1999-01-01

    This telemedicine test was developed to determine the relative ease with which an off-the-shelf ophthalmic telemedicine package could be successfully applied from within a remote theatre of operations. The project was conducted at the Camp Doha Health Clinic, located just outside Kuwait City, during the period from April 12(th) through April 23(rd), 1998. The deployed signal unit had contracted for a direct T-1 commercial satellite link (via MCI), which allowed for direct internet connectivity using a PCMCIA network card. Digital images were sent via this connection to 140 e-mail sites throughout the world, including an unsolicited image to each of 134 Army optometry officers for their review, analysis, and diagnosis. Return responses to this unsolicited survey were 53 out of 134, for a 39.7% response rate. Half of the respondents were able to view the image with ease and clarity, rendering an accurate clinical diagnosis. The other half of the respondents either did not have the software to display an image on their clinical desktop PC, or did not know how to use their provided software. This project clearly indicates that an off-the-shelf ophthalmic digital system can be successfully used from a remote deployed site. However, the consulting clinicians require up-to-date training, and their computer packages should have as wide a capability base as possible. PMID:10908445

  9. Application of Telemedicine System to Prehospital Medical Control

    PubMed Central

    Cho, Suck Ju; Kwon, In Ho

    2015-01-01

    Objectives Although ambulance-based telemedicine has been reported to be safe and feasible, its clinical usefulness has not been well documented, and different prehospital management systems would yield different results. The authors evaluated the feasibility and usefulness of telemedicine-assisted direct medical control in the Korean emergency medical service system. Methods Twenty ambulances in the Busan area were equipped with a telemedicine system. Three-lead electrocardiogram, blood pressure, and pulse oximetry data from the patient and audiovisual input from the scene were transferred to a server. Consulting physicians used desktop computers and the internet to connect to the server. Both requesting emergency medical service (EMS) providers and consulting physicians were asked to fill out report forms and submit them for analysis. Results In the 41 cases in which telemedicine equipment was used, cellular phones were concomitantly used in 28 cases (68.35%) to compensate for the poor audio quality provided by the equipment. The EMS providers rated the video transmission quality with a 4-point average score (interquartile range [IQR] 2-5) on a 5-point scale, and they rated the biosignal transmission quality as 4 (IQR 3-5). The consulting physicians rated the video quality as 4 (IQR 2.5-4) and the biosignal quality as 4 (IQR 3-4). The physicians' ratings for usefulness for making diagnosis or treatment decisions did not differ significantly in relation to the method of communication used. Conclusions Our study did not find any significant advantage of implementing telemedicine over the use of voice calls in delivering on-line medical control. More user-friendly, smaller devices with clear advantages over voice communication would be required before telemedicine can be successfully implemented in prehospital patient care. PMID:26279957

  10. Prerequisites for Effective Implementation of Telemedicine: Focusing on Current Situations in Korea

    PubMed Central

    Lee, Hyeoi-Yun; Lee, Ji-San

    2015-01-01

    Objectives The practice of telemedicine requires social interventions and systems for efficient implementation. Further, it requires sufficient discussions among related parties because the purpose of telemedicine is diagnosis and treatment, and the participation of medical specialists is essential. Based on the characteristics of the healthcare structure of Korea, which has a low proportion of public healthcare and most patients are taken care of by a few large tertiary care hospitals, the fundamental issues need to be discussed. Methods A comparison was conducted with overseas cases to discuss the prerequisites for the effective implementation of telemedicine in South Korea under the current situation. We also examined the structural characteristics of the Korean medical community. Results The current paper recommends that an in-depth analysis and studies are conducted on the following aspects: a search for telemedicine services focused on public healthcare, a search of services for illnesses that impose high levels of burden on households, and the development and implementation of a telemedicine system for follow-up management at primary and secondary care hospitals after the patient undergoes surgery or treatment at tertiary care hospitals. Conclusions As the technology develops, the focus should also be on factors such as safety, usefulness, availability, and how the functions will be realized in order to enable user communication. A clear system should be established to regulate and manage the lack of sufficient discussions. In addition, seeking projects and systems that reflect the characteristics of each country will facilitate the efficient implementation of telemedicine. PMID:26618031

  11. Patient perspectives of telemedicine quality

    PubMed Central

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

    2015-01-01

    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

  12. Perceptual Image Compression in Telemedicine

    NASA Technical Reports Server (NTRS)

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

    1996-01-01

    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.

  13. Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) Project

    PubMed Central

    Starren, Justin; Hripcsak, George; Sengupta, Soumitra; Abbruscato, C.R.; Knudson, Paul E.; Weinstock, Ruth S.; Shea, Steven

    2002-01-01

    The Columbia University Informatics for Diabetes Education and Telemedicine IDEATel) project is a four-year demonstration project funded by the Centers for Medicare and Medicaid Services with the overall goal of evaluating the feasibility, acceptability, effectiveness, and cost-effectiveness of telemedicine. The focal point of the intervention is the home telemedicine unit (HTU), which provides four functions: synchronous videoconferencing over standard telephone lines, electronic transmission for fingerstick glucose and blood pressure readings, secure Web-based messaging and clinical data review, and access to Web-based educational materials. The HTU must be usable by elderly patients with no prior computer experience. Providing these functions through the HTU requires tight integration of six components: the HTU itself, case management software, a clinical information system, Web-based educational material, data security, and networking and telecommunications. These six components were integrated through a variety of interfaces, providing a system that works well for patients and providers. With more than 400 HTUs installed, IDEATel has demonstrated the feasibility of large-scale home telemedicine. PMID:11751801

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

    PubMed Central

    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

    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

  15. Geriatric Telemedicine: Background and Evidence for Telemedicine as a Way to Address the Challenges of Geriatrics

    PubMed Central

    2015-01-01

    Objectives The global population of elderly people is increasing at a remarkable rate, which may be expected to continue for some time. Older patients require more care, and with the current model of care delivery, the costs may be expected to rise, although higher cost is unsustainable. For this reason, a new pattern of practice is needed. Telemedicine will be presented as a highly effective and necessary tool in geriatrics. Methods This review will present some of the background and evidence for telemedicine as a way to address the challenges of geriatrics through geriatric telemedicine. Some of the evidence for the value of telemedicine as a tool for physicians and healthcare systems is presented. Results Telemedicine offers many means to address the problems of geriatric care in creative ways. The use of electronic medicine, telecommunications, and information management has now found its way into the very fabric of health care. The use of telemedicine is a fait accompli in much of the world, and it continues to have an increasing role deeply imbedded in our electronic practices coupled with social media. Conclusions The evidence for successful incorporation of telemedicine into practice is abundant and continues to accrue. This is a great opportunity for medical practice to evolve to new levels of engagement with patients and new levels of attainment in terms of quality care. PMID:26618027

  16. Commercial applications of telemedicine

    NASA Technical Reports Server (NTRS)

    Natiello, Thomas A.

    1991-01-01

    Telemedicine Systems Corporation was established in 1976 and is a private commercial supplier of telemedicine systems. These systems are various combinations of communications and diagnostic technology, designed to allow the delivery of health care services to remote facilities. The technology and the health care services are paid for by the remote facilities, such as prisons.

  17. Proposal on the Establishment of Telemedicine Guidelines for Korea

    PubMed Central

    Jung, Eun-Young; Kang, Hyung Wook; Park, In-Hwa

    2015-01-01

    Objectives An official guideline must be prepared for legalizing the doctor-patient telemedicine system based on the evaluations of the ongoing telemedicine demonstration project performed by the Korean government. In this study, critical items of the Korean telemedicine guideline are suggested based on the guidelines of developed countries. Methods To investigate the telemedicine guidelines of developed countries, a keyword of 'telemedicine guidelines' was used for Google search to find out US, Australian, and Japanese guidelines. The common items included in two or more of the followings were screened: US Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions, the Australian New South Wales (NSW) Agency for Clinical Innovation Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW, and the Japanese Guidelines for the practice of home telemedicine. Results A total of 22 common items of the following four domains, which could be used for the Korean guideline were screened: the common features in overall considerations (6 items), the common features in clinical considerations (6 items), the common features in technical considerations (5 items), and the common features in privacy considerations (5 items). These 22 items were suggested as the critical items of the Korean telemedicine guideline. Conclusions The screened 22 items of the telemedicine guideline must be further organized for details. Additional studies and professional opinions on the telemedicine cases and on the guidelines of developed countries are required to establish the Korean guideline in the near future. PMID:26618032

  18. International Telemedicine/Disaster Medicine Conference: Papers and Presentations

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

  19. Telemedicine and burns: an overview.

    PubMed

    Atiyeh, B; Dibo, S A; Janom, H H

    2014-06-30

    Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency. PMID:26170782

  20. "Tuberculosis Case Management" Training.

    ERIC Educational Resources Information Center

    Knebel, Elisa; Kolodner, Jennifer

    2001-01-01

    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…

  1. Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

    PubMed

    Lapão, Luís Velez; Correia, Artur

    2015-01-01

    This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians. PMID:25980705

  2. American Telemedicine Association

    MedlinePLUS

    ... ATA Meetings ATA Business & Finance SIG Telemedicine Public Policy Corporate Product & Service Providers ATA is both a medical society and a trade association, working with all stakeholders to drive the ...

  3. Case Management Directors

    PubMed Central

    Bankston White, Cheri; Birmingham, Jackie

    2015-01-01

    Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of 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. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 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. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? 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 (CMs) reporting to them. Findings/Conclusions: Part 1 found that 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. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations that include payer, provider, and regulatory agencies. At the same time, they must also develop the skills to positively influence the revenue cycle and financial health of both the organization for which they work and those to whom they transition patients. Implications for Case Management: A director of case management with responsibility for transitions of care has more power and influence over patient safety than is commonly known. Few of the directors who are drawn from clinical case management or other leadership positions and thrust into this role are prepared to navigate within the organization, much less across the whole spectrum of payer, provider, and monitoring organizations. Yet the external focus of the director's role continues to grow in importance as the health care industry evolves and more focus is placed on population management and relationships with payers and community providers. PMID:25700135

  4. Telemedicine in Gastroenterohepatology

    PubMed Central

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

    2014-01-01

    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

  5. Design and development of a multimedia database for emergency telemedicine.

    PubMed

    Pavlopoulos, S; Berler, A; Kyriacou, E; Koutsouris, D

    1998-09-01

    Recent studies conclude that early and specialised pre-hospital patient management contributes to emergency cases survival. Recent developments in telecommunication and medical informatics by means of telemedicine can be extremely useful to accomplish such tasks in a cost-effective manner. Along that direction, we have designed a portable device for emergency telemedicine. This device is able to telematically "bring" the expert doctor at the emergency site, have him perform an accurate diagnosis, and subsequently direct the Emergency Medical Technicians on how to treat the patient until he arrives to the hospital. The need for storing and archiving all data being interchanged during the telemedicine sessions is very crucial for clinical, legal and administrative purposes. For this, we have developed a multimedia database able to store and manage the data collected by the AMBULANCE system. The database was equipped with a user-friendly graphical interface to enable use from computer naive users. Furthermore, the database has the possibility to display, in an standard way, ECG's, X-ray, CT and MRI images. The application is password protected with a three-level hierarchy access for users with different privileges. The scope of this application is to enhance the capabilities of the doctor on duty for a more precise and prompt diagnosis. The application has the ability to store audio files related to each emergency case and still images of the scene. Finally, this database can become a useful multimedia tool which will work together with the AMBULANCE portable device, the HIS and the PACS of the hospital. The system has been validated in selected non-critical cases and proved to be functional and successful in enhancing the ability of the doctor's on duty for prompt and accurate diagnosis and specialised pre-hospital treatment. PMID:9839856

  6. Telemedicine, virtual reality, and surgery

    NASA Technical Reports Server (NTRS)

    Mccormack, Percival D.; Charles, Steve

    1994-01-01

    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.

  7. Case Management Directors

    PubMed Central

    Bankston-White, Cheri; Birmingham, Jackie

    2015-01-01

    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

  8. Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study

    PubMed Central

    Lokkerbol, Joran; Adema, Dirk; Cuijpers, Pim; Reynolds, Charles F.; Schulz, Richard; Weehuizen, Rifka; Smit, Filip

    2014-01-01

    Objective Depressive disorders are important causes of disease burden and are associated with substantial economic costs. Therefore, it is important to design a health care system that can effectively manage depression at sustainable costs. This paper computes the benefit-to-costs ratio of the current Dutch health care system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall. Methods A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compares a base-case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome is the benefit-to-cost ratio, also known as return-on-investment (ROI). Results In terms of ROI, a health care system with preventive telemedicine for depressive disorders offers better value for money than a health care system without internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base-case scenario to €1.76 ($2.09) in the alternative scenario where preventive telemedicine is offered. In a scenario where the costs of offering preventive telemedicine are balanced by cutting back on the expenditure for curative interventions, ROI increases to €1.77 ($2.10), while keeping the health care budget constant. Conclusion In order for a health care system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement. PMID:23759290

  9. Telemedicine in the 'Hood.

    ERIC Educational Resources Information Center

    Elgrably, Jordan

    1998-01-01

    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…

  10. Case Management Services. Chapter 7.

    ERIC Educational Resources Information Center

    1996

    This collection of papers presented at a 1996 conference on children's mental health focuses on case management services. Papers have the following titles and authors: (1) "Providing Intensive Child Case Management Services: What Do Case Managers Do with Their Time?" (Gail B. Werrbach and James Harrod); (2) "Outcome-Oriented Case Planning in Child…

  11. The evolution of telemedicine and nano-technology

    NASA Astrophysics Data System (ADS)

    Park, Dong Kyun; Young Jung, Eun; Chan Moon, Byung

    2012-10-01

    This paper will cover definition and history of telemedicine, changes in medical paradigm and roll of telemedicine and roll of nano-technology for evolution of telemedicine. Hypothetically, telemedicine is distance communication for medical purpose and modern definition explains telemedicine as `a system of health care delivery in which physicians examine distant patients through the use of telecommunications technology. Medical service will change to personalized medicine based on gene information to prevent and manage diseases due to decrease of acute diseases, population aging and increase of prevalence in chronic diseases, which means current medical services based on manualized treatment for diseases will change to personalized medicine based on individual gene information. Also, international healthcare will be activated to provide high quality medical services with low cost using developed transportation. Moreover, hospital centered medical services will change to patients centered medical service due to increase of patient's rights. Development in sensor technology is required for telemedicine to be applied as basic infrastructure for medical services. Various researches in nano-biosensor field are conducted due to introduction of new technologies. However, most researches are in fundamental levels that requires more researches for stability and clinical usefulness. Nano technology is expected to achieve innovative development and define new criteria for disease prevention and management.

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

    PubMed Central

    2014-01-01

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

  13. Emerging Technologies for Telemedicine

    PubMed Central

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

    2012-01-01

    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

  14. Telemedicine and telepharmacy: current status and future implications.

    PubMed

    Angaran, D M

    1999-07-15

    Uses of telemedicine are described and potential roles for pharmacists are discussed. Telemedicine has been defined as "the use of electronic information and communications technologies to provide and support health care when distance separates the participants." Technologies included in telemedicine are videoconferencing, telephones, computers, the Internet, fax, radio, and television. Telepharmacy has the same basic definition but refers to pharmaceutical care provision. Although the videotelemedicine market is expected to grow considerably, lack of reimbursement and high costs are continuing obstacles. Pharmacy is using video-conferencing for education, training, and management purposes. The telephone has changed from a dial-and-talk instrument to a multimedia access tool. Medical devices are being attached to telephone lines to provide remote monitoring and therapy, and call centers are providing medication counseling, prior authorization, refill authorization, and formulary compliance monitoring. Although the Internet has quickly become a star performer, utilization by health care lags behind that of other industries. The Internet-fueled empowerment of consumers and their expectations for speed, access, and convenience are creating more unmet expectations of the traditional health care system. Pharmacy has both organizational and individual practitioner Web sites, but it is online drugstores that are attracting most attention. Potential benefits of telemedicine include improved access to care, greater efficiency in diagnosis and treatment, higher productivity, and market positioning for the coming century. Telemedicine will tax the economic, regulatory, legal, ethical, and clinical care expertise of the entire health care system. Studies of the effectiveness, cost, and societal implications of telemedicine are needed, along with practice models and standards, training programs, and solutions to regulatory, licensing, and legal questions. Securing reimbursement for cognitive services remains a problem for telemedicine and telepharmacy. Telemedicine presents profound opportunities and challenges to pharmacy and other health care professions. PMID:10428449

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

    PubMed Central

    Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

    2014-01-01

    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

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

    PubMed

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

    2014-09-01

    The purpose of this study is to explore the determinants of telemedicine acceptance in selected public hospitals in Malaysia and to investigate the effect of health culture on the relationship between these determinants and telemedicine acceptance. Data were gathered by means of a survey of physicians and nurses as the main group of users of telemedicine technology from hospitals that are currently using telemedicine technology. The results indicated that government policies, top management support, perception of usefulness and computer self-efficiency have a positive and significant impact on telemedicine acceptance by public hospitals in Malaysia. The results also confirmed the moderating role of health culture on the relationship between government policies as well as perceived usefulness on telemedicine acceptance by Malaysian hospitals. The results are useful for decision-makers as well as managers to recognize the potential role of telemedicine and assist in the process of implementation, adoption and utilization, and, therefore, spread the usage of telemedicine technology in more hospitals in the country. PMID:25038891

  17. Preliminary experiences with telemedicine, multimedia, and ATM

    NASA Astrophysics Data System (ADS)

    Cabral, James E., Jr.; Deforge, Christian; Kim, Yongmin

    1996-04-01

    With the goal of eventually increasing the quality of medical care, especially in remote areas, we have developed a system for telemedicine research based on a combination of ATM networking and a high-speed DSP board based on the Texas Instruments TMS320C80. The purpose of the system is to give health care providers at remote locations the ability to consult with specialists using a combination of video, audio, and externally-acquired images. The system can also be used for education purposes to support bi-directional video/audio communications for grand round lectures, classes, and case conferences. In order to maximize the utilization of the available transmission medium (ranging from land-based copper and fiber optic cable to satellite link) while providing the best possible video and audio quality, the compression performed by the system is adaptable to a wide variety of bandwidths. After about two years of experience with telemedicine in a research environment, we have some preliminary findings to report regarding the performance of a telemedicine application combining ATM and programmable multimedia processors in PC environments.

  18. Case management: quality care today.

    PubMed

    Firman, J

    1991-02-01

    The literature demonstrates that the concept of case management offers quality, patient-centered care. Case management promotes the wise utilization of resources and has economic advantages. The benefits of case management are widespread. Everyone concerned with patient care is affected positively, including the patient, family, caregivers, and the facility itself. The benefits far outweigh the potential problems outlined in the literature, and these problems can be eliminated with proper education. The movement toward the use of case management makes good business sense. It will continue. PMID:10108631

  19. Telemedicine Security: A Systematic Review

    PubMed Central

    Garg, Vaibhav; Brewer, Jeffrey

    2011-01-01

    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

  20. Effects and Effectiveness of Telemedicine

    PubMed Central

    Grigsby, Jim; Kaehny, Margaret M.; Sandberg, Elliot J.; Schlenker, Robert E.; Shaughnessy, Peter W.

    1995-01-01

    The use of telemedicine has recently undergone rapid growth and proliferation. Although the feasibility of many applications has been tested for nearly 30 years, data concerning the costs, effects, and effectiveness of telemedicine are limited. Consequently, the development of a strategy for coverage, payment, and utilization policy has been hindered. Telemedicine continues to expand, and pressure for policy development increases in the context of Federal budget cuts and major changes in health service financing. This article reviews the literature on the effects and medical effectiveness of telemedicine. It concludes with several recommendations for research, followed by a discussion of several specific questions, the answers to which might have a bearing on policy development. PMID:10153466

  1. Telemedicine in Critical Care

    PubMed Central

    Murias, Gastón; Sales, Bernat; Garcia-Esquirol, Oscar; Blanch, Lluis

    2009-01-01

    Critical care medicine is the specialty that cares for patients with acute life-threatening illnesses where intensivists look after all aspects of patient care. Nevertheless, shortage of physicians and nurses, the relationship between high costs and economic restrictions, and the fact that critical care knowledge is only available at big hospitals puts the system on the edge. In this scenario, telemedicine might provide solutions to improve availability of critical care knowledge where the patient is located, improve relationship between attendants in different institutions and education material for future specialist training. Current information technologies and networking capabilities should be exploited to improve intensivist coverage, advanced alarm systems and to have large critical care databases of critical care signals. PMID:19452034

  2. Telemedicine and international disaster response: Medical consultation to Armenia and Russia via a telemedicine spacebridge

    NASA Technical Reports Server (NTRS)

    Houtchens, Bruce A.; Clemmer, Terry P.; Holloway, Harry C.; Kiselev, Alexander A.; Logan, James S.; Merrell, Ronald C.; Nicogossian, Arnauld E.; Nikogossian, Haik A.; Rayman, Russell B.; Sarkisian, Ashot E.

    1991-01-01

    The Telemedicine Spacebridge, a satellite mediated audio-video-fax link between four U.S. and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several U.S. medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to onsite physicians and favorably influence clinical decisions in the aftermath of major disasters.

  3. Rural telemedicine project in northern New Mexico

    SciTech Connect

    Zink, S.; Hahn, H.; Rudnick, J.; Snell, J.; Forslund, D.; Martinez, P.

    1998-12-31

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

  4. Valuation of Online Continuing Medical Education and Telemedicine in Taiwan

    ERIC Educational Resources Information Center

    Wang, Fuhmei

    2008-01-01

    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

  5. Implementing telemedicine in medical emergency response: concept of operation for a regional telemedicine hub.

    PubMed

    Xiong, Wei; Bair, Aaron; Sandrock, Christian; Wang, Sophia; Siddiqui, Javeed; Hupert, Nathaniel

    2012-06-01

    A regional telemedicine hub, providing linkage of a telemedicine command center with an extended network of clinical experts in the setting of a natural or intentional disaster, may facilitate future disaster response and improve patient outcomes. However, the health benefits derived from the use of telemedicine in disaster response have not been quantitatively analyzed. In this paper, we present a general model of the application of telemedicine to disaster response and evaluate a concept of operations for a regional telemedicine hub, which would create distributed surge capacity using regional telemedicine networks connecting available healthcare and telemedicine infrastructures to external expertise. Specifically, we investigate (1) the scope of potential use of telemedicine in disaster response; (2) the operational characteristics of a regional telemedicine hub using a new discrete-event simulation model of an earthquake scenario; and (3) the benefit that the affected population may gain from a coordinated regional telemedicine network. PMID:21161569

  6. Teaching medical students pediatric cardiovascular examination by telemedicine.

    PubMed

    Strehle, Eugen-Matthias; Earle, Gary; Bateman, Belinda; Dickinson, Kevin

    2009-05-01

    The aim of this feasibility study was to assess whether medical students can be taught the pediatric examination of the cardiovascular system (CVS) facilitated by telemedicine equipment. The views of the students regarding this new technology were sought in a subsequent questionnaire survey. Seventy-seven (n = 77) medical students attended eight telemedicine sessions that consisted of a lecture, case discussion, and physical examination of a child using an electronic stethoscope. The acceptance of this novel teaching method was generally good, but a minority of students (10%) preferred face-to-face encounters with the lecturer. Technical problems were common and may have influenced the outcome of the sessions. Teaching by telemedicine is a viable alternative to conventional teaching and should be applied when clinicians cannot meet the students in person. PMID:19441952

  7. The HOMEY project: a telemedicine service for hypertensive patients

    E-print Network

    Grasso, Floriana

    The HOMEY project: a telemedicine service for hypertensive patients Toni Giorgino1,2, Silvana for chronic hypertensive patients. A remarkable point in the development of systems that are going to communicate with patients is the promotion of compliant behaviors. In the case of hypertension, we refer

  8. Current Perception of Telemedicine in an EU Country

    PubMed Central

    POENARU, Calin; POENARU, Elena; VINEREANU, Dragos

    2014-01-01

    Objectives: To assess the perception and expectation of beneficiaries and providers of telemedicine services in Romania. Methods: Interview (on-line and face-to-face) of 109 representatives of medical community, from two categories: physicians, involved directly in the patient care, and medical and information technology directors of state and private owned clinics and hospitals. A third group, formed by executives from main technology service provider companies, was added in order to expand the results with their vision as potential suppliers of telemedicine projects. Outcomes: We evaluated 4 important aspects of telemedicine: actual status of the services, development efforts and allocated budget, expected future services, and stoppers and enablers. On the actual status we identified in 48% of the cases the existence of core services good enough to start advanced telemedicine services. We developed a metric (SOR = Supporter/Opponents Ratio) to evaluate the suitability of telemedicine services to evolve and to deliver on expectations. The analysis shows that physicians see potential for development for EHR and PACS (both with SOR >25), but the executives start looking forward to more advanced services like remote patient monitoring. Main impact is expected in collaboration and patient quality life areas and, by far, the main stoppers are reduced budgets and organizational problems to adapt to the new data models. Conclusions: We identified a strong support from the physicians related with the introduction of new type of healthcare services accompanied with high expectations. On the executive level, the expectations are different, ranging from low optimism on the technology side, to serious support on the medical side. However, there is a clear trend, able to create the first telemedicine services during the next years. PMID:25705307

  9. Show Me Echo - Hepatitis C: A telemedicine mentoring program for patients with hepatitis C in underserved and rural areas in Missouri as a model in developing countries.

    PubMed

    Tahan, Veysel; Almashhrawi, Ashraf; Mutrux, Rachel; Ibdah, Jamal A

    2015-11-01

    Project (Extension for Community Healthcare Outcomes) (ECHO) is a telemedicine case-based training model for primary care providers to treat complex diseases by mentoring academicians of universities. It was first developed by the University of New Mexico for rural and underserved areas in New Mexico. The project Show Me ECHO- Hepatitis C (HCV) is an adaptation of Project ECHO to improve healthcare and hepatitis C therapy in the entire state of Missouri, including rural and underserved areas. Show Me ECHO- HCV uses telemedicine as videoconferencing technology for the case-based learning. The medical specialists of the University of Missouri-Columbia provide training and mentoring to primary care providers working in rural and urban underserved areas to deliver the best evidence-based care for patients with hepatitis C. This type of a model is promising in the management of patients with hepatitis C in developing countries with the availability of basic internet connections and potential voluntary participants. PMID:26510085

  10. Design and develop a video conferencing framework for real-time telemedicine applications using secure group-based communication architecture.

    PubMed

    Mat Kiah, M L; Al-Bakri, S H; Zaidan, A A; Zaidan, B B; Hussain, Muzammil

    2014-10-01

    One of the applications of modern technology in telemedicine is video conferencing. An alternative to traveling to attend a conference or meeting, video conferencing is becoming increasingly popular among hospitals. By using this technology, doctors can help patients who are unable to physically visit hospitals. Video conferencing particularly benefits patients from rural areas, where good doctors are not always available. Telemedicine has proven to be a blessing to patients who have no access to the best treatment. A telemedicine system consists of customized hardware and software at two locations, namely, at the patient's and the doctor's end. In such cases, the video streams of the conferencing parties may contain highly sensitive information. Thus, real-time data security is one of the most important requirements when designing video conferencing systems. This study proposes a secure framework for video conferencing systems and a complete management solution for secure video conferencing groups. Java Media Framework Application Programming Interface classes are used to design and test the proposed secure framework. Real-time Transport Protocol over User Datagram Protocol is used to transmit the encrypted audio and video streams, and RSA and AES algorithms are used to provide the required security services. Results show that the encryption algorithm insignificantly increases the video conferencing computation time. PMID:25199651

  11. Clinical aspects of telemedicine

    NASA Technical Reports Server (NTRS)

    Merrell, Ronald C.

    1991-01-01

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

  12. Telemedicine in the Federated States of Micronesia.

    PubMed

    Rutstein, D

    2000-09-01

    Telemedicine (other than costly long distance telephone and facsimile messages) in the Federated States of Micronesia (FSM) started approximately 4 years ago with the establishment of Internet access in the State of Yap. A local access, for medical use only, via already established trunk lines maintained by Continental Airlines was established. It provided a connection to CompuServe at a baud rate of 300 bps. FSM TeleCom provided this free service. While this connection was slow, it allowed medical staff at Yap State Hospital to send and receive text based e-mail regarding patient management. By its use interest was generated in both medical and non-medical individuals to develop a commercial full scale Internet service. In March 1996, TeleCom became a full scale commercial Internet Service Provider in Yap. Rates were reasonable and the CompuServe access was phased out. The full scale internet allowed medical personnel to engage in telemedicine activities, including email; email attachments; the search and retrieval of medical literature; transmission to medical specialists of X-rays, ECG's and other images; and real-time teleconferencing over the Internet with both audio and video. In addition, to the improvement of medical care, this allowed for greater efficiency in arranging referral of patients for medical treatment outside of the FSM. PMID:11588919

  13. Arizona TeleMedicine Project.

    ERIC Educational Resources Information Center

    Arizona Univ., Tucson. Coll. of Medicine.

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

  14. [Telemedicine and the ageing population].

    PubMed

    Otto, Ulrich; Brettenhofer, Marlene; Tarnutzer, Silvan

    2015-09-01

    Telemedicine aims to create new forms of health care delivery by the use of information and communication technologies (ICT),for example, to improve the access to health care for patients in rural regions. There is a need for assistive technologies and innovative technological solutions due to the demographic change. Population trends of western societies show concurrently an ageing population and the wish of elderly people to live at home as long as possible while there is a tendency that older people live in greater distances to their kin nowadays. More complex diseases and multimorbidity urge improved interconnectedness between different health care professionals. Hence, different health systems pursue e-health strategies with the aim to implement electronic patient records (EPR) and similar technological solutions as a first approach to tackle those challenges. Telemedicine represents an open and evolving concept which is subject to a regular process of further development as a consequence of accelerated technological progress. The increased articulated demand for patient centered health care is one driver for the use of telemedicine. In the context of the trend of shorter hospital stays technological solutions can provide an opportunity for better support and care at home to reduce health risks and improve caregiving quality after hospital discharges. Despite the still prevalent reservations of elderly people about the use of ICT research shows that acceptance and the willingness to use technical devices is increasing. The article describes different aspects of telemedicine in the context of the aging population: definitions, an overview of trends and various fields of use with specific practical examples. A synoptic view of research results of evaluations of telemedicine applications regarding their effectiveness and cost-benefit analysis complement the paper. PMID:26323956

  15. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

    This collection of case studies, based on factual situations which have challenged broadcast managers in recent years, is designed to stimulate thinking about and solving of "real world" problems in commercial radio and television operations. Topics of a serious, long-run nature include enlarging the radio audience; station revenue and economy;…

  16. A review of telemedicine business models.

    PubMed

    Chen, Shengnan; Cheng, Alice; Mehta, Khanjan

    2013-04-01

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

  17. Telemedicine in stroke care and rehabilitation.

    PubMed

    Morales-Vidal, Sarkis; Ruland, Sean

    2013-01-01

    Telemedicine allows prompt assessment of acute stroke patients. This new technology has increased the administration of intravenous recombinant tissue plasminogen activator (rtPA) to eligible patients. In addition, telemedicine is being utilized in the rehabilitation of patients with cerebrovascular disease. This article will review the use of telemedicine in patients with acute ischemic stroke and its implementation in telerehabilitation to patients with residual neurologic deficits. PMID:23611850

  18. The Research Agenda in ICU Telemedicine

    PubMed Central

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

    2011-01-01

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

  19. Telemedicine: caring for patients across boundaries.

    PubMed

    Burdick, A E; Mahmud, K; Jenkins, D P

    1996-10-01

    Telemedicine combines computer, video and telecommunications to provide healthcare to patients at distant sites. With the improved camera and transmission technologies of the 1990s, telemedicine can be used in a variety of situations. There are two basic technological systems: live interactive video and still image ("store and forward"). Potential users include patients who live in rural or difficult to reach geographic areas, who are confined (i.e. prison inmates), Telemedicine can allow ambulatory patients to continue living at home rather than moving into costly nursing facilities. Home telemedicine also allows greater responsiveness and higher frequency of visits by home care nurses, potentially reducing future hospital visits and costs. Two home telemedicine models are the personal telemedicine unit and the enhanced personal telemedicine module with pc-based video. Telemedicine technologies developed by the military for use on the battlefield that could be adapted for civilian use include medical simulations, individual monitoring devices and biosensors, portable retinal display monitors, life support for trauma/transport, and diagnostic ultrasound imagery. Ultimately, the benefits of telemedicine will be consistency of care, easy access to specialized consultants, higher responsiveness to patient needs, and lower overall healthcare costs. PMID:9016146

  20. The Use of Telemedicine to Address Access and Physician Workforce Shortages.

    PubMed

    Marcin, James P; Rimsza, Mary Ellen; Moskowitz, William B

    2015-07-01

    The use of telemedicine technologies by primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists (henceforth referred to as "pediatric physicians") has the potential to transform the practice of pediatrics. The purpose of this policy statement is to describe the expected and potential impact that telemedicine will have on pediatric physicians' efforts to improve access and physician workforce shortages. The policy statement also describes how the American Academy of Pediatrics can advocate for its members and their patients to best use telemedicine technologies to improve access to care, provide more patient- and family-centered care, increase efficiencies in practice, enhance the quality of care, and address projected shortages in the clinical workforce. As the use of telemedicine increases, it is likely to impact health care access, quality, and education and costs of care. Telemedicine technologies, applied to the medical home and its collaborating providers, have the potential to improve current models of care by increasing communication among clinicians, resulting in more efficient, higher quality, and less expensive care. Such a model can serve as a platform for providing more continuous care, linking primary and specialty care to support management of the needs of complex patients. In addition, telemedicine technologies can be used to efficiently provide pediatric physicians working in remote locations with ongoing medical education, increasing their ability to care for more complex patients in their community, reducing the burdens of travel on patients and families, and supporting the medical home. On the other hand, telemedicine technologies used for episodic care by nonmedical home providers have the potential to disrupt continuity of care and to create redundancy and imprudent use of health care resources. Fragmentation should be avoided, and telemedicine, like all primary and specialty services, should be coordinated through the medical home. PMID:26122802

  1. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ...Docket No. PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice...relevant to management of an anticipated exigent postal rate case. It has scheduled a technical conference for a...

  2. Carbon Footprint of Telemedicine Solutions - Unexplored Opportunity for Reducing Carbon Emissions in the Health Sector

    PubMed Central

    Holmner, Åsa; Ebi, Kristie L.; Lazuardi, Lutfan; Nilsson, Maria

    2014-01-01

    Background The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers. Objectives To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector. Methods A life cycle inventory was performed to evaluate the carbon reduction potential of telemedicine activities beyond a reduction in travel related emissions. The study included two rehabilitation units at Umeå University Hospital in Sweden. Carbon emissions generated during telemedicine appointments were compared with care-as-usual scenarios. Upper and lower bound emissions scenarios were created based on different teleconferencing solutions and thresholds for when telemedicine becomes favorable were estimated. Sensitivity analyses were performed to pinpoint the most important contributors to emissions for different set-ups and use cases. Results Replacing physical visits with telemedicine appointments resulted in a significant 40–70 times decrease in carbon emissions. Factors such as meeting duration, bandwidth and use rates influence emissions to various extents. According to the lower bound scenario, telemedicine becomes a greener choice at a distance of a few kilometers when the alternative is transport by car. Conclusions Telemedicine is a potent carbon reduction strategy in the health sector. But to contribute significantly to climate change mitigation, a paradigm shift might be required where telemedicine is regarded as an essential component of ordinary health care activities and not only considered to be a service to the few who lack access to care due to geography, isolation or other constraints. PMID:25188322

  3. Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram

    PubMed Central

    2015-01-01

    Objectives Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. Methods This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. Results It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. Conclusions To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions. PMID:26618028

  4. Telemedicine: Health Care for Isolated Areas.

    ERIC Educational Resources Information Center

    Development Communication Report, 1977

    1977-01-01

    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…

  5. Iowa Case Management: Innovative Social Casework.

    ERIC Educational Resources Information Center

    Hall, James A.; Carswell, Christopher; Walsh, Elizabeth; Huber, Diane L.; Jampoler, Jennifer S.

    2002-01-01

    Discusses an approach to case management for rural clients in drug abuse treatment. Describes the philosophy and goals of the Iowa Case Management model and compares it to other models. The model allows case managers, through a series of activities, to help clients develop and achieve goals as they finish substance abuse treatment. (JDM)

  6. Education for Effective Case Management Practice.

    ERIC Educational Resources Information Center

    Dickerson, Pamela S.; Mansfield, Jerry A.

    2003-01-01

    Managed care organization employees (n=115) attended case management training that included case studies, problem solving and communication skills, and focus on internal capability. Three-month follow-up showed that case managers now ask more questions, have more confidence, mentor new employees, and work with greater accuracy. (SK)

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

    PubMed

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

    2002-08-01

    Telemedicine has evolved into a valuable but underused resource for the delivery of health care to patients at a distance, particularly where patient transport is impractical, expensive, complicated, and/or urgent. Today, over 250,000 telemedicine consults are generated annually, involving various specialties in both military and civilian health delivery systems. The ability to evaluate and triage plastic surgery patients through the use of telemedicine has not been widely explored. We have designed, developed, and tested a "store-and-forward" solution at UMass Memorial Hospital and Beth Israel Deaconess Hospital whereby the plastic surgery residents who responded to a consult request transmitted digital photographs by means of the Internet to the attending physician on call. The customary telephone call between resident and attending physician benefited from the additional photographic data, and patient management resulted in a clear, concise, and unambiguous treatment plan. The initial management suggested by the resident was modified on some occasions, particularly with complex problems. The use of digital images was especially helpful for evaluation of radiographs and complex wounds of the hand and face. The solution proved to be very valuable for both attending physicians and residents in plastic surgery. The photographs provide rich detail and resolution comparable to high-quality prints. The mechanics of obtaining images and the process of sending them electronically was readily mastered. Images reached their destination in only a few minutes over standard telephone lines. No problems were encountered while sending or viewing images on Macintosh or Windows platforms. Determining course of action with a complete clinical history now includes a level of visual detail previously not available. As this application expands into wider use, data integrity and safety will have to be more formally secured and monitored. Our model of telemedicine has broad-reaching ramifications for the improvement of health-care delivery locally, nationally, and internationally. PMID:12142659

  8. Novel Telemedicine Technologies in Geriatric Chronic Non-Cancer Pain: Primary Care Providers’ Perspectives

    PubMed Central

    Levine, Mimi; Richardson, Joshua E.; Granieri, Evelyn; Reid, M. Cary

    2015-01-01

    Objective We sought to identify primary care providers’ interest in, as well as perceived barriers and facilitators to, using novel telemedicine technologies (e.g., smartphones) for managing chronic non-cancer pain (CNCP) in older adults. Design Six focus groups were conducted with 25 primary care providers. Setting Two academically affiliated primary care practices serving older adults with CNCP in New York City. Methods The investigators used content analysis to analyze transcribed focus group data and identify specific themes. Results While most providers reported limited use of telemedicine, they expressed substantial interest in trying devices such as smartphones in the management of older patients with CNCP. Perceived barriers to implementation of telemedicine tools included information overload, lack of mobile device usability among patients and clinicians, liability issues, and cost. To overcome these barriers, participants suggested implementing electronic or human-based pre-analysis of data (e.g., a computer or a person that triages patient data), creating a low-cost and user-friendly mobile device design, and targeting appropriate user populations. Conclusions Primary care providers are interested in applying telemedicine when caring for older adults with CNCP. Although they perceived multiple barriers to device implementation, they offered innovative solutions to address these barriers. Providers felt that novel telemedicine technologies may improve the management of CNCP but wanted evidence that the devices were both cost- and time-efficient, and led to improved patient outcomes before adopting their use in practice. PMID:24341423

  9. Essentials of advocacy in case management.

    PubMed

    Tahan, Hussein A

    2005-01-01

    Advocacy is vital to case management practice. It is a primary professional role of case managers functioning in various care settings and across the continuum of care. Acquiring knowledge, skills, and competence in what advocacy is and how to enact its related behaviors is essential for success of case managers and for achieving desired outcomes for both the clients and healthcare agencies alike. This article describes the use of advocacy in the field of case management and highlights several practical strategies for case managers to apply in their daily practice. PMID:15931045

  10. Clinicians’ Knowledge and Perception of Telemedicine Technology

    PubMed Central

    Ayatollahi, Haleh; Sarabi, Fatemeh Zahra Pourfard; Langarizadeh, Mostafa

    2015-01-01

    Introduction Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. Methods This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (? = 0.73). Results The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. Conclusion The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions. PMID:26604872

  11. Telemedicine in inflammatory bowel disease: opportunities and approaches.

    PubMed

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

    2015-02-01

    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

  12. Telemedicine: legal and licensure issues

    NASA Astrophysics Data System (ADS)

    Wood, Michael B.; Whelan, Leo J.

    1995-10-01

    The National Information Infrastructure program offers a great opportunity for the United States to capitalize on remarkable technological advancements over a broad range of applications benefiting society. One such application, telemedicine, has the potential to offer widespread access to sophisticated medical care, curtailed health care delivery costs, and homogeneous health and health-related educational opportunities. However, there are a variety of barriers to widespread application of telemedicine once the technical infrastructure of the information highway is well established and ubiquitous. These barriers include technical limitations, reimbursement issues, equipment and networking costs, and appropriate scientific studies to document efficacy and cost effectiveness. These issues may prove to be only transient disincentives which can be surmounted. Additional barriers exist, however, that may not be as readily resolved by traditional methods of analysis and more widespread practice applications. These political and regulatory obstacles will require clarification of the issues and solutions based on national consensus. It is the purpose of this discussion to amplify on these particular barriers which include licensure and tort jurisdiction.

  13. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 false Primary care case management services. 440.168 Section 440...Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case management related...

  14. Study on Case Teaching of Financial Management

    ERIC Educational Resources Information Center

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

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

    PubMed Central

    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

    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

  16. Virtual doctor's office telemedicine delivery system 

    E-print Network

    Sainath, Paavana

    2002-01-01

    Rapid advances in high performance global communication have accelerated telemedicine-based medical services to a new frontier. Traditional medical services can now fully utilize multimedia technologies to provide novel ...

  17. [Telemedicine in Germany. Status, Barriers, Perspectives].

    PubMed

    Brauns, H-J; Loos, Wolfgang

    2015-10-01

    Telemedicine as a subject has reached politics, doctors and patients, but it has still not been able to make the leap from research, development, and testing into real practice. This is generally because of the great barriers to implementation, mainly the lack of telematics infrastructure and of payment regulations in Germany. Telemedicine projects are mainly isolated applications and it has not been possible to integrate them in to nationwide regular health services. Other challenges along the path to standard care include that research-based small-medium enterprise (SME) companies usually face high barriers hindering access to this market, because it is imposible for them to finance all the required evidence-based studies to verify the medical benefits and the econimic efficiency. Additionally, a high market nontransparency is noted. However, the signs of progress are visible, e.g., the E-health initiative of the German government or recent legislative initiatives. However, long processes are observed that do not facilitate the use of telemedicine. Although some federal states, e.g., North Rhine Westphalia, Bavaria, Mecklenburg-Western Pomerania, and Saxony, show exemplary activities, there are still many white areas on the telemedicine map of Germany. The road to standard care will be long, but is not unattainable. The reasons for supporting telemedicine are still strong. The future development of telemedicine applications will contribute to sustainable and high-quality patient care in Germany. PMID:26324096

  18. Wearable devices for telemedicine applications.

    PubMed

    Scheffler, M; Hirt, E

    2005-01-01

    Wearable medical devices can provide both continuous monitoring and ubiquitous treatment. Challenges in this area include the need for a low-power/power-saving design to extend battery life and to reduce the size of the battery itself. This is followed by size and weight restrictions to meet patient expectations of what is 'wearable', the biocompatibility of all outer housings and the final assembly concept. Two examples of wearable medical device are described: a wrist-wearable telemedicine monitor for heart patients (AMON) and a generic belt-integrated computing platform for home and hospital use (QBIC). The electrocardiogram (ECG), the blood oxygen saturation (SpO2) sensor and the blood pressure meter of the AMON device were tested with 29 subjects. The sensors were found to be functional, but as expected the data processing algorithms will need some fine-tuning. The prototype QBIC demonstrates a size reduction of 30-50% in relation to comparable devices. PMID:16035978

  19. Evolving telemedicine/ehealth technology.

    PubMed

    Ferrante, Frank E

    2005-06-01

    This paper describes emerging technologies to support a rapidly changing and expanding scope of telemedicine/telehealth applications. Of primary interest here are wireless systems, emerging broadband, nanotechnology, intelligent agent applications, and grid computing. More specifically, the paper describes the changes underway in wireless designs aimed at enhancing security; some of the current work involving the development of nanotechnology applications and research into the use of intelligent agents/artificial intelligence technology to establish what are termed "Knowbots"; and a sampling of the use of Web services, such as grid computing capabilities, to support medical applications. In addition, the expansion of these technologies and the need for cost containment to sustain future health care for an increasingly mobile and aging population is discussed. PMID:16035932

  20. A Latin American telemedicine social perspective from a Colombian telemedicine center initiative.

    PubMed

    Velez Beltran, Jorge Alberto; Newball, Andrés Adolfo Navarro

    2005-10-01

    This paper describes a collaborative initiative for developing a telemedicine model on for Colombia and Latin America from a social perspective. This was led by the Colombian Telemedicine Center (CTMC) with the participation of teams from Mexico, Costa Rica, Panama, and Argentina, in addition to on-going interaction with academic institutions such as Javeriana University, Icesi University, and Murcia University. PMID:16250827

  1. Teleradiology and telemedicine using the advanced communications technology satellite and international maritime satellite at varying bandwidths

    NASA Astrophysics Data System (ADS)

    de Treville, Robert E.; Scotti, Stephen D.; Williamson, Morgan P.; Olson, Eric J.; Brink, Linda; Isle, Ken; Kafaro, Peter

    1995-05-01

    The United States military gained experience with a deployed telemedicine team and unit during the deployment of United States military troops to Haiti as part of `Operation Uphold Democracy.' Consults were conducted primarily between the 28th combat support hospital in Haiti and Walter Reed Army Medical Center in Washington, D.C. The Advanced Communications Technology Satellite and International Maritime Satellite services were used for telecommunications during the deployment. A total of 30 telemedicine consultations were performed during the deployment. All consultations were conducted prospectively, and data was entered in a database for later review. Treatment plans and plans for patient disposition were recorded prior to consultation. Following completion of the telemedicine consultations, each case was reviewed to determine the impact of the telemedicine consult upon the treatment plan or disposition. Fifty percent of the consultations resulted in a significant modification in the patient's treatment plan. Seventeen percent resulted in a significant or possible change in evacuation planning. The most frequently used consultants were the dermatologists, radiologists, and hand surgeons. This experience demonstrates that telemedicine can be used effectively in a deployed military environment. In addition, the ability to obtain remote consultations does impact upon medical treatment and upon medical evacuation. Having support personnel in the field was found to be an important factor in utilization of the system.

  2. Fayette County Community Action Education Case Management.

    ERIC Educational Resources Information Center

    Veghts, Jana; And Others

    The Community Action Education Case Management program was developed in Fayette County, Pennsylvania, to provide 50 homeless, undereducated adults and their families with case management services. These services were to include: individual, group, and in-home counseling; advocacy; service coordination; and evaluation. During the program, 58…

  3. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

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

    2009-01-01

    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…

  4. Clinical and Educational Support for Space Flight via Telemedicine

    NASA Technical Reports Server (NTRS)

    1997-01-01

    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.

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

    PubMed Central

    Kesavadev, Jothydev; Saboo, Banshi; Shankar, Arun; Krishnan, Gopika; Jothydev, Sunitha

    2015-01-01

    Diabetes is a chronic and costly disease. In India, the usual practice among patients is to visit the doctor once in every 2–3 months to get advice on changes in the dosages of medications. The Diabetes Tele Management System (DTMS®) is a telemedicine based follow-up program originally introduced at Jothydev's Diabetes Research Centre at Trivandrum South India in 1998. It is a chronic disease management system which enables patient to interact lively with a professionally trained multidisciplinary team comprising of diabetes educators, nurses, dieticians, pharmacists, psychologists, physicians, etc., in modifying the dosages of medications, diet, and physical activity either through telephone/email/secure website. The uniquely designed software and the trained multidisciplinary team overcomes the globally recognized major barriers to diabetes management namely fear of hypoglycemia, polypharmacy, discontinuation of stains, and antihypertensives or wrong injection techniques. DTMS is designed to provide individualized therapy advices on glycosylated hemoglobin, blood pressure, and low density lipoprotein customized to multiple patient characteristics which help attain goals of therapy. The system has been tested on various platforms over a decade and was shown to be a patient friendly approach with successful outcomes due to a live “round-the-clock” interactive communication in contrast to text or recorded messages. The major challenge to the widespread use of DTMS® is seeking a source of funding this unique telemedicine program. PMID:26693425

  6. Telemedicine odyssey customised telemedicine solution for rural and remote areas in India.

    PubMed

    Bhatia, Jagjit Singh; Sharma, Sagri

    2006-01-01

    There is a significant potential for delivering medical services in rural areas of India using Telemedicine methods. However, there is a continuous emphasis on patient privacy, which is usually not a concern in traditional consultation. We at Centre for Development of Advance Computing, Mohali Punjab have developed a customized Telemedicine solution, which overcomes the barrier--technological as well as professional, legal and financial--to Telemedicine. We implement Telemedicine in rural areas as 70% of total population in India is living in villages. We have, as a pilot project, established Telemedicine Technology at six major locations in India. These locations were subsequently connected to nearby districts and primary health centres to make a Telemedicine hub. Currently, our major project is to deploy Telemedicine sites at various locations in the hilly and remote state of Himachal Pradesh. During these developments, we have faced unavoidable hurdles and tried to overcome them with team effort, perseverance and never give up attitude. This paper will shed light on our journey from scratch to what we have achieved till date. PMID:17095800

  7. Impact of a Telemedicine System with Automated Reminders on Outcomes in Women with Gestational Diabetes Mellitus

    PubMed Central

    Deeb, Larry C.; Rohrbacher, Kimberly; Mulla, Wadia; Mastrogiannis, Dimtrios; Gaughan, John; Santamore, William P.; Bove, Alfred A.

    2012-01-01

    Abstract Background Health information technology has been proven to be a successful tool for the management of patients with multiple medical conditions. The purpose of this study was to examine the impact of an enhanced telemedicine system on glucose control and pregnancy outcomes in women with gestational diabetes mellitus (GDM). Subjects and Methods We used an Internet-based telemedicine system to also allow interactive voice response phone communication between patients and providers and to provide automated reminders to transmit data. Women with GDM were randomized to either the telemedicine group (n=40) or the control group (n=40) and asked to monitor their blood glucose levels four times a day. Women in the intervention group transmitted those values via the telemedicine system, whereas women in the control group maintained paper logbooks, which were reviewed at prenatal visits. Primary outcomes were infant birth weight and maternal glucose control. Data collection included blood glucose records, transmission rates for the intervention group, and chart review. Results There were no significant differences between the two groups (telemedicine vs. controls) in regard to maternal blood glucose values or infant birth weight. However, adding telephone access and reminders increased transmission rates of data in the intervention group compared with the intervention group in our previous study (35.6±32.3 sets of data vs.17.4±16.9 sets of data; P<0.01). Conclusions Our enhanced telemedicine monitoring system increased system utilization and contact between women with GDM and their healthcare providers but did not impact upon pregnancy outcomes. PMID:22512287

  8. Telemedicine in India: the Apollo story.

    PubMed

    Ganapathy, Krishnan; Ravindra, Aditi

    2009-01-01

    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

  9. Adoption of telemedicine: from pilot stage to routine delivery

    PubMed Central

    2012-01-01

    Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and professional incentives for potential telemedicine users and understand their importance for widespread adoption. PMID:22217121

  10. Telemedicine can make healthcare greener.

    PubMed

    Yellowlees, Peter M; Chorba, Kathy; Burke Parish, Michelle; Wynn-Jones, Hannah; Nafiz, Najia

    2010-03-01

    The American healthcare industry is generally lacking environmentally sustainable practices. The environmental impact of healthcare practices in the country has been largely disregarded due to ambivalence, ignorance, and fears of additional costs and regulations. The current practices continue to pollute the environment by requiring large amounts of travel and paperwork by both the patient and the clinician. Telemedicine and health information technology help save time, energy, raw materials (such as paper and plastic), and fuel, thereby lowering the carbon footprint of the health industry. By implementing green practices, for instance, by engaging in carbon credit programs, the health industry could benefit financially as well as reduce its negative impact on the health of our planet. Companies that reduce their carbon emissions by implementing energy-saving practices can sell their carbon credits to companies that emit more carbon than permissible by their legally binding commitment. These carbon profits can then be used for healthcare research or to provide healthcare to the underserved. Alternatively, the savings could be used for green purchasing and to implement other carbon-reducing activities. This report reviews the numerous possible options for the American health industry to become greener and lower its carbon footprint while at the same time becoming more time- and cost efficient. PMID:20156125

  11. Case Studies in River Management

    E-print Network

    Julien, Pierre Y.

    Major Stakeholders Federal Agencies State Agencies Counties and Districts Cities and Towns Private stakeholders and requires laws and regulations Things remembered from Case Studies in the US 1) Case Studies of Abandoned Channels Cheongmi Stream and Mangyeong River Cheongmi Stream South Korea In Collaboration

  12. Telemedicine: An Application in Search of Users

    NASA Technical Reports Server (NTRS)

    Khandheria, Bijoy K.

    1996-01-01

    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.

  13. Design and Customization of Telemedicine Systems

    PubMed Central

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

    2013-01-01

    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

  14. Iowa Case Management for Rural Drug Abuse

    PubMed Central

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

    2011-01-01

    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 (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. Conclusion Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time. PMID:22065018

  15. 10 CFR 2.332 - General case scheduling and management.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 false General case scheduling and management. 2.332 Section 2...Hearings § 2.332 General case scheduling and management. (a) Scheduling order...as its objectives proper case management purposes such as:...

  16. URBAN STORMWATER MANAGEMENT AND TECHNOLOGY: CASE HISTORIES

    EPA Science Inventory

    This report is the third in a series on urban stormwater and combined sewer overflow management. It presents 12 case histories representing most promising approaches to stormwater control. The case histories were developed by evaluating completed and operational facilities or ong...

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

    E-print Network

    Stough, Laura

    2011-01-01

    case management- Disaster case management and individuals with disabilities following Hurricane Katrina.pdf.txt Content-Type text/plain; charset=UTF-8 BRAIN INJURY PROFESSIONAL18 This article, submitted for inclusion in an upcoming issue... DISASTER CASE MANAGEMENT Case Management and Individuals with Disabilities Following Hurricane Katrina By laura M. StouGh, Phd, aMy n. SharP, Phd, Curt deCker, Jd and naChaMa Wilker BRAIN INJURY PROFESSIONAL 19 continued to exist for the over 2...

  18. Telemedicine in a box: overcoming complexity and high-cost telemedicine barriers using self-contained videoconferencing units.

    PubMed

    Yamamoto, L G; Toma, C S; Bell, C K

    2001-08-01

    This report describes our experience using low-and moderate-cost videoconferencing systems for telemedicine. After determining that low-cost systems using a standard personal computer and personal computer camera were unsatisfactory, a demonstration project was carried out using a $4000 self-contained videoconferencing unit (telemedicine in a box), using eight simulated telemedicine consultation scenarios. The quality of the videoconferencing was good for all eight scenarios. All eight consultation simulations demonstrated different ways of improving patient care. Two of the major problems hindering the broad proliferation of telemedicine (high cost and high complexity) are solved by the telemedicine in a box concept. Focussing on the telemedicine in a box concept when planning a telemedicine system will improve its feasibility in the real world of health care. PMID:11493833

  19. Telepointer technology in telemedicine : a review

    PubMed Central

    2013-01-01

    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

  20. Seahawk: telemedicine project in the Pacific Northwest

    NASA Astrophysics Data System (ADS)

    Kim, Yongmin; Cabral, James E., Jr.; Parsons, David M.; Lipski, Gregory L.; Kirchdoerfer, Richard G.; Sado, Anthony; Bender, Gregory N.; Goeringer, Fred

    1995-05-01

    Telemedicine is becoming increasingly possible due to the confluence of ongoing technical advances in such areas as telecommunications, imaging, multimedia, computers, and information systems. Project Seahawk is a regional telemedicine program in the Pacific Northwest with Madigan Army Medical Center (MAMC) as the hub connecting various military and other federal hospitals and clinics utilizing the state-of-the-art technologies. The first phase of Project Seahawk successfully connected MAMC in Tacoma, Wash. to the University of Washington in Seattle, Wash. through the Western Washington Local Access Transport Area (LATA) Integrated Optical Network (LION) Sonet Ring using asynchronous transfer mode (ATM) and two MediaStation 5000s as a feasibility demonstration. Several telemedicine scenarios were demonstrated including synchronized image manipulation, real- time transmission of ultrasound and medical images, and video and audio teleconferencing, and remote consultation. The second phase implementation will consist of increasing the number of hospitals and clinics with telemedicine capability, e.g., Bremerton Naval Hospital, Oak Harbor Naval Hospital, Seattle VA, and American Lake VA.

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

    PubMed

    Wu, Hsing-Hao

    2008-12-01

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

  2. American Academy of Sleep Medicine (AASM) Position Paper for the Use of Telemedicine for the Diagnosis and Treatment of Sleep Disorders.

    PubMed

    Singh, Jaspal; Badr, M Safwan; Diebert, Wendy; Epstein, Lawrence; Hwang, Dennis; Karres, Valerie; Khosla, Seema; Mims, K Nicole; Shamim-Uzzaman, Affifa; Kirsch, Douglas; Heald, Jonathan L; McCann, Kathleen

    2015-10-01

    The American Academy of Sleep Medicine's (AASM) Taskforce on Sleep Telemedicine supports telemedicine as a means of advancing patient health by improving access to the expertise of Board-Certified Sleep Medicine Specialists. However, such access improvement needs to be anchored in attention to quality and value in diagnosing and treating sleep disorders. Telemedicine is also useful to promote professionalism through patient care coordination and communication between other specialties and sleep medicine. Many of the principles and key concepts adopted here are based on U.S. industry standards, with special consideration given to the body of work by the American Telemedicine Association (http://www.americantelemed.org/), and abide by standards endorsed by the American Medical Association (http://www.ama-assn.org/). Practitioners who wish to integrate sleep telemedicine into their practice should have a clear understanding of the salient issues, key terminology, and the following recommendations from the AASM. The Taskforce recommends the following: • Clinical care standards for telemedicine services should mirror those of live office visits, including all aspects of diagnosis and treatment decisions as would be reasonably expected in traditional office-based encounters. • Clinical judgment should be exercised when determining the scope and extent of telemedicine applications in the diagnosis and treatment of specific patients and sleep disorders. • Live Interactive Telemedicine for sleep disorders, if utilized in a manner consistent with the principles outlined in this document, should be recognized and reimbursed in a manner competitive or comparable with traditional in-person visits. • Roles, expectations, and responsibilities of providers involved in the delivery of sleep telemedicine should be defined, including those at originating sites and distant sites. • The practice of telemedicine should aim to promote a care model in which sleep specialists, patients, primary care providers, and other members of the healthcare team aim to improve the value of healthcare delivery in a coordinated fashion. • Appropriate technical standards should be upheld throughout the telemedicine care delivery process, at both the originating and distant sites, and specifically meet the standards set forth by the Health Insurance Portability and Accountability Act (HIPAA). • Methods that aim to improve the utility of telemedicine exist and should be explored, including the utilization of patient presenters, local resources and providers, adjunct testing, and add-on technologies. • Quality Assurance processes should be in place for telemedicine care delivery models that aim to capture process measures, patient outcomes, and patient/provider experiences with the model(s) employed. • Time for data management, quality processes, and other aspects of care delivery related to telemedicine encounters should be recognized in value-based care delivery models. • The use of telemedicine services and its equipment should adhere to strict professional and ethical standards so as not to violate the intent of the telemedicine interaction while aiming to improve overall patient access, quality, and/or value of care. • When billing for telemedicine services, it is recommended that patients, providers, and others rendering services understand payor reimbursements, and that there be financial transparency throughout the process. • Telemedicine utilization for sleep medicine is likely to rapidly expand, as are broader telehealth applications in general; further research into the impact and outcomes of these are needed. This document serves as a resource by defining issues and terminology and explaining recommendations. However, it is not intended to supersede regulatory or credentialing recommendations and guidelines. It is intended to support and be consistent with professional and ethical standards of the profession. PMID:26414983

  3. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... care case management services. (a) Primary care case management services means case management...

  4. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... care case management services. (a) Primary care case management services means case management...

  5. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... care case management services. (a) Primary care case management services means case management...

  6. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... care case management services. (a) Primary care case management services means case management...

  7. Managing Use Cases During Goal-Driven Requirements Engineering

    E-print Network

    Antón, Annie I.

    Managing Use Cases During Goal-Driven Requirements Engineering: Challenges Encountered and Lessons and scenario analysis. Keywords Scenario management, use cases, requirements engineering, goals, requirements received widespread attention including HCI, strategic management and software engineering [JBC98

  8. "Managing after the Merger" Case Analysis.

    ERIC Educational Resources Information Center

    Cusella, Louis P.

    2000-01-01

    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…

  9. A review of telemedicine in accident and emergency: the story so far

    PubMed Central

    Benger, J.

    2000-01-01

    Recent developments in information and communications technology have the potential to revolutionise health care. This has been recognised at government level, and plays a significant part in the new information strategy for the NHS "Information For Health". Telemedicine (literally, medicine at a distance) is one of the most successful techniques in this rapidly expanding field, and in preliminary studies has proved to be both successful and popular with patients and health care professionals. In the UK telemedicine has been mainly applied to two major areas of accident and emergency (A&E) practice. These are the transmission of computed tomography scans for urgent neurosurgical opinion and the ongoing support of minor injuries units. The latter also involves transmission and interpretation of radiographs, usually peripheral limb films. Telemedicine is not a medical sub-specialty in itself, but a facilitator of all medical and surgical specialties. While recent modernisation initiatives have permitted A&E departments to purchase a range of telemedical equipment, overall progress is hampered by a lack of large or scientifically rigorous studies, and a complete absence of data on the economic implications of this new technique. This review introduces A&E telemedicine in terms that avoid jargon and complex technical details. After a brief consideration of the origins of the subject, attention is given to recent publications relating to minor injuries support and A&E teleradiology. The technical and clinical feasibility of A&E telemedicine are demonstrated, and a case is made for the transmission and interpretation of minor injuries radiographs using a relatively simple and inexpensive system, supported by timely radiological reporting. After a brief study of various legal and ethical issues, the likely developments of the future are discussed. PMID:10819375

  10. State medical licensure for telemedicine and teleradiology.

    PubMed

    Hunter, Tim B; Weinstein, Ronald S; Krupinski, Elizabeth A

    2015-04-01

    Physician medical licensure is state based for historical and constitutional reasons. It may also provide the best method for guaranteeing patient protection from unqualified, incompetent, impaired, or unprofessional practitioners of medicine. However, a significant cost for physicians practicing telemedicine is having to obtain multiple state medical licenses. There is reasonable likelihood that model legislation for the practice of telemedicine across state boundaries will be passed in the next few years, providing physicians with a simpler process for license reciprocity in multiple states via interstate licensing compacts. Physicians would have to be licensed in the state in which the patient resides. Patient complaints would still be adjudicated by the medical licensing board in the state where the patient resides according applicable state legislation. PMID:25734402

  11. Potentials of Telemedicine for Green Health Care

    PubMed Central

    Audebert, Heinrich J.; Meyer, Thomas; Klostermann, Fabian

    2010-01-01

    Neurological facilities are traditionally centered in academic hospitals and often far away from the patients’ living area. Both, the transfer of patients to remote hospitals and inpatient treatment are associated with high energy consumption. Numbers of patients with neurological diseases are expected to increase along with the demographical changes and the environmental impact of neurological treatment should become a target for health policy, therefore. Positive effects have been demonstrated for the use of telemedicine by improving inpatient treatment in local community hospitals or avoiding hospital admissions via monitoring of complex diseases in outpatient settings. We discuss the potentials of telemedicine in the field of in- and outpatient neurological care as well as the need for more scientific evaluation on environmental impacts. PMID:21188251

  12. Development of Telemedicine Capabilities for a Joint US-Russian Space Biomedical Center for Training and Research

    NASA Technical Reports Server (NTRS)

    DeBakey, Michael E.

    1998-01-01

    From the perspective of scheduling, some medical consultations can have asynchronous and synchronous components. Consultations frequently involve the compilation of patient data, its analysis, a consultant's report, and a real-time conference between the referring physician and the consultant. The bandwidth of the Internet with Moscow and advances in the hardware and software of personal computing now make possible telemedicine events with store-and-forward components and real-time components. These are hybrid telemedicine and this paper describes such a case.

  13. 10 CFR 2.332 - General case scheduling and management.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false General case scheduling and management. 2.332 Section 2... Management for NRC Adjudicatory Hearings § 2.332 General case scheduling and management. (a) Scheduling order... scheduling order must have as its objectives proper case management purposes such as: (1) Expediting...

  14. Case management insider. C-suite executives: the final frontier for hospital case management.

    PubMed

    Cesta, Toni

    2015-03-01

    In order to sit at the table with your organization's leadership and make credible arguments and a sound business case for the resources you may need tomove your department forward, remember that you need to be as well versed as you possibly can be. Anecdotal thoughts and opinions will not get you the resources you need. Best practice information will be a much better tool for making the case and having it stick. With the changes that have been imposed by CMS and other regulatory bodies, the time has never been better for case management. Case management is one of the solutions to meeting the challenges to today's health care environment! PMID:25730959

  15. Telemedicine and Plastic Surgery: A Pilot Study

    PubMed Central

    Valente, Denis Souto; Silveira Eifler, Luciano; Carvalho, Lauro Aita; Filho, Gustavo Azambuja Pereira; Ribeiro, Vinicius Weissheimer; Padoin, Alexandre Vontobel

    2015-01-01

    Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions. PMID:26609429

  16. Telemedicine and Plastic Surgery: A Pilot Study.

    PubMed

    Valente, Denis Souto; Silveira Eifler, Luciano; Carvalho, Lauro Aita; Filho, Gustavo Azambuja Pereira; Ribeiro, Vinicius Weissheimer; Padoin, Alexandre Vontobel

    2015-01-01

    Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions. PMID:26609429

  17. The Science Manager's Guide to Case Studies

    SciTech Connect

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

    2001-09-24

    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.

  18. 77 FR 27015 - Distance Learning and Telemedicine Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-08

    ...Utilities Service (RUS) is...Distance Learning and Telemedicine...top scoring applications in rank order...Many of the applications submitted...telemedicine services and distance learning services...Utilities Service published...Solicitation of Applications (NOSA...Distance Learning and...

  19. Electronic case management with homeless youth.

    PubMed

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. PMID:25748603

  20. Teleradiology usage and user satisfaction with the telemedicine system operated by médecins sans frontières.

    PubMed

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

    2014-01-01

    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

  1. Nuclear medical expertise delivered by telemedicine in a 'dirty bomb' exercise.

    PubMed

    Pieper, Bettina; Meineke, Viktor

    2007-01-01

    Management of victims in a 'dirty bomb' incident requires communication between the physicians directly involved and experts in radiation medicine. Telemedicine is an excellent tool to support doctors--who may not have specific training in radiation medicine--in handling radiation casualties. We have successfully used telemedicine in an exercise of the Federal Police in Germany. Experts in radiation medicine were provided by the Bundeswehr Institute of Radiobiology. Simple PC-based videoconferencing equipment was used with a 128 kbit/s ISDN line. To facilitate a standardized approach, a new questionnaire for radiation accidents was developed and tested during the exercise. A special camera was used for capturing skin images. Advice for patient treatment and strategies for safeguarding personnel and the environment during the exercise was provided almost immediately. PMID:17519058

  2. Case management's value is finally recognized. What happens now? .

    PubMed

    2015-10-01

    In recent years, case management has been recognized as a key in improving healthcare quality and reducing costs, but while hospitals are giving case managers more responsibilities, many administrators are not approving an increase in staff to handle the extra work. Case managers can help their hospital succeed with the Centers for Medicare & Medicaid Services' Value-based Purchasing program, the readmission reduction program, and bundled payments. Case management directors should make sure the hospital's senior leadership understands the roles and responsibilities of case managers and how their interventions can affect outcomes and the bottom line. The number of caseloads depends on the case management model, the responsibilities of case managers, and whether they have assistants or case management extenders who can take over some tasks and allow the licensed staff to work at the top of their licenses. Don't let technology replace communication and patient-centered interactions. PMID:26427224

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

    PubMed Central

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

    2011-01-01

    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

  4. Case Management in Community Corrections: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

    Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

  5. Jail Recidivism in a Forensic Case Management Program.

    ERIC Educational Resources Information Center

    Solomon, Phyllis; Draine, Jeffrey

    1995-01-01

    Explores factors related to jail recidivism among clients receiving case-management services who were seriously mentally ill, homeless, and former inmates in a large urban jail. Results indicate that clients (n=51) whose case managers actively sought legal stipulations to case management as a condition of probation and parole were more likely to…

  6. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case management services. (a) Case management services...

  7. Job Title Medical Case Manager Employer/ Agency The Montrose Center

    E-print Network

    Paulsen, Vern

    Job Title Medical Case Manager Employer/ Agency The Montrose Center Job Description Medical Case Manager to work with HIV+ clients in a primary medical care environment. Includes assessment, education for complex medical and psychosocial issues that will require medical case management services. Qualifications

  8. The role of CORBA in enabling telemedicine

    SciTech Connect

    Forslund, D.W.

    1997-07-01

    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.

  9. Transfer of telemedical support to Cornwall from a national telemedicine network during a solar eclipse.

    PubMed

    Wootton, R; McKelvey, A; McNicholl, B; Loane, M; Hore, D; Howarth, P; Tachakra, S; Rocke, L; Martin, J; Page, G; Ferguson, J; Chambers, D; Hassan, H

    2000-01-01

    During late 1998 and early 1999, planning officers in Cornwall predicted a huge increase in summer visitors to the county to observe the August solar eclipse. There was the possibility that a mass gathering in Cornwall could overload existing arrangements for handling accident and emergency patients. We therefore set up a telemedicine system to support the county's minor injury units (MIUs) from hospitals throughout the UK. Six main hospital accident and emergency departments outside Cornwall with existing links to their own MIUs were twinned with 10 of the 11 MIUs in Cornwall before the expected date of the gathering. The network was live for nine days, starting four days before the eclipse, and 2045 patients were seen in the 10 MIUs. There were 93 telemedicine calls from the 10 MIUs, involving 91 patients. Overall, 4.6% of the patients required a telemedicine consultation. Fifty-seven calls were made during working hours. Thirty-four patients were referred for further management, of whom 18 were referred on the same day. The transfer of telemedical support to a national network was successful. PMID:10794014

  10. Narrative review of telemedicine consultation in medical practice

    PubMed Central

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

    2015-01-01

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

  11. Case management and access to services for homeless women.

    PubMed

    Heslin, Kevin C; Andersen, Ronald M; Gelberg, Lillian

    2003-02-01

    Previous research on case management for homeless persons has not sufficiently addressed access to services for women of reproductive age. This cross-sectional study estimates the proportion of homeless women with case managers and the associations of case management with access to shelter; food stamps; Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and general medical care. Nine hundred seventy-four homeless women were sampled in Los Angeles County in 1997 and asked about their use of services and whether they had case managers. Approximately 56 percent of respondents had case managers. Having a case manager was associated with greater odds of using food stamps and of finding shelter without difficulty in the previous 30 days, but not with use of WIC or with unmet needs for medical care. More assertive forms of outreach may be necessary to link this population to case managers and a broader range of services. PMID:12613067

  12. Systematic review of evidence for the benefits of telemedicine.

    PubMed

    Hailey, David; Roine, Risto; Ohinmaa, Arto

    2002-01-01

    A systematic review of telemedicine assessments based on searches of electronic databases between 1966 and December 2000 identified 66 scientifically credible studies that included comparison with a non-telemedicine alternative and that reported administrative changes, patient outcomes, or results of economic assessment. Thirty-seven of the studies (56%) suggested that telemedicine had advantages over the alternative approach, 24 (36%) also drew attention to some negative aspects or were unclear whether telemedicine had advantages and five (8%) found that the alternative approach had advantages over telemedicine. The most convincing evidence on the efficacy and effectiveness of telemedicine was given by some of the studies on teleradiology (especially neurosurgical applications), telemental health, transmission of echocardiographic images, teledermatology, home telecare and on some medical consultations. However, even in these applications, most of the available literature referred only to pilot projects and to short-term outcomes. Few papers considered the long-term or routine use of telemedicine. For several applications, including teleradiology, savings and sometimes clinical benefit were obtained through avoidance of travel and associated delays. Studies of home care and monitoring applications showed convincing evidence of benefit, while those on teledermatology indicated that there were cost disadvantages to health-care providers, although not to patients. Forty-four of the studies (67%) appeared to have potential to influence future decisions on the telemedicine application under consideration. However, a number of these had methodological limitations. Although useful clinical and economic outcomes data have been obtained for some telemedicine applications, good-quality studies are still scarce and the generalizability of most assessment findings is rather limited. PMID:12020415

  13. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.

    2011-01-01

    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 seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and make adaptive changes when needed. (2) Citizen involvement, that is, the initial reductions in TN loads, which occurred in the late 1970s and early 1980s, was a result of state regulations that were developed in response to citizens’ call for action. Improved water clarity and better fishing and swimming conditions were identified as primary goals by citizens again in the early 1990s, and led to development of numeric water-quality targets and seagrass restoration goals. More recent citizen actions, from pet waste campaigns to support of reductions in residential fertilizer use, are important elements of the nitrogen management strategy. (3) Collaborative actions, that is, in addition to numerous other collaborative ventures that have benefitted Tampa Bay, the public/private Nitrogen Management Consortium, which includes more than 40 participating organizations, has implemented over 250 nutrient-reduction projects. These projects have addressed stormwater treatment, fertilizer manufacturing and shipping, agricultural practices, reclaimed water use, and atmospheric emissions from local power stations, providing more than 300 tons of TN load reductions since 1995. (4) State and federal regulatory programs, that is, regulatory requirements, such as state statutes and rules requiring compliance with advanced wastewater treatment standards by municipal sewerage works, have played a key role in Tampa Bay management efforts. The technical basis and implementation plan of the Tampa Bay nitrogen management strategy have been developed in cooperation with state and federal regulatory agencies, and the strategy has been recognized by them as an appropriate tool for meeting water-quality standards, including federally mandated total maximum daily loads. Subsequent management efforts have focused on maintaining and extending those improvements in Tampa Bay’s environmental resources by addressing water and sediment quality and habitat protection and restoration. Implementation of a collaborative, watershed-based management process, driven by an integrated scienc

  14. A telemedicine health care delivery system

    NASA Technical Reports Server (NTRS)

    Sanders, Jay H.

    1991-01-01

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

  15. Hearing aid fitting: application of telemedicine in audiology.

    PubMed

    Wesendahl, Theo

    2003-01-01

    Telemedicine is used as a tool for therapeutic performances with the aid of telematics. The term telematics, a compound of the words telecommunication and informatics, means (in general) electronic transfer of digital data. We describe an application of telemedicine in the field of audiology: the initial fitting, setup, fine tuning, and follow-up fitting of all kinds of digital programmable and digital signal-processing devices and the fitting of hearing aids in real soundscapes. Against a backdrop of limited resources and continuous innovations, telemedicine offers the possibility of increasing the efficiency of audiological methods and decreasing expenses at the same time. PMID:14763332

  16. Networking requirements and the role of multimedia systems in telemedicine

    NASA Astrophysics Data System (ADS)

    Kim, Donglok; Cabral, James E., Jr.; Kim, Yongmin

    1995-10-01

    Programmable multimedia imaging workstations over a high bandwidth network (ATM) were used to explore the role of multimedia workstations in the telemedicine application. The multimedia workstation is based on the MediaStation 5000 which uses a TMS320C80 Multimedia Video Processor to handle the multimedia bitstreams and image display/processing functions. Although the telemedicine workstation exhibited its high performance and programmability, we found from the experiment that a tighter integration of the multimedia capability with the networking component should be one of the most desired improvements for the telemedicine system to become applicable in routine clinical environments.

  17. Implementing DICOM Structured Reporting in a Large-Scale Telemedicine Network

    PubMed Central

    Barcellos, Cloves Langendorf; Andrade, Rafael; de Carlos Back Giuliano, Isabela; Borgatto, Adriano Ferreti; de Andrade, Dalton Francisco

    2013-01-01

    Abstract Introduction: Large-scale asynchronous telemedicine networks can offer a unique opportunity for the acquisition of detailed epidemiological information if the data are acquired and handled in an appropriate way. In this work, an approach is presented for the integration of medical reports in the Digital Imaging and Communications in Medicine (DICOM) Structured Reporting standard in telemedicine networks using structured vocabularies. Materials and Methods: The use of these structured vocabularies is extended beyond radiology, and a case study in telecardiology is presented. The approach was applied in the context of a real-world statewide public telemedicine network; nowadays on average 470 written electrocardiographic structured reports daily are being performed. Cardiologists provided more than 220,000 written structured reports, and these reports are stored into a central database. Results: This study was performed during a 12-month period, and it was possible to examine possible associations between a list of co-morbidities and cardiac risk factors with a diagnosis that indicates the presence of cardiac ischemia, cardiac injury, or possible necrosis by using DICOM Structured Reporting. Our application is responsible for coordinating the process of issuance of reports through various technologies and devices. The system works as a library in an HTTP server, which accesses information from studies in DICOM format from the database and from structured vocabularies. Conclusions: Results indicate that traceability of morbidity, diagnoses, and patient clinical information can be achieved, resulting in an efficient data mining–friendly framework. A multidevice application for Web-based and smartphone-based platforms showed that it is a viable solution for applying the DICOM Structured Reporting standard in telemedicine networks. PMID:23837517

  18. Telemedicine in Anesthesiology and Reanimatology

    PubMed Central

    Tafro, Lejla; Masic, Izet

    2010-01-01

    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

  19. Intensive case management for severe mental illness

    PubMed Central

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

    2014-01-01

    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

  20. Case Studies for Management Development in Bangladesh. Second Book.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    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.…

  1. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... General Provisions § 441.18 Case management services. (a) If a State plan provides for case...

  2. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... General Provisions § 441.18 Case management services. (a) If a State plan provides for case...

  3. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... General Provisions § 441.18 Case management services. (a) If a State plan provides for case...

  4. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... General Provisions § 441.18 Case management services. (a) If a State plan provides for case...

  5. Tavarua : a mobile telemedicine system using WWAN striping

    E-print Network

    Carlisle, Jennifer (Jennifer Nicole)

    2007-01-01

    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 ...

  6. MediaStation 5000: a multimedia workstation for telemedicine

    NASA Astrophysics Data System (ADS)

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

    1995-04-01

    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.

  7. Telemedicine system interoperability architecture: concept description and architecture overview.

    SciTech Connect

    Craft, Richard Layne, II

    2004-05-01

    In order for telemedicine to realize the vision of anywhere, anytime access to care, it must address the question of how to create a fully interoperable infrastructure. This paper describes the reasons for pursuing interoperability, outlines operational requirements that any interoperability approach needs to consider, proposes an abstract architecture for meeting these needs, identifies candidate technologies that might be used for rendering this architecture, and suggests a path forward that the telemedicine community might follow.

  8. Examining End-of-Life Case Management: Systematic Review

    PubMed Central

    Thomas, Roger E.; Wilson, Donna M.; Birch, Stephen

    2014-01-01

    Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL) case management identified 17 research articles, with content analysis revealing two themes: (a) seeking to determine or establish the value of EOL case management and (b) identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care. PMID:24999433

  9. Telemedicine in Tinnitus: Feasibility, Advantages, Limitations, and Perspectives

    PubMed Central

    Guitton, Matthieu J.

    2013-01-01

    Given the important patient needs for support and treatment, telemedicine—defined by medical approaches supported by the new technologies of information—could provide interesting alternative in tinnitus treatment. By analyzing the published tools and approaches which could be used in the context of telemedicine for tinnitus by health professionals or self-administrated by patients, this review summarizes, presents, and describes the principal telemedicine approaches available presently or in the near future to help assess or treat tinnitus or to offer support to tinnitus sufferers. Several pieces of evidence strongly support the feasibility of telemedicine approaches for tinnitus. Telemedicine can be used to help tinnitus sufferers at several points in the therapeutic process: for early screening, initial evaluation, and diagnosis; for optimizing therapeutic tools, particularly behavioural therapies and virtual reality-enhanced behavioral therapies; for long-term monitoring of patients and provision of online support. Several limitations are, however, discussed in order to optimize the safe development of such approaches. Cost effective and easy to implement, telemedicine is likely to represent an important part of the future of tinnitus therapies and should be progressively integrated by otolaryngologists. PMID:23762623

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

    PubMed Central

    LeRouge, Cynthia; Garfield, Monica J.

    2013-01-01

    Barriers have challenged widespread telemedicine adoption by health care organizations for 40 years. These barriers have been technological, financial, and legal and have also involved business strategy and human resources. The article canvasses recent trends—events and activities in each of these areas as well as US health reform activities that might help to break down these barriers. The key to telemedicine success in the future is to view it as an integral part of health care services and not as a stand-alone project. Telemedicine must move from experimental and separate to integrated and equivalent to other health services within health care organizations. Furthermore, telemedicine serves as vital connective tissue for expanding health care organization networks. PMID:24287864

  11. Management of recalcitrant Trichomonas vaginalis in pregnancy: a case report.

    PubMed

    Tayal, Sarup

    2016-02-01

    A case report of a pregnant woman with recalcitrant Trichomonas vaginalis is described. This case was managed with suppressive treatment with metronidazole during pregnancy and cleared with paromomycin vaginal treatment after delivery. PMID:25829518

  12. Quantitative 3-D imaging topogrammetry for telemedicine applications

    NASA Technical Reports Server (NTRS)

    Altschuler, Bruce R.

    1994-01-01

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

  13. Knowledge Management Analysis: A Case Study

    ERIC Educational Resources Information Center

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  14. A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study

    PubMed Central

    Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S

    2015-01-01

    Background Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students’ preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. Objective The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: “What are professionals’ perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?” Methods The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with the game. Results Overall, the results were positive in all dimensions of the game that were assessed as means ranged from 3.2 to 3.99 out of 5, with user engagement receiving the highest score (mean 3.99, SD 0.87). Users’ perceived difficulty level received the lowest score (mean 3.20, SD 0.65), a finding which agrees with the analysis of log files that showed a rather low success rate (20.6%). Even though professionals saw the educational value and usefulness of the tool for pre-hospital emergency training (mean 3.83, SD 1.05), they identified confusing features and provided input for improving them. Conclusions Overall, the results of the professional feedback-informed evaluation of the game provide a strong indication of its potential as an educational tool for emergency training. Professionals’ input will serve to improve the game. Further research will aim to validate VETM, in a randomized pre-test, post-test control group study to examine possible learning gains in participants’ problem-solving skills in treating a patient’s symptoms in an emergency situation. PMID:26084866

  15. Telemedicine Networks of EHAS Foundation in Latin America

    PubMed Central

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

    2014-01-01

    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

  16. Telemedicine Networks of EHAS Foundation in Latin America.

    PubMed

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

    2014-01-01

    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

  17. Application of Telemedicine Technologies to Long Term Spaceflight Support

    NASA Astrophysics Data System (ADS)

    Orlov, O. I.; Grigoriev, A. I.

    Space medicine passed a long way of search for informative methods of medical data collection and analysis and worked out a complex of effective means of countermeasures and medical support. These methods and means aimed at optimization of the habitation conditions and professional activity of space crews enabled space medicine specialists to create a background for the consecutive prolongation of manned space flights and providing their safety and effectiveness. To define support systems perspectives we should consider those projects on which bases the systems are implemented. According to the set opinion manned spaceflights programs will develop in two main directions. The first one is connected with the near space exploration, first of all with the growing interest in scientific-applied and in prospect industrial employment of large size orbit manned complexes, further development of transport systems and in long-run prospect - reclamation of Lunar surface. The second direction is connected with the perspectives of interplanetary missions. There's no doubt that the priority project of the near-earth space exploration in the coming decenaries will be building up of the International Space Station. This trend characteristics prove the necessity to provide crews whose members may differ in health with individual approach to the schedule of work, rest, nutrition and training, to the medical control and therapeutic-prophylactic procedures. In these conditions the importance of remote monitoring and distance support of crew members activities by the earth- based medical control services will increase. The response efficiency in such cases can only be maintained by means of advanced telemedicine systems. The international character of the International Space Station (ISS) gives a special importance to the current activities on integrating medical support systems of the participating countries. Creation of such a system will allow to coordinate international research projects on space biology and medicine at the modern high level. In spite of the ISS international cooperation transparency space research programs require to follow the biomedicine ethics and provide confidentiality of the special medical information exchange. That can be achieved in the telemedicine support system built on the network principle. Presently we have all technical facilities needed to create such a system. In Russia activities on space telemedicicine support improvement are carried out by the State Scientific Center of the Russian Federation - Institute for Biomedical Problems of the Russian Academy of Sciences, Mission Control Center of the Russian Aviation and Space Agency, Space Biomedical Center for Training and Research and Yu. Gagarin Cosmonaut Training Center. Communications development and next generation Internet systems creation almost eliminate differences in the types of information technologies implementation both in the earth-based and near-earth space conditions. In prospect of the information community creation the telecommunication system of the near-earth space objects and its telemedicine element will become a natural part of the Earth unified information field that will open unlimited perspectives for flight support system improvement and space biomedical research conducting. Russia has unique data of numerous investigations on simulation of long, up to a year, effects of space flight factors on the human body. The sphere of situations studied by space medicine specialists embraced orbit manned space flights of the escalating duration (438 days in 1995). However a number of biomedical problems related to space flights didn't face optimal solutions. It's evident that during a space flight to Mars biomedical problems will be much more difficult in comparison with those of the orbit flights of the same duration. The summed up factors of such flights specify a level of the total medical risk that require assessment and application of effective means lowering the risk level. The characteristics of the interplanetary flights projects

  18. Availability and Deployment of Telemedicine/Telehealth Technologies in Rural Alaska

    PubMed Central

    Khan, Burhan; Hiratsuka, Vanessa Y.; Dillard, Denise; Robinson, Renee; Mau, Marjorie

    2015-01-01

    Telemedicine technologies are important lifelines for patients in rural areas. This study found 5 different telemedicine technologies used by patients throughout the Anchorage Service Unit and sheds light on the diverse internal and external teams involved in these services.

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

    PubMed

    Mars, Maurice

    2013-01-01

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

  20. The Challenge of e-Health Presence on a Petroleum Platform: Using Telemedicine to Make Operation of Pre-Salt Wells a Reality.

    PubMed

    Nunes Ferreira, R; Lopes da Rosa, T; Benevenuto de Campos Lima, C; Brito Alves de Lima, G; dos Santos Ramos, P; Dias da Silva, T; Barbieri, A; Takeo Ueda, E

    2015-01-01

    Telemedicine can be defined as the use of electronic media for the transmission of clinical data and information from one location to another using information technology and telecommunication in order to provide immediate clinical health care at long distances. This new approach can involve specialized medical service centers in the oil production at great distances from the offshore installations in Brazil. The importance of the right health diagnosis, taken at the proper time, will make a serious difference in the facilities, which will be located around 300 km offshore. This paper presents an overview of telemedicine and its different applications, comparing them according to level of maturity and applicability. Important results from a case study in a fixed oil platform are analyzed. At the end of this work, the strategy of telemedicine implementation in a Brazilian petroleum operator is discussed. PMID:26262239

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

    PubMed Central

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

    2015-01-01

    Objectives This paper introduces a telemedicine innovation network and reports its implementation in Tehran University of Medical Sciences. The required conditions for the development of future projects in the field of telemedicine are also discussed; such projects should be based on the common needs and opportunities in the areas of healthcare, education, and technology. Methods The development of the telemedicine innovation network in Tehran University of Medical Sciences was carried out in two phases: identifying the beneficiaries of telemedicine, and codification of the innovation network memorandum; and brainstorming of three workgroup members, and completion and clustering ideas. The present study employed a qualitative survey by using brain storming method. Thus, the ideas of the innovation network members were gathered, and by using Freeplane software, all of them were clustered and innovation projects were defined. Results In the services workgroup, 87 and 25 ideas were confirmed in phase 1 and phase 2, respectively. In the education workgroup, 8 new programs in the areas of telemedicine, tele-education and teleconsultation were codified. In the technology workgroup, 101 and 11 ideas were registered in phase 1 and phase 2, respectively. Conclusions Today, innovation is considered a major infrastructural element of any change or progress. Thus, the successful implementation of a telemedicine project not only needs funding, human resources, and full equipment. It also requires the use of innovation models to cover several different aspects of change and progress. The results of the study can provide a basis for the implementation of future telemedicine projects using new participatory, creative, and innovative models. PMID:26618033

  2. Use of telemedicine in disaster and remote places

    PubMed Central

    Ajami, Sima; Lamoochi, Parisa

    2014-01-01

    One of the methods, especially those living in remote areas or have crashed and does not have access to specialists is telemedicine. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status and care. Travel and wait times between the initial consultations with the patient's own general practitioner and referral to specialist can be reduced and specialists have successfully provided remote triage and treatment consults of victims via the robot. The robot proved to be a useful means to extend resources and provide expert consulting if specialists were unable to physically be at the site. In fact, the telemedicine system is providing health care services for individuals who are not available because of geographical and environmental conditions. The aim of this study was to identify telemedicine applications in disaster, and proposed use of this technology in areas where the shortage of specialists in remote areas in disasters. This study was un-systematic (narrative) review. The literature was searched for using of telemedicine in disaster and remote places with the help of libraries, conference proceedings, data bank, and also search engines available at Google, Google scholar. In our searches, we employed the following keywords and their combinations: telemedicine, remote place, earthquake, disaster, war, and telecommunication in the searching areas of title, keyword, abstract, and full text. In this study, more than 85 articles and reports were collected and 26 of them were selected based on their relevancy. This literature review helps define the concept of “components and usages of the Telemedicine in disaster” as the new technology in the present age. PMID:25013819

  3. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

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

    2006-01-01

    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

  4. Discursive Hierarchical Patterning in Law and Management Cases

    ERIC Educational Resources Information Center

    Lung, Jane

    2008-01-01

    This paper investigates the differences in the discursive patterning of cases in Law and Management. It examines a corpus of 271 Law and Management cases and discusses the kind of information that these two disciplines call for and how discourses are constructed in discursive hierarchical patterns. A discursive hierarchical pattern is a model…

  5. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Service coordination (case management). 303.23 Section... Service coordination (case management). (a) General. (1) As used in this part, except in § 303.12(d)(11... medical and health providers; and (7) Facilitating the development of a transition plan to...

  6. 34 CFR 303.23 - Service coordination (case management).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Service coordination (case management). 303.23 Section... Service coordination (case management). (a) General. (1) As used in this part, except in § 303.12(d)(11... medical and health providers; and (7) Facilitating the development of a transition plan to...

  7. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Primary care case management services. 440.168 Section 440.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.168 Primary care case management services. (a)...

  8. School Nurse Case Management: Achieving Health and Educational Outcomes

    ERIC Educational Resources Information Center

    Bonaiuto, Maria M.

    2007-01-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management

  9. Case Management: Effects of Improved Risk and Value Information

    ERIC Educational Resources Information Center

    Weissert, William G.; Hirth, Richard A.; Chernew, Michael E.; Diwan, Sadhna; Kim, Jinkyung

    2003-01-01

    Purpose: The purpose of this study was to determine the impact on resource use of providing case managers with information on the potential for patients to benefit from home care services. Design and Methods: Twenty-four case managers working in the Arizona Long Term Care System (ALTCS) were randomized into treatment and control groups. Members of…

  10. Case study: applying management policies to manage distributed queuing systems

    NASA Astrophysics Data System (ADS)

    Neumair, Bernhard; Wies, René

    1996-06-01

    The increasing deployment of workstations and high performance endsystems in addition to the operation of mainframe computers leads to a situation where many companies can no longer afford for their expensive workstations to run idle for long hours during the night or with little load during daytime. Distributed queuing systems and batch systems (DQSs) provide an efficient basis to make use of these unexploited resources and allow corporations to replace expensive supercomputers with clustered workstations running DQSs. To employ these innovative DQSs on a large scale, the management policies for scheduling jobs, configuring queues, etc must be integrated in the overall management process for the IT infrastructure. For this purpose, the concepts of application management and management policies are introduced and discussed. The definition, automatic transformation, and implementation of policies on management platforms to effectively manage DQSs will show that policy-based application management is already possible using the existing management functionality found in today's systems.

  11. Telemedicine’s Potential to Support Good Dying in Nigeria: A Qualitative Study

    PubMed Central

    van Gurp, Jelle; Soyannwo, Olaitan; Odebunmi, Kehinde; Dania, Simpa; van Selm, Martine; van Leeuwen, Evert; Vissers, Kris; Hasselaar, Jeroen

    2015-01-01

    Objectives This qualitative study explores Nigerian health care professionals’ concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice. Materials and Methods Supported by the Centre for Palliative Care Nigeria (CPCN) and the University College Hospital (UCH) in Ibadan, Nigeria, the authors organized three focus groups with Nigerian health care professionals interested in palliative care, unstructured interviews with key role players for palliative care and representatives of telecom companies, and field visits to primary, secondary and tertiary healthcare clinics that provided palliative care. Data analysis consisted of open coding, constant comparison, diagramming of categorizations and relations, and extensive member checks. Results The focus group participants classified good dying into 2 domains: a feeling of completion of the individual life and dying within the community. Reported barriers to palliative care provision were socio-economic consequences of being seriously ill, taboos on dying and being ill, restricted access to adequate medical–technical care, equation of religion with medicine, and the faulty implementation of palliative care policy by government. The addition of telemedicine to Nigeria’s palliative care practice appears problematic, due to irregular bandwidth, poor network coverage, and unstable power supply obstructing interactivity and access to information. However, a tele-education ‘lite’ scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication. Discussion Nigerian health care professionals’ concepts on good dying/a good death and barriers and opportunities for palliative care provision were, for the greater part, similar to prior findings from other studies in Africa. Information for and education of patient, family, and community are essential to further improve palliative care in Africa. Telemedicine can only help if low-tech solutions are applied that work around network coverage problems by focusing on non-synchronous online communication. PMID:26030154

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

    PubMed Central

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

    2014-01-01

    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

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

    ERIC Educational Resources Information Center

    Mansouri-Rad, Parand

    2012-01-01

    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…

  14. 7 CFR 1700.31 - Distance Learning and Telemedicine Loan and Grant Program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false Distance Learning and Telemedicine Loan and Grant Program...and Functions § 1700.31 Distance Learning and Telemedicine Loan and Grant Program...improve telemedicine services and distance learning services in rural areas. (a)...

  15. MODELLING AND FORMAL SPECIFICATION OF A MULTIAGENT TELEMEDICINE SYSTEM FOR DIABETES

    E-print Network

    Zhu, Hong

    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

  16. [Aspects of data protection in telemedicine].

    PubMed

    Vetter, R

    2001-10-01

    Telemedical applications like the electronic patient file, the electronic physician's letter and the electronic consultation ("Telekonsil"), the electronic prescription, the electronic patient's card (the "patient smart card") facilitate and improve the processing of sensitive medical data as well as the possibilities for using medical resources in an unusual degree and can thereby substantially contribute to the well-being of the patient. However, improving the quality of medical supply must not lead to a degradation of the patients' rights, in particular their right of self-determination. The introduction and the use of telemedical applications do not change the legal basic conditions for medical data processing. Therefore, a patient-friendly telemedicine must include data protection as well. Data protective telemedicine requires medical secrecy ensuring the patients' rights of information and transparency, correction of false and the up-to-date deletion of information that is no longer necessary, as well as secure data processing. All electronic processing of patients' data must meet the requirements of data security, i.e. the confidentiality, the integrity, the availability of the data at any time and the verifiability of the data processing have to be guaranteed. For this, electronic signatures and encodings have to be used, medical information systems have to be protected effectively against any risks resulting from open networks, particularly the Internet, and data processing has to be monitored. Electronic patient files may be open only to the treating physician and the medical assistants up to the necessary extent, ensuring the possibility of an emergency access. Any access beyond that does require the special consent of the patient. The medical secrecy has to be ensured. The electronic prescription with a documentation of the patient's medication requires the consent of the patient and must protect the rights of the physicians. In particular it has to ensure that the respective physician's prescribing behaviour cannot be stored or become known from a third party. Furthermore it has to protect the pharmacists' right to hide their turnover from other pharmacies. So-called patient smart cards require the consent of the patient. The right of the patient to keep his information secret, must be ensured with access options to the information stored on the smart card. Electronic physician's letters and socalled Telekonsile, i.e. the consultation with professional colleagues who were not involved in the patient's treatment from the beginning, require basically the agreement of the patient--if there cannot be dealt with anonymized data already from the beginning. In emergencies, after adequate consideration and weighing of values and interests, the consent of the patient can be suspected. The adherence to these boundary conditions ensures security and trustworthiness of telemedicine regarding the security of data processing as well as the rights of self-determination of all who are concerned. Data protection is also a contribution for the acceptance of these revolutionary advancements in the medical world. PMID:11688233

  17. 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)

    Scott, John Carver

    1991-01-01

    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.

  18. Evolution of telemedicine in the space program and earth applications

    NASA Technical Reports Server (NTRS)

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

    2001-01-01

    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.

  19. Evolution of telemedicine in the space program and earth applications.

    PubMed

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

    2001-01-01

    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

  20. A Knowledge Management Framework to Morph Clinical Cases with Clinical

    E-print Network

    Abidi, Syed Sibte Raza

    originate from different sources and be represented in diverse modalities. Our tacit-explicit knowledge morphing framework supports the extraction of tacit knowledge from past cases stored in a case Management, Clinical Practice Guidelines, Clinical Cases, Tacit Knowledge 1. Introduction Medical knowledge

  1. Privileged Emotion Managers: The Case of Actors

    ERIC Educational Resources Information Center

    Orzechowicz, David

    2008-01-01

    Theatre provides a unique set of conditions for the management of emotions. Drawing on participant observation from one repertory theater, three university productions, and interviews with stage actors, directors, and acting instructors, I conceptualize actors as privileged emotion managers. Actors access structural resources that enable their…

  2. Telemedicine or telephone consultation in patients with acute stroke.

    PubMed

    Demaerschalk, Bart M

    2011-02-01

    The advantages of telephone consultations for patients with acute stroke syndromes are history of use, simplicity, availability, portability, short consultation time, and facile implementation. The favorable aspects of telemedicine consultations are high accuracy, reliability, efficacy, and effectiveness, the growing technological sophistication of the offerings and features, and the high grade of recommendation. Between the two modalities, telemedicine is optimal for assessing patients with acute stroke and superior to telephone-only evaluations. Telephone consultations can serve as an adequate ancillary, adjunctive, supplemental, or back-up modality for a telestroke network. With recent advances in one-way/two-way video and teleradiology features adapted to Smartphones, the dividing line between "telephone" and "telemedicine" consultations for acute stroke is indistinct. Telestroke providers prefer a figurative "tool belt" of technologies available to adapt to individual consultation requirements. PMID:20922505

  3. Telemedicine-based alcohol services for rural offenders.

    PubMed

    Staton-Tindall, Michele; Wahler, Elizabeth; Webster, J Matthew; Godlaski, Theodore; Freeman, Rebecca; Leukefeld, Carl

    2012-08-01

    Research has consistently shown that alcohol use is a problem in rural communities and access to substance abuse treatment, particularly evidence-based treatment is limited. Because telemedicine has been shown to be effective in delivering services, this article presents a novel and innovative way of using telemedicine technology in the form of videoconferencing to deliver an evidence-based alcohol intervention (motivational enhancement therapy) with at-risk alcohol users in real-world settings (rural probation and parole offices). This article focuses on: (a) creating a profile of an at-risk group of rural alcohol users; (b) describing the evidence-based intervention; and (c) describing the innovative telemedicine-based service delivery approach. PMID:22867122

  4. Reduce costs, improve outcomes with community case management.

    PubMed

    2001-03-01

    Community case management is coming of age in a time of increasing government cuts to funding for Medicare patients and home health agencies. A hospital-based community case management program can save real dollars by offering a continuum of care for elderly and chronically ill patients who might otherwise need emergency room visits, readmissions, and visits to physicians' offices. Obstetric and psychiatric patients can benefit, too. And it doesn't need to be a budget-killer. Minimal expenses and volunteer services can keep a community case management program budget-friendly within almost any health care center. PMID:11236278

  5. Management of Perforated Duodenal Diverticulum: Report of Two Cases.

    PubMed

    Song, Sanghyun

    2015-09-01

    Duodenal diverticula are common, but perforated duodenal diverticulum is rare. Because of the disease rarity, there is no standard management protocol for perforated duodenal diverticulum. To properly manage this rare complication, a clear preoperative diagnosis and clinical disease severity assessment are important. An abdomino-pelvic CT is an unquestionably crucial diagnostic tool. Perforation is considered a surgical emergency, although conservative treatment based on fasting and broad-spectrum antibiotics may be offered in some selected cases. Herein, we report two cases of perforated duodenal diverticulum, one case managed with surgical treatment and one with conservative treatment. PMID:26387699

  6. Decision-making and nurse case management: a philosophical perspective.

    PubMed

    Fraser, Kimberly D; Strang, Vicki

    2004-01-01

    Decision-making related to resource allocation in home care case management practice is addressed from the unique perspective of nursing. The case management process stipulates the adherence to both client-centered and system-centered goals. Issues that emerge from this process include the ethical dilemma of deciding the equitable and fair distribution of resources related to the provision of appropriate levels of service; economic factors as they relate to limited financial resources; and the variance among case managers in their decision-making. Moderate realism, as compared to critical and feminist theory, provides a philosophical perspective that allows a practical interpretation of these issues. PMID:15027660

  7. QoE for telemedicine: challenges and trends

    NASA Astrophysics Data System (ADS)

    Cavaro-Ménard, Christine; Lu, Zhang Ge; Le Callet, Patrick

    2013-09-01

    Telemedicine that involves sharing of digital data (i.e. physiological signals, 2D/3D images and videos) should meet the same standards of traditional healthcare in terms of usability, accessibility, efficiency, effectiveness and quality of clinical processes. All these requirements can be seen as elementary components that participate to the quality of experience (QoE) in an ad hoc medical application scenario. Although, the quality of service (QoS) in telemedicine has been quite investigated, QoE is still lacking clear definition in this context. This later should not be assimilated to QoS as it refers clearly to the experience by the user while QoS focuses mostly on the system. QoE has a potential relevancy to optimize and understand the technical transmission chain from the final task point viewpoint which one of the most important factor for adoption of telemedicine. Towards this goal, QoE studies should be conducted with an appropriate methodology incorporating user involvement and digital data and their relation with QoS. As one of the first effort in this field, this paper proposes a survey of some key issues and solutions associated to QoE in telemedicine. We first present the services offered by telemedicine and underline the significance of QoE for tele-diagnosis and tele-surgery. Next, we identify and analyze the influencing factors such as application area, application purpose (emergency care, acquisition assistance, second opinion, education...), content type (data specificities depending on acquisition modality), context of use (offline/real time, interactivity...), and user's state (stress, expertise...), that have to be considered for a relevant QoE assessment in telemedicine.

  8. Telemedicine in Space Flight - Summary of a NASA Workshop

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

  9. Case III: Managing Conflict--The Case of the Faculty Stuck in the Middle.

    ERIC Educational Resources Information Center

    Trombly, Robert M.; Comer, Robert W.; Villamil, Juanita E.

    2002-01-01

    Explores techniques of conflict management as well as the positive and negative factors that may exert progressive or detrimental influences. Presents a case scenario, drawn from a faculty development workshop, involving a dental school faculty member, and highlights central issues of the case and relevant management concepts. (EV)

  10. Stroke care using a hub and spoke model with telemedicine.

    PubMed

    Huddleston, Penny; Zimmermann, Mary Beth

    2014-12-01

    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

  11. Patient Evaluation of an Acute Care Pediatric Telemedicine Service in Urban Neighborhoods

    PubMed Central

    McIntosh, Scott; Cirillo, Dominic; Wood, Nancy; Dozier, Ann M.; Alarie, Carol

    2014-01-01

    Abstract Background: Telemedicine has enhanced care for children with illness in Rochester, NY, since May 2001, enabling 13,568 acute illness visits through December 2013. Prior findings included high parent satisfaction with childcare- and school-based telemedicine (“school telemedicine”) and potential to replace 85% of office visits for illness. Urban neighborhood telemedicine (“neighborhood telemedicine”) was designed to offer convenient care for illness episodes that school telemedicine often cannot serve because illness arises when children are at home or symptoms preclude attendance. This study was designed to characterize health problems prompting neighborhood telemedicine use and to assess parent perceptions of its value. Materials and Methods: A parent satisfaction instrument was developed with input from parents and providers. Neighborhood telemedicine was initiated in January 2009 and totaled 1,362 visits through November 2013. During a 29-month survey period through January 2012, 3,871 acute illness telemedicine visits were completed, 908 (23.5%) of them via neighborhood telemedicine. Instruments were completed for 392 (43.2%) of the 908 visits. Results: Neighborhood telemedicine comprised 27% of all telemedicine visits during the year of peak neighborhood activity. Almost all survey respondents were satisfied or highly satisfied with neighborhood visits (97.6%) and endorsed greater convenience than alternatives (94.5%). Conclusions: Family preferences and the high value placed on neighborhood telemedicine suggest such service is important, especially in health systems driven by patient values. Service provided by neighborhood telemedicine holds potential to meet a large demand for care of acute childhood illness. Financing reform to support patient-centered care (e.g., bundled payments) should encompass sustainable business models for this service. PMID:25290233

  12. School nurse case management: achieving health and educational outcomes.

    PubMed

    Bonaiuto, Maria M

    2007-08-01

    Educators and health care professionals alike understand that healthy students are likely to be successful learners. The goal of school nurse case management is to support students so that they are ready to learn. This article describes the outcomes of a 4-year process improvement project designed to show the impact of school nurse case management on attendance, behavior, academic performance, quality of life, and health compliance in a large southeastern urban school district. Recognizing a need for standardized practice, the School Health Leadership Team created a case management policy, procedures, forms, a data collection process, and ongoing education and mentoring. The policy enabled school nurses to select students with health and learning needs, target specific outcomes, implement interventions, and document the gains made. In the 4 years of this project, 84% of the students case managed improved in 1 or more of the 5 target areas. PMID:17676967

  13. Job Title Case Management Specialist Employer/ Agency The Salvation Army

    E-print Network

    Paulsen, Vern

    Job Title Case Management Specialist Employer/ Agency The Salvation Army Job Description Interviews; ensures constant compliance with funding requirements. Qualifications Bachelor's degree from an accredited college or university in Social Work, Behavioral Science, or a related field, and three years

  14. Nurse's Breakout Session Injury/Illness Case Management

    NASA Technical Reports Server (NTRS)

    Hesselgesser, Connie

    2001-01-01

    An overview of the work related injury and illness case management model developed at the Johnson Space Center was presented. The major accomplishments and the challenges of implementation were discussed.

  15. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...qualified providers of case management services for target groups of individuals with developmental disability or chronic mental illness, in accordance with § 431.51(a)(4) of this chapter, the plan must identify any limitations to be...

  16. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...qualified providers of case management services for target groups of individuals with developmental disability or chronic mental illness, in accordance with § 431.51(a)(4) of this chapter, the plan must identify any limitations to be...

  17. Congenital eversion of upper eyelids: case report and management.

    PubMed

    Maheshwari, Rajat; Maheshwari, Sejal

    2006-09-01

    Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down's syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of congenital bilateral severe upper eyelid eversion in a normal infant, born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. PMID:16921222

  18. Management of dental implant fractures. A case history.

    PubMed

    Al Quran, Firas A M; Rashan, Bashar A; Al-Dwairi, Ziad N

    2009-01-01

    The widespread use of endosseous osseointegrated implants to replace missing natural teeth increases the chances of implant complications and failures, despite the high initial success rate reported in the literature. Implant fracture is one possible complication that results in ultimate failure of the dental implant. Such a complication poses a management crisis even for the most experienced clinician. This article reports on a case of implant fracture, its possible causes, and how the case was managed. PMID:19813428

  19. The Costs of Critical Care Telemedicine Programs

    PubMed Central

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

    2013-01-01

    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

  20. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... false What is required for case management? 20.515 Section 20.515...515 What is required for case management? Social services workers...for implementation of quality case management; this requires the...

  1. Data management for genomic mapping applications: A case study

    SciTech Connect

    Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.

    1992-05-01

    In this paper we describe a new approach to the construction of data management systems for genomic mapping applications in molecular biology, genetics, and plant breeding. We discuss the architecture of such systems and propose an incremental approach to the development of such systems. We illustrate the proposed approach and architecture with a case study of a prototype data management system for genomic maps.

  2. The employer's case for health management.

    PubMed

    Coulter, Christopher H

    2006-01-01

    Employers' past solutions to rising health benefit costs--adopting managed care strategies, cost shifting to employees and reducing benefits-are no longer effectively controlling costs and are depressing the value of health benefits for employee recruitment and retention. An alternative strategy is to implement health management approaches that improve the health status of employees. These programs reduce medical costs and have a documented positive impact on workers' compensation, disability costs, absenteeism and productivity. Further, this approach is complementary to health care consumerism as a strategy for health improvement and benefit cost reduction and results in improved employee health, outlook and satisfaction. PMID:16792389

  3. http://water.epa.gov/infrastructure/septicDecentralized Wastewater Management Case Studies Office of Wastewater Management

    E-print Network

    Walter, M.Todd

    12 http://water.epa.gov/infrastructure/septicDecentralized Wastewater Management Case Studies Office of Wastewater Management OVERVIEW Jamestown is located on a small island situated in the middle passed an ordinance to better accommodate growth and manage individual wastewater systems to protect its

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

    PubMed

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

    2016-03-01

    Telemedicine helps to deliver health services electronically to patients with the advancement of communication systems and health informatics. Chronic wound (CW) detection and its healing rate assessment at remote distance is very much difficult due to unavailability of expert doctors. This problem generally affects older ageing people. So there is a need of better assessment facility to the remote people in telemedicine framework. Here we have proposed a CW tissue prediction and diagnosis under telemedicine framework to classify the tissue types using linear discriminant analysis (LDA). The proposed telemedicine based wound tissue prediction (TWTP) model is able to identify wound tissue and correctly predict the wound status with a good degree of accuracy. The overall performance of the proposed wound tissue prediction methodology has been measured based on ground truth images. The proposed methodology will assist the clinicians to take better decision towards diagnosis of CW in terms of quantitative information of three types of tissue composition at low-resource set-up. PMID:26728394

  5. Virtual reality as telemedicine tool: technology, ergonomics and actual applications.

    PubMed

    Riva, G; Gamberini, L

    2000-01-01

    This paper surveys the state of the art in telemedicine applications of virtual environments (VEs) and related technologies for health care. The possible use of VEs as telemedicine tool has attracted much interest in medicine. Actually this technology is commonly used in remote or augmented surgery, and surgical training, which are critically dependent upon eye-hand coordination. Recently, however, different researchers have tried to use VEs in anatomic learning and for the assessment and rehabilitation in neuro-psychology. To date, such applications have improved the quality of health care, and later they will lead to substantial cost savings. Tools that respond to the needs of present VE systems are being refined or developed. However, the possible use of VEs in telemedicine is not linked to the solution of technical problems only. In fact telemedicine is not simply a technology but a complex process whose successful exploitation needs significant attention to ergonomics, human factors and organizational changes in the structure of the relevant health service. PMID:10955765

  6. Arizona TeleMedicine Network: Engineering Master Plan.

    ERIC Educational Resources Information Center

    Atlantic Research Corp., Alexandria, VA.

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

  7. 77 FR 27015 - Distance Learning and Telemedicine Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-08

    ...The Rural Utilities Service (RUS) is providing notice of Fiscal Year 2012 awards for its Distance Learning and Telemedicine (DLT) Grant Program. For Fiscal Year 2012, $15 million in grants will be awarded to the top scoring applications in rank order for the national competition announced in the Federal Register on February 24, 2011 (Vol. 76, No. 37). Therefore, applications for DLT grant......

  8. Arizona TeleMedicine Network: System Procurement Specifications.

    ERIC Educational Resources Information Center

    Atlantic Research Corp., Alexandria, VA.

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

  9. Memorial University of Newfoundland international distance education and telemedicine projects

    NASA Astrophysics Data System (ADS)

    House, Max; Keough, Erin

    1989-05-01

    Several one-way and two-way satellite link audio experiments are described. These include: satellite telemedicine links with offshore oil rigs, a telephony link between Canada, Kenya, Uganda and Jamaica, and the operation of a provincial teleconference network. Possible projects to be included in the Olympus satellite program are outlined.

  10. Job Title Case Manager Employer/ Agency Horizon Outreach

    E-print Network

    Paulsen, Vern

    Department. Duties consist of: oversight of assigned case load, engaging daily with At Risk Young Fathers with teaching them strategies on how to increase self-sufficiency. Employs client-centered case management, motivational interviewing, and/or other methodologies to establish the nature and extent of client problems

  11. Combining Cases and Computer Simulations in Strategic Management Courses

    ERIC Educational Resources Information Center

    Mitchell, Rex C.

    2004-01-01

    In this study, the author compared the effectiveness of two different strategic management course designs: one centered on case discussions and the other combining a computer-based simulation with some cases. In addition to evaluation of the research literature, the study involved experiments with six course sections composed of 130 students, Both…

  12. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case...

  13. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case...

  14. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case...

  15. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Case management services. 441.18 Section 441.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES General Provisions § 441.18 Case...

  16. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Case management services. 440.169 Section 440.169 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.169 Case...

  17. Adapters, Strugglers, and Case Managers: A Typology of Spouse Caregivers

    PubMed Central

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

    2015-01-01

    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

  18. Worldwide trends in Universal Service Funds and telemedicine.

    PubMed

    Nakajima, Isao

    2010-12-01

    A survey of recent worldwide trends in Universal Service Funds (USFs) and the assistance provided for their application indicates that industrialized countries and developing nations alike have offered or plan to offer tax-relief measures or reimbursement for communications costs incurred by telemedicine programs, thus finding a way to actively apply USFs in rural areas. There are three main systems used to calculate the amount of reimbursement from a USF. While many countries adopt a service-area net-loss estimation method, Japan uses a benchmark method and provides financial assistance only to unprofitable areas. The USA has proactively introduced telemedicine to rural areas and isolated islands in order to minimize rapidly rising healthcare costs and to improve the efficiency of healthcare services. In the USA, the USF is used to pay back communications costs incurred through telemedicine programs. For instance, the budget allocated from the USF for reimbursements for telemedicine in Alaska reached USD 30 Mil. in 2007. Developing countries in Africa and Asia are operating various forms of telemedicine on a trial basis, but a tax-relief measure or payback of communications costs, which are a large portion of the running costs, will need to be implemented to ensure sustainable and autonomous operation of telemedicine. In Japan, up until January 2007, the USF system assumed the use of an NTS (non-traffic sensitive cost) system to obtain funds from connection fees, and this system would receive funds from each telecommunications carrier (payer: the telecommunications carriers). The beneficiaries would be limited to two companies, namely NTT East and NTT West. However, the Japanese USF system was revised in February 2007, and a fee is now collected from each telephone number (payer: the user). The collected funds are used to cover losses in unprofitable areas (not limited to remote areas) among 7,000 business areas in Japan. In view of worldwide trends, the author believes that Japan should also start using the USF system to reimburse communications costs (including costs of telemedicine) in order to achieve sustainable and autonomous operation of public communication systems in rural areas. PMID:20703597

  19. Complications of video-mediastinoscopy--successful management in four cases.

    PubMed

    Pereszlenyi, A; Niks, M; Danko, J; Radulov, S; Zernovicky, F; Harustiak, S

    2003-01-01

    The authors describe complications of video-mediastinoscopy in a number of clinical cases and present case reports of four patients, where this complication occurred. The following types of complications were recorded: one case of esophageal perforation, one case of tracheal lesion and two cases of massive bleeding from central greater vessel. Possibilities of treatment methods of these complications, possible ways how to manage and decrease the incidence of life-threatening complication are being discussed in this paper. (Fig. 5, Ref. 9.). PMID:14594354

  20. 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...

  1. Case Study and Maturity Model for Business Process Management Implementation

    NASA Astrophysics Data System (ADS)

    Rohloff, Michael

    This paper presents the implementation of Business Process Management in a large international company. The business case illustrates the main objectives and approach taken with the BPM initiative. It introduces a process management maturity assessment which was developed to assess the implementation of Business Process Management and the achievements. The maturity model is based on nine categories which comprehensively cover all aspects which impact the success of Business Process Management. Some findings of the first assessment cycle are pinpointed to illustrate the benefits and best practice exchange as a result of the assessment.

  2. 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

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

    2012-01-01

    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…

  3. Management case study: Tampa Bay, Florida

    USGS Publications Warehouse

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

    2012-01-01

    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.

  4. Species Conservation and Management: Case Studies

    USGS Publications Warehouse

    Akcakaya, H.R.; Burgman, M.A.; Kindvall, O.; Wood, C.C.; Sjogren-Gulve, P.; Hatfield, J.S.; McCarthy, M.A.

    2004-01-01

    This edited volume is a collection of population and metapopulation models for a wide variety of species, including plants, invertebrates, fishes, amphibians, reptiles, birds, and mammals. Each chapter of the book describes the application of RAMAS GIS 4.0 to one species, with the aim of demonstrating how various life history characteristics of the species are incorporated into the model, and how the results of the model has been or can be used in conservation and management of the species. The book comes with a CD that includes a demo version of the program, and the data files for each species.

  5. An Evolutionary Examination of Telemedicine: A Health and Computer-Mediated Communication Perspective

    PubMed Central

    Breen, Gerald-Mark; Matusitz, Jonathan

    2009-01-01

    Telemedicine, the use of advanced communication technologies in the healthcare context, has a rich history and a clear evolutionary course. In this paper, the authors identify telemedicine as operationally defined, the services and technologies it comprises, the direction telemedicine has taken, along with its increased acceptance in the healthcare communities. The authors also describe some of the key pitfalls warred with by researchers and activists to advance telemedicine to its full potential and lead to an unobstructed team of technicians to identify telemedicine’s diverse utilities. A discussion and future directions section is included to provide fresh ideas to health communication and computer-mediated scholars wishing to delve into this area and make a difference to enhance public understanding of this field. PMID:20300559

  6. Heavy Metal Risk Management: Case Analysis

    PubMed Central

    Kim, Ji Ae; Lee, Seung Ha; Choi, Seung Hyun; Jung, Ki Kyung; Park, Mi Sun; Jeong, Ji Yoon; Hwang, Myung Sil; Yoon, Hae Jung; Choi, Dal Woong

    2012-01-01

    To prepare measures for practical policy utilization and the control of heavy metals, hazard control related institutions by country, present states of control by country, and present states of control by heavy metals were examined. Hazard control cases by heavy metals in various countries were compared and analyzed. In certain countries (e.g., the U.S., the U.K., and Japan), hazardous substances found in foods (e.g., arsenic, lead, cadmium, and mercury) are controlled. In addition, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) recommends calculating the provisional tolerable weekly intake (PTWI) of individual heavy metals instead of the acceptable daily intake (ADI) to compare their pollution levels considering their toxicity accumulated in the human body. In Korea, exposure assessments have been conducted, and in other countries, hazardous substances are controlled by various governing bodies. As such, in Korea and other countries, diverse food heavy metal monitoring and human body exposure assessments are conducted, and reducing measures are prepared accordingly. To reduce the danger of hazardous substances, many countries provide leaflets and guidelines, develop hazardous heavy metal intake recommendations, and take necessary actions. Hazard control case analyses can assist in securing consumer safety by establishing systematic and reliable hazard control methods. PMID:24278603

  7. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    PubMed Central

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  8. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... management? 250.518 Section 250.518 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR... Operations Casing Pressure Management § 250.518 What are the requirements for casing pressure management? Once you install your wellhead, you must meet the casing pressure management requirements of API RP...

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

    PubMed Central

    2014-01-01

    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

  10. Conservative management of placenta increta: case report and literature review.

    PubMed

    Yarandi, Fariba; Eftekhar, Zahra; Shojaei, Hadi; Rahimi-Sharbaf, Fatemeh; Baradaran, Fatemeh

    2011-01-01

    Placenta increta, a rare complication of pregnancy, is associated with significant postpartum hemorrhage often requiring emergency hysterectomy. We report a case of conservative management, with a combination of parenteral methotrexate, serial ultrasound and ?-hCG assessment. Serum ?-hCG levels were undetectable after 8 weeks of therapy. A scan at 6 months showed complete involution of the uterus. Review of the literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with placenta increta. PMID:21874645

  11. Evaluation of Probation Case Management (PCM) for Drug-Involved Women Offenders

    ERIC Educational Resources Information Center

    Chan, Monica; Guydish, Joseph; Prem, Rosemary; Jessup, Martha A.; Cervantes, Armando; Bostrom, Alan

    2005-01-01

    Based on availability of case management services, drug-involved women offenders entered either a probation case management (PCM) intervention(n = 65) or standard probation(n = 44). Participants were placed in the case management condition until all slots were filled, then placed in standard probation until case management slots opened.…

  12. Student Affairs Case Management: Merging Social Work Theory with Student Affairs Practice

    ERIC Educational Resources Information Center

    Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce

    2014-01-01

    Case management is a functional area in higher education and student affairs that emerged after the mass shootings at Virginia Tech in 2007. Although new to higher education, case management emerged from established social work practice. This article compares social work theory and case management standards with a new case management model for…

  13. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Case tracking, data management, and reporting. 96.43 Section...to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a)...

  14. Case III: Managing conflict--the case of the faculty stuck in the middle.

    PubMed

    Trombly, Robert M; Comer, Robert W; Villamil, Juanita E

    2002-04-01

    The need for administrative faculty members to have superior leadership and management skills to handle their increasingly complex responsibilities is well established. As a part of the 2000-01 ADEA Leadership Institute curriculum, fellows were responsible for developing situational case studies for a faculty development workshop to develop participants' leadership and management skills. The case presented here involved managing conflicts in the dental academic setting. The foundation of conflict management centers on communication techniques including transparent communication, open discussion, open confrontation, and active listening. Management options such as avoidance, accommodation, competition, negotiation, and collaboration are potential strategies for the faculty leader. This case study involves a fictitious public dental school, New Horizons University, which has embarked on solutions to address limited resources, but unwittingly has created conflicts between individuals and groups of faculty members. The case discussion analyzes the cause of conflicts, presents the positive and negative potential of the conflicts, reviews techniques of conflict management, and discusses specific management concepts regarding resource allocation and equity theory. PMID:12014569

  15. Effectiveness of technology-assisted case management in low income adults with type 2 diabetes (TACM-DM): study protocol for a randomized controlled trial

    PubMed Central

    2011-01-01

    Background An estimated 1 in 3 American adults will have diabetes by the year 2050. Nationally, South Carolina ranks 10th in cases of diagnosed diabetes compared to other states. In adults, type 2 diabetes (T2DM) accounts for approximately 90-95% of all diagnosed cases of diabetes. Clinically, provider and health system factors account for < 10% of the variance in major diabetes outcomes including hemoglobin A1c (HbA1c), lipid control, and resource use. Use of telemonitoring systems offer new opportunities to support patients with T2DM while waiting to be seen by their health care providers at actual office visits. A variety of interventions testing the efficacy of telemedicine interventions have been conducted, but the outcomes have yielded equivocal results, emphasizing the shortage of controlled, randomized trials in this area. This study provides a unique opportunity to address this gap in the literature by optimizing two strategies that have been shown to improve glycemic control, while simultaneously implementing clinical outcomes measures, using a sufficient sample size, and offering health care delivery to rural, underserved and low income communities with T2DM who are seen at Federally Qualified Health Centers (FQHCs) in coastal South Carolina. Methods We describe a four-year prospective, randomized clinical trial, which will test the effectiveness of technology-assisted case management in low income rural adults with T2DM. Two-hundred (200) male and female participants, 18 years of age or older and with an HbA1c ? 8%, will be randomized into one of two groups: (1) an intervention arm employing the innovative FORA system coupled with nurse case management or (2) a usual care group. Participants will be followed for 6-months to ascertain the effect of the interventions on glycemic control. Our primary hypothesis is that among indigent, rural adult patients with T2DM treated in FQHC's, participants randomized to the technology-assisted case management intervention will have significantly greater reduction in HbA1c at 6 months of follow-up compared to usual care. Discussion Results from this study will provide important insight into the effectiveness of technology-assisted case management intervention (TACM) for optimizing diabetes care in indigent, rural adult patients with T2DM treated in FQHC's. Trial Registration National Institutes of Health Clinical Trials Registry (http://ClinicalTrials.gov identifier# NCT01373489 PMID:22014122

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

    PubMed

    Osman, T; El Sony, A

    2014-07-01

    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

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

    PubMed

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

    2008-01-01

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

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

    PubMed

    Mahadevan, S; Muralidhar, Kanchi; Shetty, Devi

    2012-11-01

    We have used a telemedicine facility to conduct academic teaching/training sessions. The objective of this study was to examine the feasibility, advantages, and disadvantages of this method of e-learning sessions. The teaching/learning sessions were organized twice a week between the two teaching hospitals. The success of each academic session was analyzed in terms of satisfaction of the participating candidates, infrastructure difficulties (if any), and the overall outcome of the program. In total, 293 academic sessions were held from 2008 to 2010. Each session's presentation was 45?min long and was made using Microsoft(®) (Redmond, WA) PowerPoint. We have found that telemedicine proved to be effective in establishing communication not only between the patient and the physician, but also between the teacher and the student. Several candidates benefited from the application of this technology. Candidates expressed satisfaction and were content with the teaching methods adapted. PMID:23046243

  19. Improving Patient Care by Unshackling Telemedicine: Adaptively Constructing Rich Wireless Communication Channels to Facilitate Continuous Remote Collaboration

    E-print Network

    Qureshi, Asfandyar

    Telemedicine has had a positive impact on some aspects of patient care. However, existing telemedicine systems that use high-quality video are inflexible, requiring investment in fixed infrastructure. We have overcome a ...

  20. Technology Solutions Case Study: Moisture Management of High-Walls

    SciTech Connect

    2013-12-01

    Moisture management of high-R walls is important to ensure optimal performance. This case study, developed by Building America team Building Science Corporation, focuses on how eight high-R walls handle the three main sources of moisture—construction moisture, air leakage condensation, and bulk water leaks.

  1. Impact of School Nurse Case Management on Students with Asthma

    ERIC Educational Resources Information Center

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

    2004-01-01

    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…

  2. Medical Training Skills Curriculum for Case Management Assistants.

    ERIC Educational Resources Information Center

    Family Planning Council of Southeastern Pennsylvania, Philadelphia.

    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…

  3. Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Rubin, Stanford E.

    2006-01-01

    "Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

  4. Evaluation of Michigan's Foster Care Case Management System

    ERIC Educational Resources Information Center

    Johnson, Kristen; Wagner, Dennis

    2005-01-01

    Objective: In 1997, Michigan's Family Independence Agency piloted case management procedures designed to expedite permanency and improve services to children in foster care. Method: A 3-year evaluation examined outcomes in nine pilot and nine comparison counties to determine if children in the pilot counties achieved permanency, either returned…

  5. Managing Educational Change: A Case of Two Leadership Approaches

    ERIC Educational Resources Information Center

    Chow, Alice

    2013-01-01

    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…

  6. 75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    ... Mexico Outer Continental Shelf Region, 504-736-2627. SUPPLEMENTARY INFORMATION: On July 31, 2009, MMS published the proposed rule Annular Casing Pressure Management for Offshore Wells (74 FR 38147). The comment... the procedural matters discussion regarding information collection requirements, cost...

  7. Practices of Management Development: A Malaysian Case Study

    ERIC Educational Resources Information Center

    Law, Kian Aun

    2008-01-01

    This paper deals with a case study of Management Development (MD) practices at Malaysian Assurance Alliance (MAA). The aim of this research is to investigate how a large Malaysian insurance corporation developed and integrated MD initiatives with current organizational needs and tasks. Attempts were made to map and categorize the MD initiatives…

  8. Magic from Social Networks that Talk to Management: Four Cases

    ERIC Educational Resources Information Center

    Sugarman, Barry

    2010-01-01

    Purpose: The purpose of this paper is to understand how social networks can help to produce the "magic" of extraordinary results for organizations. Design/methodology/approach: In this exploratory study four cases (from published reports) are compared in order to illustrate different management approaches to utilizing the power of networks.…

  9. School Asthma Screening and Case Management: Attendance and Learning Outcomes

    ERIC Educational Resources Information Center

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

    2013-01-01

    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…

  10. Practical Knowledge Builds Projects: Case for Independent Construction Information Management Proceedings IGLC '98

    E-print Network

    Tommelein, Iris D.

    Practical Knowledge Builds Projects: Case for Independent Construction Information Management for construction projects should be by independent information managers whose only interest in the project management, automatic information, schedule centric project management, e-construction, transparency, lean

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

    PubMed Central

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

    2015-01-01

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

  12. The simulation model of teleradiology in telemedicine project.

    PubMed

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

    2015-01-01

    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

  13. How Continuous Monitoring Changes the Interaction of Patients with a Mobile Telemedicine System

    PubMed Central

    Martínez-Sarriegui, Iñaki; García-Sáez, Gema; Rigla, Mercedes; Brugués, Eulalia; de Leiva, Alberto; Gómez, Enrique J.; Hernando, M. Elena

    2011-01-01

    Background The combination of telemedicine systems integrating mobile technologies with the use of continuous glucose monitors improves patients’ glycemic control but demands a higher interaction with information technology tools that must be assessed. In this article, we analyze patients’ behavior from the use-of-the-system point of view, identifying how continuous monitoring may change the interaction of patients with the mobile telemedicine system. Methods Patients’ behavior were evaluated in a clinical experiment consisting of a 2-month crossover randomized study with 10 type 1 diabetes patients. During the entire experiment, patients used the DIABTel telemedicine system, and during the intervention phase, they wore a continuous glucose monitor. Throughout the experiment, all user actions were automatically registered. This article analyzes the occurrence of events and the behavior patterns in blood glucose (BG) self-monitoring and insulin adjustments. A subjective evaluation was also performed based on the answers of the patients to a questionnaire delivered at the end of the study. Results The number of sessions established with the mobile Smart Assistant was considerably higher during the intervention period than in the control period (29.0 versus 18.8, p < .05), and it was also higher than the number of Web sessions (29.0 versus 22.2, p < .01). The number of daily boluses was higher during the intervention period than in the control period (5.27 versus 4.40, p < .01). The number of daily BG measurements was also higher during the intervention period (4.68 versus 4.05, p < .05) and, in percentage, patients increased the BG measurements not associated to meals while decreasing the percentage of preprandial measurements. The subjective evaluation shows that patients would recommend the use of DIABTel in routine care. Conclusions The use of a continuous glucose monitor changes the way patients manage their diabetes, as observed in the increased number of daily insulin bolus, the increased number of daily BG measurements, and the differences in the distribution of BG measurements throughout the day. Continuous monitoring also increases the interaction of patients with the information system and modifies their patterns of use. We can conclude that mobile technologies are especially useful in scenarios of tight monitoring in diabetes, and they are well accepted by patients. PMID:21303619

  14. A regulated telemedicine system for day to day application in remote areas.

    PubMed

    Samiotakis, Y; Anagnostopoulou, S; Alexakis, A

    2000-01-01

    The NIVEMES project creates an international network of Health Service providers which offer Telemedicine-Teleconsultation services to Remote, Isolated places and to ship vessels for both routine and emergency situations. The base of the system is the powerful Multimedia Health Record, with the ability to manage conventional data, images, videos and biosignals, acquired directly from the medical device. National and international medical codification schemata are employed such as ICD-X and WHO standards. Telemedicine and Computing in Health Care are rapidly covering a pending gap, not fulfilled by current bureaucratic and telematic procedures. However even from the first test fields conducted during the past year, it is obvious that a variety of new training needs has arisen. The users of such systems need to be instructed new ways of conducting their business, of taking advantage of the services, even a new way of perceiving health care provision. The user interface of the software is kept simple, thus getting acquainted with it requires minimum effort; however there are other issues on which training is required to best exploit the advantages the system offers. The telemedical networks spawned in each country must be co-ordinated, and the user needs to know where and how he/she will acquire the necessary support. Home-cared patients will have to operate medical devices and telemedical software, a task which although made easy from today's technology, it still requires some basic training, specially as far as elderly users are concerned. The NIVEMES system uncovers a set of new training needs, but it offers at the same time a vehicle for educating the professional health-carers. The Health Record comprises a multimedia, explicit account of the patient history, which can be used for detailed and integrated study from trainee health carers of all levels (as well as from officers on board, people taking care of home-confined patients and others), on real data or in a simulated environment. At the same time the telemedicine facilities may increase the effectiveness of junior doctors working in remote areas and enhance the confidence residents have about their local health centres. Systems like NIVEMES prove that new user needs arise nowadays and employment of modern tools requires training in modern methods and in a new way of thinking. PMID:10947676

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

    ERIC Educational Resources Information Center

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

    2000-01-01

    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…

  16. Case series: management of immature permanent teeth with pulpal necrosis: a case series.

    PubMed

    McTigue, Dennis J; Subramanian, Kumar; Kumar, Ashok

    2013-01-01

    The management of immature permanent teeth with necrotic pulps has changed in recent years from apexification techniques to regenerative endodontic procedures, which enable apexogenesis with physiologic maturation of the roots. This regenerative technique lies squarely in the endodontist's scope of practice, but children presenting with necrotic immature incisors may pose behavior management problems that endodontists are untrained and unwilling to handle. Treatment of these immature permanent teeth provides an excellent opportunity for collaboration and shared patient management between pediatric dentists and endodontists that can yield optimal clinical outcomes. The purpose of this paper was to report a series of 32 regenerative endodontic cases in 28 children treated at the Nationwide Children's Hospital, Columbus, Ohio. The report describes procedural and patient management issues and the need for a collaborative relationship between pediatric dentists and endodontists in tackling these challenging cases. PMID:23635900

  17. Energy management study: A proposed case of government building

    NASA Astrophysics Data System (ADS)

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-01

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  18. Energy management study: A proposed case of government building

    SciTech Connect

    Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

    2015-05-15

    Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

  19. 7 CFR 1700.57 - Distance Learning and Telemedicine Loan and Grant Program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...Agriculture 11 2010-01-01 2010-01-01 false Distance Learning and Telemedicine Loan and Grant Program. 1700.57 Section...Loan and Grant Approval Authorities § 1700.57 Distance Learning and Telemedicine Loan and Grant Program. (a)...

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

    ERIC Educational Resources Information Center

    Bangert, David; Doktor, Boert; Johnson, Erik

    2001-01-01

    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)

  1. Current Status and Progress of Telemedicine in Korea and Other Countries

    PubMed Central

    Oh, Ji-Young; Park, Young-Taek; Jo, Emmanuel C.

    2015-01-01

    Objectives The purpose of this study was to review the current telemedicine of the Korea and the telemedicine of the other countries. Methods This study reviewed several documents on telemedicine and summarized the documents on the initiation of the telemedicine of the Korea, the recent regulations of the government, the analytical research results, and the telemedicine of foreign countries. Results One of recent demonstration trials of telemedicine began in July 2015 in the Korea. The plan was to conduct an emergency telemedical treatment trial among the cooperative medical service centers until the end of February 2016. No telemedical services were provided at the level of local primary care clinics, and there was 1.2% provision at the hospital level. The Europe Union and the United States had more active telemedical services in comparison to the Korea. Conclusions The introduction and usage of telemedicine in the Korea was behind those of other countries. It is necessary to develop a proactive support policy for telemedicine through a government implemented trial. PMID:26618029

  2. The Role of Outcome Mapping in Developing a Rural Telemedicine System

    E-print Network

    Blake, Edwin

    The Role of Outcome Mapping in Developing a Rural Telemedicine System William D. TUCKER1 , Edwin H@cs.uct.ac.za Abstract: We describe the use of Outcome Mapping to guide the design of a rural telemedicine consultation system in South Africa. While Outcome Mapping was not primarily intended to guide design, we show

  3. [The integration of telemedicine concepts in the regional care of rural areas: Possibilities, limitations, perspectives].

    PubMed

    van den Berg, Neeltje; Schmidt, S; Stentzel, U; Mühlan, H; Hoffmann, W

    2015-04-01

    In rural areas with a low population density and (imminent) gaps in regional health care, telemedicine concepts can be a promising option in supporting the supply of medical care.Telemedicine connections can be established between different health care providers (e.g., hospitals) or directly between health care providers and patients.Different scenarios for the implementation of telemedicine have been developed, from the monitoring of chronically ill patients to the support of acute care. Examples of frequently applied telemedicine concepts are teleradiology, telemedicine stroke networks, and the telemedicine monitoring of patients with heart failure. The development of concepts for other indications and patient groups is apparently difficult in Germany; one reason could be that research institutions are involved in only a small number of projects. However, the participation of research institutes would be of importance in creating more scientific evidence. The development of appropriate evaluation designs for analyzing the effectiveness of telemedicine concepts and economic effects is an important task and challenge for the future. Mandatory evaluation criteria should be developed to provide a basis for the translation of positively evaluated telemedicine concepts into routine care. PMID:25698122

  4. [Hepatic subcapsular hematoma: a case report and management update].

    PubMed

    Berveiller, P; Vandenbroucke, L; Popowski, T; Afriat, R; Sauvanet, E; Giovangrandi, Y

    2012-06-01

    Hepatic subcapsular hematoma (HSH) is a rare complication of pregnancy that keeps a materno-fetal high mortality rate. Given this severity, HSH management requires a prompt diagnosis and an appropriate care. Before focusing on the current management strategy of HSH, we illustrate this article with a clinical case presenting an original method of abdominal exploration, which has not been described to our knowledge. Thus, taking into account the presence of a moderate hemoperitoneum during a caesarean section procedure for HSH, introduction of laparoscopy through the same incision allowed a satisfactory evaluation of the abdominal cavity and hepatic area without performing an invasive midline laparotomy. PMID:22177755

  5. Management challenges in a case of gender identity disorder

    PubMed Central

    Rathi, Anubhav; Bhatia, Manjeet Singh

    2014-01-01

    Gender identity disorder (GID) is a complex disorder and can be defined as a group of disorders whose common feature is a strong and persistent preference for living as a person of the other sex. It is associated with significant impairment in social, occupational, interpersonal, and other areas of functioning. We describe the case of an adolescent, biologically male who was brought to our outpatient department primarily with symptoms of adjustment disorder with GID and the management provided. The role of a psychiatrist in the management, ethical and legal issues involved is also discussed. PMID:25788806

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

    PubMed

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

    2009-01-01

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

  7. Development of a standardized language for case management among high-risk elderly.

    PubMed

    Maravilla, Vilma; Graves, Maria T; Newcomer, Robert

    2005-01-01

    Consistency and communication remain key barriers to tracking case management outcomes and developing the best practices. A dictionary of case management problems, goals, interventions, and outcomes was developed to support a prevention-oriented case management program targeted on elderly high-risk patients. Case management featured an annual screening questionnaire, appointment monitoring, disease education, self-management support, and ongoing care coordination. The dictionary resulted in a Standardized Language for Case Management (SLED). This has since been reviewed and modified on the basis of comments and recommendations from 5 leading case management organizations and is aligned with Standards of Practice for Case Management. The article provides a description of the standardized language terms, the rationale underlying the documentation, examples of how this dictionary of definitions can be incorporated into the daily practice of case management, and examples of some of the benefits to the field that can be achieved with the use of a common data-recording system. PMID:15685005

  8. The chiropractic management of two cases of cervical spondylotic radiculopathy

    PubMed Central

    Dufton, John A.; Giantomaso, Tony

    2003-01-01

    Cervical spondylotic radiculopathy (CSR) is one of the potential sources of radiculopathy, particularly in patients aged 40 to 60 years. The hallmark sign of cervical-brachial pain presents in the majority of the cases, however a definitive clinical diagnosis is often difficult in the absence of reliable and valid diagnostic tests. Two cases of presumed CSR illustrate the usefulness of applying a comprehensive mechanical assessment that guides the patient's rehabilitation regardless of the traditional anatomical diagnosis. A brief overview of the epidemiology, clinical presentation, and management of CSR is also presented.

  9. Management and outcomes of three cases of rhinocerebral mucormycosis.

    PubMed

    Viterbo, Stefano; Fasolis, Massimo; Garzino-Demo, Paolo; Griffa, Alessandro; Boffano, Paolo; Iaquinta, Caterina; Tanteri, Giulia; Modica, Remo

    2011-12-01

    Mucormycosis is a rare opportunistic infection caused by fungi belonging to Mucorales order. The infection usually starts in the middle or inferior nasal meatus and then spreads to the paranasal sinuses and the orbit. Then it reaches the brain through the ethmoid and the orbit apex and can lead to lethargy, paralysis, and death. The majority of cases of rhinocerebral mucormycosis are diagnosed in patients with immunologic and metabolic disorders. Early diagnosis is fundamental, and so is medical therapy with amphotericin B along with surgical toilet of the compromised tissues. This article presents and discusses the management of 3 cases of rhinocerebral mucormycosis with different onsets, progressions, and outcomes. PMID:21862361

  10. Trigeminal Neuralgia: Management of Two Cases with Hypnotherapy

    PubMed Central

    Gurian, Bernard

    1985-01-01

    Tic douloureux, unlike other chronic pain disorders, exhibits a number of very specific features unassociated with either sensory loss or demonstrable neuropathology.1 The etiology is obscure but various contributory factors have been cited, and the condition is considered an important cause of face pain. Although a variety of drugs and surgical procedures have been employed to control the symptoms, the results in many cases have been temporary with many adverse side effects.2 For many years, hypnotherapy has been utilized as a valid tool for the control of severe protracted pain, and relief of symptoms has been achieved in many instances where other modalities of pain management had been inadequate. The author presents two cases in which hypnotherapy was employed for the management of symptoms associated with idiopathic trigeminal neuralgia. PMID:3866504

  11. High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.

    PubMed

    Shah, Manish N; Gillespie, Suzanne M; Wood, Nancy; Wasserman, Erin B; Nelson, Dallas L; Dozier, Ann; McConnochie, Kenneth M

    2013-11-01

    Accessing timely acute medical care is a challenge for older adults. This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. This program, based in a primary care geriatrics practice that cares for SLC residents, is designed to offer acute care through telemedicine for complaints that are felt to need attention before the next available outpatient visit but not to require emergency department (ED) resources. This option gives residents access to care in their residence. Measures used to evaluate the program include successful completion of telemedicine visits, satisfaction of residents and caregivers with telemedicine care, and site of care that would have been recommended had telemedicine been unavailable. During the first 2 years of the program's operation, 281 of 301 requested telemedicine visits were completed successfully. Twelve residents were sent to an ED for care after the telemedicine visit. Ninety-four percent of residents reported being satisfied or very satisfied with telemedicine care. Had telemedicine not been available, residents would have been sent to an ED (48.1%) or urgent care center (27.0%) or been scheduled for an outpatient visit (24.4%). The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use. Continuation of the program will require evaluation demonstrating equal or better resident-level outcomes and the development of sustainable business models. PMID:24164485

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

    PubMed Central

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

    2014-01-01

    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

  13. Oral bullous lichen planus: Case report and review of management.

    PubMed

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

    2012-07-01

    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

  14. Management of haemangioma with sclerosing agent: a case report

    PubMed Central

    M K, Parvathidevi; Koppal, Shrinivas; Rukmangada, Thriveni; Byatnal, Amit R

    2013-01-01

    The use of multiple weekly intralesional injections of 3% sodium tetradecyl sulfate as a sclerosing agent for the management of facial haemangiomas is a safe treatment with acceptable results. As presented in this case report, this technique offers the patient considerable relief of symptoms with minimal complications. However, the possibility of second-stage surgery to correct residual deformity is still considered. Sclerotherapy with 3% sodium tetradecyl sulfate provides a good preparation for further surgery. PMID:24130207

  15. Oral bullous lichen planus: Case report and review of management

    PubMed Central

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

    2012-01-01

    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

  16. Chiropractic management of abdominal aortic aneurysm: a case report

    PubMed Central

    Weston, JP

    1995-01-01

    Aortic dilatation is a common and potentially life-threatening condition with which a patient may present to the chiropractor. It is most often detected in males over 50, particularly in association with hypertensive disease. This case illustrates the classic clinical and radiologic features of a large (13cms) abdominal aortic aneurysm. The manipulative management of patients with abdominal aortic aneurysm is discussed. ImagesFigure 1(a)Figure 1(b)

  17. Anesthetic management in a case of antiphospholipid antibody syndrome

    PubMed Central

    Mikkiliineni, Venkata Rama Rao; Panidapu, Nagarjuna; Parasa, Mrunalini; Shaik, Mastan Saheb

    2015-01-01

    Antiphospholipid antibody (APLA) syndrome is one of the most common thrombocytophilias but, unfortunately, goes unrecognized most often. It is an auto-immune disorder in which thrombotic events and a recurrent fetal loss occur in the presence of antibodies to phospholipids. It is the most common acquired hyper-coagulable state. There is a limited literature on peroperative management of patients with this syndrome. We report a case of APLA syndrome in a parturient due to its rarity and complexity. PMID:26712985

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

    E-print Network

    Hinson, F.; Curtin, D.

    1988-01-01

    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 comprises separate...

  19. Long-running telemedicine networks delivering humanitarian services: experience, performance and scientific output

    PubMed Central

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

    2012-01-01

    Abstract Objective To summarize the experience, performance and scientific output of long-running telemedicine networks delivering humanitarian services. Methods Nine long-running networks – those operating for five years or more– were identified and seven provided detailed information about their activities, including performance and scientific output. Information was extracted from peer-reviewed papers describing the networks’ study design, effectiveness, quality, economics, provision of access to care and sustainability. The strength of the evidence was scored as none, poor, average or good. Findings The seven networks had been operating for a median of 11 years (range: 5–15). All networks provided clinical tele-consultations for humanitarian purposes using store-and-forward methods and five were also involved in some form of education. The smallest network had 15 experts and the largest had more than 500. The clinical caseload was 50 to 500 cases a year. A total of 59 papers had been published by the networks, and 44 were listed in Medline. Based on study design, the strength of the evidence was generally poor by conventional standards (e.g. 29 papers described non-controlled clinical series). Over half of the papers provided evidence of sustainability and improved access to care. Uncertain funding was a common risk factor. Conclusion Improved collaboration between networks could help attenuate the lack of resources reported by some networks and improve sustainability. Although the evidence base is weak, the networks appear to offer sustainable and clinically useful services. These findings may interest decision-makers in developing countries considering starting, supporting or joining similar telemedicine networks. PMID:22589567

  20. Engaging recreational fishers in management and conservation: global case studies.

    PubMed

    Granek, E F; Madin, E M P; Brown, M A; Figueira, W; Cameron, D S; Hogan, Z; Kristianson, G; de Villiers, P; Williams, J E; Post, J; Zahn, S; Arlinghaus, R

    2008-10-01

    Globally, the number of recreational fishers is sizeable and increasing in many countries. Associated with this trend is the potential for negative impacts on fish stocks through exploitation or management measures such as stocking and introduction of non-native fishes. Nevertheless, recreational fishers can be instrumental in successful fisheries conservation through active involvement in, or initiation of, conservation projects to reduce both direct and external stressors contributing to fishery declines. Understanding fishers' concerns for sustained access to the resource and developing methods for their meaningful participation can have positive impacts on conservation efforts. We examined a suite of case studies that demonstrate successful involvement of recreational fishers in conservation and management activities that span developed and developing countries, temperate and tropical regions, marine and freshwater systems, and open- and closed-access fisheries. To illustrate potential benefits and challenges of involving recreational fishers in fisheries management and conservation, we examined the socioeconomic and ecological contexts of each case study. We devised a conceptual framework for the engagement of recreational fishers that targets particular types of involvement (enforcement, advocacy, conservation, management design [type and location], research, and monitoring) on the basis of degree of stakeholder stewardship, scale of the fishery, and source of impacts (internal or external). These activities can be enhanced by incorporating local knowledge and traditions, taking advantage of leadership and regional networks, and creating collaborations among various stakeholder groups, scientists, and agencies to maximize the probability of recreational fisher involvement and project success. PMID:18637911

  1. Standard case management of asthma in Sudan: a pilot project

    PubMed Central

    Chiang, C-Y.; Malik, E.; Hassanain, S. A.; Hussien, H.; Khamis, A. H.; Bassilli, A. F.; Enarson, D. A.

    2013-01-01

    Setting: A pilot project for asthma management in selected hospitals in Khartoum and Gezira States, Sudan. Objective: To assess standard case management of asthma in 2007–2008. Design: Local adaptation of guidelines, followed by situational analysis, pre-intervention study, training and implementation. Treatment outcome was assessed 1 year after patient enrolment. Results: Situational analysis revealed that inhaled beclometasone was not available in the public sector. During the project, 2068 patients were enrolled: severity of asthma was intermittent in 185 (9.0%), mild persistent in 231 (11.2%), moderate persistent in 640 (31.0%), severe persistent in 812 (39.3%) and unclassified in 200 (9.7%). Of the 1654 patients with persistent asthma who were treated with inhaled corticosteroids, 1157 (70.0%) had treatment cards available for outcome assessment. Of these, 652 (56.4%) did not attend their annual evaluation, among whom 1 (0.1%) died and 651 (56.3%) were lost to follow-up. Of the 505 patients who attended their annual evaluation, 417 (82.6%) improved, 32 (6.3%) were stable and 56 (11.1%) were worse. The frequency of emergency visits and hospitalisation decreased substantially among those who presented for the 1 year follow-up assessment. Conclusion: The results of standard case management of asthma were encouraging; however, a high proportion of patients did not return for long-term management. PMID:26393039

  2. Clinicopathological profile and management of 161 cases of actinic cheilitis*

    PubMed Central

    Lopes, Maria Luiza Diniz de Sousa; da Silva Júnior, Francisco Leonardo; Lima, Kenio Costa; de Oliveira, Patrícia Teixeira; da Silveira, Éricka Janine Dantas

    2015-01-01

    BACKGROUND Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation from the sun. OBJECTIVES To evaluate the clinical, demographic, morphological and therapeutic management in AC cases data associating to the histopathological grading. METHODS Demographic, clinical and management data of 161 patients with AC were analyzed. In biopsied cases, two calibrated examiners performed histopathological grading by binary system. RESULTS There was a prevalence of males (79.5%), aged 40 years or older (77.5%), light-skinned (85.7%), experiencing occupational exposure to sunlight (80.3%), with AC presenting clinically as white lesions (33.6%). Conservative treatment was adopted in 78 cases and biopsy in 83 cases (60.2% graded as low-risk AC). There were no significant associations between histopathological grading and gender (p= 0.509), age (p=0.416), ethnicity (p=0.388), occupational exposure to sunlight (p=1.000) or clinical presentation (p=0.803). CONCLUSION This study reinforces the hypothesis that demographic and clinical characteristics of AC are not related to histopathological grading. Advice on protection from sun exposure should be encouraged to avoid progression of AC and invasive therapies. PMID:26375219

  3. Revenue management under demand uncertainty: the case for a robust optimization approach Revenue management under demand uncertainty

    E-print Network

    Snyder, Larry

    to revenue management under demand uncertainty that: 1 Takes risk into account, i.e., tries to avoid veryRevenue management under demand uncertainty: the case for a robust optimization approach Revenue management under demand uncertainty: the case for a robust optimization approach Aur´elie Thiele Lehigh

  4. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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...

  5. Job Stress in Disaster Case Managers Working with Hurricane Ike Recovery 

    E-print Network

    Forman, Megan Hajecate

    2011-10-21

    resources. The purpose of this study was to evaluate stress levels of the disaster case managers employed through the ten smaller faith-based organizations that make up one of the larger recipient organizations providing case management services to victims...

  6. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...1 2010-04-01 2010-04-01 false What case management responsibilities does the social services worker have...Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker...

  7. Diagnostic ultrasound and telemedicine utilization in the international space station

    NASA Astrophysics Data System (ADS)

    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

    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).

  8. The Portable Dynamic Fundus Instrument: Uses in telemedicine and research

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

    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.

  9. Farmers' use of nutrient management: lessons from watershed case studies.

    PubMed

    Osmond, Deanna L; Hoag, Dana L K; Luloff, Al E; Meals, Donald W; Neas, Kathy

    2015-03-01

    Nutrient enrichment of water resources has degraded coastal waters throughout the world, including in the United States (e.g., Chesapeake Bay, Gulf of Mexico, and Neuse Estuary). Agricultural nonpoint sources have significant impacts on water resources. As a result, nutrient management planning is the primary tool recommended to reduce nutrient losses from agricultural fields. Its effectiveness requires nutrient management plans be used by farmers. There is little literature describing nutrient management decision-making. Here, two case studies are described that address this gap: (i) a synthesis of the National Institute of Food and Agriculture, the Conservation Effects Assessment Project, and (ii) field surveys from three nutrient-impaired river basins/watersheds in North Carolina (Neuse, Tar-Pamlico, and Jordan Lake drainage areas). Results indicate farmers generally did not fully apply nutrient management plans or follow basic soil test recommendations even when they had them. Farmers were found to be hesitant to apply N at university-recommended rates because they did not trust the recommendations, viewed abundant N as insurance, or used recommendations made by fertilizer dealers. Exceptions were noted when watershed education, technical support, and funding resources focused on nutrient management that included easing management demands, actively and consistently working directly with a small group of farmers, and providing significant resource allocations to fund agency personnel and cost-share funds to farmers. Without better dialogue with farmers and meaningful investment in strategies that reward farmers for taking what they perceive as risks relative to nutrient reduction, little progress in true adoption of nutrient management will be made. PMID:26023957

  10. Implementing store-and-forward telemedicine: organizational issues.

    PubMed

    Bangert, D; Doktor, R

    2000-01-01

    This article documents a study of an organization's cultural readiness for successful implementation of a store-and-forward telemedicine system in a military health care environment. The study focused on the organization's cultural attributes that reflect its learning propensity and thereby its capability to adapt effectively and utilize the new technology. Results suggest that the organization did not possess the most favorable attributes for the utilization of a new technology, and the utilization of the new system was significantly lower than expected during the first 6 months of implementation. PMID:11110639

  11. Neurosurgical management of anterior meningo-encephaloceles about 60 cases

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

    2015-01-01

    Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics results in 8 cases, poor results in 5 cases and worse cosmetics results in 4 cases, The AME are rare conditions we used the multiples approach first intracranial approach followed by facial approach, but after 1998 we used one-step correction by combined approach, only cranial approach when needed or facial correction. PMID:26448810

  12. A Case Management Model for School-Age Children with Multiple Needs.

    ERIC Educational Resources Information Center

    Smith, Vanessa Khouri; Prelock, Patricia A.

    2002-01-01

    This article suggests that the speech-language pathologist may appropriately serve as a case manager for students who have multiple needs and describes a case management model. The skills necessary for effective case management are outlined and functional outcomes are demonstrated with a child and family story. (Contains references.) (DB)

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

    PubMed

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

    2015-12-01

    Over the past two decades, the use of telemedicine as a way to provide medical services has grown as communication technologies advance and patients seek more convenient ways to receive care. Because developments within this field are still rapidly evolving, identifying trends within telemedicine literature is an important task to help delineate future directions of telemedicine research. In this study, we analyzed 7960 telemedicine-related publication records found in the Science Citations Index - Expanded database between 1993 and 2012. Bibliometric analyses revealed that while the total growth in telemedicine literature has been significant in the last twenty years, the publication activity per country and over time has been variable. While the United States led the world in the cumulative number of telemedicine publications, Norway ranked highest when we ordered countries by publications per capita. We also saw that the growth in the number of publications per year has been inconsistent over the past two decades. Our results identified that neuroscience neurology and nursing as two fields of research in telemedicine that have seen considerable growth in interest in this field, and are poised to be the focus of research activity in the near future. PMID:26415760

  14. [Extravascular lung water: from genes to telemedicine].

    PubMed

    Gargani, Luna; Raso, Rossella; Pioggia, Giovanni; Pratali, Lorenza

    2013-04-01

    Extravascular lung water is a crucial parameter for the management of many different pathological conditions, especially heart failure. Many modalities can be employed for its evaluation, each with different advantages and limitations. In a near future, we hope that extravascular lung water assessment could be performed by non-invasive wearable devices, allowing remote continuous monitoring of pulmonary congestion. Recently, it has been proposed that some specific genetic variations may be responsible for the heterogeneous individual response to the development of extravascular lung water. These data could be relevant to titrate and personalize both treatments and preventive interventions. PMID:23748634

  15. Case management in a DUI lab: effect on drugs reported.

    PubMed

    Tiscione, Nicholas B; Shan, Xiaoqin; Yeatman, Dustin Tate

    2014-10-01

    An evaluation of an internal laboratory decision to implement a protocol for limiting drug testing based on ethanol concentration in laboratory analysis for driving under the influence (DUI) cases is presented. The described case management strategy is supported by known impairment of ethanol at relatively high concentrations, difficulty assigning a level of contributing impairment from drugs in the presence of high ethanol levels and the likelihood that the drug results may be suppressed at trial. Although the results of this study reinforce the assertion that such protocols lead to the under reporting of drugs in DUI cases, for the majority of cases, 95% in this study, the drug analysis results were not significant and did not warrant the time and resources needed for the additional blood drug testing. Furthermore, the study demonstrated that a high drug positivity rate does not necessarily mean that those drug results are legally or pharmacologically meaningful. Additional research should be conducted with quantitative drug results and casework impact of blood drug screen protocols as previous studies only report drug positivity rates and not whether the drug results would be meaningful to the case. PMID:25217546

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

    PubMed

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

    2014-09-01

    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

  17. 75 FR 82053 - Notification of a New Privacy Act System of Records, Effort to Outcomes-Case Management System...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ...Records, Effort to Outcomes--Case Management System for the Disaster Housing...housing assistance and on-going case management services, due to the catastrophic...SYSTEM NAME: Efforts to Outcome Case Management Tracking System for...

  18. Project RavenCare: global multimedia telemedicine in Alaska

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

    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.

  19. A transmission security framework for email-based telemedicine.

    PubMed

    Caffery, Liam J; Smith, Anthony C

    2010-01-01

    Encryption is used to convert an email message to an unreadable format thereby securing patient privacy during the transmission of the message across the Internet. Two available means of encryption are: public key infrastructure (PKI) used in conjunction with ordinary email and secure hypertext transfer protocol (HTTPS) used by secure web-mail applications. Both of these approaches have advantages and disadvantages in terms of viability, cost, usability and compliance. The aim of this study was develop an instrument to identify the most appropriate means of encrypting email communication for telemedicine. A multi-method approach was used to construct the instrument. Technical assessment and existing bodies of knowledge regarding the utility of PKI were analyzed, along with survey results from users of Queensland Health's Child and Youth Mental Health Service secure web-mail service. The resultant decision support model identified that the following conditions affect the choice of encryption technology: correspondent's risk perception, correspondent's identification to the security afforded by encryption, email-client used by correspondents, the tolerance to human error and the availability of technical resources. A decision support model is presented as a flow chart to identify the most appropriate encryption for a specific email-based telemedicine service. PMID:21191156

  20. Open-Source Telemedicine Platform for Wireless Medical Video Communication

    PubMed Central

    Panayides, A.; Eleftheriou, I.; Pantziaris, M.

    2013-01-01

    An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings. PMID:23573082

  1. Open-source telemedicine platform for wireless medical video communication.

    PubMed

    Panayides, A; Eleftheriou, I; Pantziaris, M

    2013-01-01

    An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings. PMID:23573082

  2. Projection-based medical image compression for telemedicine applications.

    PubMed

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

    2015-04-01

    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

  3. Automated retinal image analysis for diabetic retinopathy in telemedicine.

    PubMed

    Sim, Dawn A; Keane, Pearse A; Tufail, Adnan; Egan, Catherine A; Aiello, Lloyd Paul; Silva, Paolo S

    2015-03-01

    There will be an estimated 552 million persons with diabetes globally by the year 2030. Over half of these individuals will develop diabetic retinopathy, representing a nearly insurmountable burden for providing diabetes eye care. Telemedicine programmes have the capability to distribute quality eye care to virtually any location and address the lack of access to ophthalmic services. In most programmes, there is currently a heavy reliance on specially trained retinal image graders, a resource in short supply worldwide. These factors necessitate an image grading automation process to increase the speed of retinal image evaluation while maintaining accuracy and cost effectiveness. Several automatic retinal image analysis systems designed for use in telemedicine have recently become commercially available. Such systems have the potential to substantially improve the manner by which diabetes eye care is delivered by providing automated real-time evaluation to expedite diagnosis and referral if required. Furthermore, integration with electronic medical records may allow a more accurate prognostication for individual patients and may provide predictive modelling of medical risk factors based on broad population data. PMID:25697773

  4. Scheduling in Sensor Grid Middleware for Telemedicine Using ABC Algorithm

    PubMed Central

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

    2014-01-01

    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

  5. Management of Ectopically Erupting Maxillary Incisors: A Case Series

    PubMed Central

    Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J

    2015-01-01

    ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  6. Meta-case based realization of design rationale management systems

    SciTech Connect

    Paul, G.

    1996-12-31

    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.

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

    SciTech Connect

    Aykac, Deniz; Chaum, Edward; Fox, Karen; Garg, Seema; Giancardo, Luca; Karnowski, Thomas Paul; Li, Yaquin; Nichols, Trent L; Tobin Jr, Kenneth William

    2011-01-01

    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.

  8. Conservative management of a case of tarsal tunnel syndrome

    PubMed Central

    Hudes, Karen

    2010-01-01

    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

  9. Comprehensive behavioral management of complex tinnitus: a case illustration.

    PubMed

    Duckro, P N; Pollard, C A; Bray, H D; Scheiter, L

    1984-12-01

    This paper describes a comprehensive program for behavioral management of complex tinnitus. The clinical characteristics and typical treatment of tinnitus are reviewed. Psychosocial sequelae are discussed in terms of their exacerbation of the symptom and their potential as foci of treatment. The management problems of tinnitus are considered analogous to those of chronic pain. A case illustration is provided with a description of the treatment process. The comprehensive behavioral program discussed in the present paper included biofeedback therapy, pain management training, social skills training, assertion training, in vivo exposure to being alone, cognitive treatment of depression, and marital therapy. Outcomes were monitored multidimensionally. Self-report of tinnitus severity decreased after the 6th treatment day and stabilized at a "mild" rating after the 9th day. Skin temperature readings at baseline increased and stabilized after the 8th day, and the patient was able to reliably increase skin temperature on request. Scores on the Beck Depression Inventory and the Willoughby Personality Schedule, and a self-rating of Fear of Being Alone dropped markedly by the end of treatment. Follow-up data at 3 months indicated maintenance of gains. PMID:6399462

  10. Chiropractic management of postpartum pubic symphysis diastasis: A case report.

    PubMed

    Henry, Lucian

    2015-03-01

    This case report describes the chiropractic management of a 30-year-old female patient with severe postpartum pelvic pain secondary to pubic symphysis diastasis. No literature was found on the chiropractic management of postpartum symphysis pubis diastasis. The existing literature concerning chiropractic care for symphysis pubis dysfunction during pregnancy is limited and indicates a potential benefit. Separation of the pubic symphysis may include ligamentous injury to the sacroiliac joints and may lead to chronic pain. Pubic symphysis separation of 17 millimeters was present on digital radiograph. Management consisted of chiropractic adjustments, trigger point release, electrical stimulation, moist heat, sacroiliac belt, and specific stabilizing exercises. The patient's pain improved immediately following treatment on the initial visit. Pain was reduced from 8/10 VAS at the first visit to 2/10 at the fourth visit. She was able to resume normal activities and reached a final pain level of 1/10. The diastasis was reduced by 7 millimeters at 14-weeks post radiograph for a final separation of just under 10 millimeters. Collaboration between obstetricians, midwives and chiropractors may be warranted. PMID:25729083

  11. Evaluation of a case management service to reduce sickness absence

    PubMed Central

    Smedley, Julia; Harris, E. Clare; Cox, Vanessa; Ntani, Georgia; Coggon, David

    2013-01-01

    Background It is unclear whether and to what extent intensive case management is more effective than standard occupational health services in reducing sickness absence in the healthcare sector. Aims To evaluate a new return to work service at an English hospital trust. Methods The new service entailed intensive case management for staff who had been absent sick for longer than four weeks, aiming to restore function through a goal-directed and enabling approach based on a bio-psycho-social model. Assessment of the intervention was by controlled before and after comparison with a neighbouring hospital trust at which there were no major changes in the management of sickness absence. Data on outcome measures were abstracted from electronic databases held by the two trusts. Results At the intervention trust, the proportion of 4-week absences which continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.9% in 2010. The reduction from 2008 to 2010 contrasted with an increase at the control trust from 51.2% to 56.1% – a difference in change of 10.7% (95%CI 1.5% to 20.0%). There was also a differential improvement in mean days of absence beyond four weeks, but this was not statistically significant (1.6 days per absence, 95%CI ?7.2 to 10.3 days). Conclusion Our findings suggest that the intervention was effective, and calculations based on an annual running cost of £57,000 suggest that it was also cost-effective. A similar intervention should now be evaluated at a larger number of hospital trusts. PMID:23365116

  12. The laparoscopic management of Swyer syndrome: Case series

    PubMed Central

    Malhotra, Neena; Dadhwal, Vatsla; Sharma, Kandala Aparna; Gupta, Deepika; Agarwal, Sumita; Deka, Dipika

    2015-01-01

    Swyer syndrome, also known as 46 XY pure gonadal dysgenesis, is a rare endocrine disorder. Affected individuals are phenotypically female with female genitalia, normal Mullerian structures, absent testicular tissue, and a 46 XY chromosomal constitution. We report a series of eight cases of Swyer syndrome, of which six were managed by laparoscopic gonadectomy. The two other cases had to undergo an exploratory laparotomy in view of their presentation with adnexal masses. Two of the girls were siblings. The chief presenting complaint was primary amenorrhea. Four girls also presented with a history of poor development of secondary sexual characters. The average age at presentation was 16.19±2.85 years. The average height was 158.33 ±4.63 cm, and the average weight was 49.33±8.44 kg. Breast development was either Tanner 2 or 3 in four girls, whereas three girls had a Tanner 1 underdeveloped breasts. Axillary and pelvic hair was sparse in all the girls. The vagina was well canalized in all the girls. Hormonal evaluation revealed hypergonadotropic hypogonadism with a mean follicle-stimulating hormone (FSH) level of 95.81 mIU/L and a mean luteinizing (LH) level of 24.15 mIU/L. Imaging analysis revealed the presence of a small uterus in all the cases, except one. Bilateral ovaries were either not visualized or streak gonads were present. Adnexal mass was detected in two of the six cases with raised carcinoembryonic antigen (CA) 125 levels in one case. Genetic analysis revealed a karyotype of 46 XY in six girls, 46 XY/45 X in one, and the culture repeatedly failed in one girl. Because of the risk of malignancy, bilateral gonadectomy was performed in all cases. Histopathological analysis revealed that three of the six cases had dysgerminoma. The patients have been started on hormone replacement therapy. Laparoscopy is a minimally invasive modality for the definitive diagnosis and treatment of cases with Swyer syndrome. An early diagnosis of Swyer syndrome is possible during workup for primary amenorrhea before they present with adnexal masses.

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

    E-print Network

    Malik, Shaheen, 1974-

    2003-01-01

    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. ...

  14. An Empirical Chart Analysis of the Suitability of Telemedicine for Hospice Visits

    E-print Network

    Doolittle, Gary C.; Whitten, Pamela; Mccartney, Michael; Cook, David J.; Nazir, Niaman

    2005-03-22

    student researcher fa- miliar with hospice care and practice. Both observers were knowledgeable about the capa- bilities of telemedicine technologies and mon- itoring devices including videophones, elec- tronic stethoscopes, otoscopes, and blood pressure...

  15. Technology assessment for an integrated PC-based platform for three telemedicine applications

    NASA Astrophysics Data System (ADS)

    Tohme, Walid G.; Hayes, Wendelin S.; Dai, Hailei L.; Komo, Darmadi; Pahira, John J.; Abernethy, Darrell R.; Rennert, Wolfgang; Kuehl, Karen S.; Hauser, Gabriel J.; Mun, Seong K.

    1996-05-01

    This paper investigates the design and technical efficacy of an integrated PC based platform for three different medical applications. The technical efficacy of such a telemedicine platform has not been evaluated in the literature and optimal technical requirements have not been developed. The first application, with the Department of Surgery, Division of Urology, tests the utility of a telemedicine platform including radiology images for a surgical stone disease consultation service from an off site location in West Virginia. The second application, with the Department of Internal Medicine, Division of Clinical Pharmacology, investigates the usefulness of telemedicine when used for a clinical pharmacology consultation service from an off-site location. The third application, with the Department of Pediatrics, will test telemedicine for trauma care triage service first within an off-site location in Virginia and then from there to Georgetown University Medical Center.

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

    ERIC Educational Resources Information Center

    Reed, Philip A.

    2003-01-01

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

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

    PubMed Central

    Abd Ghani, Mohd Khanapi; Jaber, Mustafa Musa

    2015-01-01

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

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

    E-print Network

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

    2002-01-01

    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 ...

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

    E-print Network

    Lunds Universitet,

    Toward personal eHealth in cardiology. Results from the EPI-MEDICS telemedicine project Paul Rubel¨, Sweden f LIRIS, INSA de Lyon, 69100 Villeurbanne, France g Department of Cardiology, Ferrarotto Hospital

  20. Development of a multimedia CD-ROM on telemedicine and teleradiology

    NASA Astrophysics Data System (ADS)

    Schnur, Mark T.; Williamson, Morgan P.; Goeringer, Fred; Zimnik, Paul; Linn, Reid; Suitor, Charles T.; Rocca, Mitra A.; Strother, Thomas

    1996-04-01

    The Department of Defense Telemedicine Test Bed produced a CD-ROM including information on telemedicine, teleradiology and military medical advanced technology projects. The CD-ROM was produced using media from the Telemedicine Test Bed World Wide Web site and academic papers and presentations. Apple Media Tools software was used to produce the interactive program and the authoring was done on a high speed Apple Macintosh Power PC computer. The process took roughly 100 hours to author 50 Mb of data into 200 frames of interactive material. Future versions of the Telemedicine CD-ROM are in progress which will include much more material to take advantage of the 650 Mb available on a compact disk. This paper graphically depicts and explains the authoring process.

  1. Telemedicine on the move: health care heads down the information superhighway.

    PubMed

    Berek, B; Canna, M

    1994-01-01

    Telemedicine has drawn increasing attention as one of the emerging new service delivery vehicles that will run on the information superhighway. In reality, remote diagnosis and consultation through the application of telecommunications technology have been practiced for many years. But advances in technology and reform imperatives to extend access beyond traditional boundaries are pushing telemedicine into new applications. This is evidenced by the explosion in the number of pilot projects begun within the last 12 months. While demonstrating telemedicine's growing capabilities--for education and administration, as well as medical practice--these projects also raise a number of legal, clinical, and technical questions that must be answered before government and other payers will routinely reimburse for remote services. Academic and industry consortia are springing up to deal with the most compelling issues, including documenting telemedicine's safety and efficacy, developing uniform data and transmission standards, and determining the minimum resolution needed to maintain the integrity of clinical transmissions. Almost every type of medical specialty has proved amenable to performing evaluations via telemedicine links; however, specialties with less direct patient contact, like radiology and pathology, are generally identified as better candidates for telemedicine interactions. The telemedicine equipment required for these consults ranges from the simple to the ultra-sophisticated, depending on the type of system used and its clinical application. The most common system configuration involves a base station in the main facility where specialists and other consultants are housed and a number of remote referral sites. Consults are performed by interactively sharing voice, video, or image data. Increasingly, systems are being introduced that use easy-to-learn, intuitive displays and controls. Systems also require the use of any number of different communication media including land-based wire networks, high-speed fiberoptics, microwave links, or satellite transponders. Quantum leaps in telemedicine performance are being made constantly, many being swept along as a result of intensified interest in developing similar consumer and business services that are destined for the new information highway. In addition to information infrastructure projects, telemedicine has also recently benefitted from the effects of defense reinvestment, political interest in cost-reducing technologies, increased availability of funding for pilot projects, and the emergence of multifacility, multitiered, integrated delivery systems. Technical, financial, and logistical factors, which had once worked against telemedicine feasibility, are suddenly shifting to rapidly propel telemedicine technologies out of investigational settings and into mainstream clinical practice. PMID:10134202

  2. Health information management using optical storage technology: case studies.

    PubMed

    Kohn, D

    1992-05-01

    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

  3. 22 CFR 96.43 - Case tracking, data management, and reporting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Case tracking, data management, and reporting... Accreditation and Approval Responding to Complaints and Records and Reports Management § 96.43 Case tracking, data management, and reporting. (a) When acting as the primary provider, the agency or person...

  4. Application of integrative information system improves the quality and effectiveness of cancer case management

    PubMed Central

    Lee, Pei-Yi; Chang, Tsue-Rung

    2015-01-01

    Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, and monthly data summarization of case managers. It also promoted the case follow-up rate. This integrative information system may improve the quality and effectiveness for cancer case management, one important part of cancer nursing. PMID:26089680

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  6. High-Surety Telemedicine in a Distributed, 'Plug-andPlan' Environment

    SciTech Connect

    Craft, Richard L.; Funkhouser, Donald R.; Gallagher, Linda K.; Garcia, Rudy J.; Parks, Raymond C.; Warren, Steve

    1999-05-17

    Commercial telemedicine systems are increasingly functional, incorporating video-conferencing capabilities, diagnostic peripherals, medication reminders, and patient education services. However, these systems (1) rarely utilize information architectures which allow them to be easily integrated with existing health information networks and (2) do not always protect patient confidentiality with adequate security mechanisms. Using object-oriented methods and software wrappers, we illustrate the transformation of an existing stand-alone telemedicine system into `plug-and-play' components that function in a distributed medical information environment. We show, through the use of open standards and published component interfaces, that commercial telemedicine offerings which were once incompatible with electronic patient record systems can now share relevant data with clinical information repositories while at the same time hiding the proprietary implementations of the respective systems. Additionally, we illustrate how leading-edge technology can secure this distributed telemedicine environment, maintaining patient confidentiality and the integrity of the associated electronic medical data. Information surety technology also encourages the development of telemedicine systems that have both read and write access to electronic medical records containing patient-identifiable information. The win-win approach to telemedicine information system development preserves investments in legacy software and hardware while promoting security and interoperability in a distributed environment.

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

    PubMed

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

    2000-01-01

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

  8. Telemedicine activities at memorial University of Newfoundland: a historical review, 1975-1997.

    PubMed

    Elford, R

    1998-01-01

    Memorial University of Newfoundland has been continuously involved in telemedicine activities since 1975. Unlike most early telemedicine programs, which did not continue after grant funding ended, Memorial made the transition to create a self-sufficient Telemedicine Centre. Key to its success was the vision and drive of its founder, Dr. Max House, and adherence to the following principles: (1) all activities were based on a legitimate need; (2) the simplest, least expensive technology was used to meet the need; (3) the network was shared by a variety of users; and (4) users were given proper training and support. Over the years, Memorial has been involved in 30 telemedicine projects, many of which became ongoing services. Although most initial activity was health related, educational activities have played an increasingly important role. In 1997, the Telemedicine Centre delivered approximately 7000 hours of programming and administered a network of 247 dedicated audioconference sites in 161 communities (168 of the sites had telewriter workstations and 75 had multimedia workstations) and eight videoconferencing sites. Approximately 70% of all programming was distant high school and university education, 20% health education, 5% clinical activities, and 5% other uses. Current clinical activities include tele-electroencephalograms, tele-ultrasonography, tele-nuclear medicine, child telepsychiatry, general teleconsultation from a remote nursing station, and general teleconsultation from an offshore oil platform. Lessons learned from more than 20 years of telemedicine experience are presented. PMID:9831746

  9. Fifteen-year Experience with Telemedicine Services in Gangwon Province in Korea

    PubMed Central

    Kim, Hyung-Gi; Choi, Young-A; Choi, Eun-Hi; Kim, Dong-Won; Shin, Se-Gye; Park, Kyung-Suk; Han, Jae-Hyun

    2015-01-01

    Objectives This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. Methods A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. Results The satisfaction surveys in all three periods showed similar results for patients (4.46±0.70 point) and healthcare practitioners, including nurses (3.82±0.62 point) and physicians (3.60±0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. Conclusions The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage. PMID:26618035

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

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  11. Evaluating a Web-Based Interface for Internet Telemedicine

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

    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.

  12. Telemedicine via satellite to support offshore oil platforms.

    PubMed

    Mair, Fiona; Fraser, Susan; Ferguson, James; Webster, Karyn

    2008-01-01

    On any one day, approximately 15,000-28,000 oil industry personnel are employed in the North Sea oil and gas industry. First aid in this remote environment is provided by non-medical staff on the rigs. Remote specialist advice via videoconferencing should improve the quality of offshore health care and reduce avoidable medical evacuations. Satellite communications and videoconferencing equipment was installed on the 'Alwyn North' oil platform, with medical advice provided via a call centre in Milan. Over a nine-month period, trial telemedicine links were conducted approximately twice per week. The three onshore physicians were very satisfied on each occasion with communications and diagnostic data image quality, including the ultrasound screening carried out by the rig provider. Remote specialist advice via videoconferencing should reduce unnecessary and/or untimely patient evacuation to hospital or onshore for medical assessment. PMID:18430278

  13. Patient Perceptions of Acute Care Telemedicine: A Pilot Investigation.

    PubMed

    Robinson, James D; Turner, Jeanine W; Wood, Kelly S

    2015-12-01

    This investigation focuses on the patient perceptions of the interaction that occurs during acute telemedical care in an emergency department and the effectiveness of this technology. Data indicate 95% of the patients were seen by a specialist within 15 minutes of arriving at the emergency room and fewer than 12% reported experiencing a technical problem (n = 150). Further, 80% of the patients indicated that they were satisfied with level of concern communicated to them by the specialist and 80% were satisfied with the explanation of their medical condition. Finally, 80% of the patients believed the use of telemedicine was a positive factor in the diagnostic process and 80% were reported being satisfied with their overall treatment. PMID:25668582

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    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

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

    PubMed

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

    2010-05-01

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

  16. QL-10NEURO-ONCOLOGY TELEMEDICINE FOLLOW-UP VISITS

    PubMed Central

    Green, Richard; Woyshner, Emily

    2014-01-01

    We report our 18 month experience with the use of a videoconferencing system to perform neuro-oncology follow-up visits. The Neuro-oncology Program at the Kaiser Permanente-Los Angeles Medical center serves the majority of Kaiser HMO patients in the Southern California region. We installed a videoconferencing system (Cisco TelePresence EX90, Cisco Systems, San Jose, CA) in our office in Los Angeles and in a medical office building in Anaheim, CA at a distance of 35 miles. Established neuro-oncology patients from Orange County chose between in-person and remote visits. Patients were seated in an examination room and the neuro-oncology provider alerted by text page. A focused history and physical examination was performed, followed by desktop sharing of clinical and laboratory data using an electronic medical record (Epic Systems Corporation, Verona, WI) and of neuroimages (Phillips iSite PACS, Andover, MA). Patients were asked, but not required, to complete an anonymous online 16 question satisfaction survey after each visit. Visits were performed by either a neuro-oncologist (179) or a Physician's Assistant (12). Of the 191 visits, 174 included evaluation of neuroimaging and 77 included evaluation of response to ongoing chemotherapy. During 12 visits chemotherapy was initiated, and during 15 visits the chemotherapy regimen was changed based on imaging findings. One-hundred and eleven surveys (58% of visits) were completed. Patients reported a high level of satisfaction with the visits (average 9.6, on a 1-10 scale). The average estimated travel time saved was 118 minutes per visit. Four surveys reported technical problems and 1 indicated a preference for an in-person visit. No adverse events could be attributed to use of the telemedicine system. These data suggest that neuro-oncology follow-up visits can be practiced safely and effectively using a telemedicine system, with high levels of patient satisfaction.

  17. Conservative Management of Horizontal Root Fracture – A Case Series

    PubMed Central

    Manjunath, MK

    2015-01-01

    Root fracture has been defined as a fracture involving dentin, cementum, pulp and periodontal ligament. Depending on the level of the fracture line various treatment modalities may be employed by the clinician to promote healing. The following case reports highlight how changes in technique allow for conservative management of horizontal root fractures at different levels. This approach allows the patient to retain their natural dentition at an affordable cost and provide a viable alternative to the use of more invasive and expensive alternatives. These patients presented with complaints of pain and mobility in upper front tooth region following trauma. Diagnosis was confirmed on the basis of intra-oral periapical radiographs following which non-surgical root canal treatment was performed. PMID:26436061

  18. School asthma screening and case management: attendance and learning outcomes.

    PubMed

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

    2013-04-01

    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 to link these students to medical care and assure asthma action plans at school. In the 40 children with confirmed diagnosis who received CM, academic performance on standardized testing postintervention was similar to the 76 children who were low risk for asthma. Average days absent due to illness in the CM group were reduced from 5.8 to 3.7 days in the postintervention school year. School nurse screening, CM, and collaboration with a medical provider resulted in early identification, referral, and subsequent treatment of students at risk for asthma and may have contributed to reduced illness absences. PMID:22797976

  19. Burns from illegal drug manufacture: case series and management.

    PubMed

    Porter, C J W; Armstrong, J R

    2004-01-01

    This case series presents our experience with burns sustained while manufacturing illegal drugs. All adult burn admissions in an 18-month period were retrospectively reviewed. All patients suspected of sustaining burns from illegal drug manufacture were contacted. Information regarding the burn mechanism was sought. Nine of the 64 adult burn admissions were caused by explosions during the manufacture of cannabis oil. Young males with hand and face burns were heavily represented. First-aid treatment was often ignored in favor of hiding incriminating evidence. Only two patients gave honest admission histories. Illegal drug manufacture is becoming more common as synthetic drugs become more consumer desirable. Burns sustained may be thermal and/or chemical. Dishonest patient histories negatively influence burn management. A high level of suspicion is required for diagnosing and treating burns from illegal drug manufacture. Public education is unlikely to be effective as the financial rewards outweigh the perceived risks. PMID:15273473

  20. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    PubMed

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform. PMID:20481307

  1. The Case for Chronic Disease Management for Addiction

    PubMed Central

    Saitz, Richard; Larson, Mary Jo; LaBelle, Colleen; Richardson, Jessica; Samet, Jeffrey H.

    2009-01-01

    Chronic disease (care) management (CDM) is a patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability. The model, incorporating mental health and specialty addiction care, holds promise for improving care for patients with substance dependence who often receive no care or fragmented ineffective care. We describe a CDM model for substance dependence and discuss a conceptual framework, the extensive current evidence for component elements, and a promising strategy to reorganize primary and specialty health care to facilitate access for people with substance dependence. The CDM model goes beyond integrated case management by a professional, colocation of services, and integrated medical and addiction care—elements that individually can improve outcomes. Supporting evidence is presented that: 1) substance dependence is a chronic disease requiring longitudinal care, although most patients with addictions receive no treatment (eg, detoxification only) or short-term interventions, and 2) for other chronic diseases requiring longitudinal care (eg, diabetes, congestive heart failure), CDM has been proven effective. PMID:19809579

  2. Dyskeratosis congenita- management and review of complications: a case report.

    PubMed

    Sinha, Shivam; Trivedi, Vikas; Krishna, Arvind; Rao, Nidhi

    2013-07-01

    Among the inherited bone marrow failure disorders, dyskeratosis congenita is an X-linked inherited disorder arising as a consequence of short telomere and mutations in telomere biology. Production of the altered protein dyskerin, leads to vulnerable skin, nails, and teeth which lead to higher permeability for noxious agents which can induce carcinogenesis accounting for the classical triad of skin pigmentation, nail dystrophy and oral leukoplakia. This condition is fatal and patients succumb to aplastic anemia, malignancy or immunocompromised state. We present a young male with the classic clinical triad and avascular necrosis of both femoral heads, with no evidence of hematologic anomaly or any malignancy. He was managed for osteonecrosis with uncemented total hip arthroplasty for the symptomatic left hip. Our case represents a benign form of such a fatal and rare condition, which if detected and managed early can result in improved quality of life for the patient suffering from this disorder. This patient is under our meticulous follow-up for the last 2 years in order to determine any late development of complications before being labelled as a variant of this syndrome. PMID:23904924

  3. Job Title Bi-Lingual PPI Case Manager Houston Texas Employer/ Agency Behavioral Health Alliance of Texas

    E-print Network

    Paulsen, Vern

    Job Title Bi-Lingual PPI Case Manager ­ Houston Texas Employer/ Agency Behavioral Health Alliance and skills in community-based behavioral health care and case management. Experience in case management of Texas Job Description Dual Language Case management with women and children who have a combination

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

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

    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.

  5. Interactive modelling with stakeholders in two cases in flood management

    NASA Astrophysics Data System (ADS)

    Leskens, Johannes; Brugnach, Marcela

    2013-04-01

    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.

  6. A Web-based telemedicine system for diabetic retinopathy screening using digital fundus photography.

    PubMed

    Wei, Jack C; Valentino, Daniel J; Bell, Douglas S; Baker, Richard S

    2006-02-01

    The purpose was to design and implement a Web-based telemedicine system for diabetic retinopathy screening using digital fundus cameras and to make the software publicly available through Open Source release. The process of retinal imaging and case reviewing was modeled to optimize workflow and implement use of computer system. The Web-based system was built on Java Servlet and Java Server Pages (JSP) technologies. Apache Tomcat was chosen as the JSP engine, while MySQL was used as the main database and Laboratory of Neuro Imaging (LONI) Image Storage Architecture, from the LONI-UCLA, as the platform for image storage. For security, all data transmissions were carried over encrypted Internet connections such as Secure Socket Layer (SSL) and HyperText Transfer Protocol over SSL (HTTPS). User logins were required and access to patient data was logged for auditing. The system was deployed at Hubert H. Humphrey Comprehensive Health Center and Martin Luther King/Drew Medical Center of Los Angeles County Department of Health Services. Within 4 months, 1500 images of more than 650 patients were taken at Humphrey's Eye Clinic and successfully transferred to King/Drew's Department of Ophthalmology. This study demonstrates an effective architecture for remote diabetic retinopathy screening. PMID:16478413

  7. A Norwegian study of seafarers' and rescuers' recommendations for maritime telemedicine services.

    PubMed

    Norum, Jan; Moksness, Stein Gunnar; Larsen, Eli

    2002-01-01

    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

  8. Knowledge Management in Preserving Ecosystems: The Case of Seoul

    ERIC Educational Resources Information Center

    Lee, Jeongseok

    2009-01-01

    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…

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

    PubMed Central

    2014-01-01

    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

  10. Presented at the workshop on "Managing as Designing: Creating a vocabulary for management education and research," Weatherhead School of Management, Case

    E-print Network

    Presented at the workshop on "Managing as Designing: Creating a vocabulary for management education and research," Weatherhead School of Management, Case Western Reserve University, Cleveland OH, , June 14 Organizations and Idea Labs Joseph A. Paradiso One of the first things one notices at leading design firms

  11. Effectively managing partnership evolution: a case study from Chicago.

    PubMed

    Tishuk, Brian S

    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

  12. [Gunshot wound to the kidney: case report and therapeutic management].

    PubMed

    Maruschke, M; Hakenberg, O W

    2008-04-01

    Gunshot wounds to the kidney occur with different regional incidence. They are commonly combined with thoracic and abdominal injuries. Gunshot wounds may be caused by low-velocity or high-velocity bullets. The latter are usually used with military weapons and cause a higher degree of tissue damage. The therapeutic management of renal gunshot wounds has changed in recent decades resulting in more organ-preserving strategies. An imperative indication for surgical exploration of the kidney is critical renal bleeding with symptoms of hypovolaemic shock. We report the case of a 23-year-old male admitted to the hospital with combined gunshot wounds from a small-bore weapon with damage of the liver, stomach and the left kidney. There were no signs of thoracic injuries. The patient underwent transabdominal exploration with treatment of the liver and stomach lesions, removal of the bullet and preservation of the left kidney. A percutaneous nephrostomy and drainage of the retroperitoneal region were inserted; antibiotic prophylaxis was given. A 4-week postoperative intravenous pyelogram showed complete integrity of the upper left tract and good renal function. PMID:18210067

  13. Early analysis of the United States Army's telemedicine orthopaedic consultation program.

    PubMed

    Blank, Elizabeth; Lappan, Charles; Belmont, Philip J; Machen, M Shaun; Ficke, James; Pope, Richard; Owens, Brett D

    2011-01-01

    Telemedicine is a recent development, designed to assist patients with limited physical access to expert subspecialty medical care. The United States Army has established a telemedicine program, consisting of e-mail consultations from deployed health care providers to subspecialty consultants. Orthopaedic surgery became a participating consultant group in July 2007. The goal of this study is to describe the Army's telemedicine orthopaedic program and to review its progress and achievements. All consults initiated from July 2007 through April 2009 were reviewed. A total of 208 consults were received by the telemedicine orthopaedic consultation program. Predominant regions of origin were Iraq, Navy Afloat, and Afghanistan. The Army accounted for the majority of consults. Prevalent musculoskeletal complaints were fracture, sprain, neuropathy, and tendon injury. Of the 74 fracture consultations, hand and wrist fractures were most common. Symptomatic treatment or casting/splinting were the most common recommended treatments for all orthopaedic consults. Of the 170 consults requesting specific treatment recommendations for patients who likely otherwise would have been evacuated for further evaluation, surgical intervention or medical evacuation was only recommended in 25% and 16% of the consultations, respectively. The novel Army telemedicine orthopaedic consultation program developed for combat-deployed service members provides expert treatment recommendations for a variety of musculoskeletal injuries. Deployed health care providers located in austere combat environments can better determine both the necessity of medical evacuation and appropriate treatments for service members with musculoskeletal injuries when aided by orthopaedic surgery consultants, thereby limiting the number of unnecessary medical evacuations. PMID:21477534

  14. 32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Case management for Unrestricted Reports of....13 Case management for Unrestricted Reports of sexual assault. (a) General. (1) The installation... and SAPR VAs, in the event of the SARC's or SAPR VA's change of duty station, to ensure continuity...

  15. 32 CFR 105.13 - Case management for Unrestricted Reports of sexual assault.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Case management for Unrestricted Reports of....13 Case management for Unrestricted Reports of sexual assault. (a) General. (1) The installation... and SAPR VAs, in the event of the SARC's or SAPR VA's change of duty station, to ensure continuity...

  16. Perceptions about Services and Dropout from a Substance Abuse Case Management Program

    ERIC Educational Resources Information Center

    Sosin, Michael R.; Durkin, Elizabeth

    2007-01-01

    This article uses event history analysis to examine certain determinants of dropout from a case management program that serves homeless adults with substance abuse problems. The examined determinants are perceptions of conventional treatment services: (a) client perceptions concerning the value of the conventional services that case managers help…

  17. Introducing Case Management to Students in a Virtual World: An Exploratory Study

    ERIC Educational Resources Information Center

    Levine, Joanne; Adams, Ruifang Hope

    2013-01-01

    This paper discusses a small, exploratory study introducing students to case management using role-plays conducted in a virtual world. Data from pre- and posttest questionnaires (to assess self-efficacy regarding a range of case management tasks) suggest students felt more confident in their abilities after virtual role-play participation. Also…

  18. Defining, Delivering, and Documenting the Outcomes of Case Management by School Nurses

    ERIC Educational Resources Information Center

    Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.

    2009-01-01

    Case management is a component of school nurse practice that provides an opportunity to demonstrate the contribution that school nurses make to the health and academic success of children, particularly children with chronic health conditions. However, case management programs vary in their mission and scope, leading to confusion about what it…

  19. Academic Case Management: Promising Interventions for Closing Achievement Gaps in Multicultural Urban Settings

    ERIC Educational Resources Information Center

    Van Kannel-Ray, Nancy; Zeller, Pamela J.; Lacefield, Warren E.

    2009-01-01

    This article explains how individual academic case manager intervention programs were implemented in three urban middle schools. Academic case managers helped students integrate their personal lives with academic expectations by helping students learn to cope with their own personal challenges with the goal of improving their academic performance.…

  20. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

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

    ERIC Educational Resources Information Center

    Rendtorff, Jacob Dahl

    2015-01-01

    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…

  2. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  3. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  4. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  5. 25 CFR 20.318 - What case management responsibilities does the social services worker have?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What case management responsibilities does the social... HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Employment Requirements § 20.318 What case management responsibilities does the social services worker have? In...

  6. Case study: incorporating project management skills in the design of a clinical research patient management system.

    PubMed

    Carroll-Barefield, A; Smith, S P

    2001-09-01

    Faced with the problem of managing over 3,000 records with no systematic location and retrieval mechanism, a project management team relied on health information management skills, including those of project management, data modeling, and records management, to plan and implement an effective system for managing patient data. PMID:11556555

  7. Content and Workflow Management for Library Websites: Case Studies

    ERIC Educational Resources Information Center

    Yu, Holly, Ed.

    2005-01-01

    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…

  8. Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position Paper.

    PubMed

    Daniel, Hilary; Sulmasy, Lois Snyder

    2015-11-17

    Telemedicine-the use of technology to deliver care at a distance-is rapidly growing and can potentially expand access for patients, enhance patient-physician collaboration, improve health outcomes, and reduce medical costs. However, the potential benefits of telemedicine must be measured against the risks and challenges associated with its use, including the absence of the physical examination, variation in state practice and licensing regulations, and issues surrounding the establishment of the patient-physician relationship. This paper offers policy recommendations for the practice and use of telemedicine in primary care and reimbursement policies associated with telemedicine use. The positions put forward by the American College of Physicians highlight a meaningful approach to telemedicine policies and regulations that will have lasting positive effects for patients and physicians. PMID:26344925

  9. Rigorous engineering of product-line requirements: a case study in failure management

    E-print Network

    Southampton, University of

    Rigorous engineering of product-line requirements: a case study in failure management Colin Snook detection and management function for engine control systems as an application domain where product line combination of product line, failure management and safety-critical engineering, is evaluated and considered

  10. Solar radiation management impacts on agriculture in China: A case study in the Geoengineering

    E-print Network

    Robock, Alan

    Solar radiation management impacts on agriculture in China: A case study in the Geoengineering-Earth Science and Technology, Yokohama, Japan Abstract Geoengineering via solar radiation management could of the responses, even though the spread across models is large. This suggests that solar radiation management

  11. Applicability of Logistics Management in Lean Construction: a Case Study Approach in Brazilian Building Companies

    E-print Network

    Tommelein, Iris D.

    Applicability of Logistics Management in Lean Construction: a Case Study Approach in Brazilian Building Companies Proceedings IGLC-7 147 APPLICABILITY OF LOGISTICS MANAGEMENT IN LEAN CONSTRUCTION Cardoso2 ABSTRACT Logistics management concepts and tools currently have a great value for several

  12. Addressing Agent Autonomy in Business Process Management -with Case Studies on the Patient Discharge Process

    E-print Network

    Cysneiros, Luiz Marcio

    Addressing Agent Autonomy in Business Process Management - with Case Studies on the Patient, Toronto, Canada yu@fis.utoronto.ca 1. Introduction Business Process Management (BPM) has arisen as a new process execution, e.g., the Business Process Management Notation [Owen 03; White 03] and the Business

  13. Reflections on Case Management in Youth Support Using a Program Example

    ERIC Educational Resources Information Center

    Kennedy, Rosemary; Kennedy, Barry

    2010-01-01

    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

  14. An ontological case base engineering methodology for diabetes management.

    PubMed

    El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

    2014-08-01

    Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology. PMID:24957391

  15. Experience in the application of Java Technologies in telemedicine.

    PubMed

    Fedyukin, IV; Reviakin, YG; Orlov, OI; Doarn, CR; Harnett, BM; Merrell, RC

    2002-09-17

    Java language has been demonstrated to be an effective tool in supporting medical image viewing in Russia. This evaluation was completed by obtaining a maximum of 20 images, depending on the client's computer workstation from one patient using a commercially available computer tomography (CT) scanner. The images were compared against standard CT images that were viewed at the site of capture. There was no appreciable difference. The client side is a lightweight component that provides an intuitive interface for end users. Each image is loaded in its own thread and the user can begin work after the first image has been loaded. This feature is especially useful on slow connection speed, 9.6 Kbps for example. The server side, which is implemented by the Java Servlet Engine works more effective than common gateway interface (CGI) programs do. Advantages of the Java Technology place this program on the next level of application development. This paper presents a unique application of Java in telemedicine. PMID:12459045

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

    PubMed Central

    Bossen, Ann L; Kim, Heejung; Williams, Kristine N; Steinhoff, Andreanna E; Strieker, Molly

    2015-01-01

    Demographic aging of the world population contributes to an increase in the number of persons diagnosed with dementia (PWD), with corresponding increases in health care expenditures. In addition, fewer family members are available to care for these individuals. Most care for PWD occurs in the home, and family members caring for PWD frequently suffer negative outcomes related to the stress and burden of observing their loved one’s progressive memory and functional decline. Decreases in cognition and self-care also necessitate that the caregiver takes on new roles and responsibilities in care provision. Smart technologies are being developed to support family caregivers of PWD in a variety of ways, including provision of information and support resources online, wayfinding technology to support independent mobility of the PWD, monitoring systems to alert caregivers to changes in the PWD and their environment, navigation devices to track PWD experiencing wandering, and telemedicine and e-health services linking caregivers and PWD with health care providers. This paper will review current uses of these advancing technologies to support care of PWD. Challenges unique to widespread acceptance of technology will be addressed and future directions explored. PMID:26636049

  17. Transmission of olfactory information for tele-medicine

    SciTech Connect

    Keller, P.E.; Kouzes, R.T.; Kangas, L.J.; Hashem, S.

    1995-01-01

    While the inclusion of visual, aural, and tactile senses into virtual reality systems is widespread, the sense of smell has been largely ignored. We have developed a chemical vapor sensing system for the automated identification of chemical vapors (smells). Our prototype chemical vapor sensing system is composed of an array of tin-oxide vapor sensors coupled to an artificial neural net-work. The artificial neural network is used in the recognition of different smells and is constructed as a standard multilayer feed-forward network trained with the backpropagation algorithm. When a chemical sensor array is combined with an automated pattern identifier, it is often referred to as an electronic or artificial nose. Applications of electronic noses include monitoring food and beverage odors, automated flavor control, analyzing fuel mixtures, and quantifying individual components in gas mixtures. Our prototype electronic nose has been used to identify odors from common household chemicals. An electronic nose will potentially be a key component in an olfactory input to a telepresent virtual reality system. The identified odor would be electronically transmitted from the electronic nose at one site to an odor generation system at another site. This combination would function as a mechanism for transmitting olfactory information for telepresence. This would have direct applicability in the area of telemedicine since the sense of smell is an important sense to the physician and surgeon. In this paper, our chemical sensing system (electronic nose) is presented along with a proposed method for regenerating the transmitted olfactory information.

  18. Case management: a source of support and stability for the client and the healthcare system.

    PubMed

    Thurkettle, Mary Ann; Noji, Ariko

    2003-01-01

    This article is updated from a series written to introduce a Japanese audience to case management after the enactment of Japan's Long Term Care Insurance Acted in 2000. This act includes a provision for care management, and its anticipation resulted in the creation of a new professional called 'care manager' or 'kaigo shien senmon in.' The series was published last summer in Quality Nursing: The Japanese Journal of Research and Scholarship. The article presents the role of the case manager in the United States including background, definition, and functions of assessment planning, implementation, coordination, monitoring, and evaluation. Benefits of case management to the consumer, providers, payors, and the system are discussed. New directions for case management discussed include working with Community Health Workers to reach culturally diverse populations, population health management case management for long-term care populations, and direct contracting. The article is accompanied by a sidebar, which discusses case management as a linchpin, or central cohesive element that enhances the work of other health system components. PMID:12698952

  19. Implementing transnational telemedicine solutions: a connected health project in rural and remote areas of six Northern Periphery countries Series on European collaborative projects.

    PubMed

    Casey, Monica; Hayes, Patrick S; Heaney, David; Dowie, Lee; Ólaighin, Gearoid; Matero, Matti; Hun, Soo; Knarvik, Undine; Alrutz, Käte; Eadie, Leila; Glynn, Liam G

    2013-03-01

    This is the first article in a Series on collaborative projects between European countries, relevant for general practice/family medicine and primary healthcare. Telemedicine, in particular the use of the Internet, videoconferencing and handheld devices such as smartphones, holds the potential for further strides in the application of technology for the delivery of healthcare, particularly to communities in rural and remote areas within and without the European Union where this study is taking place. The Northern Periphery Programme has funded the 'Implementing Transnational Telemedicine Solutions' (ITTS) project from September 2011 to December 2013, led by the Centre for Rural Health in Inverness, Scotland. Ten sustainable projects based on videoconsultation (speech therapy, renal services, emergency psychiatry, diabetes), mobile patient self-management (physical activity, diabetes, inflammatory bowel disease) and home-based health services (medical and social care emergencies, rehabilitation, multi-morbidity) are being implemented by the six partner countries: Scotland, Finland, Ireland, Northern Ireland, Norway and Sweden. In addition, an International Telemedicine Advisory Service, created for the project, provides business expertise and advice. Community panels contribute feedback on the design and implementation of services and ensure 'user friendliness'. The project goals are to improve accessibility of healthcare in rural and remote communities, reducing unnecessary hospital visits and travel in a sustainable way. Opportunities will be provided for comparative research studies. This article provides an introduction to the ITTS project and how it aims to fulfil these needs. The ITTS team encourage all healthcare providers to at least explore possible technological solutions within their own context. PMID:23432039

  20. Environmental management with knowledge of uncertainty: a methylmercury case study.

    PubMed

    Hope, Bruce K; Lut, Agnes; Aldrich, Greg; Rubin, Jared

    2007-01-01

    In Oregon's Willamette River Basin, health advisories currently limit consumption of fish that have accumulated methylmercury to levels posing a potential health risk for humans. Under the Clean Water Act, these advisories represent an impairment of the beneficial use of fish consumption and create the requirement for a mercury total maximum daily load. A percent load reduction for total mercury was determined by comparing mercury levels in surface water to a water column guidance value linked to the protection of specified beneficial uses. In this case study, we discuss how probabilistic (Monte Carlo) methods were used to quantify uncertainty in the water column guidance value, how they provided decision makers with knowledge as to the probability of any given water column guidance value affording human health protection for methylmercury, and how this knowledge affected decisions as to a mercury load reduction for the Willamette River Basin. Through consultations with stakeholders, a water column guidance value of 0.92 ng/L (a median for higher trophic level fish) was chosen from among a suite of values of differing probabilities. The selected water column guidance value, when compared with ambient total mercury levels, indicated that a 50% probability of achieving the tissue criterion would require a load reduction of about 26%. Having and working with an explicit knowledge of uncertainty was not easy for many decision makers or stakeholders. However, such knowledge gave them more informed choices, a better understanding of what a specific choice of water column guidance value could mean in terms of achieving protectiveness, and led to a lower load reduction than suggested by a purely deterministic analysis. Nonetheless, more attention must be given to developing management, communication, and regulatory frameworks that can effectively use the greater knowledge of uncertainty afforded by probabilistic methods. PMID:17283603

  1. Musical hallucinations – a challenge for psychiatric therapeutical management. Case report

    PubMed Central

    Focseneanu, BE; Marian, G

    2015-01-01

    Background. Musical hallucinations occur in individuals with and without mental illness, and many patients tend to have intact reality testing. Although literature on musical hallucinations is limited, they have been associated with hearing abnormalities, adverse effects of pharmacological agents, female gender, advances in age and psychiatric illness. Aim. To present the psychiatric management of a case of an old female patient, who suddenly developed verbal and musical hallucinations with a pervasive impact on her daily activities. Method. Female, 71 years old, developed verbal and musical hallucinations 6 months before that have intensified later. She was known with bilateral hypoacusia starting with the age of 45, and magnetic resonance imaging performed 1 year before proved multiple lacunar infarcts. Because of the persistence, most of the time of these auditory hallucinations, the patient experienced pervasive difficulties with her major areas of activities. She was referred to a psychiatric department for evaluation and treatment. Results. The psychiatric consult revealed neither a depressive relapse, nor a mild cognitive impairment, and obsessive-compulsive disorder was suspected with intrusive obsessions. Patient received, as antiobsessional augmentation escitalopram 10mg/ day, an atypical antipsychotic, risperidone, which at 3 mg/ day induced extrapyramidal symptoms and cognitive impairment. Therefore, the dose of risperidone was reduced, extrapyramidal symptoms disappeared, and 300mg/ day of acidum valproicum was initiated. Discussion. Our patient presented with diminished sensory input to the auditory cortex, and it was hard to make a differential diagnosis between an organic and a mental etiology. Conclusion. The integration of musical hallucinations into a psychiatric disorder may be a difficult task, and, their treatment represents a challenge. PMID:26664485

  2. SCIRehab Project Series: The Social Work/Case Management Taxonomy

    PubMed Central

    Abeyta, Nicola; Freeman, Erma S; Primack, Donna; Hammond, Flora M; Dragon, Charlotte; Harmon, Ashley; Gassaway, Julie

    2009-01-01

    Context: Social work and case management (SW/CM) are integral components of acute inpatient spinal cord injury (SCI) rehabilitation. However, evidence is sparse regarding the impact of SW/CM interventions on outcomes. To advance research on SW/CM clinical practice in SCI rehabilitation, SW/CM providers and researchers first must have standard classifications for SW/CM interventions. Background/Objective: To develop a taxonomy (classification) of the various interventions and services that comprise SW/CM. Methods: A group of SW/CM clinicians compiled a list of activities performed as routine practice at the participating rehabilitation facilities. These activities were grouped and defined systematically. Results: The resulting taxonomy includes 8 major activity topics (financial planning, discharge planning, discharge services, supportive counseling, information about and referral to peer/advocacy groups, education about SCI and other relevant topics, information about and referral to community/in-house services, and team conferences), which were further stratified into specific content areas. Interactions with the patient, family, or other team members and resources, along with descriptions of the interactions that are applicable to each of the 8 activity topics, were included as well. Conclusion: An intervention taxonomy is required to study the SW/CM interventions and the potential association with positive rehabilitation outcomes for patients with SCI. The SW/CM taxonomy developed for the SCIRehab project, which will be used with 1,500 patients admitted to 6 SCIRehab centers over 2.5 years, will provide an infrastructure for such research. PMID:19810635

  3. A Review on Telemedicine-Based WBAN Framework for Patient Monitoring

    PubMed Central

    Gupta, Bharat; Ghosh, Soumya K.

    2013-01-01

    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

  4. Telemedicine for genetic and neurologic evaluation in the Neonatal Intensive Care Unit

    PubMed Central

    Wenger, Tara L.; Gerdes, Jeffrey; Taub, Katherine; Swarr, Daniel T.; Deardorff, Matthew A.; Abend, Nicholas S.

    2013-01-01

    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

  5. Telemedicine for detecting diabetic retinopathy: a systematic review and meta-analysis

    PubMed Central

    Shi, Lili; Wu, Huiqun; Dong, Jiancheng; Jiang, Kui; Lu, Xiting; Shi, Jian

    2015-01-01

    Objective To determine the diagnostic accuracy of telemedicine in various clinical levels of diabetic retinopathy (DR) and diabetic macular oedema (DME). Methods PubMed, EMBASE and Cochrane databases were searched for telemedicine and DR. The methodological quality of included studies was evaluated using the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2). Measures of sensitivity, specificity and other variables were pooled using a random effects model. Summary receiver operating characteristic curves were used to estimate overall test performance. Meta-regression and subgroup analyses were used to identify sources of heterogeneity. Publication bias was evaluated using Stata V.12.0. Results Twenty articles involving 1960 participants were included. Pooled sensitivity of telemedicine exceeded 80% in detecting the absence of DR, low- or high-risk proliferative diabetic retinopathy (PDR), it exceeded 70% in detecting mild or moderate non-proliferative diabetic retinopathy (NPDR), DME and clinically significant macular oedema (CSME) and was 53% (95% CI 45% to 62%) in detecting severe NPDR. Pooled specificity of telemedicine exceeded 90%, except in the detection of mild NPDR which reached 89% (95% CI 88% to 91%). Diagnostic accuracy was higher with digital images obtained through mydriasis than through non-mydriasis, and was highest when a wide angle (100–200°) was used compared with a narrower angle (45–60°, 30° or 35°) in detecting the absence of DR and the presence of mild NPDR. No potential publication bias was detected. Conclusions The diagnostic accuracy of telemedicine using digital imaging in DR is overall high. It can be used widely for DR screening. Telemedicine based on the digital imaging technique that combines mydriasis with a wide angle field (100–200°) is the best choice in detecting the absence of DR and the presence of mild NPDR. PMID:25563767

  6. Barriers and Facilitators to Pediatric Emergency Telemedicine in the United States

    PubMed Central

    Kahn, Jeremy M.

    2014-01-01

    Abstract Background: Pediatric emergency telemedicine has the potential to improve the quality of pediatric emergency care in underserved areas, reducing socioeconomic disparities in access to care. Yet, telemedicine in the pediatric emergency setting remains underutilized. We aimed to assess the current state of pediatric emergency telemedicine and identify unique success factors and barriers to widespread use. Materials and Methods: We conducted a telephone survey of current, former, and planned pediatric emergency telemedicine programs in the United States. Results: We surveyed 25 respondents at 20 unique sites, including 12 current, 5 planned, and 3 closed programs. Existing programs were located primarily in academic medical centers and served an average of 12.5 spoke sites (range, 1–30). Respondents identified five major barriers, including difficulties in cross-hospital credentialing, integration into established workflows, usability of technology, lack of physician buy-in, and misaligned incentives between patients and providers. Uneven reimbursement was also cited as a barrier, although this was not seen as major because most programs were able to operate independent of reimbursement, and many were not actively seeking reimbursement even when allowed. Critical success factors included selecting spoke hospitals based on receptivity rather than perceived need and cultivating clinical champions at local sites. Conclusions: Although pediatric emergency telemedicine confronts many of the same challenges of other telemedicine applications, reimbursement is relatively less significant, and workflow disruption are relatively more significant in this setting. Although certain challenges such as credentialing can be addressed with available policy options, others such as the culture of transfer at rural emergency departments require innovative approaches. PMID:25238565

  7. Airway management of an unusual case of recurrent rhinoscleroma

    PubMed Central

    D’souza, Nita; Kulkarni, Shilpa; Bhagwat, Shama; Marolia, Rusi

    2011-01-01

    Rhinoscleroma is a rare entity encountered in anesthesia practice. We discuss the management of a patient after its recurrence, involving the upper respiratory tract i.e. nasopharynx and oropharynx, which compromised the airway. The pateint was referred for anesthesia on three different occasions with different presentations owing to the recurrence of symptoms.The presence of an oropharyngeal membrane with a small opening made airway management a challenge. The patient was successfully managed on all three occasions. Imaging facilitated assessment and subsequent airway management. PMID:21897516

  8. The integrated scheduling system: A case study in project management

    NASA Technical Reports Server (NTRS)

    Bishop, Peter C.; Learned, David B.; Yoes, Cissy A.

    1989-01-01

    A prototype project management system was developed for the Level III Project Office for the Space Station Freedom. The main goal was to establish a framework for the Space Station Project Office whereby Project and Office Managers can jointly establish and review scheduled milestones and activities. The objective was to assist office managers in communicating their objectives, milestones, schedules, and other project information more effectively and efficiently. Consideration of sophisticated project management systems was included, but each of the systems had limitations in meeting the stated objectives.

  9. Does products liability litigation threaten picture archiving and communication systems and/or telemedicine?

    PubMed

    McMenamin, J P

    1998-02-01

    Numerous writers have commented on barriers to the growth and progress of telemedicine. Among these barriers are reimbursement concerns, professional liability exposure, licensing restrictions, hospital credentialing questions, and other problems. A legal threat not generally described in the literature to date is the possibility that products liability claims could be brought against manufacturers and distributors of hardware, software, and peripherals used in providing telemedicine services. Several of these concerns extend to picture archiving and communication systems (PACS), including, of course, teleradiology. This article considers that possibility in the context of several potential plaintiffs' theories, discusses currently applicable law, and proposes approaches to diminishing the magnitude and severity of this potential threat. PMID:9502323

  10. Non-mydriatic ocular fundus photography and telemedicine: past, present, and future

    PubMed Central

    Bruce, Beau B.; Newman, Nancy J.; Pérez, Mario A.; Biousse, Valérie

    2013-01-01

    Non-mydriatic ocular fundus photography is a promising alternative to direct ophthalmoscopy, particularly when combined with telemedicine. This review discusses these technologies from a longitudinal perspective: past, present, and future. The focus is directed to the role that non-mydriatic fundus photography and telemedicine have played in medical research and patient care, with emphasis on the major advances to date. Also discussed are the challenges to their widespread application and their substantial promise for revitalizing the importance of the ocular fundus examination in patient care, providing improved access to ophthalmic consultative services, and facilitating clinical and epidemiologic research. PMID:24244059

  11. The telemedicine spacebridge project: A joint US/Russian venture in long distance medicine via satellite

    NASA Technical Reports Server (NTRS)

    Zuzek, John E.; Cauley, Michael A.; Hollansworth, James E.

    1994-01-01

    The Telemedicine Spacebridge Demonstration Project is a joint U.S./Russian program whose purpose is to further the application of telemedicine both internationally, domestically, and in space. The system has been set up to use a Russian satellite over the Atlantic Ocean and a U.S. domestic satellite to allow physicians a two-way video and audio link between various sites of medical centers in the United States and the Central Hospital in Moscow, Russia. This paper contains a description of the project background, the Spacebridge system, the individual pieces of the system, and the operational experience gained thus far in the project.

  12. Integrating LAN/WAN technologies in support of multimedia telemedicine and teleradiology

    NASA Astrophysics Data System (ADS)

    McNeill, Kevin M.; Holcomb, Michael J.; Ovitt, Theron W.

    1999-07-01

    In July 1996 the Arizona Telemedicine Program (ATP) was initiated by the state legislature in recognition of the needs of under-served populations in the state. Two important goals are: establish a statewide telemedicine network infrastructure; and use that infrastructure as a test bed to evaluate the effectiveness of state-of-the-art telemedicine services. These two goals exist in the context of an integrated, multidisciplinary telemedicine program. It is necessary to accommodate distinct levels of connectivity for sites depending on their association with the program and the corresponding level of services to be provided. For remote client sites requiring the highest level of service were selected the use of dedicated T1 circuits. At these sites the capabilities provided include: PC based store-and- forward services; point-to-point interactive real-time video interactions for clinical encounters; and multi-point interactive real-time video interactions for support groups and educational activities. For sites funded for lower levels of service we selected simple dial-up telephone based communications to support store-and-forward activities and inexpensive telephone based video conferencing equipment for administrative interactions. At the service sites distributed within the Arizona Health Sciences Center (AHSC) we selected standard LAN technology for store-and-forward applications and T1 based services for interactive video. To integrate these services we selected the Asynchronous Transfer Mode (ATM) protocol, integrated with the LAN environment within the AHSC. The integrated telemedicine network supports eight client sites and two service sites with T1-based ATM and four sites with dial-up lines. At the AHSC, ATM and LAN infrastructure is distributed to several clinical areas, allowing physicians to support telemedicine activities where they normally work. Between July 1997 and Jan 1999 over 2000 telemedicine sessions have been performed, nearly 50 percent of which are teleradiology consults. The use of T1-based ATM has facilitated the development of a wide-area infrastructure that has been easily integrated with LAN and dial-up technology to provide the foundation for diverse telemedicine services.

  13. The telemedicine spacebridge project: A joint US/Russian venture in long distance medicine via satellite

    NASA Astrophysics Data System (ADS)

    Zuzek, John E.; Cauley, Michael A.; Hollansworth, James E.

    1994-03-01

    The Telemedicine Spacebridge Demonstration Project is a joint U.S./Russian program whose purpose is to further the application of telemedicine both internationally, domestically, and in space. The system has been set up to use a Russian satellite over the Atlantic Ocean and a U.S. domestic satellite to allow physicians a two-way video and audio link between various sites of medical centers in the United States and the Central Hospital in Moscow, Russia. This paper contains a description of the project background, the Spacebridge system, the individual pieces of the system, and the operational experience gained thus far in the project.

  14. A Randomized Controlled Trial of Consensus-Based Child Abuse Case Management

    ERIC Educational Resources Information Center

    Goldbeck, L.; Laib-Koehnemund, A.; Fegert, J. M.

    2007-01-01

    Objective: This study evaluates the effects of expert-assisted child abuse and neglect case management in the German child welfare and healthcare system as perceived by the case workers themselves. Methods: Case workers with different professions (social workers, counselors, clinic-based and office-based psychotherapists, and physicians)…

  15. Recidivism among Offenders with Developmental Disabilities Participating in a Case Management Program.

    ERIC Educational Resources Information Center

    Linhorst, Donald M.; McCutchen, Tami A.; Bennett, Leslie

    2003-01-01

    A study examined recidivism among 252 clients (ages 15-59) with developmental disabilities in a case management program. Overall, 40% were arrested while in the program and 34% were arrested within 6 months after case closure. Clients who completed the program (n=115) were less likely to be arrested after case closure. (Contains references.)…

  16. Management of A Rare Case of Communicating Internal-External Inflammatory Resorption

    PubMed Central

    Arora, Suraj; Saluja, Priyanka; Setia, Vikas

    2015-01-01

    The present case describes the successful management of a rare case of communicating internal-external resorption in which both internal and external resorption seem to develop independent of each other. The case report highlights the importance of correct diagnosis and need of revision of classification system of resorptive defects. PMID:26155588

  17. Balancing formal and informal care for older persons: how case managers respond.

    PubMed

    Peckham, Allie; Williams, A Paul; Neysmith, Sheila

    2014-06-01

    This study examined how front-line home and community-care (H&CC) case managers view the role of informal caregivers, and the factors that contribute to H&CC managers' resource allocation decisions. The study research used two methods of data collection: (a) secondary analysis of the results from balance of care (BoC) simulations conducted in nine regions of Ontario, and (b) in-depth follow-up interviews with participating BoC case managers. Results suggest that case managers unanimously agree that the unit of care in the H&CC sector is not confined to the individual, as in acute care, but encompasses both the individual and the caregiver. We found, however, considerable variation in the mix and volume of H&CC services recommended by case managers. We conclude that variability in decision making may reflect the lack of regulations, best practices, and accountability guidelines in the H&CC sector. PMID:24780306

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

    PubMed Central

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

    2007-01-01

    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 have reported positive effects, but only some randomized and controlled trials have demonstrated the effectiveness of case management compared with other interventions. Longitudinal effects of this intervention remain unclear. Although no compelling evidence was found for the effectiveness of case management, some evidence is available about the (differential) effectiveness of intensive case management and assertive community treatment for homeless and dually-diagnosed substance abusers. Strengths-based and generalist case management have proven to be relatively effective for substance abusers in general. Most positive effects concern reduced use of inpatient services and increased utilization of community-based services, prolonged treatment retention, improved quality of life, and high client satisfaction. Outcomes concerning drug use and psychosocial functioning are less consistent, but seem to be mediated by retention in treatment and case management. Further research is required to learn more about the extent of the effects of this intervention, how long these are sustained and what specific elements cause particular outcomes. PMID:17523588

  19. Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study

    PubMed Central

    2015-01-01

    Objective To evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management. Methods A multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others. Results Thirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001). Conclusions Dynamic case-vignettes accurately reflect actual practices in complex emergency situations. Therefore, they can be used to assess the quality of management in these situations. PMID:26383261

  20. Interdisciplinary Programs Focused Populations: The Case of Health Management Program

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Yavich, Roman

    2015-01-01

    The Ariel University has a unique interdisciplinary program in healthcare management that targets experienced healthcare professionals who wish to earn an academic degree. Only one academic study has been held so far on the integration of graduates of an academic university-level school in healthcare management in the field. In the current study,…

  1. Comparative Effectiveness of Different Forms of Telemedicine for Individuals with Heart Failure (HF): A Systematic Review and Network Meta-Analysis

    PubMed Central

    Kotb, Ahmed; Cameron, Chris; Hsieh, Shuching; Wells, George

    2015-01-01

    Background Previous studies on telemedicine have either focused on its role in the management of chronic diseases in general or examined its effectiveness in comparison to standard post-discharge care. Little has been done to determine the comparative impact of different telemedicine options for a specific population such as individuals with heart failure (HF). Methods and Findings Systematic reviews (SR) of randomized controlled trials (RCTs) that examined telephone support, telemonitoring, video monitoring or electrocardiographic monitoring for HF patients were identified using a comprehensive search of the following databases: MEDLINE, EMBASE, CINAHL and The Cochrane Library. Studies were included if they reported the primary outcome of mortality or any of the following secondary outcomes: all-cause hospitalization and heart failure hospitalization. Thirty RCTs (N = 10,193 patients) were included. Compared to usual care, structured telephone support was found to reduce the odds of mortality(Odds Ratio 0.80; 95% Credible Intervals [0.66 to 0.96]) and hospitalizations due to heart failure (0.69; [0.56 to 0.85]). Telemonitoring was also found to reduce the odds of mortality(0.53; [0.36 to 0.80]) and reduce hospitalizations related to heart failure (0.64; [0.39 to 0.95]) compared to usual post-discharge care. Interventions that involved ECG monitoring also reduced the odds of hospitalization due to heart failure (0.71; [0.52 to 0.98]). Limitations Much of the evidence currently available has focused on the comparing either telephone support or telemonitoring with usual care. This has therefore limited our current understanding of how some of the less common forms of telemedicine compare to one another. Conclusions Compared to usual care, structured telephone support and telemonitoring significantly reduced the odds of deaths and hospitalization due to heart failure. Despite being the most widely studied forms of telemedicine, little has been done to directly compare these two interventions against one another. Further research into their comparative cost-effectiveness is also warranted. PMID:25714962

  2. Case Analysis of Farm Agriculture Machinery Informatization Management Network System

    NASA Astrophysics Data System (ADS)

    Yang, Hui; Wang, Xi; Zhuang, Weidong

    In the process of China's agricultural modernization, especially agricultural machinery modernization, in terms of equipment, we've chose the way that foreign imports (and domestic research) with the combination of self-developed, in the software, it is difficult to fully apply this approach, the specific reasons are: the modernization of China's agriculture development model is diversified, it is difficult to find a unified management model, even in the scale of operations of the representative state-owned farms and the abroad farms are also very different management models. Due to various types of growth models of biological complexity, diverse climatic and geographical environment factors, coupled with the characteristics such as long cycle of agricultural production, high input, high-risk, and decentralized management, industrial management mode it is very difficult to apply. Moreover, the application of modern management tools is also difficult to quantify the benefits, leading to the current research and application are in a state of comparatively dropped behind.

  3. Self-powered wireless sensor networks for telemedicine applications

    NASA Astrophysics Data System (ADS)

    Polk, Todd William

    Technology advances in wireless sensor networks have made it possible for these tiny systems to enter the realm of ubiquitous or pervasive computing which has been forecast for several years. These nodes, or motes as they are known, typically run off of battery power and when used sparingly can operate in excess of one year. When requirements necessitate higher usage, battery monitoring and replacement becomes a major issue. Large systems can quickly become cost prohibitive. To combat this issue, researchers have looked to energy harvesting to power these motes. However, this research has mainly centered on outdoor solar harvesting to take advantage of higher energy levels provided by the sun. Indoor harvesting has been presented in the past as not feasible. In this dissertation, we present a system that utilizes energy harvested from overhead fluorescent lights to power the infrastructure (routing) nodes of an indoor telemedicine based wireless network. The limitations of indoor harvesting are exploited and leveraged through creative hardware design. A unique message routing protocol has been developed to control these routing nodes and allow continual operation. Standard medical devices have been interfaced to the system to allow wireless transmission of patient data to a central collection point where the data is organized, stored and presented to the user via a graphical user interface (GUI). The range of the system has been extended by interfacing a cellular modem to the system to allow two-way communication between the GUI and a remote healthcare provider. Extensive physical testing has been done to determine the robustness of the system, and the boundary conditions for extremely large networks were tested via simulation.

  4. Applications of telemedicine in the United States space program.

    PubMed

    Doarn, C R; Nicogossian, A E; Merrell, R C

    1998-01-01

    Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth. PMID:9599070

  5. Applications of telemedicine in the United States space program

    NASA Technical Reports Server (NTRS)

    Doarn, C. R.; Nicogossian, A. E.; Merrell, R. C.

    1998-01-01

    Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth.

  6. WATERSHED NITROGEN MANAGEMENT "UPPER POTOMAC RIVER BASIN CASE STUDY"

    EPA Science Inventory

    Are watershed processes controlling the yield, transport, and transformation of carbon, nitrogen, and phosphorous scientifically understood and amenable to man's control in an ecological management framework? or many large estuarine ecosystems such as the Hudson, Chesapeake Bay, ...

  7. Active Social Media Management: The Case of Health Care

    E-print Network

    Miller, Amalia R.

    Given the demand for authentic personal interactions over social media, it is unclear how much firms should actively manage their social media presence. We study this question empirically in a health care setting. We show ...

  8. Training managers for high productivity: Guidelines and a case history

    NASA Technical Reports Server (NTRS)

    Ranftl, R. M.

    1985-01-01

    Hughes Aircrafts 13-year productivity study clearly identifies management as the key link in the entire productivity chain. This fact led to the establishment of a long-term series of seminars on personal, managerial, organizational, and operational productivity for all levels and sectors of line and staff management. To inspire the work force to higher levels of productivity and creativity management, itself, must first be inspired. In turn they have to clearly understand the productive and creative processes, fashion an effective productivity improvement plan with sound strategy and implementation, create an optimal environmental chemistry, and provide the outstanding leadership necessary to propel their organizations to achieve full potential. The primary goals of the seminars are to (1) ignite that spark of inspiration, enabling productive action to follow, (2) provide participants a credible roadmap and effective tools for implementation, and (3) develop a dedicated commitment to leadership and productivity throughout the management team.

  9. Interim Evaluation of the Pilot Program of the Truancy Case Management Partnership Intervention in the District of Columbia

    ERIC Educational Resources Information Center

    Liberman, Akiva; Cahill, Meagan; Cramer, Lindsey

    2012-01-01

    The Case Management Partnership Initiative (CMPI) addresses chronic truancy by linking truant ninth graders and their families to social services and case management, along with regular interagency case management meetings. A pilot was conducted at Anacostia and Ballou High Schools in 2011-2012. The implementation evaluation found that the pilot…

  10. NASA-Navy Telemedicine: Autogenic Feedback Training Exercises for Motion Sickness

    NASA Technical Reports Server (NTRS)

    Acromite, Michael T.; Cowings, Patricia; Toscano, William; Davis, Carl; Porter, Henry O.

    2010-01-01

    Airsickness is the most significant medical condition affecting naval aviation training. A 2001 study showed that airsickness was reported in 81% of naval aviation students and was associated with 82% of below average flight scores. The cost to a single training air-wing was over $150,000 annually for fuel and maintenance costs alone. Resistent cases are sent to the Naval Aerospace Medical Institute (NAMI) for evaluation and desensitization in the self-paced airsickness desensitization (SPAD) program. This approach is 75% successful, but can take up to 8 weeks at a significant travel cost. NASA Ames Research Center's Autogenic Feedback Training Exercises (AFTE) uses physiological and biofeedback training for motion sickness prevention. It has a remote capability that has been used from Moffett Field, CA to Atlanta, GA . AFTE is administered in twelve (30-minute) training sessions. The success rate for the NASA AFTE program has been over 85%. Methods: Implementation Phases: Phase I: Transfer NASA AFTE to NAMI; NASA will remotely train aviation students at NAMI. Phase II: NAMI-centered AFTE application with NASA oversight. Phase III: NAMI-centered AFTE to remotely train at various Navy sites. Phase IV: NAMI to offer Tri-service application and examine research opportunities. Results: 1. Use available telemedicine connectivity between NAMI and NASA. 2. Save over $2,000 per student trained. 3. Reduce aviation training attrition. 4. Provide standardization of multi-location motion sickness training. 5. Future tri-service initiatives. 6. Data to NASA and Navy for QA and research opportunities.

  11. A platform to integrate climate information and rural telemedicine in Malawi

    NASA Astrophysics Data System (ADS)

    Lowe, R.; Chadza, T.; Chirombo, J.; Fonda, C.; Muyepa, A.; Nkoloma, M.; Pietrosemoli, E.; Radicella, S. M.; Tompkins, A. M.; Zennaro, M.

    2012-04-01

    It is commonly accepted that climate plays a role in the transmission of many infectious diseases, particularly those transmitted by mosquitoes such as malaria, which is one of the most important causes of mortality and morbidity in developing countries. Due to time lags involved in the climate-disease transmission system, lagged observed climate variables could provide some predictive lead for forecasting disease epidemics. This lead time could be extended by using forecasts of the climate in disease prediction models. This project aims to implement a platform for the dissemination of climate-driven disease risk forecasts, using a telemedicine approach. A pilot project has been established in Malawi, where a 162 km wireless link has been installed, spanning from Blantyre City to remote health facilities in the district of Mangochi in the Southern region, bordering Lake Malawi. This long Wi-Fi technology allows rural health facilities to upload real-time disease cases as they occur to an online health information system (DHIS2); a national medical database repository administered by the Ministry of Health. This technology provides a real-time data logging system for disease incidence monitoring and facilitates the flow of information between local and national levels. This platform allows statistical and dynamical disease prediction models to be rapidly updated with real-time climate and epidemiological information. This permits health authorities to target timely interventions ahead of an imminent increase in malaria incidence. By integrating meteorological and health information systems in a statistical-dynamical prediction model, we show that a long-distance Wi-Fi link is a practical and inexpensive means to enable the rapid analysis of real-time information in order to target disease prevention and control measures and mobilise resources at the local level.

  12. Case-Based Learning: Educating Future Human Service Managers

    ERIC Educational Resources Information Center

    Austin, Michael J.; Packard, Thomas

    2009-01-01

    Using teaching cases in professional education programs has gained increased attention in the past several decades. While the use of teaching cases has been an important part of social work education, the majority of current casebooks focus on micro or direct practice issues and settings. Over the past forty years only four major casebooks have…

  13. The intellectual property cookbook: a guide for the novice health-care telemedicine provider working with industry.

    PubMed

    Beauregard, D; Beauregard, G

    2000-01-01

    Telemedicine is a new field and many health-care providers are developing their own products with the help of industry. Most practitioners are novices in the legal tools necessary to protect their own work with regard to any future commercialization. To summarize these issues for the telemedicine practitioner, a review of intellectual property protection has been performed. Intellectual property can be protected by tools such as copyrights, patents, non-disclosure and confidentiality agreements, integrated circuit topographies and industrial design. Knowledge of the intellectual property background should allow telemedicine providers to protect their own work when working with industry. PMID:10793990

  14. Strengths-Based Case Management: Implementation With High-Risk Youth

    E-print Network

    Arnold, Elizabeth Mayfield; Walsh, Adam K.; Oldham, Michael S.; Rapp, Charles A.

    2007-01-01

    Few effective methods of intervention exist for youth at risk for negative life outcomes. One method used successfully with both adults with chronic mental illness and adults with substance abuse problems is strengths-based case management (SBCM...

  15. Telemedicine. Final report/project accomplishments summary CRADA number 95-KCP-1014

    SciTech Connect

    VanDeusen, A.L.

    1997-04-01

    This project was initiated to fill existing voids in the telemedicine equipment market. Currently, when a medical facility adds telemedicine capability to their video conference system, they must purchase expensive and bulky encoders and decoders in order to send information over the available data channel. Even with this expensive equipment, only one data type (stethoscope or ECG) can be sent at a time. In addition, since existing encoders and decoders are not designed specifically for telemedicine, special cables must be built to connect with this equipment. This project resulted in the design and construction of an encoder/decoder system that resolved these issues. The unit (referred to as the Telecoder) is designed specifically for the telemedicine market. The Telecoder is compact, handles two types of data (stethoscope and ECG) simultaneously, integrates with existing medical equipment, and is less expensive. In addition to the Telecoder module, a prototype was built that adds all the necessary logic and interfaces necessary to integrate the basic encoder design into additional Cardionics products. Although a complete integration into other Cardionics products was not in the scope of this CRADA, all the basic design work has been done to allow Cardionics to complete the work.

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

    E-print Network

    Kassegne, Samuel Kinde

    Science, Addis Ababa University, Addis Ababa, Ethiopia ++ Visiting Scientist, Henri Samueli School. To study the past and current effort on the application of telemedicine in Ethiopia, a survey of government. Two considerations are possible here. For the national network for the public and government hospitals

  17. Group Speech Therapy in Individuals With Parkinson Disease: Face-to-Face Versus Telemedicine

    E-print Network

    Wilson, Kristel Renee

    2008-07-31

    The purpose of this study was to evaluate the outcomes of group speech therapy for individuals with Parkinson Disease (IWPD) in general and to compare outcomes of group treatment delivered face-to-face (FtF) versus delivery via telemedicine (TM...

  18. Food Insecurity and Food Choices in Rural Older Adults with Diabetes Receiving Nutrition Education via Telemedicine

    ERIC Educational Resources Information Center

    Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.

    2010-01-01

    Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…

  19. Telemedicine for postoperative visits at the Minneapolis VA Medical Center. Results of a needs assessment study.

    PubMed

    Stypulkowski, Katie; Uppaluri, Sarika; Waisbren, Steven

    2015-02-01

    The Minneapolis VA Medical Center initiated a telemedicine program in the early 1990s as a way to streamline care and increase convenience for patients and clinicians. In this study, we explored employing telemedicine for postoperative visits for patients in the general surgery clinic. We surveyed 346 veterans about their preferred method of follow-up. In addition, we asked about their need to complete insurance paperwork, use of VA satellite clinics, distance from the VA Medical Center and from the nearest satellite clinic, and need for travel assistance. We found half of the respondents preferred face-to-face follow-up while the other half preferred follow up using some form of telemedicine. These findings suggest there is a demand for remote postop visits using telemedicine and that such visits may have advantages over face-to-face clinic appointments, especially for patients who have to travel long distances. Further studies are ongoing to determine the actual acceptance of remote visits by the patients and surgeons and to determine if there have been delays in recognition of postoperative complications. PMID:25771648

  20. An 802.11 n wireless local area network transmission scheme for wireless telemedicine applications.

    PubMed

    Lin, C F; Hung, S I; Chiang, I H

    2010-10-01

    In this paper, an 802.11 n transmission scheme is proposed for wireless telemedicine applications. IEEE 802.11n standards, a power assignment strategy, space-time block coding (STBC), and an object composition Petri net (OCPN) model are adopted. With the proposed wireless system, G.729 audio bit streams, Joint Photographic Experts Group 2000 (JPEG 2000) clinical images, and Moving Picture Experts Group 4 (MPEG-4) video bit streams achieve a transmission bit error rate (BER) of 10-7, 10-4, and 103 simultaneously. The proposed system meets the requirements prescribed for wireless telemedicine applications. An essential feature of this proposed transmission scheme is that clinical information that requires a high quality of service (QoS) is transmitted at a high power transmission rate with significant error protection. For maximizing resource utilization and minimizing the total transmission power, STBC and adaptive modulation techniques are used in the proposed 802.11 n wireless telemedicine system. Further, low power, direct mapping (DM), low-error protection scheme, and high-level modulation are adopted for messages that can tolerate a high BER. With the proposed transmission scheme, the required reliability of communication can be achieved. Our simulation results have shown that the proposed 802.11 n transmission scheme can be used for developing effective wireless telemedicine systems. PMID:21138238

  1. An Introduction to Telemedicine; Interactive Television for Delivery of Health Services.

    ERIC Educational Resources Information Center

    Park, Ben

    Telemedicine is defined as the use of two-way or interactive television to conduct transactions in the field of health care. A history of its development to provide two-way communication between central facilities and remote locations is given, along with descriptions of pioneer systems. Technical, psychological and cultural aspects of the method…

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

    E-print Network

    Kassegne, Samuel Kinde

    with the urban public and government hospitals. Specifically, we propose a high level telemedicine network connects all regional clinics with public/government urban hospitals for the purpose of data transmission of Engineering, 4200 Engineering Gateway Building, Irvine, CA 92697. E-mail: samk@digitaladdis.com · Tel: (760

  3. Remote Cerebellar Infarction after Supratentorial Craniotomy and Its Management: Two Case Reports

    PubMed Central

    Yoon, Seon-Jin

    2015-01-01

    The cerebellar infarction resulting from supratentorial craniotomy is uncommon event and its management has been controversial. After removal of space occupying lesion on right frontal area, two cases of remote cerebellar infarctions occurred. We reviewed each cases and the techniques to manage such complications are discussed. Early extraventricular catheter insertion and midline suboccipital craniectomy were effectively performed in obtunded patients from cerebellar infarction. PMID:26605273

  4. Forest management strategies for reducing carbon emissions, the French case

    NASA Astrophysics Data System (ADS)

    Valade, Aude; Luyssaert, Sebastiaan; Bellassen, Valentin; Vallet, Patrick; Martin, Manuel

    2015-04-01

    International agreements now recognize the role of forest in the mitigation of climate change through the levers of in-situ sequestration, storage in products and energy and product substitution. These three strategies of carbon management are often antagonistic and it is still not clear which strategy would have the most significant impact on atmospheric carbon concentrations. With a focus on France, this study compares several scenarios of forest management in terms of their effect on the overall carbon budget from trees to wood-products. We elaborated four scenarios of forest management that target different wood production objectives. One scenario is 'Business as usual' and reproduces the current forest management and wood production levels. Two scenarios target an increase in bioenergy wood production, with either long-term or short-term goals. One scenario aims at increasing the production of timber for construction. For this, an empirical regression model was developed building on the rich French inventory database. The model can project the current forest resource at a time horizon of 20 years for characteristic variables diameter, standing volume, above-ground biomass, stand age. A simplified life-cycle analysis provides a full carbon budget for each scenario from forest management to wood use and allows the identification of the scenario that most reduces carbon emissions.

  5. “Because Somebody Cared about Me. That's How It Changed Things”: Homeless, Chronically Ill Patients’ Perspectives on Case Management

    PubMed Central

    Davis, Elizabeth; Tamayo, Aracely; Fernandez, Alicia

    2012-01-01

    Background Case management programs for chronically ill, homeless people improve health and resource utilization by linking patients with case managers focused on improving management of medical and psychosocial problems. Little is known about participants’ perspectives on case management interventions. Methods This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective of participants. A standardized interview guide with open-ended questions explored experiences with the case management program and feelings about readiness to leave the program. Results Four recurrent themes emerged: (1) Participants described profound social isolation prior to case management program enrollment; (2) Participants perceived that caring personal relationships with case managers were key to the program; (3) Participants valued assistance with navigating medical and social systems; and (4) Participants perceived that their health improved through both the interpersonal and the practical aspects of case management. Conclusions Chronically ill, homeless people enrolled in a case management program perceived that social support from case managers resulted in improved health. Programs for this population should consider explicitly including comprehensive social support interventions. Further research on case management should explore the impact of different types of social support on outcomes for homeless chronically ill patients. PMID:23029350

  6. Case report: Non-invasive management of Madura foot with oral posaconazole and ciprofloxacin.

    PubMed

    Sharma, Amit M; Sharma, Namita; Nat, Amritpal; Rane, Meghan; Endy, Timothy P

    2014-12-01

    Madura foot is a chronic infection caused by fungus and/or bacteria. Traditionally, treatment has been surgical debridement or amputation. Non-invasive management with long-term antimicrobials alone has been reported as successful. We report a case of Madura foot in a Somali refugee successfully managed with oral posaconazole and ciprofloxacin. PMID:25349373

  7. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE... management? Social services workers must document regular contact with children and families in...

  8. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE... management? Social services workers must document regular contact with children and families in...

  9. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE... management? Social services workers must document regular contact with children and families in...

  10. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE... management? Social services workers must document regular contact with children and families in...

  11. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What is required for case management? 20.515 Section 20.515 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE... management? Social services workers must document regular contact with children and families in...

  12. Governing and managing water resources under changing hydro-climatic contexts: The case of the

    E-print Network

    Butler, David R. - Department of Geography, Texas State University

    Governing and managing water resources under changing hydro-climatic contexts: The case Water governance Water management Rhone basin Switzerland a b s t r a c t Climate change represents challenges in the governance context. The study draws on adaptive governance principles, to propose policy

  13. Water Resources Management in the Lerma-Chapala Basin, Mexico: A Case Study

    ERIC Educational Resources Information Center

    Villamagna, Amy M.; Murphy, Brian R.

    2008-01-01

    Water resources have become an increasingly important topic of discussion in natural resources and environmental management courses. To address the need for more critical thinking in the classroom and to provide an active learning experience for undergraduate students, we present a case study based on water competition and management in the…

  14. Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

    ERIC Educational Resources Information Center

    Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

    2014-01-01

    With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages,…

  15. Paper and Process: How Youth Programs Manage Program Intake, Individual Service Strategy Development, and Case Files.

    ERIC Educational Resources Information Center

    Callahan, Jim; McLaughlin, Brenda

    This guide presents information and materials to help youth programs manage program intake, design an individual service strategy (ISS) as mandated in the Workforce Investment Act, and manage case files. The materials are based on information obtained from staff working in seven successful youth workforce investment programs in Maryland,…

  16. Dynamic Management of Internet Telephony Servers: A Case Study based on JavaBeans and JDMK

    E-print Network

    , systems and applications. The Java Dynamic Management Kit (JDMK) [19] by Sun Microsystems, Inc. aimsDynamic Management of Internet Telephony Servers: A Case Study based on JavaBeans and JDMK is the Java Dynamic Ma- nagement Kit (JDMK) that relies on the JavaBeans compo- nent technology. Based on our

  17. 75 FR 16486 - Proposed Comment Request for Review of ACF Disaster Case Management Implementation Guide; Office...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... Management Implementation Guide; Office of Human Services Emergency Preparedness and Response AGENCY... human dignity. If necessary, Disaster case management helps transition the client with pre-existing... and help him/ her organize and access disaster-related resources, human services, health care...

  18. Implementation phase of a multicentre prehospital telemedicine system to support paramedics: feasibility and possible limitations

    PubMed Central

    2013-01-01

    Background Legal regulations often limit the medical care that paramedics can provide. Telemedical solutions could overcome these limitations by remotely providing expert support. Therefore, a mobile telemedicine system to support paramedics was developed. During the implementation phase of this system in four German emergency medical services (EMS), the feasibility and possible limitations of this system were evaluated. Methods After obtaining ethical approval and providing a structured training program for all medical professionals, the system was implemented on three paramedic-staffed ambulances on August 1st, 2012. Two more ambulances were included subsequently during this month. The paramedics could initiate a consultation with EMS physicians at a teleconsultation centre. Telemedical functionalities included audio communication, real-time vital data transmission, 12-lead electrocardiogram, picture transmission on demand, and video streaming from a camera embedded into the ceiling of each ambulance. After each consultation, telephone-based debriefings were conducted. Data were retrieved from the documentation protocols of the teleconsultation centre and the EMS. Results During a one month period, teleconsultations were conducted during 35 (11.8%) of 296 emergency missions with a mean duration of 24.9 min (SD 12.5). Trauma, acute coronary syndromes, and circulatory emergencies represented 20 (57%) of the consultation cases. Diagnostic support was provided in 34 (97%) cases, and the administration of 50 individual medications, including opioids, was delegated by the teleconsultation centre to the paramedics in 21 (60%) missions (range: 1–7 per mission). No medical complications or negative interpersonal effects were reported. All applications functioned as expected except in one case in which the connection failed due to the lack of a viable mobile network. Conclusion The feasibility of the telemedical approach was demonstrated. Teleconsultation enabled early initiation of treatments by paramedics operating under the real-time medical direction. Teleconsultation can be used to provide advanced care until the patient is under a physician’s care; moreover, it can be used to support the paramedics who work alone to provide treatment in non-life-threatening cases. Non-availability of mobile networks may be a relevant limitation. A larger prospective controlled trial is needed to evaluate the rate of complications and outcome effects. PMID:23844941

  19. Recent Directions in Telemedicine: Review of Trends in Research and Practice

    PubMed Central

    Wilson, Laurence S.

    2015-01-01

    Objectives Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. Methods To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. Results The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. Conclusions It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare. PMID:26618026

  20. Improving Computer Literacy of Business Management Majors: A Case Study

    ERIC Educational Resources Information Center

    Johnson, David W.; Bartholomew, Kimberly W.; Miller, Duane

    2006-01-01

    Stakeholders, such as future employers, parents, and educators, have raised their expectations of college graduates in the area of computer literacy. Computer skills and understanding are especially critical for business management graduates, who are expected to use computer technology as a tool in every aspect of their career. Business students…

  1. Management of wastes from hospitals: A case study in Pakistan.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-01-01

    Proper management of hospital waste is a critical concern in many countries of the world. Pakistan is the sixth most populous country in the world, with one of the highest urbanisation and population growth rates in South Asia. Data and analyses regarding hospital waste management practices in Pakistan are scarce in scientific literature. This study was meant to determine waste management practices at selected hospitals in a major city in Pakistan, Gujranwala. A total of 12 different hospitals were selected for the survey, which involved quantification of waste generation rates and investigation of waste management practices. The results were analysed using linear regression. The weighted average total, general and infectious hospital waste generation rates were found to be 0.667, 0.497 and 0.17?kg?bed-day(-1), respectively. Of the total, 73.85% consisted of general, 25.8% consisted of hazardous infectious and 0.87% consisted of sharps waste. The general waste consisted of 15.76% paper, 13.41% plastic, 21.77% textiles, 6.47% glass, 1.99% rubber, 0.44% metal and 40.17% others. Linear regression showed that waste generation increased with occupancy and decreased with number of beds. Small, private and specialised hospitals had relatively greater waste generation rates. Poor waste segregation, storage and transportation practices were observed at all surveyed hospitals. PMID:26628050

  2. Time Management in Higher Education Administration: A Case Study.

    ERIC Educational Resources Information Center

    Lewis, Darrell R.; Dahl, Tor

    How do departmental chairpersons and deans in a major university setting manage their time? What are the major administrative activities and functions associated with such responsibilities? What relationships do these have with an ability to delegate, to control one's time for planning and self-initiated activities, or personal sense of…

  3. Time Management in Higher Education Administration: A Case Study

    ERIC Educational Resources Information Center

    Lewis, Darrell R.; Dahl, Tor

    1976-01-01

    Drawing on data from a staff development project for administrators in a college at a major American university, it was determined that there is considerable commonality across individuals and that it is possible to deal with such issues as time management, job stress, and enjoyment on an organizational level. (Editor/JT)

  4. Human Performance Technology and Knowledge Management: A Case Study

    ERIC Educational Resources Information Center

    Massey, Anne P.; Montoya-Weiss, Mitzi M.; O'Driscoll, Tony M.

    2005-01-01

    As organizations respond to competitive environments and strive to enhance performance, knowledge management (KM) has increasingly become a strategic activity. A KM strategy entails consciously helping people share and put knowledge into action. A key challenge is how to develop and implement KM solutions that provide performance support to…

  5. The Art of Strategic Management: A Case-Based Exercise

    ERIC Educational Resources Information Center

    Maranville, Steven

    2011-01-01

    This article contends that the strategic thinking process is composed of two joint, but paradigmatically distinct, activities--analysis and synthesis. Analysis represents the scientific paradigm, whereas synthesis represents the artistic paradigm. Nevertheless, the Strategic Management course is dominated by the scientific paradigm, even though…

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

    PubMed

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

    2014-01-01

    The concept of telemedicine was formalised in France in the 2009 "Hospital, patients, health territories" (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation. With this background, the round table wanted to produce recommendations on different areas of medical telemonitoring (the role of telemonitoring, the regulatory system, the principles for assessment, methods of use and conditions for sustained and seamless deployment). Whilst many studies carried out on new medical telemonitoring approaches have led to the postulate that it offers benefit, both clinically and in terms of patient quality of life, more information is needed to demonstrate its impact on the organisation of healthcare and the associated medico-economic benefit (criteria, methods, resources). Similarly, contractual frameworks for deployment of telemonitoring do exist, although they are complicated and involve many different stakeholders (Director General fo the Care Offering [Direction générale de l'offre de soins, DGOS], ARS, HAS, Agency for Shared Health Information Systems [Agence des systèmes d'information partagés de santé, ASIP], French National Data Protection Commission [Commission nationale informatique et libertés, CNIL], French National Medical Council [Conseil national de l'Ordre des médecins, CNOM], etc.) that would benefit from a shared approach and seamless exchange between the partners involved. The current challenge is also to define the conditions required to validate a stable economic model in order to promote organisational change. One topical issue is placing the emphasis on its evaluation and operation. Access to patient data, particularly data from the health insurance funds and the use of these data, may enable the process to be more effective. In addition, the budgetary non-fungibility of the various financial envelopes for the different areas of work, restricts the consolidation of financial impact. Funding methods will need to be adapted to this new distribution of roles, both at the centre of the healthcare system and in the industrial ecosystem. All of these changes will help the leaders of our healthcare system to bring this new ambition closer to all of the people working in the health economy. PMID:25230356

  7. Formal Modeling of Resource Management for Cloud Architectures: An Industrial Case Study

    E-print Network

    Johnsen, Einar Broch

    Formal Modeling of Resource Management for Cloud Architectures: An Industrial Case Study Frank S consumption, and deployment on the cloud can be formally modeled for an industrial case study of a distributed characteristics and used to simulate and compare deployment scenarios on the cloud. 1 Introduction Virtualization

  8. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report

    PubMed Central

    Alsancak, Yakup; Sezenoz, Burak; Turkoglu, Sedat; Abac?, Adnan

    2015-01-01

    Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication. PMID:26491572

  9. Utilizing Multimedia Case Studies to Teach the Professional Side of Project Management

    ERIC Educational Resources Information Center

    Elrod, Cassandra C.; Murray, Susan L.; Flachsbart, Barry B.; Burgher, Karl E.; Foth, Drew M.

    2010-01-01

    This research was conducted to evaluate the effectiveness of using a LITEE multimedia case study to teaching concepts in engineering courses. The LITEE Superstar case study was implemented in an engineering Project Management course. Numerous surveys regarding student expectations, outcomes, and attitudes were collected and results are presented…

  10. True and False Allegations of Child Sexual Abuse: Assessment and Case Management.

    ERIC Educational Resources Information Center

    Ney, Tara, Ed.

    This book addresses the clinical, legal, and ethical issues arising in child sexual abuse cases; the assessment and case management of allegations; research issues; and practice recommendations. Chapter titles are as follows: "Assessing Allegations in Child Sexual Abuse: An Overview" (Tara Ney); "The Nature of Allegations of Child Sexual Abuse"…

  11. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...you must meet the casing pressure management requirements of API RP 90 (incorporated by reference as specified in § 250.198...250.519 through 250.530. If there is a conflict between API RP 90 and the casing pressure requirements of this subpart,...

  12. 30 CFR 250.519 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...you must meet the casing pressure management requirements of API RP 90 (as incorporated by reference in § 250.198) and the...250.519 through 250.530. If there is a conflict between API RP 90 and the casing pressure requirements of this...

  13. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...you must meet the casing pressure management requirements of API RP 90 (as incorporated by reference in § 250.198) and the...250.519 through 250.530. If there is a conflict between API RP 90 and the casing pressure requirements of this subpart,...

  14. 30 CFR 250.518 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...you must meet the casing pressure management requirements of API RP 90 (incorporated by reference as specified in § 250.198...250.519 through 250.530. If there is a conflict between API RP 90 and the casing pressure requirements of this subpart,...

  15. 30 CFR 250.519 - What are the requirements for casing pressure management?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...you must meet the casing pressure management requirements of API RP 90 (as incorporated by reference in § 250.198) and the...250.519 through 250.530. If there is a conflict between API RP 90 and the casing pressure requirements of this...

  16. Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

    ERIC Educational Resources Information Center

    Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

    2006-01-01

    This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

  17. Learning from Action Evaluation of the Use of Multimedia Case Studies in Management Information Systems Courses

    ERIC Educational Resources Information Center

    Kawulich, Barbara B.

    2011-01-01

    This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…

  18. Clinical management of a unique case of fusion between supernumerary canine and maxillary first premolar.

    PubMed

    Simratvir, Mauli; Prabhakar, Manisha

    2011-12-01

    Fusion is one of the few developmental disorders that may account for alteration in morphology and number of teeth in the dental arch. This case report presents a unique case of fusion between supernumerary canine and maxillary first premolar, the associated problems, and their comprehensive clinical management. PMID:22409140

  19. Internet Telehealth for Pediatric Asthma Case Management: Integrating Computerized and Case Manager Features for Tailoring a Web-Based Asthma Education Program

    PubMed Central

    Wise, Meg; Gustafson, David H.; Sorkness, Christine A.; Molfenter, Todd; Staresinic, Anthony; Meis, Tracy; Hawkins, Robert P.; Shanovich, Kathleen Kelly; Walker, Nola P.

    2008-01-01

    This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthmanurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the yearlong integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised. PMID:16928987

  20. Case Studies for Management Development in Bangladesh. Third Book. Prepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains 10 case studies of management situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. Two to four discussion questions follow each case study. Three case studies on the subject of pay and compensation were prepared by Abu Hossain Siddique; the…

  1. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics.

    PubMed

    Khatami, Ameneh; Sparks, Rebecca T; Marais, Ben J

    2015-12-01

    Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible. PMID:26574586

  2. Competition, Organizational change, and conflict: the changing role of case managers in Ontario's homecare system.

    PubMed

    Randall, Glen E

    2007-01-01

    As health care costs climb, governments continue to seek ways of controlling expenditures and improving accountability. One approach recently used by the government of Ontario to reform the delivery of homecare services focused on the introduction of competitive market forces in conjunction with the establishment of greater managerial controls over the activities of frontline health professionals. The purpose of this article is to assess how this "managed competition" model impacted the role of homecare case managers and their relationships with frontline health professionals. Data for this case study were obtained primarily through 36 in-depth key informant interviews with representatives from homecare provider agencies and the community care access centers (CCACs), which contract with the provider agencies for client services. The managed competition reform dramatically altered the role of homecare case managers by requiring them to take on greater responsibility for monitoring budgets and rationing services. This shift from a collaborative to a competitive system promoted conflict between case managers and other health care professionals. In the presence of an increasingly bureaucratized case manager role, interprofessional conflict and a focus on cost containment seems to have left clients without any clear advocate of their interests. PMID:17491444

  3. Identification and management of filament-wound case stiffness parameters

    NASA Technical Reports Server (NTRS)

    Verderaime, V.; Rheinfurth, M.

    1983-01-01

    The high specific strength and the high specific modules made graphite epoxy laminate an expedient material substitute for the Shuttle Solid Rocket Motor steel case to substantially increase the payload performance without increasing the composite case axial growth during thrust build up which was constrained to minimize liftoff excitation effects on existing structural elements and interfaces. Parameters associated with axial growth were identified for quality and manufacturing controls. Included is an innovative method for experimentally verifying extensional elastic properties on a laminate pressurized test bottle.

  4. Development of plant maintenance management system (pmms): a case study

    NASA Astrophysics Data System (ADS)

    Che Azhar, N. A.; Mansor, M. A.

    2013-12-01

    In large plant industry, it is not easy to maintain machine performance without using any method such as checklist system. Manual checklist is a common maintenance checklist used in industry. All machine, equipment and parts that need to be checked will be written down for the employee to do maintenance checks. Converting the manual checklist to the Plant Maintenance Management System (PMMS) can improve the way of employees work and make plant management easier. Therefore, a new system was designed to maintain the equipment so that the activities are more efficient and cost effective. The system consists of three frames that connect to each other. The frames divide to section, equipment and checklist. This system also builds to prevent data from arbitrarily changes. Only certain officers or staffs are permitted to make modifications to data. Using this system, a company can make the office environment a paperless environment.

  5. Curriculum and cases for pain medicine crisis resource management education.

    PubMed

    Brenner, Gary J; Newmark, Jordan L; Nemark, Jordan L; Raemer, Daniel

    2013-01-01

    Medical crises that may occur in the setting of a pain medicine service are rare events that require skillful action and teamwork to ensure safe patient outcome. A simulated environment is an ideal venue for both acquisition and reinforcement of this knowledge and skill set. Here, we present an educational curriculum in pain medicine crisis resource management for both pain medicine fellows and attending physicians as well as the results of a successful pilot program. PMID:23223099

  6. Hospital waste management and toxicity evaluation: A case study

    SciTech Connect

    Tsakona, M.; Anagnostopoulou, E.; Gidarakos, E.

    2007-07-01

    Hospital waste management is an imperative environmental and public safety issue, due to the waste's infectious and hazardous character. This paper examines the existing waste strategy of a typical hospital in Greece with a bed capacity of 400-600. The segregation, collection, packaging, storage, transportation and disposal of waste were monitored and the observed problematic areas documented. The concentrations of BOD, COD and heavy metals were measured in the wastewater the hospital generated. The wastewater's toxicity was also investigated. During the study, omissions and negligence were observed at every stage of the waste management system, particularly with regard to the treatment of infectious waste. Inappropriate collection and transportation procedures for infectious waste, which jeopardized the safety of staff and patients, were recorded. However, inappropriate segregation practices were the dominant problem, which led to increased quantities of generated infectious waste and hence higher costs for their disposal. Infectious waste production was estimated using two different methods: one by weighing the incinerated waste (880 kg day{sup -1}) and the other by estimating the number of waste bags produced each day (650 kg day{sup -1}). Furthermore, measurements of the EC{sub 50} parameter in wastewater samples revealed an increased toxicity in all samples. In addition, hazardous organic compounds were detected in wastewater samples using a gas chromatograph/mass spectrograph. Proposals recommending the application of a comprehensive hospital waste management system are presented that will ensure that any potential risks hospital wastes pose to public health and to the environment are minimized.

  7. Challenges to improving case management of childhood pneumonia at health facilities in resource-limited settings.

    PubMed

    Graham, Stephen M; English, Mike; Hazir, Tabish; Enarson, Penny; Duke, Trevor

    2008-05-01

    Effective case management is an important strategy to reduce pneumonia-related morbidity and mortality in children. Guidelines based on sound evidence are available but are used variably. This review outlines current guidelines for childhood pneumonia management in the setting where most child pneumonia deaths occur and identifies challenges for improved management in a variety of settings and different "at-risk" groups. These include appropriate choice of antibiotic, clinical overlap with other conditions, prompt and appropriate referral for inpatient care, and management of treatment failure. Management of neonates, and of HIV-infected or severely malnourished children is more complicated. The influence of co-morbidities on pneumonia outcome means that pneumonia case management must be integrated within strategies to improve overall paediatric care. The greatest potential for reducing pneumonia-related deaths in health facilities is wider implementation of the current guidelines built around a few core activities: training, antibiotics and oxygen. This requires investment in human resources and in equipment for the optimal management of hypoxaemia. It is important to provide data from a variety of epidemiological settings for formal cost-effectiveness analyses. Improvements in the quality of case management of pneumonia can be a vehicle for overall improvements in child health-care practices. PMID:18545737

  8. Managing Communication during a School Crisis: A Case Study

    ERIC Educational Resources Information Center

    Gentilucci, James L.

    2007-01-01

    Crisis communication training of school principals is problematic because it overemphasizes media relations and underemphasizes the critical importance of immediate and personal communication with students, staff, and parents--those most affected by school crises. A case study involving the death of a student in a small rural school explains why…

  9. Secondary School Art: A Case for Increased Senior Management Support

    ERIC Educational Resources Information Center

    Etherington, Margaret

    2015-01-01

    This case study explores the way that school art in England remains a marginalised subject at secondary level, despite the expansion of art-based career opportunities. A recent government document evaluating art, craft and design education highlights the potential role of head teachers in raising an art department's profile. The current study…

  10. Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

    PubMed Central

    Joseph, Suja; Cherackal, George J; Jacob, Jose; Varghese, Alex K

    2015-01-01

    Key Clinical Message Hypohydrotic ectodermal dysplasia is a hereditary disorder, which affects ectodermal derivatives. It manifests several abnormalities of the teeth, and is commonly inherited through female carriers. This case report presents a patient with compromised esthetics and function. A multidisciplinary approach was planned involving an oral pathologist, endodontist, orthodontist and a prosthodontist. PMID:25984305

  11. Effective management of sarin exposure: simulation case scenario.

    PubMed

    Hanson, Neil A; Hobbs, Eugene; Taekman, Jeffrey M

    2008-01-01

    Biological and chemical warfare training is often overlooked in residency programs, but is nonetheless an extremely important part of the curriculum and should be implemented before allowing residents to graduate. The purpose of this case is twofold: (1) explore the diagnosis and treatment of Sarin exposure, (2) discuss the methods of protecting against contamination with toxic agents. PMID:19088651

  12. Etiology and management of hemmorrhage in spontaneous liver rupture: a report of 70 cases

    PubMed Central

    Chen, Zhe-Yu; Qi, Qing-Hui; Dong, Zuo-Liang

    2002-01-01

    AIM: To analyze the causes and management of hemorrhage in spontaneous liver rupture. METHODS: Seventy cases of spontaneous liver rupture were retrospectively analyzed for causes of hemorrhage and therapeutic effects of surgical approaches. RESULTS: It was demonstrated that the causes of spontaneous liver rupture were primary liver cancer in 60 cases (85.7%), cirrhosis in 3 cases (4.3%), liver angioma in 2 cases (2.9%), liver adenoma in 4 cases (5.7%),and secondary liver cancer in 1 case (1.4%). Hemostasis was achieved with surgical approaches in 68 cases (97.1%) and non-surgical approaches in 2 cases (2.9%). Surgical interventions included suture, ligation of hepatic artery, hepatic artery chemoembolization and partial hepatic resection. CONCLUSION: The results suggest that surgical intervention is still the main therapeutic method and the best procedure that should be selected according to causes of disease and patient’s condition and history. PMID:12439926

  13. Survival of the project: a case study of ICT innovation in health care.

    PubMed

    Andreassen, Hege K; Kjekshus, Lars Erik; Tjora, Aksel

    2015-05-01

    From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success. Our empirical material is based on Norwegian telemedicine. Through a case study, we take an in-depth look into the history of one particular telemedical initiative and highlight how ICT projects matter on a managerial level. Our analysis reveals how management tasks were delegated to the ICT project, which thus contributed to four processes of organisational control: allocating resources, generating and managing enthusiasm, system correction and aligning local practice and national policies. We argue that the innovation project in itself can be considered an innovation that has become normalised in health care, not in clinical, but in management work. In everyday management, the ICT project appears to be a convenient tool suited to ease the tensions between state regulatory practices and claims of professional autonomy that arise in the wake of new public management reforms. Separating project management and funding from routine practice handles the conceptualised heterogeneity between innovation and routine within contemporary health care delivery. Whilst this separation eases the execution of both normal routines and innovative projects, it also delays expected diffusion of technology. PMID:25795426

  14. Management of superior sagittal sinus injury encountered in traumatic head injury patients: Analysis of 15 cases

    PubMed Central

    Behera, Sanjay K.; Senapati, Satya Bhusan; Mishra, Sudhansu Sekhar; Das, Srikant

    2015-01-01

    Background: Significant dural sinus injury occurs in 1.5- 5% of all head injuries and injury to superior sagittal sinus accounts for 70-80% of these. Its management is also a challenging issue to every neurosurgeon. Materials and Methods: In a period of one year (Aug 2011 to july2012) out of 549 cases of head injuries operated in our department analysis of 15 cases (2.73%) shown to have superior sagittal sinus injury. Three dimensional reconstruction of skull bone during CT scan helped us to diagnose possible dural sinus injury pre-operatively. Results: SSS injury was due to direct impact of fracture segment (5 cases), extension of fracture line over sinus area (4 cases) or due to coronal suture diastases (6 cases). Injury to anterior third of sagittal sinus occurred in 12 cases (80%) and injury to middle third occurred in 3 cases (20%). Small tear over superior sagittal sinus was found in 7 cases (46.66%) and was managed with Gelfoam® compression only and in two cases (13.33%) were large tear, which was managed with sinoraphy. In four cases (36.34%) hitch stitches over Gelfoam® to adjacent bone given and in rest two cases (13.33%) a strip of bone was left over the sinus area and bilateral hitch stitches were applied. Conclusion: Injury to SSS in traumatic head injury patient though rarely encountered during surgery, the management is challenging to every neurosurgeon. Preoperative suspicion and combination of surgical techniques rather than one single technique may be effective in decreasing the sinus related mortality rate. PMID:25767570

  15. [Management of obstructive renal candidiasis. Report of a clinical case].

    PubMed

    Alvarez Kindelán, J; Alameda Aragonéses, V; Regueiro López, J C; Prieto Castro, R; Carmona Campos, E; Anglada Curado, F; Requena Tapia, M J

    1997-03-01

    Neonatal renal candidiasis is a rare complication but serious, associated with prematurity, immunodeficiency, parenteral nutrition and other risk factors, with a mortality rate until 50%. We describe a neonate premature of 28 weeks who developed septicaemia by Candida, complicated with bilateral ureterohydronephrosis and intrapelvic fungus ball. The patient was managed by bilateral nephrostomy drainage and amphotericin B local irrigation, anyway with systemic amphotericin B together with oral fluconazol, needing subsequently bilateral open surgery and external drainage. The infection was eradicated, reaching the patient a gradual healing. PMID:9324899

  16. Data management for community research projects: A JGOFS case study

    NASA Technical Reports Server (NTRS)

    Lowry, Roy K.

    1992-01-01

    Since the mid 1980s, much of the marine science research effort in the United Kingdom has been focused into large scale collaborative projects involving public sector laboratories and university departments, termed Community Research Projects. Two of these, the Biogeochemical Ocean Flux Study (BOFS) and the North Sea Project incorporated large scale data collection to underpin multidisciplinary modeling efforts. The challenge of providing project data sets to support the science was met by a small team within the British Oceanographic Data Centre (BODC) operating as a topical data center. The role of the data center was to both work up the data from the ship's sensors and to combine these data with sample measurements into online databases. The working up of the data was achieved by a unique symbiosis between data center staff and project scientists. The project management, programming and data processing skills of the data center were combined with the oceanographic experience of the project communities to develop a system which has produced quality controlled, calibrated data sets from 49 research cruises in 3.5 years of operation. The data center resources required to achieve this were modest and far outweighed by the time liberated in the scientific community by the removal of the data processing burden. Two online project databases have been assembled containing a very high proportion of the data collected. As these are under the control of BODC their long term availability as part of the UK national data archive is assured. The success of the topical data center model for UK Community Research Project data management has been founded upon the strong working relationships forged between the data center and project scientists. These can only be established by frequent personal contact and hence the relatively small size of the UK has been a critical factor. However, projects covering a larger, even international scale could be successfully supported by a network of topical data centers managing online databases which are interconnected by object oriented distributed data management systems over wide area networks.

  17. Laboratory Information Management System (LIMS): A case study

    NASA Technical Reports Server (NTRS)

    Crandall, Karen S.; Auping, Judith V.; Megargle, Robert G.

    1987-01-01

    In the late 70's, a refurbishment of the analytical laboratories serving the Materials Division at NASA Lewis Research Center was undertaken. As part of the modernization efforts, a Laboratory Information Management System (LIMS) was to be included. Preliminary studies indicated a custom-designed system as the best choice in order to satisfy all of the requirements. A scaled down version of the original design has been in operation since 1984. The LIMS, a combination of computer hardware, provides the chemical characterization laboratory with an information data base, a report generator, a user interface, and networking capabilities. This paper is an account of the processes involved in designing and implementing that LIMS.

  18. Orthopaedic management in four cases of mucolipidosis type III.

    PubMed Central

    Hetherington, C; Harris, N J; Smith, T W

    1999-01-01

    Four patients with mucolipidosis type III, three of them brothers, were seen initially in the first two decades of life. Their main symptoms were carpal tunnel syndrome, trigger fingers and generalized joint stiffness. Radiographs showed spinal deformities and hip dysplasia, but these were not causing pain. Carpal tunnel syndrome was treated surgically but joint stiffness and hip and knee contractures were managed by physiotherapy. Up to the age of 24 none of these patients has had pelvic osteotomy for hip dysplasia; this operation, not yet reported in mucolipidosis type III, may eventually be necessary. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:10472261

  19. Breast cancer management in a case of hemihypertrophy/lymphedema.

    PubMed

    Alipour, Sadaf

    2013-03-01

    Breast cancer can occur in women affected by congenital disorders because of its very high incidence. The circumstances of the underlying disease may affect the treatment plan for the cancer. In our case, breast cancer occurred in a 43-year-old woman with congenital hemihypertrophy and lymphedematous features of the overgrowth. These conditions are described in the article while questions about the best practice for the cancer surgery are mentioned. PMID:23631109

  20. Method of sealing casings of subsurface materials management system

    DOEpatents

    Nickelson, Reva A.; Richardson, John G.; Kostelnik, Kevin M.; Sloan, Paul A.

    2007-02-06

    Systems, components, and methods relating to subterranean containment barriers. Laterally adjacent tubular casings having male interlock structures and multiple female interlock structures defining recesses for receiving a male interlock structure are used to create subterranean barriers for containing and treating buried waste and its effluents. The multiple female interlock structures enable the barriers to be varied around subsurface objects and to form barrier sidewalls. The barrier may be used for treating and monitoring a zone of interest.