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1

Telemedicine for wound management  

PubMed Central

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

Chittoria, Ravi K.

2012-01-01

2

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

Microsoft Academic Search

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

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

2006-01-01

3

A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study.  

PubMed

CONTEXT Telemedicine is a promising but largely unproven technology for providing case management services to patients with chronic conditions and lower access to care. OBJECTIVES To examine the effectiveness of a telemedicine intervention to achieve clinical management goals in older, ethnically diverse, medically underserved patients with diabetes. DESIGN, Setting, and Patients A randomized controlled trial was conducted, comparing telemedicine case management to usual care, with blinded outcome evaluation, in 1,665 Medicare recipients with diabetes, aged >/= 55 years, residing in federally designated medically underserved areas of New York State. Interventions Home telemedicine unit with nurse case management versus usual care. Main Outcome Measures The primary endpoints assessed over 5 years of follow-up were hemoglobin A1c (HgbA1c), low density lipoprotein (LDL) cholesterol, and blood pressure levels. RESULTS Intention-to-treat mixed models showed that telemedicine achieved net overall reductions over five years of follow-up in the primary endpoints (HgbA1c, p = 0.001; LDL, p < 0.001; systolic and diastolic blood pressure, p = 0.024; p < 0.001). Estimated differences (95% CI) in year 5 were 0.29 (0.12, 0.46)% for HgbA1c, 3.84 (-0.08, 7.77) mg/dL for LDL cholesterol, and 4.32 (1.93, 6.72) mm Hg for systolic and 2.64 (1.53, 3.74) mm Hg for diastolic blood pressure. There were 176 deaths in the intervention group and 169 in the usual care group (hazard ratio 1.01 [0.82, 1.24]). CONCLUSIONS Telemedicine case management resulted in net improvements in HgbA1c, LDL-cholesterol and blood pressure levels over 5 years in medically underserved Medicare beneficiaries. Mortality was not different between the groups, although power was limited. Trial Registration http://clinicaltrials.gov Identifier: NCT00271739. PMID:19390093

Shea, Steven; Weinstock, Ruth S; Teresi, Jeanne A; Palmas, Walter; Starren, Justin; Cimino, James J; Lai, Albert M; Field, Lesley; Morin, Philip C; Goland, Robin; Izquierdo, Roberto E; Ebner, Susana; Silver, Stephanie; Petkova, Eva; Kong, Jian; Eimicke, Joseph P

2009-01-01

4

A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus: 5 Year Results of the IDEATel Study  

PubMed Central

Context Telemedicine is a promising but largely unproven technology for providing case management services to patients with chronic conditions and lower access to care. Objectives To examine the effectiveness of a telemedicine intervention to achieve clinical management goals in older, ethnically diverse, medically underserved patients with diabetes. Design, Setting, and Patients A randomized controlled trial was conducted, comparing telemedicine case management to usual care, with blinded outcome evaluation, in 1,665 Medicare recipients with diabetes, aged ? 55 years, residing in federally designated medically underserved areas of New York State. Interventions Home telemedicine unit with nurse case management versus usual care. Main Outcome Measures The primary endpoints assessed over 5 years of follow-up were hemoglobin A1c (HgbA1c), low density lipoprotein (LDL) cholesterol, and blood pressure levels. Results Intention-to-treat mixed models showed that telemedicine achieved net overall reductions over five years of follow-up in the primary endpoints (HgbA1c, p = 0.001; LDL, p < 0.001; systolic and diastolic blood pressure, p = 0.024; p < 0.001). Estimated differences (95% CI) in year 5 were 0.29 (0.12, 0.46)% for HgbA1c, 3.84 (?0.08, 7.77) mg/dL for LDL cholesterol, and 4.32 (1.93, 6.72) mm Hg for systolic and 2.64 (1.53, 3.74) mm Hg for diastolic blood pressure. There were 176 deaths in the intervention group and 169 in the usual care group (hazard ratio 1.01 [0.82, 1.24]). Conclusions Telemedicine case management resulted in net improvements in HgbA1c, LDL-cholesterol and blood pressure levels over 5 years in medically underserved Medicare beneficiaries. Mortality was not different between the groups, although power was limited. Trial Registration http://clinicaltrials.gov Identifier: NCT00271739. PMID:19390093

Shea, Steven; Weinstock, Ruth S.; Teresi, Jeanne A.; Palmas, Walter; Starren, Justin; Cimino, James J.; Lai, Albert M.; Field, Lesley; Morin, Philip C.; Goland, Robin; Izquierdo, Roberto E.; Ebner, Susana; Silver, Stephanie; Petkova, Eva; Kong, Jian; Eimicke, Joseph P.

2009-01-01

5

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

PubMed

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

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

6

An ontology-based telemedicine tasks management system architecture.  

PubMed

The recent developments in ambient intelligence and ubiquitous computing offer new opportunities for the design of advanced Telemedicine systems providing high quality services, anywhere, anytime. In this paper we present an approach for building an ontology-based task-driven telemedicine system. The architecture is composed of a task management server, a communication server and a knowledge base for enabling decision makings taking account of different telemedical concepts such as actors, resources, services and the Electronic Health Record. The final objective is to provide an intelligent management of the different types of available human, material and communication resources. PMID:19162954

Nageba, Ebrahim; Fayn, Jocelyne; Rubel, Paul

2008-01-01

7

Use of telemedicine technologies in the management of infectious diseases: a review.  

PubMed

Telemedicine technologies are rapidly being integrated into infectious diseases programs with the aim of increasing access to infectious diseases specialty care for isolated populations and reducing costs. We summarize the utility and effectiveness of telemedicine in the evaluation and treatment of infectious diseases patients. The use of telemedicine in the management of acute infectious diseases, chronic hepatitis C, human immunodeficiency virus, and active pulmonary tuberculosis is considered. We recapitulate and evaluate the advantages of telemedicine described in other studies, present challenges to adopting telemedicine, and identify future opportunities for the use of telemedicine within the realm of clinical infectious diseases. PMID:25516192

Parmar, Parmvir; Mackie, David; Varghese, Sunil; Cooper, Curtis

2015-04-01

8

A telemedicine platform: a case study of Apollo hospitals telemedicine project  

Microsoft Academic Search

This paper analyzes the application of information communication technologies for the delivery of medical services, namely telemedicine. As an attempt to understand the working of telemedicine the Aaragonda project by Apollo hospitals has been studied. Various aspects of telemedicine such as implementation and infrastructure and possible lessons from the implementation of such a project have been highlighted.

B. Bowonder; Mohit Bansal; A. Sharnitha Giridhar

2005-01-01

9

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

USGS Publications Warehouse

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.

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

2005-01-01

10

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

Microsoft Academic Search

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

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

2002-01-01

11

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

Microsoft Academic Search

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

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

2002-01-01

12

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

PubMed Central

Aims: To evaluate the feasibility and effectiveness of a telemedicine system based on internet in the follow-up of patients with type 2 diabetes mellitus (T2DM). Methods: A prospective randomized telemedicine study with two parallel groups was designed. 114 patients diagnosed T2DM were randomly divided into telemedicine group and traditional face-to-face visit group as control. 57 cases were included for each group. 108 patients completed the trial, in which 53 cases in telemedicine group and 55 cases in control group. Patients in telemedicine group were taught to use telemedicine software to upload their blood glucose and other metabolic information at home at least every 2 weeks, and the researchers gave proper advices according to patients’ key behaviors. The telemedicine interval is 3 months. Results: Compared to control group, telemedicine group exhibited better HbA1c and fasting blood glucose controlling (P < 0.05). Moreover, telemedicine intervention decreased hypoglycemia risk (P = 0.044), and contributed to levels of HbA1c less than 7% which is the target of our study (P = 0.049). Conclusions: Telemedicine system can provide a tighter glycemic control for the treatment of T2DM patients, especially in cases with difficulties to access to the medical centre. PMID:25674254

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

2014-01-01

13

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

Microsoft Academic Search

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

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

2002-01-01

14

Pilot study optimizing MEDLINE queries in an automated disease management telemedicine system.  

PubMed Central

Clinicians encounter many medical questions while providing outpatient medical care. A significant number of these questions can be answered using MEDLINE; however it has proven to be difficult to incorporate MEDLINE into routine clinical workflow and for clinicians to generate well constructed MEDLINE queries. This study however hypothesized that that well-constructed MEDLINE queries could be semi-automatically generated by an application named LitButton which was incorporated into the TeleWatch telemedicine system. The LitButton application was then prospectively evaluated in a pilot study by four nurse case managers (NCM) who monitored sixty-eight outpatients for three weeks. During this period the NCMs used the LitButton application sixteen times, and they subjectively reported in real-time that they obtained an answer in 56% of the cases, but that none of the successful information retrieval events resulted in a change in a patient's clinical management. The small number of LitButton events and lack of clinical impact was likely due to the fact that the LitButton function was designed to search MEDLINE for treatment related information; however the NCMs had limited medical decision making responsibilities. As a result there was a mismatch between the user's information needs and the system capabilities. PMID:12463918

Spaeder, Jeffrey A.

2002-01-01

15

A completely decentralized workflow management system for the support of emergency telemedicine and patient monitoring.  

PubMed

In this work we propose a completely decentralized workflow system, based on peer to peer (P2P) computing, in order to support the procedures followed: a) when handling a patient in a hospital emergency health care department: b) telemedicine services needed during emergency cases or during remote patient examination and monitoring. The proposed architecture is an addition to an already existing telemedicine system that enables telediagnosis and long distance support during emergency and monitoring cases. The existing system is based on a client server architecture, which has dependability limitations as it depends on a single centralized machine. Dependability is a critical requirement for such cases; so the new proposed system addresses these limitations by facilitating operation and even when some peers are unavailable for any reason. Concluding, the system design has been completed successfully. PMID:17946322

Kyriacou, E; Fakas, G; Pavlaki, V

2006-01-01

16

Case management.  

PubMed

Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. PMID:25680491

Woodward, Judy; Rice, Eve

2015-03-01

17

Management of heart failure patients using telemedicine communication systems  

Microsoft Academic Search

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

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

2006-01-01

18

Intelligent image management in a distributed PACS and telemedicine environment  

Microsoft Academic Search

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

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

1996-01-01

19

Neurotology telemedicine consultation.  

PubMed

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

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

2011-12-01

20

Telemedicine and adherence to national guidelines for ADHD evaluation: a case study.  

PubMed

The pilot project evaluated a telemedicine clinic's adherence to American Academy of Pediatrics (AAP) guidelines for attention-deficit/hyperactivity disorder (ADHD) evaluation. Real-time videoconferencing linked the patients, the families, and the specialty mental health team. The ADHD Telemedicine Clinic adherence to AAP guidelines was tracked using chart data. The study included 22 patients (Mean age = 9.3 years, SD = 2.3 years) participating in 69 telemedicine visits across 13 different school-related sites. The ADHD Telemedicine Clinic reached extremely high adherence rates across the AAP evaluation guidelines for ADHD, ranging from 95-100% across the six guidelines. No factor inherent to the telemedicine service delivery mechanism impeded adherence to national guidelines for ADHD evaluation. Telemedicine-based outreach had the greatest impact on AAP Guideline #4, stating that information should be obtained from the child's academic setting. The school-based telemedicine clinic allowed increased communication across the school and specialty mental health systems and facilitated greater input across child, parent, school personnel, and mental health professionals. PMID:22867121

Nelson, Eve-Lynn; Duncan, Angela Banitt; Peacock, Georgina; Bui, Thao

2012-08-01

21

The role of telemedicine in hypertension management: focus on blood pressure telemonitoring.  

PubMed

This review aims at updating and critically assessing the role of telemedicine, and in particular, of home blood pressure telemonitoring (HBPT), in the management of the hypertensive patient. Result from several randomized trials suggest that HBPT represents a promising tool for improving blood pressure (BP) control of hypertensive patients, in particular, those at high risk. Most studies documented a significant BP reduction with regular HBPT compared to usual care. HBPT interventions showed a very high degree of acceptance by patients, helped improving the patients' quality of life, and were associated with lower medical costs than standard care, even though such costs were offset by those of the technology, thus reducing the overall cost-effectiveness of HBPT. The high heterogeneity of the technologies, study designs, and type of patients in the various studies suggest that further well-designed, large cohort, prospective studies are needed to identify key elements of HBPT approach to be able to give impact on specific outcomes. Likely, patients who need a constant monitoring of multiple vital signs and a tight BP control, such as high risk patients with chronic diseases (ischemic heart disease or heart failure, diabetes, etc.), as well as non-adherent patients, may particularly benefit from HBPT. In general, HBPT can be an advantageous choice when a network among healthcare professionals (doctors, nurses, and pharmacists) is needed to improve the screening and management of hypertension and related comorbidities and to achieve an effective prevention of cardiovascular diseases in the community. PMID:25790799

Omboni, Stefano; Ferrari, Rossella

2015-04-01

22

Mobile technologies in the management of disasters: the results of a telemedicine solution.  

PubMed Central

Nowadays a great number of applications are used to compile and transmit casualties and disasters information but there are many troubles associated with the technology as can be the communications reliability and the size and weight of the devices medical staff has to carry with. Telecommunication infrastructures support information movement among geographically dispersed locations. Recently a large family of little devices has appeared in the buyer's market. They are called Personal Digital Assistants and because of their physic and technical features, they are very useful in the emergency field. As for the communications reliability, many technologies have been developed in the last years but it is necessary to find a solution that can be used in whatever situation independently of the emergency circumstances. Facing this reality, the Spanish government funded REMAF, an ATYCA (Initiative of Support for the Technology, Security and Quality in the Industry) project. REMAF joined research groups (UPM), phone operators (Fundación Airtel Móvil) and end users (SAMUR) to build a disaster data management system conceived to use modern telemedicine systems to optimize the management in these situations, taking the advantage of the above mentioned mobile communication tools and networks. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:11825159

Cabrera, M. F.; Arredondo, M. T.; Rodriguez, A.; Quiroga, J.

2001-01-01

23

Telemedicine and ISDN  

SciTech Connect

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

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

1993-01-01

24

Telemedicine Spacebridge  

NASA Technical Reports Server (NTRS)

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

1994-01-01

25

The emerging role of telemedicine in managing glycemic control and psychobehavioral aspects of pregnancy complicated by diabetes.  

PubMed

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

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

2014-01-01

26

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

PubMed Central

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

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

2014-01-01

27

Diabetes disease management program for an indigent population empowered by telemedicine technology.  

PubMed

Mercy Health Center in Laredo, Texas implemented a Telemedicine Diabetes Disease Management Program to determine the impact of a web-based patient interface technology as part of a diabetes disease management program. The program featured the use of the Health Hero iCare Desktop and the Health Buddy appliance. The Mercy Health Center outcomes study aimed to assess the effect of telemedicine technology on the health of indigent border residents with diabetes. The study was conducted in calendar year 2000-2001 using comparative cohort data from calendar year 1999. Using the technology, patients were monitored daily at home, and to ensure early intervention, nurses were alerted if patients reported abnormalities. The goals of the program were to decrease hospital-based resource utilization, improve patient compliance with treatment plans, improve the level of patient satisfaction with healthcare services, and improve patients' perceived quality of life. Objective outcomes, including inpatient admissions, emergency room visits, postdischarge care visits, and outpatient visits, as well as charges for healthcare services, were all measured on a per patient per year basis. Subjective outcomes, including quality of life and patient satisfaction, were estimated from surveys conducted before, quarterly for two quarters within the program, and at the end of the study period. For each measure except for quality of life, comparisons were made between the year just prior to and the year of Health Buddy utilization. Quality of life was compared for the year just prior to Health Buddy utilization and at the end of the second quarter. After 1 year, reductions in overall utilization and charges, as well as improvements in quality of life, were demonstrated. Patients in the program showed reduced overall charges of 747 dollars per patient per year. Inpatient admissions were reduced 32% (p < 0.07), emergency room encounters were reduced 34% (p < 0.06), postdischarge care visits were reduced 44% (p < 0.28), and outpatient visits were reduced 49% (p < 0.001). Quality of life was assessed using the Medical Outcomes Study 12-item Short Form health survey. The mean improvement in the mental component after 6 months in the program was 2.8, from 45.1 preprogram to 47.9 within the program (p < 0.0264). The mean improvement in the physical component after 6 months in the program was 2.1, from 41.7 preprogram to 43.8 within the program (p < 0.0518). The reductions in utilization and improvement in quality of life can likely be attributed to the patient's enhanced self-management behaviors and the nurse's ability to intervene in a timely manner when warranted. Without technology and daily remote monitoring, standard patient care is based on episodic encounters between patients and their care providers, which does not allow for prevention, education, or early intervention. This program bridged the gap between office visits for the patients. The early intervention ultimately reduced the cost of care. PMID:12685802

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

2002-01-01

28

Teledermatology: the case of adoption and diffusion of telemedicine health Waikato in New Zealand.  

PubMed

Telemedicine emerged as a possible solution to New Zealand health providers in reaching out to rural patients, by offering medical services and conducting administrative meetings and training. However, despite the rapid growth and high visibility of these projects in countries like the United States, relatively few patients are now being seen through telemedicine. Accordingly, this research attempts to investigate telemedicine's effectiveness in New Zealand by using a theoretical framework. Thus, the purpose of this paper is to explain factors influencing the adoption and diffusion of telemedicine utilising the video conferencing technology (TMVC) for dermatology within Health Waikato Ltd. (HW). Findings indicate weak presence of critical assessment into technological innovation prior to adoption. Factors like complexity, compatibility, and trialability were not assessed extensively by HW, and would have hindered its adoption. Teledermatology was mainly assessed according to its relative advantage and cost effectiveness. While essential this should be alongside other factors pertaining to as addressed within this research. On the other hand, the wide diffusion of teledermatology relied on its economical benefit to HW and on its effectiveness as a diagnostic tool. This research highlights the importance of the product champion for the successful adoption and diffusion of teledermatology. PMID:12855039

Al-Qirim, Nabeel A Y

2003-01-01

29

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

Microsoft Academic Search

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

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

1998-01-01

30

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

PubMed Central

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

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

2014-01-01

31

Applications of Telemedicine and Telecommunications to Disaster Medicine  

PubMed Central

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

Garshnek, Victoria; Burkle, Frederick M.

1999-01-01

32

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

PubMed

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

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

2014-10-27

33

Telemedicine Program  

NASA Technical Reports Server (NTRS)

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

1996-01-01

34

Telemedicine options appraisal for a health district--a strategic clinical and business case.  

PubMed

A clinical and business plan examined five areas in which telemedicine could be introduced to support the strategic objectives of a large health authority: coronary heart disease; links between community hospitals and local care centres and acute hospitals; store-and-forward consultations; care in the community; and mental health. The plan identified substantial clinical, organizational and economic potential benefits, which were greatest when a radical re-engineering of the service was envisaged. Similar studies in other health districts would help to test these conclusions and inform future health service planning. PMID:11576477

Jardine, I; Griffiths, J; Kelly, J; Navein, J

2001-01-01

35

[Telemedicine today].  

PubMed

Modern communication and information technologies are ubiquitous nowadays, and the medical field is no exception. Telemedicine is a reasonable way to prevent accidents, communicate faster in an emergency, and improve medical care in the hospital. Home aftercare benefits from this development, too; the use of networks - started by the electronic health card - can help reduce costs. This article highlights these subjects and discusses national and international structures that promote the spread of health telematics. Barriers to this path are also shown. PMID:18273587

Leis, A

2008-03-01

36

A mobile telemedicine system for remote consultation in cases of acute stroke.  

PubMed

A mobile telemedicine system, capable of transmitting video and audio simultaneously, was designed for consulting acute stroke patients remotely. It could use a wireless local area network (e.g. inside the hospital) or a mobile phone network (e.g. outside the hospital). When initiating a call, the sending unit chose a suitable encoding profile based on the measured data throughput, in order to allocate appropriate bit rates for video and audio transmission. The system was tested using a portable digital assistant (PDA) type phone and smart phone as receiving units. Video and audio recordings were made from five patients (two normal and three stroke patients) and then transmitted at different rates. Subjectively, both video and audio qualities improved as the data throughput increased. The physical findings, including facial droop, arm drift and abnormal speech, were observed remotely by four specialists according to the Cincinnati Pre-hospital Stroke Scale guideline. A comparison between the face-to-face method and the mobile telemedicine method showed that there were no discrepancies at bit rates of more than 400 kbit/s. We conclude that specialists could generally conduct remote consultations for stroke patients either using a public mobile network or a wireless LAN. PMID:19246612

Kim, Dong-Keun; Yoo, Sun K; Park, In-Cheol; Choa, Minhong; Bae, Kyoung Y; Kim, Young-Dae; Heo, Ji-Hoe

2009-01-01

37

Case Management  

Microsoft Academic Search

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

2009-01-01

38

Applications of Telemedicine and Telecommunications to Disaster Medicine  

Microsoft Academic Search

Abstract,, 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

Victoria Garshnek

39

Patient perspectives of telemedicine quality  

PubMed Central

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

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

2015-01-01

40

Perceptual Image Compression in Telemedicine  

NASA Technical Reports Server (NTRS)

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

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

1996-01-01

41

Telemedicine: challenges and opportunities  

Microsoft Academic Search

Telemedicine is many things to many people. Only until a few years ago, telemedicine was equated to video teleconferencing between physicians, while nowadays, perhaps the most active area in telemedicine is the store-and-forward model. There is a big shift from private and dedicated modes of communications to connectivity through the Internet. Presented is a collection of applications that provide snapshots

Sang-goo Lee; Seong K. Mun; Prakash Jha; Betty Ann Levine; Duk-Woo Ro

2000-01-01

42

Telemedicine by mobile communication  

Microsoft Academic Search

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

Koichi Shimizu

1999-01-01

43

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

PubMed Central

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

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

44

Using Telemedicine to Conduct Behavioral Assessments  

PubMed Central

We describe the use of telemedicine by the Biobehavioral Service at the University of Iowa Hospitals and Clinics to conduct brief functional analyses for children with developmental and behavioral disorders who live in rural areas of Iowa. Instead of being served at our outpatient facility, participants received initial behavioral assessments in their local schools or social service agencies via videoconference. Case descriptions for 2 participants whose evaluations were conducted via telemedicine, and a brief summary of all outpatient assessments conducted over a 4-year period by the Biobehavioral Service, are provided. This report extends previous applications of functional analysis procedures by examining brief behavioral assessments conducted via telemedicine. PMID:17020213

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

2006-01-01

45

Applications of telemedicine and telecommunications to disaster medicine: historical and future perspectives.  

PubMed

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

Garshnek, V; Burkle, F M

1999-01-01

46

Telemedicine in wound care.  

PubMed

Telemedical wound care is one of the applications of teledermatology. We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 x 10 cm) and one on his right leg (9 x 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via email to a wound care specialist in Mexico City. The photographs allowed the expert to diagnose and evaluate the chronic wounds periodically. In the present cases, telemedicine allowed us to have a rapid evaluation, diagnosis and treatment. The images were of enough quality to be useful and small enough to be sent via regular email to the remote physician who immediately gave his feedback. The expert was confident to give therapeutic recommendations in this way, and we considered this method to be very cost-effective, saving the patient and the health care system, especially in transportation. PMID:18808429

Chanussot-Deprez, Caroline; Contreras-Ruiz, José

2008-12-01

47

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

E-print Network

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

McSharry, Patrick E.

48

Applications of Telemedicine and Telecommunications to Disaster Medicine : Historical and Future Perspectives  

Microsoft Academic Search

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

Victoria Garshnek; FREDERICK M. BURKLE

1999-01-01

49

Security and privacy in RFID and applications in telemedicine  

Microsoft Academic Search

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

Yang Xiao; Xuemin Shen; BO Sun; Lin Cai

2006-01-01

50

"Tuberculosis Case Management" Training.  

ERIC Educational Resources Information Center

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

Knebel, Elisa; Kolodner, Jennifer

2001-01-01

51

Survey of global telemedicine  

Microsoft Academic Search

The number and scope of telemedicine projects and applications world-wide are growing rapidly along with exponential expansions in national and international information infrastructures and computer capabilities to support them. To track these rapid changes, the Center for Public Service Communications (CPSC) of Arlington, VA, developed theTelemedicine and Information Technologies in Health Care: Project Tracking Document for the National Aeronautics and

Earl W. Ferguson; Charles R. Doarn; John C. Scott

1995-01-01

52

Commercial applications of telemedicine  

NASA Technical Reports Server (NTRS)

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.

Natiello, Thomas A.

1991-01-01

53

[Reimbursement questions in telemedicine].  

PubMed

Taking professional law and rumuneration relevance into account physician services that are based on tele-medicine are not reimbursed in Germany. Both the medical fee schedule for private services and the medical fee schedule for statutory health insurance services do not allow reimbursement of tele-medicine, with the exception of simple consultation via phone. PMID:11688221

Weichmann, H

2001-10-01

54

Telemedicine infrastructure development  

Microsoft Academic Search

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

Dena S. Puskin; Jay H. Sanders

1995-01-01

55

Telemedicine: The Up Side, and . . .  

ERIC Educational Resources Information Center

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

Risser, Joseph

1998-01-01

56

Case Management Directors  

PubMed Central

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

Bankston White, Cheri; Birmingham, Jackie

2015-01-01

57

Survey of global telemedicine.  

PubMed

The number and scope of telemedicine projects and applications world-wide are growing rapidly along with exponential expansions in national and international information infrastructures and computer capabilities to support them. To track these rapid changes, the Center for Public Service Communications (CPSC) of Arlington, VA, developed the Telemedicine and Information Technologies in Health Care: Project Tracking Document for the National Aeronautics and Space Administration (NASA). This document is maintained by CPSC and frequently updated. It tracks the following areas in telemedicine and health care informatics: (1) major existing Federal grant and other assistance programs and activities; (2) legislation effecting policy in these areas; (3) projects using various technologies throughout the US; and (4) telemedicine projects/interests in other nations. This paper is a survey of international (global) telemedicine activities that are outlined in that document. PMID:7790806

Ferguson, E W; Doarn, C R; Scott, J C

1995-02-01

58

International Telemedicine/Disaster Medicine Conference: Papers and Presentations  

NASA Technical Reports Server (NTRS)

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.

1991-01-01

59

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

PubMed Central

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

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

60

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

PubMed

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

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

61

Case Management Directors  

PubMed Central

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

Bankston-White, Cheri; Birmingham, Jackie

2015-01-01

62

Telemedicine: a cautious welcome.  

PubMed Central

Telemedicine is a major new development. Having become technically and economically feasible, it deserves proper investigation. Rushing into equipment purchase, however, is almost certain to prove counterproductive. Face to face contact is fundamental to health care and enthusiasts of telemedicine should recognise that it is not as good as the real thing (and unlikely ever to be). However, constraints on time and resources will make face to face consultation increasingly expensive, and telemedicine has the potential to produce major efficiencies in the diagnostic process. The goal of current research is therefore to marry medicine with technology, capitalising on the advantages of telemedicine and producing a robust system that delivers an acceptable service at an appropriate price. Images p1375-a p1375-b p1376-a PMID:8956707

Wootton, R.

1996-01-01

63

Transfer and adoption of advanced information technology solutions in resource-poor environments: the case of telemedicine systems adoption in Ethiopia.  

PubMed

The study of the adoption of information technology (IT) by individuals has taken two approaches, one emphasizing rationalistic goal-oriented behavior and the other focusing on poignant forces that influence an individual's reaction to a new IT. These approaches are not necessarily mutually exclusive. Individuals' acceptance and subsequent usage of a new IT is predicated on both. Additionally, the tendency in past studies has been to examine either the rational or the poignant factors in the context of a "resource-rich" environment-one in which there is an abundance of IT, adequate infrastructure, and a high level of acculturation to technology solutions. Consequently, there is a clear need for the examination of these factors in resource-poor environments, where assumptions on technology abundance and technology culturation do not hold. We empirically test a model that explains the intention of physicians in a resource-poor environment (epitomized by rural Ethiopia) to adopt telemedicine systems. This model integrates the rational factors driving goal-oriented behavior with the poignant/emotive factors that are an innate part of each adopter's reaction to the new technology. We use the model to expose salient contextual factors that explain the acceptance behavior of individuals toward complex information and communications technology (ICT) solutions and implications of these on the management of technology transfer initiatives in a resource-poor environment. The model is parsimonious, yet explains 28% of the variance in the intention to adopt telemedicine systems and 58% in perceived ease of use. The theoretical and practical implications of this model are discussed. Namely, Sub-Saharan African, in general, and Ethiopian culture, in particular, plays an integral role in the adoption of ICT solutions. Organizational positions and roles among physicians, clinical professionals, and superiors stand to impact the adoption of telemedicine and other healthcare applications. Last, the degree to which users perceive that ICT is easy to use (i.e., ease of use) can be a function of technology experience and can influence perceived usefulness on behalf of users and healthcare organizations. PMID:20406120

Kifle, Mengistu; Payton, Fay Cobb; Mbarika, Victor; Meso, Peter

2010-04-01

64

Telemedicine and European law.  

PubMed

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

Callens, Stefaan

2003-01-01

65

[Telemedicine and wireless devices in heart failure].  

PubMed

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

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

2014-05-01

66

Telemedicine in Gastroenterohepatology  

PubMed Central

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

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

2014-01-01

67

Design of a centralized telemedicine model in Palestine.  

PubMed

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

Zatari, Daoud I

2002-01-01

68

Telemedicine: a new dimension in the practice of medicine.  

PubMed

Telemedicine has drawn increasing attention as one of the emerging service delivery vehicles running on the information highway. Until recently, the adoption of telemedicine has been discouraged by the cost of telecommunications and equipment and by the lack of infrastructure, standards, and evidence of cost-effectiveness and cultural acceptance. Although there have been attempts to reduce costs by making use of computer communication networks, they were technically limited by slow network speed and the lack of real-time audio/video compression technology. Ongoing technologic advances in telecommunications, imaging, multimedia computers, and information systems are making interactive telemedicine increasingly possible as high-speed video, voice, and data services are brought to large segments of the general population. The current synergy between health reform initiatives, which are redefining how health care services are accessed and delivered, and advances in technologies that support telemedicine has resulted in a proliferation of telemedicine projects. However, there is still no proof that telemedicine is necessarily cost-effective for a broad set of applications. Each prospective application requires its own business case analysis. Within the current environment, the development of a telemedicine strategy should be based on a sound knowledge of the current and future potential of telemedicine to improve health care access and quality while containing and possibly reducing health care costs. PMID:10484993

Zajtchuk, R; Gilbert, G R

1999-06-01

69

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

ERIC Educational Resources Information Center

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

Rafiq, Azhar; Merrell, Ronald C.

2005-01-01

70

Telemedicine: the slow revolution.  

PubMed

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

Moncrief, Jack W

2014-01-01

71

Telemedicine, virtual reality, and surgery  

NASA Technical Reports Server (NTRS)

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

Mccormack, Percival D.; Charles, Steve

1994-01-01

72

Current status of domestic telemedicine  

Microsoft Academic Search

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

Jim Grigsby

1995-01-01

73

Case Management: A Resource Manual.  

ERIC Educational Resources Information Center

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

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

74

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

E-print Network

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

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

2009-01-01

75

Virtual reality in telemedicine.  

PubMed

Virtual reality (VR) can be considered as the leading edge of a general evolution of present communication interfaces involving the television, computer, and telephone. The main characteristic of this evolution is the full immersion of the human sensorimotor channels into a vivid and global communication experience. Because telemedicine principally focuses on transmitting medical information, VR has the potential to enhance this function. Particularly, VR can be used in telemedicine as an advanced communication interface, which enables a more intuitive mode of interacting with information, and as a flexible environment that enhances the feeling of physical presence during the interaction. In this article, the state of the art in VR-based telemedicine applications is described. This technology is now used in remote or augmented surgery as well as surgical training, which are critically dependent on eye-hand coordination. Recently, however, different researchers have tried to use virtual environments in medical visualization and for assessment and rehabilitation in neuropsychology. This article also discusses technological, ergonomical, and human factor issues, and specific guidelines are presented for expanding the use of VR in telemedicine. PMID:11110636

Riva, G; Gamberini, L

2000-01-01

76

Telemedicine and Ophthalmology  

Microsoft Academic Search

Technology to create and move multimedia medical information is creating alternatives to physically transporting patients and health care professionals. Teletechnology is a physician extender, both supplementing and reinventing traditional health care delivery systems. The potential of comprehensive teleophthalmology is compelling. This article provides a historical perspective of telemedicine, describes various teleophthalmology systems, and surveys teleophthalmology in clinical consultation, research, and

Helen K. Li

1999-01-01

77

Telemedicine in otolaryngology  

Microsoft Academic Search

Background: Telemedicine (TM) is the use of advanced information and communication technology to provide health care services. TM in general, and specifically in the field of otolaryngology, has become a reality. Because of the improvements in telecommunications and computer technology, TM applications are becoming more common in both hospitals and private practice. These applications are altering the manner in which

David Goldenberg; Barry L. Wenig

2002-01-01

78

Telemedicine in the 'Hood.  

ERIC Educational Resources Information Center

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

Elgrably, Jordan

1998-01-01

79

Coastal Management case study  

NSDL National Science Digital Library

To prepare for the case study, lecture material on coastal landforms and processes is presented. Particular attention is paid to barrier islands, such as the Outer Banks. During the lecture, typical coastal engineering structures, such as groins, breakwaters, and jetties, are introduced. The case study is introduced with a brief overview of North Carolina's coastal management laws, Figure Eight Island's geography, and the current controversy over whether to build a terminal groin. Students are then broken down into small groups and presented with two opposing editorials. The groups are instructed to try to come to consensus as to whether the terminal groin should be allowed or disallowed or to suggest a third alternative. After approximately 25 minutes, each group informally reports out to the rest of the class.

Anne Jefferson

80

The evolution of telemedicine and nano-technology  

NASA Astrophysics Data System (ADS)

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.

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

2012-10-01

81

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

PubMed Central

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

2014-01-01

82

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

PubMed

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

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

2015-03-01

83

Telemedicine for neonatal resuscitation.  

PubMed

Maintaining high levels of readiness for neonatal resuscitation in low-risk maternity settings is challenging. The neonatal resuscitation program (NRP) algorithm is a community standard in the United States; yet training is biannual, and exposure to enough critical events to be proficient at timely implementation of the algorithm and the advanced procedures is rare. Evidence supports hands-free leadership to help prevent task saturation and communication to promote patient safety. Telemedicine for neonatal resuscitation involves the addition of remote, expert NRP leadership (a NICU-based neonatal nurse practitioner) via camera link to augment effectiveness of the low-risk birth center team. Unanticipated outcomes to report include faster times to transfer initiation and neuroprotective cooling. The positive impact of remote NRP leadership could lead to use of telemedicine to support teams at birthing centers throughout the United States as well as around the world. PMID:25161137

Scheans, Patricia

2014-01-01

84

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

PubMed Central

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

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

2014-01-01

85

Emerging Technologies for Telemedicine  

PubMed Central

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

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

2012-01-01

86

Wireless technologies for telemedicine  

Microsoft Academic Search

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

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

2006-01-01

87

Telemedicine: socio-ethical considerations in the Indian milieu.  

PubMed

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

Sharma, Luv K; Rajput, Meena

2009-01-01

88

Internet technologies and requirements for telemedicine  

NASA Technical Reports Server (NTRS)

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

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

1997-01-01

89

One hundred case studies of Asia-Pacific telemedicine using a digital video transport system over a research and education network.  

PubMed

Although the use of video in telemedicine is most helpful, the transmission of high-quality moving images is difficult in conventional systems due to the limitation of network bandwidth and the quality of service. We have established a new system via the academic broadband network that can preserve the original quality and assure smooth movement of the image. Here we report on 100 case studies and discuss the lessons we have learned. Kyushu University Hospital in Fukuoka, Japan, was linked to 53 medical institutions and meeting venues in 13 countries and regions over the Asia-Pacific Advanced Network, an international research and education consortium. The digital video transport system (DVTS), free software that transforms digital video signals directly into Internet Protocol, was installed on a personal computer (PC) with a network bandwidth of 30 Mbps per channel. Between February 2003 and June 2007, 100 telecommunication sessions were held, 94 of which were international and 6 domestic. Furthermore, 47 involved real-time demonstrations and 53 interactive teleconferences using video or PC presentations. Multiple stations were connected in 37 events, and the number of connected stations in total reached 269. The time delay was restricted to 0.3-1.0 seconds between the stations. Participants provided feedback via questionnaires, and with respect to image quality, 509 (68.3%) participants reported "very good," 206 (27.7%) reported "good," 19 (2.6%) reported "poor," and 11 (1.5%) reported "very poor." DVTS is both economical, with a minimal initial investment, and simple to set up, and this is the first time that this advanced system has been used so widely in the Asia-Pacific region. Because the high-speed academic network for research and education is available worldwide, we believe our cutting-edge technology will facilitate medical standardization beyond geographic borders in the world. PMID:19199856

Shimizu, Shuji; Nakashima, Naoki; Okamura, Koji; Tanaka, Masao

2009-01-01

90

HIV Subspecialty Care in Correctional Facilities Using Telemedicine.  

PubMed

In the United States, prisons and jails contain a population at high risk for HIV infection with a relatively large proportion known to be HIV positive. However, many incarcerated persons lack access to subspecialty HIV care due to barriers of geography and travel. Telemedicine clinics can remove these barriers, increasing access to expert, multidisciplinary care. With telemedicine, correctional facilities can provide up-to-date, evidence-based HIV management, which may lead to improved compliance, greater virologic suppression, improved CD4 T-cell counts, fewer adverse drug interactions, and decreased transmission in the community. While HIV care in prisons is an example of harnessing this technology, telemedicine can be used for the diagnosis and management of multiple acute and chronic diseases for underserved populations. PMID:25788612

Young, Jeremy D; Patel, Mahesh

2015-04-01

91

Telemedicine taxonomy: a classification tool.  

PubMed

Telemedicine allows medical doctors and specialized skilled experts to provide services to patients who are in remote locations using advanced telecommunications. This paper presents a taxonomy that systematically classifies various telemedicine efforts worldwide using five major dimensions: application purpose, application area, environmental setting, communication infrastructure, and delivery options. To identify relationships and patterns between these different dimensions telemedicine programs survey data from the Telemedicine Information Exchange (TIE) was analyzed using multiple regression and path analysis. Major findings indicate that interactive video is the most preferred modality. Store-and-forward technology is preferred for ophthalmology, radiology, and pathology. However, a negative correlation exists between store-and-forward and interactive video with mental health application. The study also indicates that the Internet is still not the dominant communications infrastructure when it comes to telemedicine. We showed that these dimensions can capture almost all efforts in telemedicine and also help program planners to understand the issues in telemedicine deployment. Our findings indicate that the taxonomy is useful for categorizing and comparing existing programs, and can be used for planning future programs. PMID:17603838

Tulu, Bengisu; Chatterjee, Samir; Maheshwari, Megha

2007-06-01

92

Health policy and case management.  

PubMed

The purpose of this article is to analyze the performance of and support for case management using a policy framework in order to increase case managers' awareness of policy making and facilitate successful planning for future policy initiatives. Feldstein's (1996) theory of opposing legislative outcomes indicates that legislation can be viewed on a continuum, ranging from legislation that meets the needs of the public to legislation considered to be in the self-interest of the participants and legislators. The current health care system requires that case managers working for publicly funded health care organizations balance the need for stewardship of U.S. tax dollars and the health care needs of consumers. It is apparent from the literature that case managers are successfully achieving this balance. However, certain conditions should exist that allow for case manager decision-making that promotes effective and efficient utilization of health care resources. Case managers must work within the context of the health care policy environment. Realizing that it is more likely that the conflicts between stewardship and the provision of health care services will continue, case managers' knowledge and influence regarding policy making becomes imperative in order to ensure that these conflicting goals do not become mutually exclusive. PMID:11398572

Mark, D D

2000-01-01

93

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

E-print Network

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

McSharry, Patrick E.

94

Towards technical interoperability in telemedicine.  

SciTech Connect

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

Craft, Richard Layne, II

2004-05-01

95

Successes and Challenges in the Implementation and Application of Telemedicine in the Eastern Province of Saudi Arabia  

PubMed Central

Telemedicine is the practice of healthcare using audio, video, and data communications. The aim of this study was to determine the perceptions of health professionals at hospitals adopting and not adopting telemedicine on its benefits and challenges, and their willingness to use it. The study was conducted at one hospital not adopting telemedicine and three hospitals adopting telemedicine. It was a cross-sectional descriptive study, and the target population was health professionals. Data collection methods included two paper-based questionnaires. Nonparametric statistical analysis and descriptive statistics were used. The study concluded that although telemedicine is promising and the Ministry of Health in Saudi Arabia has allocated a huge budget for e-health, the telemedicine modalities used were very limited. The percentage of adoption of telemedicine by health professionals was low in comparison to the high interest of nonadopters. Nonadopters’ perception of benefits was higher than that of adopters. The most frequently cited benefits among adopters were improving the quality of care, enhancing access to healthcare, and providing patient care and management. However, adopters’ perceptions were low for other benefits such as easy use of the network, the use of store-and-forward telemedicine, and the ability to follow up after face-to-face contacts. The greatest barrier as perceived by health providers was the lack of knowledge about telemedicine. Dissemination of information about telemedicine and proper training of health professionals on its use are recommended. PMID:23209455

El-Mahalli, Azza Ali; El-khafif, Sahar Hafez; Al-Qahtani, Mona Faisal

2012-01-01

96

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

PubMed

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

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

2009-01-01

97

Interplay of cost and adoption of tele-medicine in Sub-Saharan Africa: The case of tele-cardiology in Ethiopia  

Microsoft Academic Search

...the barriers to diffusion of Tele-Medicine are not entirely technical. Cost has to simultaneously satisfy a number of stakeholders...\\u000a (Anderson, Aydin and Jay, et al., 1994).\\u000a \\u000a Rising costs of the provision of healthcare have been a major issue for debate in both developing and developed countries.\\u000a This is especially true of very capitalistic societies such as the United States where

Mengistu Kifle; Victor Wacham A. Mbarika; Pratim Datta

2006-01-01

98

Effects and Effectiveness of Telemedicine  

PubMed Central

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

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

1995-01-01

99

New technology applied to telemedicine  

NASA Technical Reports Server (NTRS)

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

Miller, Edward F.

1991-01-01

100

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

NASA Technical Reports Server (NTRS)

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.

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

101

Evaluation of a Telemedicine System for Supporting Thyroid Disease Diagnosis  

Microsoft Academic Search

A telemedicine system connecting Japan and Belarus via a communication satellite and the international ISDN has been in use since February, 1999. Two relational databases, which are essentially the same, are set respectively at Nagasaki University School of Medicine and Gomel Regional Specialized Dispensary in Belarus for management of patients' data and for research including epidemiologic studies. The thyroid ultrasonographic

Ken-ichi Yokota; Noboru Takamura; Yoshisada Shibata; Shunichi Yamashita; Mariko Mine; Masao Tomonaga

102

Valuation of Online Continuing Medical Education and Telemedicine in Taiwan  

ERIC Educational Resources Information Center

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

Wang, Fuhmei

2008-01-01

103

Rural telemedicine project in northern New Mexico  

SciTech Connect

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

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

1998-12-31

104

Four years of experience of telemedicine for paediatric care in three Punjab hospitals, North India: achievements and lessons.  

PubMed

Children in India constitute a very high risk group from mortality and morbidity due to lack of specialised healthcare. Remote care of paediatric patients by offsite specialists using telemedicine technology is a highly potential solution for coping up with the shortage of specialists in Indian subcontinent. We at a tertiary care teaching hospital in North India assessed the application of telemedicine services for diagnosis and management of paediatric illnesses, through prospective analyses of electronic databases over 4 years. The age groups covered were from newborn up to children of 15 years of age. The outcomes assessed were: feasibility, diagnostic possibilities, management, outcomes, referral and mean costs per patient. The results were as follows: major consultations involved children <5 years age, with neonates contributing to 5.5% of the total consultations. The major system-related problems were: gastrointestinal, respiratory, neurological, infectious and haematological. Referral was advised in 14.3% of cases. Ten percent of children were critically ill and could not have been in a position to be transported safely. Videoconferencing was done in 21.4% patients. There was a paucity of feedback and follow up of these consultations (12% of the total). The total savings for all the consultations per child was ?1000 Indian rupees (approximately US$22) leaving behind the telemedicine consultation charges. To conclude, telepaediatrics in India is still in its fetal stage. The hurdles and medico-legal issues need to be addressed before the telepaediatrics service is widely accepted in India. PMID:20870650

Singh, Meenu; Das, Rashmi Ranjan

2010-12-01

105

Paediatric cardiac telemedicine--transmitting echocardiography images in Wales.  

PubMed

We started a telemedicine service for paediatric cardiology work in 2006, enabling transmission of echocardiography images via videoconferencing equipment to the specialist paediatric cardiac department at Cardiff for review and/or diagnosis. The system has been used regularly for a range of paediatric cardiology cases. Despite increasing the transmission bandwidth to 1 Mbit/s the transmission of live echocardiography was still considered to be suboptimum. Nonetheless, the implementation of a simple telemedicine service has demonstrated the feasibility of transmitting echocardiography images via videoconferencing equipment for diagnosis and second opinions. PMID:20511574

Lewis, Delyth; Morris, Sheryl; Uzun, Orhan; Tranter, Glynis

2010-01-01

106

Chapter 1 Introduction 1.1 Telemedicine  

E-print Network

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

Qi, Xiaojun

107

Telemedicine effects: Cost, quality, and access  

Microsoft Academic Search

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

Rashid L. Bashshur

1995-01-01

108

Opportunities and challenges to telemedicine in rural America  

Microsoft Academic Search

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

Dena S. Puskin

1995-01-01

109

Current Perception of Telemedicine in an EU Country  

PubMed Central

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

POENARU, Calin; POENARU, Elena; VINEREANU, Dragos

2014-01-01

110

The business of telemedicine: strategy primer.  

PubMed

There is some tacit understanding that telemedicine can provide cost efficiency along with increased access and equality of care for the geographically disadvantaged. However, concrete strategic guidance for healthcare organizations to attain these benefits is fragmented and limited in existing literature. Telemedicine programs need to move from a grant-funded to a profit-centered status to sustain their existence. This article extends work presented at a recent American Telemedicine Association Business and Finance Special Interest Group course to provide a conceptual framework for strategic planning and for effectively implementing telemedicine programs. An expert panel of telemedicine coordinators provides insight and recommendations. PMID:20925561

LeRouge, Cynthia; Tulu, Bengisu; Forducey, Pamela

2010-10-01

111

A Computational framework for telemedicine.  

SciTech Connect

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

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

1998-07-01

112

Secure mobile agent for telemedicine based on P2P networks.  

PubMed

Exploring intelligent mobile agent (MA) technology for assisting medical services or transmitting personal patient-health information in telemedicine applications has been widely investigated. Conversely, peer-to-peer (P2P) networking has become one of the most popular applications used in the Internet because of its benefits for easy-to-manage resources and because it balances workloads. Therefore, constructing an agent-based telemedicine platform based on P2P networking architecture is necessary. The main purpose of this paper is to construct a safe agent-based telemedicine that based on P2P networking architecture. Two themes are addressed in this paper: (a) the P2P network architecture for an agent-based telemedicine service, and (b) the security mechanisms for the proposed telemedicine networking architecture. When an MA contains patient information and migrates from one host to another through the Internet, it can be attacked by other software agents or agent platforms that can illegally access patient information. The proposed P2P network architecture is based on the JXTA protocol and provides two types of telemedicine service models: the predictable service model and unpredictable service model. This architecture employs a two-layer safety mechanism for MAs (i.e., time-limited black boxes and RSA undetachable signature technologies), to provide a secure solution for agent-based telemedicine services. PMID:23605144

Hsu, Wen-Shin; Pan, Jiann-I

2013-06-01

113

Telemedicine in neurosurgical emergency: Indian perspective.  

PubMed

Telemedicine is rapidly developing telecommunication technology to provide medical information and services. The importance of telemedicine for neurosurgical emergencies was established with the fact that majority of the neurosurgical specialists are practicing in urban settings and in most of the rural areas, neurosurgical care is far off or non-existing. Countries with inadequate health care must incorporate telemedicine in their health care system. Telemedicine offers real benefits in a country as vast as India, where the majority of the population lives in remote areas with no access to even the most basic healthcare. Issues pertaining security, privacy, maintaining standards, and legal aspects are relevant. A recommended set of standards and guidelines for telemedicine needs to be set in place and constantly refined to promote the integrated growth of telemedicine in the country. The paper discusses various issues, shortcomings, and utility of telemedicine in India. PMID:22870155

Sinha, Virendra Deo; Tiwari, Rahul Nath; Kataria, Rashim

2012-04-01

114

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

PubMed

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

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

2014-10-01

115

Implementation of m-health applications in Botswana: telemedicine and education on mobile devices in a low resource setting.  

PubMed

Although Botswana has recently been categorised as an upper middle income country, it is burdened by a scarcity of resources, both human and technological. There are barriers to patients' access to specialized care and healthcare providers' access to medical knowledge. Over the past three years, the Botswana-University of Pennsylvania Partnership (BUP) has piloted four mobile telemedicine projects in the specialties of women's health (cervical cancer screening utilizing visual inspection with acetic acid), radiology, oral medicine and dermatology. Mobile telemedicine has been used in 11 locations in Botswana, training a total of 24 clinicians and successfully contributing to the management of 643 cases. In addition to mobile telemedicine, BUP has initiated an m-learning programme with the University of Botswana School of Medicine. While successfully providing patients and providers with improved access to healthcare resources, the m-health projects have faced numerous technical and social challenges. These include malfunctioning mobile devices, unreliable IT infrastructure, accidental damage to mobile devices, and cultural misalignment between IT and healthcare providers. BUP has worked with its local partners to develop solutions to these problems. To ensure sustainability, m-health programmes must have strategic goals that are aligned with those of the national health and education system, and the initiatives must be owned and led by local stakeholders. Whenever possible, open source technology and local IT expertise and infrastructure should be employed. PMID:23454821

Littman-Quinn, Ryan; Mibenge, Chikoti; Antwi, Cynthia; Chandra, Amit; Kovarik, Carrie L

2013-02-01

116

Multimedia systems for telemedicine and their communications requirements  

Microsoft Academic Search

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

Yongmin Kim

1996-01-01

117

Clinical aspects of telemedicine  

NASA Technical Reports Server (NTRS)

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

Merrell, Ronald C.

1991-01-01

118

Telemedicine in the Federated States of Micronesia.  

PubMed

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

Rutstein, D

2000-09-01

119

The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.  

PubMed

A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff. PMID:16205207

Hogan, Tierney D

2005-01-01

120

Arizona TeleMedicine Project.  

ERIC Educational Resources Information Center

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

Arizona Univ., Tucson. Coll. of Medicine.

121

Deploying a Rural Wireless Telemedicine  

E-print Network

Deploying a Rural Wireless Telemedicine System: Experiences in Sustainability S ince the end emerged including the World Bank and many regional and national development programs. A primary concern in rural india uses long-distance Wi-fi networking to enable high-quality videoconferencing between eye

Sanders, Seth

122

Evaluation of a telemedicine system for supporting thyroid disease diagnosis.  

PubMed

A telemedicine system connecting Japan and Belarus via a communication satellite and the international ISDN has been in use since February, 1999. Two relational databases, which are essentially the same, are set respectively at Nagasaki University School of Medicine and Gomel Regional Specialized Dispensary in Belarus for management of patients' data and for research including epidemiologic studies. The thyroid ultrasonographic images, microscopic images of cytological findings and other information on patients are sent from Gomel to Nagasaki once a week with diagnoses and comments by physicians at Gomel Regional Specialized Dispensary for cases whom they found difficult to diagnose. Thyroid specialists at Nagasaki University School of Medicine correct the diagnoses, if necessary, on the basis of information from Gomel and send their comments and instructions to Gomel for improving diagnosis skills of physicians at Gomel. The findings of 330 cases have been sent from Gomel to Nagasaki by September, 2000 since the commencement of the system in February, 1999. Of the 329 cases, thyroid diagnosis was made at Gomel for 261 cases in whom two or more diagnoses were made for 35 cases. As of the end of October, 2000, the Gomel diagnoses have been reviewed for 217 cases and the remaining 112 cases are under review at Gomel. The diagnoses made at Gomel and Nagasaki were in agreement for 110 (50.7%) of 217 cases. Thyroid cancer was diagnosed in 8 cases in whom 6 had been diagnosed at Gomel while the other 2 were diagnosed anew at Nagasaki. The usefulness of the system for improving thyroid diagnosis in Belarus was indicated. PMID:11604859

Yokota, K; Takamura, N; Shibata, Y; Yamashita, S; Mine, M; Tomonaga, M

2001-01-01

123

77 FR 27015 - Distance Learning and Telemedicine Grant Program  

Federal Register 2010, 2011, 2012, 2013, 2014

...AGRICULTURE Rural Utilities Service Distance Learning and Telemedicine Grant Program AGENCY...of Funding for FY 2012 of the Distance Learning and Telemedicine Grant Program...Fiscal Year 2012 awards for its Distance Learning and Telemedicine (DLT) Grant...

2012-05-08

124

NASA's telemedicine testbeds: Commercial benefit  

NASA Astrophysics Data System (ADS)

The National Aeronautics and Space Administration (NASA) has been developing and applying telemedicine to support space flight since the Agency's beginning. Telemetry of physiological parameters from spacecraft to ground controllers is critical to assess the health status of humans in extreme and remote environments. Requisite systems to support medical care and maintain readiness will evolve as mission duration and complexity increase. Developing appropriate protocols and procedures to support multinational, multicultural missions is a key objective of this activity. NASA has created an Agency-wide strategic plan that focuses on the development and integration of technology into the health care delivery systems for space flight to meet these challenges. In order to evaluate technology and systems that can enhance inflight medical care and medical education, NASA has established and conducted several testbeds. Additionally, in June of 1997, NASA established a Commercial Space Center (CSC) for Medical Informatics and Technology Applications at Yale University School of Medicine. These testbeds and the CSC foster the leveraging of technology and resources between government, academia and industry to enhance health care. This commercial endeavor will influence both the delivery of health care in space and on the ground. To date, NASA's activities in telemedicine have provided new ideas in the application of telecommunications and information systems to health care. NASA's Spacebridge to Russia, an Internet-based telemedicine testbed, is one example of how telemedicine and medical education can be conducted using the Internet and its associated tools. Other NASA activities, including the development of a portable telemedicine workstation, which has been demonstrated on the Crow Indian Reservation and in the Texas Prison System, show promise in serving as significant adjuncts to the delivery of health care. As NASA continues to meet the challenges of space flight, the technologies adapted to support humans in extreme and remote environments, and the resultant protocols and procedures will further evolve the commercial practice of medicine and thereby enhance life on Earth.

Doarn, Charles R.; Whitten, Raymond

1998-01-01

125

Feasibility of telemedicine in detecting diabetic retinopathy and age-related macular degeneration.  

PubMed

Abstract Age-related macular degeneration and diabetic retinopathy are important causes of visual impairment and blindness in the world. Because of recent advances and newly available treatment modalities along with the devastating consequences associated with late stages of these diseases, much attention has been paid to the importance of early detection and improving patient access to specialist care. Telemedicine or, more specifically, digital retinal imaging utilizing telemedical technology has been proposed as an important alternative screening and management strategy to help meet this demand. In this paper, we perform a literature review and analysis that evaluates the validity and feasibility of telemedicine in detecting diabetic retinopathy and age-related macular degeneration. Understanding both the progress and barriers to progress that have been demonstrated in these two areas is important for future telemedicine research projects and innovations in telemedicine technology. PMID:24171781

Vaziri, Kamyar; Moshfeghi, Darius M; Moshfeghi, Andrew A

2015-03-01

126

Web-based home telemedicine system for orthopedics  

NASA Astrophysics Data System (ADS)

Traditionally, telemedicine systems have been designed to improve access to care by allowing physicians to consult a specialist about a case without sending the patient to another location, which may be difficult or time-consuming to reach. The cost of the equipment and network bandwidth needed for this consultation has restricted telemedicine use to contact between physicians instead of between patients and physicians. Recently, however, the wide availability of Internet connectivity and client and server software for e- mail, world wide web, and conferencing has made low-cost telemedicine applications feasible. In this work, we present a web-based system for asynchronous multimedia messaging between shoulder replacement surgery patients at home and their surgeons. A web browser plug-in was developed to simplify the process of capturing video and transferring it to a web site. The video capture plug-in can be used as a template to construct a plug-in that captures and transfers any type of data to a web server. For example, readings from home biosensor instruments (e.g., blood glucose meters and spirometers) that can be connected to a computing platform can be transferred to a home telemedicine web site. Both patients and doctors can access this web site to monitor progress longitudinally. The system has been tested with 3 subjects for the past 7 weeks, and we plan to continue testing in the foreseeable future.

Lau, Christopher; Churchill, Sean; Kim, Janice; Matsen, Frederick A., III; Kim, Yongmin

2001-05-01

127

Disaster case management and individuals with disabilities  

E-print Network

recovery needs of individuals with disabilities following Hurricane Katrina. The case managers and supervisors in this study provided case management to individuals with disabilities as part of the largest coordinated disaster case management program in U....S. history, the Katrina Aid Today consortium. This study provides an account of the disaster case management needs of individuals with disabilities as well as a picture of their long-term recovery process two years following the disaster. Design: Forty...

Stough, Laura

2010-01-01

128

Iowa Case Management: Innovative Social Casework.  

ERIC Educational Resources Information Center

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)

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

2002-01-01

129

Case Management: Let Us Count the Ways.  

ERIC Educational Resources Information Center

Case management as implemented in programs for the elderly, has focused on interactions between the client and case manager in the areas of assessment, care planning, service plan implementation, and follow-up. Variation in these case management tasks suggests that no single model can be implemented in all local delivery systems. This emphasis on…

Austin, Carol D.

130

A review of telemedicine business models.  

PubMed

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

Chen, Shengnan; Cheng, Alice; Mehta, Khanjan

2013-04-01

131

The effectiveness of telemedicine for paediatric retrieval consultations: rationale and study design for a pragmatic multicentre randomised controlled trial.  

PubMed

BackgroundIn many health systems, specialist services for critically ill children are typically regionalised or centralised. Studies have shown that high-risk paediatric patients have improved survival when managed in specialist centres and that volume of cases is a predictor of care quality. In acute cases where distance and time impede access to specialist care, clinical advice may be provided remotely by telephone. Emergency retrieval services, attended by medical and nursing staff may be used to transport patients to specialist centres. Even with the best quality retrieval services, stabilisation of the patient and transport logistics may delay evacuation to definitive care. Several studies have examined the use of telemedicine for providing specialist consultations for critically ill children. However, no studies have yet formally examined the clinical effectiveness and economic implications of using telemedicine in the context of paediatric patient retrieval.Methods/DesignThe study is a pragmatic, multicentre randomised controlled trial running over 24 months which will compare the use of telemedicine with the use of the telephone for paediatric retrieval consultations between four referring hospitals and a tertiary paediatric intensive care unit. We aim to recruit 160 children for whom a specialist retrieval consultation is required. The primary outcome measure is stabilisation time (time spent on site at the referring hospital by the retrieval team) adjusted for initial risk. Secondary outcome measures are change in patient¿s physiological status (repeated measure, two time points) scored using the Children¿s Emergency Warning Tool; change in diagnosis (repeated measure taken at three time points); change in destination of retrieved patients at the tertiary hospital (general ward or paediatric intensive care unit); retrieval decision, and length of stay in the Paediatric Intensive Care Unit for retrieved patients. The trial has been approved by the Human Research Ethics Committees of Children¿s Health Services Queensland and The University of Queensland, Australia.DiscussionHealth services are adopting telemedicine, however formal evidence to support its use in paediatric acute care is limited. Generalisable evidence is required to inform clinical use and health system policy relating to the effectiveness and economic implications of the use in telemedicine in paediatric retrieval.Trial registrationAustralian and New Zealand Clinical Trials Registry ACTRN12612000156886. PMID:25381774

Armfield, Nigel R; Coulthard, Mark G; Slater, Anthony; McEniery, Julie; Elcock, Mark; Ware, Robert S; Scuffham, Paul A; Bensink, Mark E; Smith, Anthony C

2014-11-11

132

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

PubMed

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

Pérez-Manchón, David

2015-01-01

133

"Initiate-build-operate-transfer"--a strategy for establishing sustainable telemedicine programs in developing countries: initial lessons from the balkans.  

PubMed

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in Kosova has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in the Balkans. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy, "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services in developing countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs, was discussed. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the healthcare infrastructure. The endpoint is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program will be transitioned to the national Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Albania, Macedonia, and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries. PMID:19832055

Latifi, Rifat; Merrell, Ronald C; Doarn, Charles R; Hadeed, George J; Bekteshi, Flamur; Lecaj, Ismet; Boucha, Kathe; Hajdari, Fatmir; Hoxha, Astrit; Koshi, Dashurije; de Leonni Stanonik, Mateja; Berisha, Blerim; Novoberdaliu, Kadri; Imeri, Arben; Weinstein, Ronald S

2009-12-01

134

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

PubMed Central

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

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

2014-01-01

135

Case Studies for Management Development in Bangladesh.  

ERIC Educational Resources Information Center

Eight case studies appropriate for use in a course in management development were prepared and are provided in this document. 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. Questions for…

McLean, Gary N.

136

Telemedicine: Its Effects on Health Communication  

Microsoft Academic Search

This article analyzes telemedicine, the use of distant communication technologies within the context of clinical health care, and the effects it has on health communication. The main effect is that telemedicine has the capacity to substantially transform health care in both positive and negative ways and to radically modify personal face-to-face communication (Turner, 2003). This has tremendous implications for health

Jonathan Matusitz; Gerald-Mark Breen

2007-01-01

137

Telemedicine: Health Care for Isolated Areas.  

ERIC Educational Resources Information Center

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

Development Communication Report, 1977

1977-01-01

138

Telemedicine evaluation of cutaneous diseases: A blinded comparative study  

Microsoft Academic Search

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

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

1998-01-01

139

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

PubMed Central

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

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

2015-01-01

140

[The case manager, a geriatrics healthcare coordinator].  

PubMed

The case manager mobilises the resources available within a geographic sector determined by the Centre for the autonomy and integration of Alzheimer's patients in order to respond to complex cases of elderly patient care. PMID:23951867

Dauriac, Christine

2013-01-01

141

Telemedicine for Epilepsy Support in Resource-Poor Settings  

PubMed Central

The Problem: Epilepsy is a common disease worldwide causing significant physical and social disability. It is one of the most treatable neurological diseases. Yet, in rural, poorer countries like much of India and Nepal, most people with epilepsy are not undergoing any treatment often because they cannot access doctors. Conventional Approaches: It is being appreciated that perhaps doctors are not the solution and that enabling health workers to treat epilepsy may be better. Few details, however, have been put forward about how that might be achieved. Thinking Differently: Untreated epilepsy should be considered a public health problem like HIV/AIDS, the various steps needed for treatment identified and solutions found. Telemedicine Approaches: Telemedicine might contribute to two steps – diagnosis and review. A tool that enables non-doctors to diagnose episodes as epileptic has been developed as a mobile phone app and has good applicability, sensitivity, and specificity for the diagnosis. There are a number of ways in which the use of phone review or short messaging service can improve management. Conclusion: Telemedicine, as part of a public health program, can potentially help the millions of people in the resource-poor world with untreated epilepsy. PMID:25191650

Patterson, Victor

2014-01-01

142

Case Study -- Improving Management Performance  

ERIC Educational Resources Information Center

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

Stait, Norman

1970-01-01

143

Case Studies in Middle Management Supervision  

ERIC Educational Resources Information Center

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

White, Lori S.

2011-01-01

144

Iowa Case Management for Rural Drug Abuse  

ERIC Educational Resources Information Center

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

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

2009-01-01

145

Advanced telemedicine development  

SciTech Connect

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

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

1998-12-31

146

Telemedicine in Iran: Chances and Challenges  

PubMed Central

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

Salehahmadi, Zeinab; Hajialiasghari, Fatemeh

2013-01-01

147

Enhancing trauma education worldwide through telemedicine  

PubMed Central

Advances in information and communication technologies are changing the delivery of trauma care and education. Telemedicine is a tool that can be used to deliver expert trauma care and education anywhere in the world. Trauma is a rapidly-evolving field requiring access to readily available sources of information. Through videoconferencing, physicians can participate in continuing education activities such as Grand Rounds, seminars, conferences and journal clubs. Exemplary programs have shown promising outcomes of teleconferences such as enhanced learning, professional collaborations, and networking. This review introduces the concept of telemedicine for trauma education, and highlights efforts of programs that are utilizing telemedicine to unite institutions across the world. PMID:23531408

2012-01-01

148

Enhancing trauma education worldwide through telemedicine.  

PubMed

Advances in information and communication technologies are changing the delivery of trauma care and education. Telemedicine is a tool that can be used to deliver expert trauma care and education anywhere in the world. Trauma is a rapidly-evolving field requiring access to readily available sources of information. Through videoconferencing, physicians can participate in continuing education activities such as Grand Rounds, seminars, conferences and journal clubs. Exemplary programs have shown promising outcomes of teleconferences such as enhanced learning, professional collaborations, and networking. This review introduces the concept of telemedicine for trauma education, and highlights efforts of programs that are utilizing telemedicine to unite institutions across the world. PMID:23531408

Marttos, Antonio C; Kuchkarian, Fernanda M; Abreu-Reis, Phillipe; Pereira, Bruno Mt; Collet-Silva, Francisco S; Fraga, Gustavo P

2012-08-22

149

The evidence base for case management practice.  

PubMed

Little is known about the role performance of case managers, who come from a variety of professional disciplines. The purpose of this secondary analysis is to identify and compare case management (CM) activities and knowledge elements by professions and by work settings. In an online field survey conducted by the Commission for Case Manager Certification in 2004, 4,419 case managers rated the frequency and importance of 103 activities (8 domains) and 64 knowledge statements (6 domains). Nursing and social work showed a relatively similar pattern as to their role activities and knowledge factors for CM practice. Similar patterns were seen in work settings: between hospitals and rehabilitation facilities; health insurance companies and managed care organizations; and CM companies, workers' compensation agencies, and third-party administrators. These results indicate that there is evidence for how to develop CM programs consistent with both organizational characteristics and strengths of the nursing profession. PMID:19349615

Park, Eun-Jun; Huber, Diane L; Tahan, Hussein A

2009-10-01

150

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

PubMed Central

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

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

2014-01-01

151

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

PubMed Central

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

Ajami, Sima; Arzani-Birgani, Arezo

2014-01-01

152

Towards grid-enabled telemedicine in Africa  

E-print Network

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

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

2006-01-01

153

Virtual doctor's office telemedicine delivery system  

E-print Network

delivery services that are two-way telecommunications using a File Transfer Protocol over an Ethernet connection. The system is used to demonstrate effective telemedicine delivery to enable tele-consultation. Virtual instruments are developed for both ends...

Sainath, Paavana

2002-01-01

154

The telemedicine information exchange: an online resource.  

PubMed

Telemedicine is the use of telecommunications to provide health care services at a distance. It has grown from mostly government-subsidized research initiatives into a fledgling industry. This growth was fueled by decreasing costs of telecommunications and information technologies and fanned by rising health care costs. The telemedicine information exchange (TIE) (http:(/)/tie.telemed.org), developed by the Telemedicine Research Center in Portland, OR, is both a product and a vehicle of this rapid growth. It facilitates collection of telemedicine information from many sources, providing an easy-to-use hypertext format. This article describes the TIE's development, advantages and disadvantages of a web-based online library, and it's codevelopment with a rapidly expanding industry. PMID:9861508

Brown, N A

1998-09-01

155

San Diego ED leverages telemedicine in a bid to ease crowding, long wait times.  

PubMed

In a study dubbed Emergency Department Telemedicine Initiative to Rapidly Accommodate in Times of Emergency (EDTITRATE), investigators at the University of California San Diego Health System are gauging whether remote physicians can be quickly and cost-effectively mobilized to evaluate patients when the ED is busy. While there have been administrative hurdles involved with implementing the approach, investigators say the strategy could offer big savings in terms of time and efficiency. Onsite nurses facilitate telemedicine encounters, utilizing technology that enables remote physicians to evaluate patients. While both patients and providers give the telemedicine encounters high marks, managing the workflow is challenging. Investigators say the approach could produce significant gains in efficiency, including the possibility that a single on-call physician could remotely treat patients from multiple ED sites. PMID:23923522

2013-08-01

156

Patient confidentiality, ethics and licensing in telemedicine.  

PubMed

Telemedicine is fast becoming popular in many countries in the world. It has several advantages such as being cost saving and providing better access to health care in the remote areas in many parts of the world. However, it has some disadvantages as well. One of the major problems is the problem of patients' rights and confidentiality in the use of telemedicine. There are no standard guidelines and procedures in the practice of telemedicine as yet. Both the patient and the physician are unsure of the standard of practice and how to maintain confidentiality. The patient is uncertain as to how to protect her/his rights in the use of telemedicine. The issue of litigation is also unclear as to where the physician is practicing when he/she uses telemedicine. Is she/he practicing in the country where the patient is or is the physician practicing in the country of her/his origin? These issues need to be addressed urgently so that telemedicine will have standards of ethical practice and the patient's rights and confidentiality will be protected. PMID:12109246

Yadav, H; Lin, W Y

2001-01-01

157

[Current capabilities of telemedicine in anaesthesiology].  

PubMed

Because of an ageing population and a relative lack of professionals, the German health system is under great pressure. In rural regions in particular, anesthesiology is also affected - nursing staff, anesthetists, intensive care physicians, and emergency physicians often have to be supported by freelancers from other regions and from abroad - at least periodically. In addition to the increasing number of treatments, the potential quality of therapy is also increasing owing to progress in medical research. Against this background the need for resources is increasing to ensure the optimal quality of treatment. This applies to all clinical disciplines, including all sections of anesthesiology - especially in economically underdeveloped regions where highly qualified experts are lacking. In various cases it is not the physical attendance or manual skills of experts that is primarily requested on-site, but rather their medical expertise and experience. Therefore, telemedicine systems are suitable for closing these gaps very effectively and efficiently. In the various anesthesiological sub-sections the number of scientific papers published to date varies. For anesthesia and pain therapy only a few telemedical applications or concepts have been reported in the literature. However, in tele-intensive care medicine and tele-emergency medicine several national and international research projects have successfully been carried out, leading to established routine systems in some cases. PMID:25772604

Czaplik, M; Brokmann, J; Hochhausen, N; Beckers, S K; Rossaint, R

2015-03-01

158

Multimedia case management system implemented in Java  

NASA Astrophysics Data System (ADS)

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

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

1999-01-01

159

The last challenges and barriers to the development of telemedicine programs.  

PubMed

Over the past several decades the concept of telemedicine has evolved to be more commonplace with many unique applications. These applications have been made possible by overcoming challenges and barriers that have been present for most of telemedicine's development. The application of telemedicine continues to undergo growth and scrutiny. However, the rapid infusion of technology continues to serve as a catalyst for adoption and validation. Looking into the future requires a review of the past. Overcoming barriers and challenges has not been easy. Many have been minimized, in part because of technologies rapid flow and diffusion. Yet there are still significant challenges that must be overcome. In many parts of the world, healthcare and education are limited because of access. This has been driven by many influences, which continue to have an impact, albeit in many cases, minimal. Future generations of telemedicine users will look back at this period as one of transition. The first 30 years or so of telemedicine implementation were fraught with barriers and challenges. The next 30 years will see and entirely different paradigm of practicing medicine, including consumerism and smart systems. PMID:18305322

Doarn, Charles R

2008-01-01

160

34 CFR 303.23 - Service coordination (case management).  

Code of Federal Regulations, 2010 CFR

...Service coordination (case management). 303.23 Section 303...Service coordination (case management). (a) General. ...g), have demonstrated knowledge and understanding about...makes reference to “case management” services. See...

2010-07-01

161

Vendor managed inventory model: a case study  

Microsoft Academic Search

This paper describes with the help of a case study how vendor managed inventory (VMI) model managers in real time the dynamic needs of supply chain process. Throughout the supply chain, VMI model is a way to cut inventory related costs and keep inventory levels low. VMI model helps companies to reduce the inventory-associated costs by shifting the responsibility of

Malla Reddy; Prem Vrat

2007-01-01

162

Telemedicine in wound care: a review.  

PubMed

Telemedicine (TM) is a new, rapidly evolving area and can be of great value in the provision of healthcare to remote and rural populations. Wound healing and wound management are prime candidates for TM. The treatment of skin ulcers requires frequent assessments of local wound status and adjustment of therapy. The availability of reasonably priced photographic equipment and quick electronic transfer of high-quality digital images should make the assessment of wound status by remote experts possible. Several studies showing the feasibility and the usefulness of teleconsultations in dermatology have already been described in the literature, and high accordance for diagnosis and treatment between face-to-face visits and teleconsultations has been reported. Some used digital photographs and sent the image and clinical data via the Internet to a wound care specialist (store and forward), whereas others used a webcam (televideoconferencing). Tele-wound care offers great potential for the future in chronic wound care. By reducing the need to travel long distances to the hospital or to consult with a physician, TM decreases the costs and improves the quality of life for patients with chronic wounds, while still maintaining high standards of wound care. The intent of TM is to reduce, in a clinically equivalent way, the number of visits to a specialized clinic, but not necessarily to eliminate all visits. Further well-designed research is necessary to understand how best to deploy TM services in healthcare. PMID:23337648

Chanussot-Deprez, Caroline; Contreras-Ruiz, José

2013-02-01

163

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems  

E-print Network

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems Dimitrios I. Kosmopoulos dkosmo Force Hospital 11525 Athens, Greece Abstract The timely diagnosis and treatment of pressure ulcers for automated pressure ulcer stage classification can be integrated into an asynchronous telemedicine system

Kosmopoulos, Dimitrios I.

164

Knowledge management enablers: a case study  

Microsoft Academic Search

Purpose – To analyze the crucial role that enablers play in carrying out knowledge management within the enterprise. Design\\/methodology\\/approach – This research uses the method of a case study and has directed the survey on Advanced Semiconductor Engineering, Inc. (ASE) and VIA Technologies, Inc. (VIA). It is anticipated through the case study of these two companies that it will be

Ying-jung Yeh; Sun-quae Lai; Chin-tsang Ho

2006-01-01

165

Primary care case management: lessons for Medicare?  

PubMed

This paper looks at primary care case management (PCCM) as a tool that states have used to manage the delivery of care to their Medicaid populations, an alternative to contracting with commercial managed care plans. PCCM has proved a flexible means of advancing state policy goals, including quality improvement, disease management, and coverage of special-needs populations. The paper considers provider and beneficiary perspectives on PCCM as well as state agency objectives and accomplishments. Finally, it raises the question of adapting the PCCM model for Medicare. Speakers at the accompanying Forum session will expand on these topics. PMID:11800002

Sprague, L

2001-10-01

166

Telemedicine in India: current scenario and the future.  

PubMed

India, with its diverse landmass and huge population, is an ideal setting for telemedicine. Telemedicine activities were started in 1999. The Indian Space Research Organization has been deploying a SATCOM-based telemedicine network across the country since that year. Various government agencies-Department of Information Technology and Ministry of Health & Family Welfare, state governments, premier medical and technical institutions of India-have taken initiatives with the aim to provide quality healthcare facilities to the rural and remote parts of the country. The Government of India has planned and implemented various national-level projects and also extended telemedicine services to South Asian and African countries. Efforts are taking place in the field of medical e-learning by establishing digital medical libraries. Some institutions that are actively involved in telemedicine activities have started curriculum and noncurriculum telemedicine training programs. To support telemedicine activities within the country, the Department of Information Technology has defined the Standards for Telemedicine Systems and the Ministry of Health & Family Welfare has constituted the National Telemedicine Task Force. There are various government and private telemedicine solution providers and a few societies and associations actively engaged to create awareness about telemedicine within the country. With its large medical and IT manpower and expertise in these areas, India holds great promise and has emerged as a leader in the field of telemedicine. PMID:19659413

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

2009-01-01

167

Telemedicine in the context of the National Broadband Network  

E-print Network

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

Heiser, Gernot

168

Robust tissue classification for reproducible wound assessment in telemedicine environments  

E-print Network

Robust tissue classification for reproducible wound assessment in telemedicine environments Hazem Bourges cedex, France E-mail: yves.lucas@bourges.univ-orleans.fr Abstract. In telemedicine environments of telemedicine environments. Pio- neer experiments in this area consisted simply of uploading images to a web

Boyer, Edmond

169

Clinical and Educational Support for Space Flight via Telemedicine  

NASA Technical Reports Server (NTRS)

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

1997-01-01

170

A novel mobile telemedicine system for ambulance transport. Design and evaluation  

Microsoft Academic Search

It is generally accepted that early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. The focus of this paper is to present the implementation and the evaluation of an ambulance located telemedicine system for pre-hospital patient treatment The primary emphasis is on the vital sign transmission from the accident site or the

G. J. Mandellos; D. K. Lymperopoulos; M. N. Koukias; A. Tzes; N. Lazarou; C. Vagianos

2004-01-01

171

Telemedicine in India: the Apollo story.  

PubMed

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

Ganapathy, Krishnan; Ravindra, Aditi

2009-01-01

172

Adoption of telemedicine: from pilot stage to routine delivery  

PubMed Central

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

2012-01-01

173

Strategic Procedures and Revisions for implementing Telemedicine and Telecare in Greece.  

PubMed

The development of telemedicine and telecare has been changed all over the world the recent decades as practitioners and health care managers reached better understanding of the use of information and communication technologies to offer urgent and qualified medical services at a distance. Governments and health care providers have shown a large initial interest in the benefits of telemedicine services to reduce costs mostly for patient's transfer to tertiary hospitals or for educational purposes but have been slow to provide strategic plans and procedures in order to proceed the projects into practice. The paper identifies the involvement of governments, healthcare management, healthcare professionals and IT suppliers in telemedicine policy development and reviews the experience of Greece in the specific field which seems that despite the enormous scientific interest for both medicine and health informatics, the practice until now has not gained the expected results. Furthermore, the analysis concerns the critical success factors that have to be revised simultaneously with the main managerial principles for the design and implementation of quality telemedicine and telecare services. PMID:23616897

Tsirintani, M

2012-01-01

174

Strategic Procedures and Revisions for implementing Telemedicine and Telecare in Greece  

PubMed Central

The development of telemedicine and telecare has been changed all over the world the recent decades as practitioners and health care managers reached better understanding of the use of information and communication technologies to offer urgent and qualified medical services at a distance. Governments and health care providers have shown a large initial interest in the benefits of telemedicine services to reduce costs mostly for patient’s transfer to tertiary hospitals or for educational purposes but have been slow to provide strategic plans and procedures in order to proceed the projects into practice. The paper identifies the involvement of governments, healthcare management, healthcare professionals and IT suppliers in telemedicine policy development and reviews the experience of Greece in the specific field which seems that despite the enormous scientific interest for both medicine and health informatics, the practice until now has not gained the expected results. Furthermore, the analysis concerns the critical success factors that have to be revised simultaneously with the main managerial principles for the design and implementation of quality telemedicine and telecare services. PMID:23616897

Tsirintani, M.

2012-01-01

175

Telemedicine: An Application in Search of Users  

NASA Technical Reports Server (NTRS)

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

Khandheria, Bijoy K.

1996-01-01

176

Design and Customization of Telemedicine Systems  

PubMed Central

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

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

2013-01-01

177

Managing Use Cases During Goal-Driven Requirements Engineering  

E-print Network

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

Reeves, Douglas S.

178

Applicability of Telemedicine in Bangladesh: Current Status and Future Prospects  

E-print Network

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

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

2009-01-01

179

"Initiate-build-operate-transfer" - a strategy for establishing sustainable telemedicine programs not only in the developing countries.  

PubMed

Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in the Balkans has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in Kosova. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy developed by IVeH "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services not only in developing countries, but in developed countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs is described. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the very core of healthcare infrastructure. The end point is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova and Albania has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program is transitioned to the Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Macedonia, Montenegro and other countries around the world. The IBOT model has been effective in creating sustainable telemedicine and e-health integrated programs in the Balkans and may be a good model for establishing such programs in developing countries. PMID:21685579

Latifi, Rifat

2011-01-01

180

Gardening waste management - case study: Tehran - Iran  

Microsoft Academic Search

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

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

2010-01-01

181

Case Management of Adolescents with Chronic Disease.  

ERIC Educational Resources Information Center

This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

Lankard, Bettina A.

182

"Managing after the Merger" Case Analysis.  

ERIC Educational Resources Information Center

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

Cusella, Louis P.

2000-01-01

183

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

PubMed

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

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

2014-10-13

184

Anesthesia case management for bariatric surgery.  

PubMed

An increasing number of bariatric surgeries are performed every year. A thorough understanding of the pathophysiologic changes, surgical procedure, and anesthesia case management for morbidly obese patients and of the pharmacology of weight-reduction and anesthetic drugs is essential to provide high-quality anesthetic care. The various comorbidities associated with obesity may complicate anesthetic management. Anesthetists must perform a thorough preoperative assessment to identify potential risk factors related to anesthesia and adequately prepare for intraoperative management. Intubation, maintenance of oxygenation, and pain management may be particularly challenging, and various strategies are presented. In addition, an obese patient is at higher risk for postoperative complications. Signs and symptoms of surgical complications may mimic medical complications, making diagnosis difficult. PMID:21560977

Thompson, Jennifer; Bordi, Sandra; Boytim, Michael; Elisha, Sass; Heiner, Jeremy; Nagelhout, John

2011-04-01

185

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

PubMed

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

Wu, Hsing-Hao

2008-12-01

186

Telemedicine and diabetes: Achievements and prospects  

Microsoft Academic Search

Health authorities currently have high expectations for telemedicine (TM), as it addresses several major challenges: to improve access to healthcare (especially for patients in underserved or remote areas); to overcome the scarcity of specialists faced with epidemic disease; and to reduce the costs of healthcare while improving quality. The aims of TM in the field of diabetes differ according to

S. Franc; A. Daoudi; S. Mounier; B. Boucherie; D. Dardari; H. Laroye; B. Neraud; E. Requeda; L. Canipel; G. Charpentier

187

Telepointer technology in telemedicine : a review  

PubMed Central

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

2013-01-01

188

Telemedicine and Medical Informatics: The Global Approach  

Microsoft Academic Search

Telemedicine is brought to life by contemporary changes of our world and summarizes the entire range of services that are at the crossroad of traditional healthcare and information technology. It is believed that eHealth can help in solving critical issues of rising costs, care for ageing and housebound population, staff shortage. It is a feasible tool to provide routine as

F. Lievens; M. Jordanova

2007-01-01

189

The virtual hospital: the emergence of telemedicine  

Microsoft Academic Search

The current practice of medicine, while utilizing the advances in biological and physical science, still takes place in the physician office or hospital. Unfortunately, traditional practice as integrated into the current Healthcare system is unsustainable. Accommodating the increase demand for medical services with the attendant rising costs has caused a crisis in healthcare. Telemedicine, the practice of medicine by means

Danny Petrasek; Alan Barr; Krishna V. Palem

2010-01-01

190

Using JPEG image compression to facilitate telemedicine  

Microsoft Academic Search

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

Loren G Yamamoto

1995-01-01

191

Telemedicine Experience for Chronic Care in COPD  

Microsoft Academic Search

Information and telecommunication technologies are called to play a major role in the changes that healthcare systems have to face to cope with chronic disease. This paper reports a telemedicine experience for the home care of chronic patients suf- fering from chronic obstructive pulmonary disease (COPD) and an integrated system designed to carry out this experience. To de- termine the

P. Detoledo; S. Jimeanez; F. Delpozo; Josep Roca; Albert Alonso; Carmen Hernandez

2006-01-01

192

The role of medical informatics in telemedicine  

Microsoft Academic Search

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

Terry P. Clemmer

1995-01-01

193

The telemedicine frontier: going the extra mile  

Microsoft Academic Search

Telemedicine has the potential to have a greater impact on the future of medicine than any other modality and will profoundly alter the medical landscape of the twenty-first century. In the most remote areas, it can bring high-quality health care where none is now available. In global health care, it can enhance and standardize the quality of medical care, including

V. Garshnek; J. S. Logan; L. H. Hassell

1997-01-01

194

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

PubMed

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

Cesta, Toni

2015-03-01

195

Provision of Telemedicine Services by Community Health Centers  

PubMed Central

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

Sharac, Jessica; Jacobs, Feygele

2014-01-01

196

Adoption of routine telemedicine in Norway: the current picture  

PubMed Central

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

Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

2014-01-01

197

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

Code of Federal Regulations, 2013 CFR

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

2013-01-01

198

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

Code of Federal Regulations, 2014 CFR

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

2014-01-01

199

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

Code of Federal Regulations, 2012 CFR

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

2012-01-01

200

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

Code of Federal Regulations, 2011 CFR

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

2011-01-01

201

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

E-print Network

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

Boyer, Edmond

202

Case histories in pharmaceutical risk management  

Microsoft Academic Search

The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The

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

2009-01-01

203

Case management: planning and coordinating strategies.  

PubMed

In summary, planning a case management system involves moving through sequenced stages; namely, (1) a developmental stage; (2) a phase-in stage; and (3) an operational stage. During the developmental stage, before processes have been formalized, attention is given to the political realities, the formation of a representative planning group, formulating goals and objectives, obtaining administrative support, information gathering, assessment of needs, resource procurement, program structure and design, selection of a case management model, participatory decision making, determining organizational fit, and beginning networking. During the phase-in or early implementation state, the formal stage of system introduction, attention is given to the establishment of interorganizational relationships, contracting for services, job descriptions, work assignments, training, problem solving, and conflict resolution. During the operational or full implementation stage, a period when the system should become more stabilized, attention needs to be given to managing movement of the client through the system, the flow of information, program updating, quality assurance, recordkeeping, resource management, evaluating, and system refurbishing. In practice, these stages will interact and overlap. Closure, if the system is to remain viable and open to change, should never occur. PMID:10110505

Walden, T; Hammer, K; Kurland, C H

1990-01-01

204

Electronic case management with homeless youth.  

PubMed

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

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

2015-06-01

205

The influence of economic performance on telemedicine provision.  

PubMed

Based on the experiences of Taiwan, this study aims to examine how country-level economic performance affects the provision of healthcare through telecommunications systems and how these health services influence individual-level health status. Regression analysis is undertaken and an ordinary least-squares method is applied. A panel dataset consists of a national sample over the period from 1995 to 2004. Empirical evidences show that increases in gross domestic product (GDP) increase the reported demand for telemedicine, but the price (cost) of telemedicine reduces that demand. In contrast, the price of conventional medical care and the indicator of healthcare environment (per capita national health expenditure) have no impact on the demand for telemedicine. The study provides quantitative estimates of the impact of GDP and telemedicine prices on the reported demand for telemedicine. A 10% increase in GDP increases the demand for telemedicine services by 3.9%. A 10% increase in the price of telemedicine reduces the demand for telemedicine by 7.4%. Furthermore, Taiwan's current GDP is used to estimate the unmet demand for telemedicine. The estimated current unmet demand for telemedicine is more than three times that currently being provided. In a well-run tele-healthcare system, the residents' capacities to generate income result in their health status being enhanced. Eventually, the economy will enjoy a higher level of welfare due to the impact of health and the provision of telemedicine. This is possibly a much more important source of economic performance and is derived from a policy aimed at promoting telemedicine. PMID:19292629

Wang, Fuhmei

2009-03-01

206

Design and Implementation of Telemedicine based on Java Media Framework  

NASA Astrophysics Data System (ADS)

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

Xiong, Fengguang; Jia, Zhiyan

207

Are you tired, overworked? You must be a case manager.  

PubMed

Case managers are being asked to take on more and more tasks, but the caseloads haven't changed, resulting in tired case managers who aren't able to do the job adequately. Make sure the hospital administration understands what case managers do and the value they bring to the organization. Consider developing specialty positions or adding clerical staff to optimize skill sets for staff. Use hard data, not anecdotes, when you make your case to management. PMID:24218691

2013-11-01

208

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

PubMed Central

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

Benger, J.

2000-01-01

209

The Case for Improvisation in Information Security Risk Management  

E-print Network

The Case for Improvisation in Information Security Risk Management Kennedy Njenga,1 , Irwin Brown2 IS management on the functionalist and incrementalist viewpoint of managing IS risk. We examine improvisation presents a case for improvisation in ISRM. Keywords: Improvisation, Information Security, Risk Management

Boyer, Edmond

210

Case Management Takes Hold in Long-Term Care.  

ERIC Educational Resources Information Center

Includes "Empowering Case Management Clients" (Rose); "Case Management in Rural Japan" (Maeda, Takahashi); "Coordinated-Care Teams" (Brodsky, Sobol); "Comparing Practice in the United States and the United Kingdom" (Sturges); "Business of Case Management Flourishing in the U.S." (Cress); and "Community Options Bring Change to Long-Term Care in…

Rose, Stephen M.; And Others

1992-01-01

211

Case Management in Community Corrections: Current Status and Future Directions  

ERIC Educational Resources Information Center

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…

Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

2012-01-01

212

Shaping Case Management in Minnesota: In Theory, Reality and Practice.  

ERIC Educational Resources Information Center

This monograph reports the conclusions of seven 6-month projects addressing issues of case management in the field of developmental disabilities in Minnesota. First, the theory supporting case management is reviewed and alternative definitions and guiding principles are offered. Next, the Minnesota rule on case management is detailed, noting…

Lang, Joyce; Kragthorpe, Candice

213

Telemedicine and the National Information Infrastructure  

PubMed Central

Abstract Health care is shifting from a focus on hospital-based acute care toward prevention, promotion of wellness, and maintenance of function in community and home-based facilities. Telemedicine can facilitate this shifted focus, but the bulk of the current projects emphasize academic medical center consultations to rural hospitals. Home-based projects encounter barriers of cost and inadequate infrastructure. The 1996 Telecommunications Act as implemented by the Federal Communications commission holds out significant promise to overcome these barriers, although it has serious limitations in its application to health care providers. Health care advocates must work actively on the federal, state, and local public and private sector levels to address these shortcomings and develop cost effective partnerships with other community-based organizations to build network links to facilitate telemedicine-generated services to the home, where the majority of health care decisions are made. PMID:9391928

Jones, Mary Gardiner

1997-01-01

214

Potentials of Telemedicine for Green Health Care  

PubMed Central

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

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

2010-01-01

215

State medical licensure for telemedicine and teleradiology.  

PubMed

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

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

2015-04-01

216

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

NASA Technical Reports Server (NTRS)

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.

DeBakey, Michael E.

1998-01-01

217

Development of a military competency checklist for case management.  

PubMed

This presentation will discuss the design, implementation, and evaluation of a competency-based checklist in military nursing network. The checklist was initiated to help assess case manager competency where background and preparation for the case manager role were quite diverse. The checklist assisted initially with the assessment of learning needs; later, it served as a self-assessment for case managers to determine their areas for improvement. Finally, the assessment was used not only to verify competency by the case management supervisor, but also to establish systemwide quality in case management. PMID:15931044

Stanton, Marietta P; Swanson, Carol; Baker, Rebecca D

2005-01-01

218

Integrated case management: the 21st century challenge for HMO case managers: Part I.  

PubMed

As HMOs approach the new millennium, their care and cost management strategies still will be under attack by policy-makers, legislative bodies, the media, American businesses, and the medical professions. The HMO industry will continue to be held accountable for the efficiency of its services, the quality of its care, and the performance and outcome measures that are the results of managing both the care and medical costs of its membership. This first of a two-part series put forward the concept of an integrated CM model to manage the total care of needs of HMO members at the turn of the century. This model consists of three care management approaches commonly used in mature HMOs: demand management, CM, and DM, as illustrated in Figure 1 and defined in Table 1. This article also described the new challenges facing HMOs, physicians, and nurse case managers and how they are navigating the difficult process of mapping demand management and CM approaches to the medical, social, and environmental needs of HMO members. With the costs of chronic conditions consuming 61% of the nation's annual health bill and increased numbers of the elderly joining HMOs, HMOs strongly need to implement DM approaches for economic survival reasons alone. Part two of this series will focus on the newest care management approach: disease state management. PMID:11094952

Coleman, J R

1999-01-01

219

Mobimed: a telemedicine system for mobile monitoring of physiological parameters  

NASA Astrophysics Data System (ADS)

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

Thorborg, Sten; Sjoqvist, Bengt A.

1990-06-01

220

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

E-print Network

BRAIN INJURY PROFESSIONAL18 This article, submitted for inclusion in an upcoming issue of Re- habilitation Psychology, investigates the long-term recovery of in- dividuals with disabilities following Hurricane Katrina through data collected from.... In this study, case managers, along with their supervisors who were part of the Katrina Aid Today (KAT) National Case Man- agement Consortium were interviewed to better understand the needs of individuals with disabilities post-disaster. Katrina Aid Today...

Stough, Laura

2011-01-01

221

[Medical support for Belarus after Chernobyl accident using a telemedicine system].  

PubMed

To achieve a close relationship among Gomel Regional Hospital (Gomel, Belarus), Belarusian Children Center of Hematology/Oncology (Minsk, Belarus) and Shinshu University Hospital, we established a telemedicine system using the Inmarsat satellite. The system consists of a TV conference system, a digital microscopic imaging system and a high-definition image server/viewer network system (DICOM). The detailed case conference is possible among three areas of physicians. PMID:12832864

Koike, Kenichi; Takizawa, Masaomi; Kamiya, Sadako; Kamata, Minoru; Oleinikova, Olga Vitelievna; Bogatchenko, Michail; Nakai, Keiji; Murase, Sumio; Komiyama, Atsushi

2003-01-01

222

Telecare for diabetes mellitus: case managers' experiences.  

PubMed

Diabetes is a metabolic disorder that, if not treated promptly and appropriately, can cause complex health complications and mortality. Changes in societal structure have fostered an increase in the incidence of diabetes and made the traditional hospital visit model less efficient for meeting the care needs of these patients. The care models that apply technology, such as telecare or so-called telehealth, may be useful in working with diabetes patients. The current study applied qualitative research methodology through interviews with nine diabetes case managers involved in telecare services. To identify the participants' acceptance and perceived effectiveness of telecare services, content analysis of the interview data was used. The following four major themes were identified in the study results: (1) improved case management, (2) setting appropriate expectations for care outcome, (3) acknowledging patients' sense of losing privacy, and (4) disease prevention and interdisciplinary cooperation. The study findings may serve as an indicator of the need for further promotion, appraisal, and validation of the telecare services model, to enhance the comprehensiveness of diabetes care. PMID:23958966

Chang, Chi-Ping; Lee, Ting-Ting; Chou, Chun-Chen; Mills, Mary Etta

2013-10-01

223

Technical overview of a web-based telemedicine system for wound assessment.  

PubMed

This report provides a technical overview of a Web-based telemedicine system for monitoring wounds in patients who do not have immediate access to the services of a consulting physician, including patients at home or in long-term-care facilities. Such a system would allow for the easy transmission and access of digital images of a patient's wounds and would allow multiple types of data required for comprehensive management of a patient's condition to be summarized and displayed. A store-and-forward method of data transmission was chosen for this project, rather than real-time videoconferencing, to limit the use of expensive technology and to maximize convenience for both the patient and the consulting physician. Under the store-and-forward technique, a clinician obtains wound data from the patient, then transmits these data to a Web site where the telemedicine physician can view data from multiple patients at his or her convenience. PMID:12151982

Lowery, Julie C; Hamill, Jennifer B; Wilkins, Edwin G; Clements, Ellen

2002-01-01

224

A Cognitive Framework for Understanding Barriers to the Productive Use of a Diabetes Home Telemedicine System  

PubMed Central

Telemedicine has the potential to transcend geographic and socio-cultural barriers to the delivery of high quality health care to the medically underserved populations. However, there are significant cognitive and usability barriers. This paper presents a multifaceted cognitive evaluation of the IDEATel diabetes education and telemedicine program. The evaluation included a cognitive walkthrough analysis to characterize task complexity and identify potential problems as well as field usability testing in patients’ homes. The study revealed dimensions of the interface that impeded optimal access to system resources. In addition, we found significant obstacles corresponding to perceptual-motoric skills, mental models of the system, and health literacy. The objective of this work is to contribute to a design framework so that participants with a wide range of skills can better manage their chronic illnesses. PMID:14728194

Kaufman, David R.; Starren, Justin; Patel, Vimla L.; Morin, Philip C.; Hilliman, Charlyn; Pevzner, Jenia; Weinstock, Ruth S.; Goland, Robin; Shea, Steven

2003-01-01

225

Cost Analysis in Telemedicine: Empirical Evidence From Sites in Arizona  

ERIC Educational Resources Information Center

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

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

2004-01-01

226

Assessing telemedicine: a systematic review of the literature  

Microsoft Academic Search

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

Risto Roine; Arto Ohinmaa; David Hailey

2001-01-01

227

A telemedicine system for remote cooperative medical imaging diagnosis  

Microsoft Academic Search

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

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

1996-01-01

228

Telemedicine in the United Kingdom: current status and future prospects  

Microsoft Academic Search

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

Robert S. H. Istepanian; H. Istepanian

1999-01-01

229

Successful Adoption of a School-Based Telemedicine System  

ERIC Educational Resources Information Center

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

Mackert, Michael; Whitten, Pamela

2007-01-01

230

Is there a contradiction between telemedicine and business?  

PubMed

Is there a contradiction between telemedicine and business? The driving forces in the telemedicine market are: competition within the health-care industry, newly developed cheap information technology (especially the Internet) and 21st-century health-care consumers, with their expectations of free choice and a high level of health-care. The market has four segments (citizens, patients, professionals and employees) and the boundaries between these segments are blurred. The telemedicine market is obviously growing, but it is still unstructured, fractured and disorganized. The telemedicine market needs a meeting place where the status of telemedicine and telecare can be reviewed. This would be a place in which to explore new ways to improve the efficiency of health-care services and a forum in which to draw a roadmap for future developments. One such place is the International Trade Event and Conference for eHealth, Telemedicine and Health ICT, Med-e-Tel. At the 2004 event, there were 32 exhibitors from 23 countries and over 400 industry and medical participants. A survey of participants showed that the event was judged to be a success. There is no conflict between telemedicine and business. On the contrary, telemedicine is a promising area of business development. PMID:15603616

Lievens, Frank; Jordanova, Malina

2004-01-01

231

A qualitative study of the organizational consequences of telemedicine.  

PubMed

The organizational consequences of telemedicine have frequently been mentioned in the telemedicine community, but there are few empirical studies. A study was therefore carried out of what happens in organizations when telemedicine is implemented. Qualitative interviews were undertaken with 30 persons working in teledermatology, telepsychiatry, a telepathology frozen-section service and tele-otolaryngology. Almost all respondents reported numerous organizational changes, some important. Changes in work processes were the most common. Examples of the organizational consequences of telemedicine were organizational restructuring, new organizational units, changed mechanisms for internal coordination, different flows of patients through the health-care system, improved coordination of care, new job descriptions, relocation of the place of work, employment of personnel living far away from the workplace, effects on employees not directly involved in telemedicine, sharing of experiences, minor staffing changes, clinical teamwork independent of co-location, administrative meetings arranged by telemedicine, merger of organizations independent of location, less travel by staff (and patients), a possible beneficial effect on the quality of care, and limited opposition to the adoption of the technology. Telemedicine may be important in the future organization of the disciplines studied and in health-care generally. The infrastructure of electronic networks may play an important role for organizations as the volume of telemedicine activity increases and economies of scale are realized. PMID:11265934

Aas, I H

2001-01-01

232

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

PubMed

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

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

2014-08-01

233

Prevention of Diabetes in Rural India with a Telemedicine Intervention  

PubMed Central

Background Diabetes care is not presently available, accessible, or affordable to people living in rural areas in developing countries, such as India. The Chunampet Rural Diabetes Prevention Project (CRDPP) was conceived with the aim of implementing comprehensive diabetes screening, prevention, and treatment using a combination of telemedicine and personalized care in rural India. Methods This project was undertaken in a cluster of 42 villages in and around the Chunampet village in the state of Tamil Nadu in southern India. A telemedicine van was used to screen for diabetes and its complications using retinal photography, Doppler imaging, biothesiometry, and electrocardiography using standardized techniques. A rural diabetes center was set up to provide basic diabetes care. Results Of the total 27,014 adult population living in 42 villages, 23,380 (86.5%) were screened for diabetes, of which 1138 (4.9%) had diabetes and 3410 (14.6%) had prediabetes. A total of 1001 diabetes subjects were screened for complications (response rate of 88.0%). Diabetic retinopathy was detected in 18.2%, neuropathy in 30.9%, microalbuminuria in 24.3%, peripheral vascular disease in 7.3%, and coronary artery disease in 10.8%. The mean hemoglobin A1c levels among the diabetes subjects in the whole community decreased from 9.3 ± 2.6% to 8.5 ± 2.4% within 1 year. Less than 5% of patients needed referral for further management to the tertiary diabetes hospital in Chennai. Conclusions The Chunampet Rural Diabetes Prevention Project is a successful model for screening and for delivery of diabetes health care and prevention to underserved rural areas in developing countries such as India. PMID:23294780

Mohan, Viswanathan; Deepa, Mohan; Pradeepa, Rajendra; Prathiba, Venkat; Datta, Manjula; Sethuraman, Ravikumar; Rakesh, Hari; Sucharita, Yarlagadda; Webster, Premila; Allender, Steven; Kapur, Anil; Anjana, Ranjit Mohan

2012-01-01

234

A telemedicine distributed system for cooperative medical diagnosis.  

PubMed Central

Telemedicine is changing the classical form of health care delivery, dramatically increasing the number of new applications in which some type of distributed synchronous cooperation between health care professionals is required. This paper presents the design and development of a telemedicine distributed system for cooperative medical diagnosis based on two new approaches: 1) a distributed layered architecture specially designed to add synchronous computer supported cooperative work features either to new or existing medical applications; 2) the definition of a methodological procedure to design graphical user interfaces for telemedicine cooperative working scenarios. The cooperative work is supported by a collaborative toolkit that provides telepointing, window sharing, coordination and synchronization. Finally, we have implemented and installed the telemedicine system in clinical practice between two hospitals, providing teleconferencing facilities for cooperative decision support in haemodynamics studies. This specific implementation and a preliminary evaluation were accomplished under the Research Project FEST "Framework for European Services in Telemedicine" funded by the EU AIM Programme. PMID:7949965

Gómez, E. J.; del Pozo, F.; Quiles, J. A.; Sanz, M.; Rahms, H.; Vaquero, J. J.; Cano, P.; Hernando, M. E.; Arredondo, M. T.

1994-01-01

235

Intensive case management for severe mental illness  

PubMed Central

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

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

2014-01-01

236

Case management in the social health maintenance organization demonstrations  

PubMed Central

In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system. PMID:10312977

Yordi, Cathleen L.

1988-01-01

237

Case management insider. Back to basics: a day in the life of a hospital case manager--Part 1.  

PubMed

In this month's Case Management Insider we have begun to review the case management process. The process has a total of eight steps, and we have completed our review of six of them. Next month we will continue with the final two steps in the case management process and also discuss best practices for doing an admission assessment. We will also review a case study which should help you in applying the steps we have been reviewing! PMID:23923193

Cesta, Toni

2013-08-01

238

Global excellence in management systems: a Diamond Offshore Drilling case  

Microsoft Academic Search

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

Denis Graham; Vipul K. Gupta

1996-01-01

239

Perinatal Management of Major Congenital Heart Disease  

PubMed Central

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

McGovern, Eiméar; Sands, Andrew J

2014-01-01

240

Case Studies for Management Development in Bangladesh. Second Book.  

ERIC Educational Resources Information Center

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

McLean, Gary N.

241

Examining End-of-Life Case Management: Systematic Review  

PubMed Central

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

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

2014-01-01

242

Telemedicine optoelectronic biomedical data processing system  

NASA Astrophysics Data System (ADS)

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

Prosolovska, Vita V.

2010-08-01

243

The role of CORBA in enabling telemedicine  

SciTech Connect

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

Forslund, D.W.

1997-07-01

244

Wartime toxicology: evaluation of a military medical toxicology telemedicine consults service to assist physicians serving overseas and in combat (2005-2012).  

PubMed

Those medical providers deployed to remote countries and tasked with caring for military personnel must diagnose and treat diseases and nonbattle injuries that result from exposures rarely seen in developed countries. Military providers must also function with limited resources and a lack of access to physician specialists, to include medical toxicologists. There have been limited published approaches to addressing this clinical gap for medical toxicology. To address this void, the US Army Medical Department deployed an electronic mail telemedicine system to provide teleconsultations for remote health-care providers worldwide, including Iraq and Afghanistan. This study aimed to describe the types and the frequency of toxicology teleconsultation and consultant responses using electronic mail to assist physicians serving in resource-limited locations. This was a retrospective observational study in which an unblinded data extractor independently reviewed all medical toxicology email consultations. Using a previously developed data collection worksheet, the extractor recorded the type of question asked by the consultant (overdose case, envenomation, occupational exposure, etc.) and the duration of time from when the teleconsultation was placed until the consultant replied. The extractor also recorded if the patient was adult or pediatric and if the patient was US military, US contractor, or local national. The extractor also recorded how often the toxicologist provided the consulting physician with information, resources, or protocols to aid in the management of future cases. In addition, for clinical teleconsultations, the extractor documented the frequency that the consulted toxicologist (i) provided a differential diagnosis or specific diagnosis, (ii) provided specific management guidelines for a patient, and (iii) recommended to evacuate or not evacuate a patient. The results were analyzed using descriptive statistics. Of the 99 consultations evaluated, the most common consultation was for snake envenomation and antivenom recommendations (n?=?23, 23 %) followed by accidental chemical exposures (n?=?14, 14 %), drug testing (n?=?13, 13 %), and substance abuse (n?=?10, 10 %). In 41 % of consults, the toxicologist provided a differential diagnosis or specific diagnosis, and in 60 % of cases, the toxicologist provided specific management or evaluation guidelines. In 11 % of cases, the toxicologist recommended for or against evacuation of the patient. In 25 % of consults, the toxicologist provided the consulting physician with information, resources, or protocols to aid in the management of future cases. The most frequent consultations for the military telemedicine consultation service were for direct patient cases, specifically snake envenomation management and accidental chemical exposures. Our results may be used to educate physicians prior to military deployment or international humanitarian efforts and to create toxicology clinical guidelines for remote locations. Expansion of the current military teleconsultation program capabilities to include video teleconsultation may improve the effectiveness of military medical toxicology teleconsultation. PMID:24752493

Maddry, Joseph K; Sessions, Daniel; Heard, Kennon; Lappan, Charles; McManus, John; Bebarta, Vikhyat S

2014-09-01

245

Knowledge Management Analysis: A Case Study  

ERIC Educational Resources Information Center

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…

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

2009-01-01

246

Clinical- and cost-effectiveness of telemedicine in type 2 diabetes mellitus: a systematic review and meta-analysis.  

PubMed

Emerging telemedicine programs offer potential low-cost solutions to the management of chronic disease. We sought to evaluate the clinical effectiveness and cost effectiveness of telemedicine approaches on glycemic control in patients with type 2 diabetes mellitus. Using terms related to type 2 diabetes and telemedicine, MEDLINE, Cochrane, EMBASE, and CINAHL Plus were searched to identify relevant studies published through February 28, 2014. Data from identified clinical trials were pooled according to telemedicine approach, and evaluated using conventional meta-analytical methods. We identified 47 articles, from 35 randomized controlled trials, reporting quantitative outcomes for hemoglobin A1c (HbA1c). Twelve of the 35 studies provided intervention via telephone, either in the form of a call or a text message; 19 studies tested internet-based programs, employing video-conferencing and/or informational websites; and four studies used interventions involving electronically transmitted recommendations made by clinicians in response to internet-based reporting by patients. Overall, pooled results from these studies revealed a small, but statistically significant, decrease in HbA1c following intervention, compared to conventional treatment (pooled difference in means=-0.37, 95% CI=-0.49 to -0.25, Z=-6.08, P<0.001). Only two of the 35 studies included assessment of cost-effectiveness. These studies were disparate, both in terms of overall expense and relative cost-effectiveness. Optimization of telemedicine approaches could potentially allow for more effective self-management of disease in type 2 diabetes patients, though evidence to-date is unconvincing. Furthermore, significant publication bias was detected, suggesting that the literature should be interpreted cautiously. PMID:25526482

Zhai, Yun-kai; Zhu, Wei-jun; Cai, Yan-ling; Sun, Dong-xu; Zhao, Jie

2014-12-01

247

Telemedicine for the care of children in the hospital setting.  

PubMed

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

McSwain, S David; Marcin, James P

2014-02-01

248

Implementing DICOM Structured Reporting in a Large-Scale Telemedicine Network  

PubMed Central

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

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

2013-01-01

249

A telemedicine health care delivery system  

NASA Technical Reports Server (NTRS)

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

Sanders, Jay H.

1991-01-01

250

Telemedicine in a cloud — A review  

Microsoft Academic Search

The Information communication Technologies (ICT) has assumed an important role in all domains of life today. The computation requirements are often larger than resources available at hand in an enterprise and it would like to outsource it for high speed computation or data management requirements. In other cases a small enterprise would like to lease computation or data archiving resources

Shaftab Ahmed; Azween Abdullah

2011-01-01

251

Telemedicine in Anesthesiology and Reanimatology  

PubMed Central

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

Tafro, Lejla; Masic, Izet

2010-01-01

252

Case Management: Effects of Improved Risk and Value Information  

ERIC Educational Resources Information Center

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…

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

2003-01-01

253

School Nurse Case Management: Achieving Health and Educational Outcomes  

ERIC Educational Resources Information Center

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

Bonaiuto, Maria M.

2007-01-01

254

Cost-Effectiveness of Case Management in Substance Abuse Treatment  

ERIC Educational Resources Information Center

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

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

2006-01-01

255

Problems in Office Management: Cases in Practice  

ERIC Educational Resources Information Center

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

Hemby, K. Virginia; Smith, Vincent W.

2006-01-01

256

A disease management case study on asthma  

Microsoft Academic Search

This paper provides an overview of how one pharmacy benefits manager, Med-Impact Pharmaceutical Management, Inc. (San Diego, California), approaches its disease management (DM) program for asthma. This group's experience with DM counters the common but fallacious belief that reduction of component costs leads to reduction of total expenditures. In fact, greater expenditures on certain components (in particular, drug therapies and

Robert V. Dasilva

1996-01-01

257

Hospitality crisis management practices: the Israeli case  

Microsoft Academic Search

This study attempts to examine hospitality crisis management practices within the context of the Israeli hospitality industry. The study develops a questionnaire that evaluates the importance and usage of four categories of practices: marketing, hotel maintenance, human resources, and governmental assistance. The findings illustrate which practices managers consider important and which practices managers actually use during an industry crisis. The

Aviad A. Israeli; Arie Reichel

2003-01-01

258

PERFORMANCE MANAGEMENT SYSTEM IN UK RETAIL INDUSTRY: A CASE STUDY  

Microsoft Academic Search

The main bojective of this study is to investigate the impact of employee performance management system on business process improvement and to find out the importance of employee development through performance management system in order to achieve the superior business goal. This case study reviews the employee performance management system of the retail industry in the UK market through in-depth

M. Khasro Miah; Chowdhury Golam Hossan

2012-01-01

259

A Case for Customizable Resource Management in Networks  

E-print Network

A Case for Customizable Resource Management in Networks Peter Steenkiste Allan Fisher Hui Zhang by the presence of an integrated set of customizable resource management mechanisms. In this paper, we introduce will be integrated in a virtual network that forms the basis of runtime resource management and quality of service

Steenkiste, Peter

260

Practising cloud-based telemedicine in developing countries.  

PubMed

In industrialised countries, telemedicine has proven to be a valuable tool for enabling access to knowledge and allowing information exchange, and showing that it is possible to provide good quality of healthcare to isolated communities. However, there are many barriers to the widespread implementation of telemedicine in rural areas of developing countries. These include deficient internet connectivity and sophisticated peripheral medical devices. Furthermore, developing countries have very high patients-per-doctor ratios. In this paper, we report our work on developing a cloud-based health information system, which promotes telemedicine and patient-centred healthcare by exploiting modern information and communication technologies such as OWL-ontologies and SQL-triggers. The reason for using cloud technology is twofold. First, cloud service models are easily adaptable for sharing patients health information, which is of prime importance in patient-centred healthcare as well as in telemedicine. Second, the cloud and the consulting physicians may locate anywhere in the internet. PMID:24191340

Puustjärvi, Juha; Puustjärvi, Leena

2013-01-01

261

Telemedicine interventions for substance-use disorder: a literature review.  

PubMed

A literature review was conducted to identify research into multiple-contact (i.e. extended) telemedicine interventions for substance-use disorder. The goals were: (1) to describe the methodology used to evaluate telemedicine interventions; (2) to identify the range of interventions which have been formally evaluated; and (3) to summarize the findings. Fourteen databases and Google Scholar were searched, as well as bibliographies of relevant papers and online conference abstracts. There were 50 studies which met the inclusion criteria, of which 50% were randomized controlled trials. The studies most frequently reported the effect on substance use and 61% of those findings fully supported telemedicine interventions. Although the studies reported persistent challenges in sustaining participation, 76% of the studies reporting on satisfaction indicated that participants were enthusiastic supporters of telemedicine. Only 30% of reviewed studies addressed the effect on resource utilization. The majority of studies reported evidence of clinical effectiveness, which justifies continued research in the field. PMID:22101610

Young, Lance Brendan

2012-01-01

262

Telemedicine in the NHS for the millennium and beyond.  

PubMed Central

This article defines telemedicine, discusses evidence of its effectiveness, looks at its advantages and disadvantages (and barriers to implementation), and considers its role in the NHS for the millennium and beyond. PMID:10320886

Wallace, S.; Wyatt, J.; Taylor, P.

1998-01-01

263

Arogyasree: an enhanced grid-based approach to mobile telemedicine.  

PubMed

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

Kailasam, Sriram; Kumar, Santosh; Dharanipragada, Janakiram

2010-01-01

264

Challenges for user-interface designers of telemedicine systems.  

PubMed

Problems associated with telemedicine systems include high telecommunications costs, lack of physician interest, and failure to build evaluation into the design process from the onset of the telemedicine project. An overview of the human-factors engineering approach to systems design and how it can be applied to the development of telemedicine systems is described. Design of an interface is based on an analysis of user capabilities, tasks, and work environment. Task analyses are performed to understand and document the interaction between a user's work activities and a system. Two characteristics of a human factors approach that are important for telemedicine are: (1) defining and measuring user performance, and (2) involving users in the design and testing of a system. Usability goals are operationally defined and tracked to quantify performance. Having users participate in the design, testing, and critique of a system also increases the likelihood that the system will be accepted and used after it is released. PMID:10908428

Salvemini, A V

1999-01-01

265

Tavarua : a mobile telemedicine system using WWAN striping  

E-print Network

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

Carlisle, Jennifer (Jennifer Nicole)

2007-01-01

266

Clinical outcomes resulting from telemedicine interventions: a systematic review  

Microsoft Academic Search

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

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

2001-01-01

267

Implementation of In-home Telemedicine in Rural Kansas  

PubMed Central

Abstract The Interactive Home Health Care Program is a demonstration project evaluating the use of in-home telemedicine to provide health care for elderly and disabled people. Local cable systems interconnect a base station staffed by a telemedicine nurse with a modified television in the home. Six months into the project, 38 patients are being cared for at three sites in rural Kansas. Individual patient profiles show improvement. Technical and social challenges appear solvable. An evaluation is in progress. PMID:8988469

Lindberg, Christopher C. S.

1997-01-01

268

Telemedicine system interoperability architecture: concept description and architecture overview.  

SciTech Connect

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.

Craft, Richard Layne, II

2004-05-01

269

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

PubMed Central

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

Guitton, Matthieu J.

2013-01-01

270

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

PubMed Central

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

LeRouge, Cynthia; Garfield, Monica J.

2013-01-01

271

The case manager through the eyes of the users: benefits and failures of a French case management experimentation  

PubMed Central

Purpose The PRISMA France project consists in the implementation of a global services integration in which a case management services is dedicated to old people with complex needs. One of the purposes of the research team was to analyze the representations of the users, i.e., the old people and their proxies, of the case management service through their own experience of profane expert. Theory According to the literature that deals with qualitative interviewing, we consider that the users of case management are able to express themselves on the benefit and the failures of the case management services even if some of them suffer from cognitive impairments. Methods In this view, 30 comprehensive and semi-structured talks were done, 19 old people and 11 proxies. All the interviews were face to face interview and were done by an anthropologist. The interviews were transcribed verbatim and analyzed by focusing on the node of sense in the user’s words. Results and conclusions On one side, the proxies describe the case manager as the one who give answers face to the complexity of the system. On the other side, the old people insisted on the relationship established with their case manager. She/he is the one who listens and asks questions in order to help them. Discussion The analysis of the user’s representations raises three main points: Is the main role of the case manager is to bring an answer to the failures of the system? By basing their representation of the case management on relational continuity, the old people reduce the work of the case manager of the work he/she done at home. So, when the presence of the case manager diminished, old people think that his/her work in not efficient. How the policy makers could include the user’s points of view in the implementation of such kind of service?

Balard, Frederic; Somme, Dominique

2012-01-01

272

Telemedicine in the Michigan Upper Peninsula region: an evaluation of the first five years.  

PubMed

A telemedicine network has operated in the Upper Peninsula (UP) region of Michigan since 1995. The Marquette General Health System (MGHS) is the tertiary hospital that provides telemedicine services to 14 surrounding rural health facilities and another seven clinics. In order to assess the state of telemedicine in the UP region and its potential for development, three main factors were assessed: organizational development, telemedicine activity and perceptions of the key players. Data were collected through interviews with five MGHS telemedicine staff, 10 physicians (five from the MGHS and five from surrounding rural areas), 13 of the 14 chief executive officers (CEOs) of the remote telemedicine sites and a survey of 21 telemedicine site coordinators. This information was analysed in order to outline job roles and responsibilities; to document the process of doing telemedicine; and to understand current policies and procedures. Telemedicine activity from 1995 to 1999 was analysed in terms of the purpose of the session. In 1999, a total of 515 telemedicine sessions were conducted, 323 being non-educational and 192 being educational. Most CEOs of the rural hospitals were interested in furthering their use of clinical telemedicine applications. The data also indicated a great need for education, particularly of the rural physicians. The overall view of those surveyed about MGHS's telemedicine programme was positive. Respondents were quick to compliment the staff whenever possible. New telemedicine staff have been employed, which will allow responsibilities to be reassigned in such a way as to create a more efficient system. PMID:11571084

Whitten, P; Eastin, M S; Davis, S

2001-01-01

273

Quantifying case management workloads: Development of the PACE tool.  

PubMed

In 1999, the Clinical Resource Management (CRM) group at Saint Alphonsus Regional Medical Center in Boise, Idaho, implemented a specialty-based nursing case management model for individual caseload assignment of all inpatient admissions. This model assigns caseloads by proportion determined by physician specialty type. This model does not consider patient acuity and may have weaknesses associated with self-report. In addition, time requirements for effective case management outcomes are not always reflected in admission volumes alone. This article describes the development and pilot testing of the Patient Acuity Case management Evaluation (PACE) measurement tool. Five phases of methodological development are discussed: (1) conceptualization phase, (2) content development, (3) Delphi technique using expert opinion and critique, (4) inter (intrarater reliability testing, and (5) pilot testing of acuity tool. Examples of instrument development throughout these phases are included. This instrument is expected to provide verifiable measurement of individual and group case management workload. PMID:17135872

Balstad, Amy; Springer, Pam

2006-01-01

274

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

Microsoft Academic Search

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

D. Niyato; E. Hossain; J. Diamond

2007-01-01

275

Object management in a CASE environment  

Microsoft Academic Search

The Sun Network Software Environment (NSE) is a network-based object manager for software development. The NSE supports parallel development through an optimistic concurrency control mechanism, in which developers do not acquire locks before modifying objects. Instead, developers copy objects, modify the copies, and merge the modified objects with the originals. Objects managed by the NSE are typed, and the set

Evan W. Adams; Masahiro Honda; Terrence C. Miller

1989-01-01

276

Quantitative 3-D imaging topogrammetry for telemedicine applications  

NASA Technical Reports Server (NTRS)

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

Altschuler, Bruce R.

1994-01-01

277

Telemedicine Networks of EHAS Foundation in Latin America  

PubMed Central

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

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

2014-01-01

278

Logistical aspects of large telemedicine networks. 1: Site directories.  

PubMed

We carried out a survey of the site coordinators in a mature telemedicine network of about 200 sites. The site directory contained information about 221 videoconference facilities. There were 191 site coordinators in all (i.e. some coordinators were responsible for more than one site). Of the 221 sites, we were able to contact 87 on first attempt and 155 by the fourth attempt. Thus there were 66 sites (30%) which were not contactable. We asked each site coordinator to describe any videoconference activity that had taken place over the previous five working days. Of the contacted 155 sites, 78 reported some videoconference activity during the period in question. The total reported videoconference activity was 12,800 min during the one-week monitoring period, that is, an estimated 924 h per month. The most common categories of work were education or training (511 h) and management or administration (225 h), which between them accounted for 80% of all reported videoconference activity. Fifty of the 155 sites (32%) reported that the equipment was not located in an area suitable for patient consultations. In addition, 20 sites (13%) volunteered that their videoconferencing facilities were not in working order at the time of the survey. We did not ask this question in the survey, so that this result represents a lower bound for the true number of inoperable systems. PMID:12661632

Wootton, Richard; Smith, Anthony C; Gormley, Sinead; Patterson, Jessica

2002-01-01

279

Logistical aspects of large telemedicine networks. 1: Site directories.  

PubMed

We carried out a survey of the site coordinators in a mature telemedicine network of about 200 sites. The site directory contained information about 221 videoconference facilities. There were 191 site coordinators in all (i.e. some coordinators were responsible for more than one site). Of the 221 sites, we were able to contact 87 on first attempt and 155 by the fourth attempt. Thus there were 66 sites (30%) which were not contactable. We asked each site coordinator to describe any videoconference activity that had taken place over the previous five working days. Of the contacted 155 sites, 78 reported some videoconference activity during the period in question. The total reported videoconference activity was 12,800 min during the one-week monitoring period, that is, an estimated 924 h per month. The most common categories of work were education or training (511 h) and management or administration (225 h), which between them accounted for 80% of all reported videoconference activity. Fifty of the 155 sites (32%) reported that the equipment was not located in an area suitable for patient consultations. In addition, 20 sites (13%) volunteered that their videoconferencing facilities were not in working order at the time of the survey. We did not ask this question in the survey, so that this result represents a lower bound for the true number of inoperable systems. PMID:12537913

Wootton, Richard; Smith, Anthony C; Gormley, Sinead; Patterson, Jessica

2002-12-01

280

Telemedicine Networks of EHAS Foundation in Latin America.  

PubMed

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

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

2014-01-01

281

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

PubMed

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

Mars, Maurice

2013-01-01

282

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

Code of Federal Regulations, 2011 CFR

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

2011-01-01

283

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

Code of Federal Regulations, 2014 CFR

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

2014-01-01

284

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

Code of Federal Regulations, 2013 CFR

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

2013-01-01

285

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

Code of Federal Regulations, 2012 CFR

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

2012-01-01

286

Concept of Operations for a Regional Telemedicine Hub to Improve Medical Emergency Response  

Microsoft Academic Search

Telemedicine (TM) is a tool that permits medical services to be provided remotely. Applications of telemedicine to disaster response began in the mid-1980s for natural disasters such as earthquakes, tsunamis, and hurricanes and for \\

Hui Wang; Wei Xiong; Nathaniel Hupert; Christian Sandrock; Javeed Siddiqui; Aaron E. Bair

2009-01-01

287

Application of Telemedicine Technologies to Long Term Spaceflight Support  

NASA Astrophysics Data System (ADS)

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

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

288

Case study on knowledge-management gaps  

Microsoft Academic Search

Purpose – To propose a holistic framework for understanding the “knowledge-management (KM) gap” – illustrating six types of gaps that might occur within KM activities. Design\\/methodology\\/approach – The content-analytical approach with the thematic analysis was implemented in the study. Through an in-depth interview with the top managers of two firms, explores the causes of these gaps and fundamental approaches to

Chinho Lin; Jong-Mau Yeh; Shu-Mei Tseng

2005-01-01

289

Foreign body ingestion: Management of 167 cases  

Microsoft Academic Search

We reviewed the management of 167 patients with foreign body ingestion from 1980 to 1986. Two patients (1.1%) refused treatment. Nonoperative management was attempted in 14 (8.4%) patients. Endoscopy was performed on 117 patients with an overall success rate of 85.5% and a complication rate of 1.7%. Surgical treatment was required in 51 (30.0%) patients, 14 of whom had previous

J. L. Barros; J. C. Rueda; J. M. Monturiol

1991-01-01

290

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

PubMed Central

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

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

2014-01-01

291

Use of telemedicine in disaster and remote places.  

PubMed

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

Ajami, Sima; Lamoochi, Parisa

2014-01-01

292

Use of telemedicine in disaster and remote places  

PubMed Central

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

Ajami, Sima; Lamoochi, Parisa

2014-01-01

293

Adoption of intensive care unit telemedicine in the United States  

PubMed Central

Objective Intensive care unit (ICU) telemedicine is a novel approach for providing critical care services from a distance. We sought to study the extent of use and patterns of adoption of this technology in United States ICUs. Design Retrospective study combining a systematic listing of ICU telemedicine installations with hospital characteristic data from the Centers for Medicare and Medicaid Services. We examined adoption over time and compared hospital characteristics between facilities that have adopted ICU telemedicine and those that have not. Setting United States hospitals from 2003 to 2010. Measurements and main results The number of hospitals using ICU telemedicine increased from 16 (0.4% of total) to 213 (4.6% of total) between 2003 and 2010. The number of ICU beds covered by telemedicine increased from 598 (0.9% of total) to 5,799 (7.9% of total). The average annual rate of ICU bed coverage growth was 101% per year in the first four study years but slowed to 8.1% per year over the last four study years (p<0.001 for difference in linear trend). Compared to non-adopting hospitals, hospitals adopting ICU telemedicine were more likely to be large (percentage with >400 beds: 11.1% vs. 3.7%, p<0.001), teaching (percentage with resident coverage: 31.4% vs. 21.9%, p=0.003) and urban (percentage located in metropolitan statistical areas with over one million residents: 45.3% vs. 30.1%, p<0.001). Conclusions ICU telemedicine adoption was initially rapid but recently slowed. Efforts are needed to uncover the barriers to future growth, particularly regarding the optimal strategy for using this technology most effectively and efficiently. PMID:24145839

Kahn, Jeremy M.; Cicero, Brandon D.; Wallace, David J.; Iwashyna, Theodore J.

2013-01-01

294

Case management interventions for HIV-infected individuals.  

PubMed

Engagement of HIV-positive persons into care and achieving optimal antiretroviral treatment outcomes is a fundamental HIV prevention strategy. Case management model was recommended as a beneficial model of care for patients with a new HIV diagnosis, focusing on individuals with unmet needs, and linking them with the coordinated health and social services to achieve desired outcomes. HIV case management is population-driven and programs are designed to respond to the unique needs of the client population they serve, such as substance users, homeless, youth, and prison inmates. This view found 28 studies addressing effectiveness and impacts of case management intervention for people living with or at risk of HIV/AIDS. Effectiveness of case management intervention was categorized as follows: decreased mortality and improve health outcomes, linkage to and retention in care, decreased unmet needs, and reducing risky behaviors. PMID:24222475

Ko, Nai-Ying; Liu, Hsiao-Ying; Lai, Yi-Yin; Pai, Yun-Hui; Ko, Wen-Chien

2013-12-01

295

School nurse case management: achieving health and educational outcomes.  

PubMed

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

Bonaiuto, Maria M

2007-08-01

296

34 CFR 303.34 - Service coordination services (case management).  

Code of Federal Regulations, 2012 CFR

...assist families in identifying available EIS providers; (6) Coordinating, facilitating...services. The lead agency's or an EIS provider's use of the term service coordination...coordination services does not preclude characterization of the services as case management or...

2012-07-01

297

34 CFR 303.34 - Service coordination services (case management).  

Code of Federal Regulations, 2014 CFR

...assist families in identifying available EIS providers; (6) Coordinating, facilitating...services. The lead agency's or an EIS provider's use of the term service coordination...coordination services does not preclude characterization of the services as case management or...

2014-07-01

298

34 CFR 303.34 - Service coordination services (case management).  

Code of Federal Regulations, 2013 CFR

...assist families in identifying available EIS providers; (6) Coordinating, facilitating...services. The lead agency's or an EIS provider's use of the term service coordination...coordination services does not preclude characterization of the services as case management or...

2013-07-01

299

Personnel in Transition: The Case of Polish Women Personnel Managers.  

ERIC Educational Resources Information Center

A case study of a Polish company undergoing restructuring demonstrates the influence of political, economic, and social change on postcommunist personnel management. It investigates whether change is providing opportunities to improve the employment status of women. (SK)

Crow, Mary

1998-01-01

300

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

NASA Technical Reports Server (NTRS)

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

Scott, John Carver

1991-01-01

301

Congenital eversion of upper eyelids: case report and management.  

PubMed

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

Maheshwari, Rajat; Maheshwari, Sejal

2006-09-01

302

Applying geriatric case management in your medical group practice.  

PubMed

One of the biggest questions medical groups will have to answer in relation to America's shifting demographics is how to deal with the diverse needs of the elderly effectively. Authors Candace Bruno and Cheryl Schraeder believe one alternative is a case management approach. Their article presents ways in which other medical groups are using case management to meet the needs of the elderly. PMID:10106625

Bruno, C; Schraeder, C

1990-01-01

303

75 FR 16486 - Proposed Comment Request for Review of ACF Disaster Case Management Implementation Guide; Office...  

Federal Register 2010, 2011, 2012, 2013, 2014

...comments on the ACF Disaster Case Management Implementation Guide, dated December 2009. Disaster case management is the process of organizing...caused or exacerbated by the event and may adversely impact an...addressed. Disaster case management facilitates the delivery...

2010-04-01

304

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

Code of Federal Regulations, 2014 CFR

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

2014-07-01

305

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

Code of Federal Regulations, 2013 CFR

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

2013-07-01

306

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

Code of Federal Regulations, 2010 CFR

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

2010-07-01

307

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

Code of Federal Regulations, 2011 CFR

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

2011-07-01

308

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

Code of Federal Regulations, 2012 CFR

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

2012-07-01

309

Development of a multimedia CD-ROM on telemedicine and teleradiology  

Microsoft Academic Search

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

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

1996-01-01

310

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

ERIC Educational Resources Information Center

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

Mansouri-Rad, Parand

2012-01-01

311

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

E-print Network

1 Design of Architecture for a Terrestrial LAN & VSAT- based National Telemedicine Network-doctor ratios anywhere in the world (almost 30,000 to 1), telemedicine offers a cost-effective health for Telemedicine. The core technical contributions of our study include a Web-interface for a hierarchical model

Kassegne, Samuel Kinde

312

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

Code of Federal Regulations, 2010 CFR

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

2010-01-01

313

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

E-print Network

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

Yang, Junfeng

314

Mobile Telemedicine Sensor Networks with Low-Energy Data Query and  

E-print Network

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

Wu, Hongyi

315

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

E-print Network

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

Kumar, Sunil

316

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

E-print Network

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

Mihaylova, Lyudmila

317

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

E-print Network

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

Kassegne, Samuel Kinde

318

Models to Extend the Scope of Usability Testing for Telemedicine Systems  

E-print Network

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

Stevens, Perdita

319

The Role of Outcome Mapping in Developing a Rural Telemedicine System  

E-print Network

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 Technology for Development project. Keywords: ICT design methodology, telemedicine, telehealth, Outcome

Blake, Edwin

320

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

E-print Network

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

Paris-Sud XI, Université de

321

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

E-print Network

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

Paris-Sud XI, Université de

322

Move to accountable care puts case managers in the spotlight.  

PubMed

Medicare accountable care organizations (ACOs) offer opportunities and challenges for case managers as providers focus on coordinating care throughout the continuum. Pressure for accountability and managing resources efficiently are increasing. The Centers for Medicare and Medicaid Services (CMS) and other payers are beginning to base reimbursement on quality. ACOs change the payment system by bundling reimbursement across settings of care. PMID:21874914

2011-09-01

323

Organizational transformation and renewal : a case for reframing management development  

Microsoft Academic Search

Evidence has emerged from an analysis of two organizational case studies to suggest that a relatively discrete and processual view of management development may be contributing to the “failure” of development strategies and activities to meet organizational expectations during a time of radical change. Proposes a more holistic, relational perspective in which management development is reframed to take account of

Michael Doyle

1995-01-01

324

The employer's case for health management.  

PubMed

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

Coulter, Christopher H

2006-01-01

325

Blake's Illness A Case of "Wildlife Management"  

NSDL National Science Digital Library

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

Cathy R. Santanello

2009-01-01

326

A real-time, mobile phone-based telemedicine system to support young adults with type 1 diabetes.  

PubMed

Telemedicine systems have been proposed as a means of supporting people with diabetes in the self-management of their condition. Requirements for monitoring parameters of care, including glycaemic control, extent of analysis and interpretation of data, patient-clinician contacts, and involvement of a multidisciplinary care team with effective communication, can be addressed by telemedicine systems. We describe the development and implementation of an innovative real-time telemedicine system based around transmission and feedback of data to and from a mobile phone. Proprietary Java-based programs were used to link a blood glucose meter to a mobile phone. In addition to immediate transmission of blood glucose data, information about insulin dose, eating patterns and physical exercise were collected. Immediate feedback to the phone included a colour histogram to draw attention to levels of control over glycaemia over the previous two weeks. Clinicians supporting patients had access to summary screens identifying users not testing, and those with levels of blood glucose outside pre-defined limits. More detailed graphical displays of data were used to provide data about control of insulin dose and the degree to which it was modified in response to diet and exercise. The system has been evaluated in a clinical trial conducted in secondary care and is now being adapted for use in a trial in primary care, which is designed to assess its effectiveness in providing integrated management for the patient, general practitioner and pharmacist. PMID:16259856

Farmer, Andrew; Gibson, Oliver; Hayton, Paul; Bryden, Kathryn; Dudley, Christina; Neil, Andrew; Tarassenko, Lionel

2005-01-01

327

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

PubMed

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

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

2014-11-01

328

Evolution of telemedicine in the space program and earth applications.  

PubMed

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

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

2001-01-01

329

Evolution of telemedicine in the space program and earth applications  

NASA Technical Reports Server (NTRS)

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

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

2001-01-01

330

A Knowledge Management Platform for Documentation of Case Reports in  

E-print Network

A Knowledge Management Platform for Documentation of Case Reports in Pharmacovigilance Florence, France d INSERM U936, Université Rennes 1, Rennes, France e Centre Régional de Pharmacovigilance, Hôpital documentation of pharmacovigilance case reports for the pharmaceutical industry and regulatory authorities

Paris-Sud XI, Université de

331

Case Management and Assertive Community Treatment in Europe  

Microsoft Academic Search

Objective: Case management studies from Europe and the United States continue to yield conflicting results. At a symposium at the World Psychiatric Conference in Hamburg in 1999, researchers from four Eu- ropean countries explored the possible reasons for differences in out- come. They also examined reasons for the differing foci of case man- agement studies across the different cultures. The

Tom Burns; F. R. C. Psych; Angelo Fioritti; Frank Holloway; Ulf Malm; Wulf Rössler

2001-01-01

332

Shift manager workload assessment - A case study  

SciTech Connect

In early 2003, Bruce Power restarted two of its previously laid up units in the Bruce A generating station, Units 3 and 4. However, due to challenges relating to the availability of personnel with active Shift Manager licenses, an alternate shift structure was proposed to ensure the safe operation of the station. This alternate structure resulted in a redistribution of responsibility, and a need to assess the resulting changes in workload. Atomic Energy of Canada Limited was contracted to perform a workload assessment based on the new shift structure, and to provide recommendations, if necessary, to ensure Shift Managers had sufficient resources available to perform their required duties. This paper discusses the performance of that assessment, and lessons learned as a result of the work performed during the Restart project. (authors)

Berntson, K.; Kozak, A. [Bruce Power, P O Box 1540 B10, Tiverton, Ont. N0G 2T0 (Canada); Malcolm, J. S. [Atomic Energy of Canada Ltd., 2251 Speakman Drive, Mississauga, Ont. L5K 1B2 (Canada)

2006-07-01

333

Case manager as therapy extender for cognitive behavior therapy of serious mental illness: a case report.  

PubMed

Cognitive behavior therapy (CBT) is an evidence-based intervention for individuals with serious mental illness and potentiates standard medication management. Americans receiving publicly funded treatment for serious mental illnesses have limited access to CBT and hence we need to devise innovative ways of providing access to this important intervention. We present a case of a man who had severe disability, was medication resistant, and diagnosed with Obsessive Compulsive Disorder and Major Depressive Disorder. After being home bound for many years he was provided CBT utilizing his existing case manager as a therapy extender. The specific roles of the primary therapist and case manager as well as the improvement in quality of life of the individual are delineated. This case report opens up the possibility of further studying case managers as therapy extenders for treating serious mental illnesses. PMID:23828035

Pinninti, Narsimha R; Schmidt, Lisa T; Snyder, Richard P

2014-05-01

334

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...

335

Telemedicine-based alcohol services for rural offenders.  

PubMed

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

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

2012-08-01

336

Telemedicine and health care policy: the new federalism taking hold.  

PubMed

The new federalism is now taking hold in Washington, with far-reaching implications for the role of the federal government in health, education, and welfare programs; financial support for such programs; and the shift of control to the states. For telemedicine, the implications of these changes include having to make do with less external financial support and a need to establish partnerships between state and local governments, public sector developers and vendors, third-party payers, and community-based telemedicine programs. The long-term challenge for telemedicine programs, particularly in rural, medically underserved areas, is likely to be their sustainability in an adverse financial environment. The problem is further compounded by the lack of reimbursement for teleconsultations. PMID:10165160

Bashshur, R L; Neuberger, N; Worsham, S

1995-01-01

337

Telemedicine in Space Flight - Summary of a NASA Workshop  

NASA Technical Reports Server (NTRS)

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

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

2011-01-01

338

QoE for telemedicine: challenges and trends  

NASA Astrophysics Data System (ADS)

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.

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

2013-09-01

339

Integrated dementia care in The Netherlands: a multiple case study of case management programmes.  

PubMed

The number of dementia patients is growing, and they require a variety of services, making integrated care essential for the ability to continue living in the community. Many healthcare systems in developed countries are exploring new approaches for delivering health and social care. The purpose of this study was to describe and analyse a new approach in extensive case management programmes concerned with long-term dementia care in The Netherlands. The focus is on the characteristics, and success and failure factors of these programmes.A multiple case study was conducted in eight regional dementia care provider networks in The Netherlands. Based on a literature study, a questionnaire was developed for the responsible managers and case managers of the eight case management programmes. During 16 semistructured face-to-face interviews with both respondent groups, a deeper insight into the dementia care programmes was provided. Project documentation for all the cases was studied. The eight programmes were developed independently to improve the quality and continuity of long-term dementia care. The programmes show overlap in terms of their vision, tasks of case managers, case management process and the participating partners in the local dementia care networks. Differences concern the targeted dementia patient groups as well as the background of the case managers and their position in the local dementia care provider network. Factors for success concern the expert knowledge of case managers, investment in a strong provider network and coherent conditions for effective inter-organizational cooperation to deliver integrated care. When explored, caregiver and patient satisfaction was high. Further research into the effects on client outcomes, service use and costs is recommended in order to further analyse the impact of this approach in long-term care. To facilitate implementation, with a focus on joint responsibilities of the involved care providers, policy recommendations are to develop incentives for collaborative financial contracts between insurers and providers. PMID:19694030

Minkman, Mirella M N; Ligthart, Suzanne A; Huijsman, Robbert

2009-09-01

340

Telemedicine: interventional decentralised blood pressure telemonitoring (idTBPM).  

PubMed

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

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

2015-01-01

341

Heavy Metal Risk Management: Case Analysis  

PubMed Central

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

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

342

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

PubMed

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

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

2014-06-01

343

Opportunities for improving disaster management in Chile: a case study  

Microsoft Academic Search

Purpose – This paper seeks to propose measures to improve management of rainfall-related disasters in Chile. Design\\/methodology\\/approach – This research was carried out as a case study in the semi-arid region of Chile where above-normal rainy events occur once or twice during some rainy seasons. Measures to improve management are suggested based on theory, field data, and community participation. The

Paulina Aldunce; Alejandro León

2007-01-01

344

Web Service management system for bioinformatics research: a case study  

Microsoft Academic Search

In this paper, we present a case study of the design and development of a Web Service management system for bioinformatics\\u000a research. The described system is a prototype that provides a complete solution to manage the entire life cycle of Web Services\\u000a in bioinformatics domain, which include semantic service description, service discovery, service selection, service composition,\\u000a service execution, and service

Kai Xu; Qi Yu; Qing Liu; Ji Zhang; Athman Bouguettaya

2011-01-01

345

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

ERIC Educational Resources Information Center

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.…

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

2005-01-01

346

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

ERIC Educational Resources Information Center

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…

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

2014-01-01

347

Managing Transition in an Artistic Company With Entrepreneurial Management: A Case Study of Groupe Bernard Loiseau  

E-print Network

1 Managing Transition in an Artistic Company With Entrepreneurial Management: A Case Study. The artists, or the producers, often have to develop their own structure to realize a personal vision or an art project. Moreover, the characteristics of artistic companies and institutions

Boyer, Edmond

348

26 CFR 301.7454-2 - Burden of proof in foundation manager, etc. cases.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Burden of proof in foundation manager, etc. cases. 301.7454-2 Section...7454-2 Burden of proof in foundation manager, etc. cases. (a) Foundation manager. In any proceeding involving the issue...

2010-04-01

349

Suicide in a community based case management service.  

PubMed

Over a 9 year period, 532 people with a long term mental illness received the services of a community based case management program. Of the 532 clients, 13 committed suicide (2%). This group was compared to a control group matched for age, sex and length of stay in the program. No differences were found with regard to most socio-demographic and clinical variables investigated. However, statistically significant differences were found with regard to chronicity and number of post-admittance hospitalizations. Difficulties in establishing a working relationship were noted more often for clients who committed suicide. Some of the implications for case management programs are discussed. PMID:1486763

Pyke, J; Steers, M J

1992-12-01

350

Non-pharmacological management of nasal polyp: a case report.  

PubMed

Nasal polyp causes difficulty in breathing due to blockage of nasal passage. The pathogenesis of nasal polyposis is not known. The primary medical therapy available for nasal polyposis is steroid administration. Antihistamines, decongestants and cromolyn sodium provide little benefit. With this background of nasal polyp pathophysiology and the existing management, a case of nasal polyp was treated with the cleansing process of yoga i.e. neti kriya and naturopathy with good result. This isolated case report warrants a need for controlled clinical trial of neti kriya to establish its role in the management of nasal polyposis. PMID:20509333

Rastogi, Rajiv; Murthy, B T C; Vinudha

2009-01-01

351

Challenges facing case management in a changing social service environment.  

PubMed

Case management has been a difficult practice to track, particularly for the purposes of outcome measurements and accountability. As both policymakers and program administrators consider options for providing long-term care, the Data Analysis and Regulations Team of the California Department of Aging studied computerized client information for one of its case management programs to examine what we know about the people being served and the ability of the data collection system to meet the increasing demand for accountability. This article details the results of our study and discusses their implications within the dynamics of a changing social service environment. PMID:11974573

Lee, B

2001-01-01

352

Conservative Management of Fetus Papyraceus: A Report of Two Cases  

PubMed Central

The term fetus papyraceus is used to describe a mummified fetus associated with multiple gestations where one fetus dies and is flattened between the membranes of living fetus and uterine wall. Though the maternal and fetal complications in affected cases can be severe, we report of two cases of fetus papyraceus managed conservatively without any complications. Successful outcome is related to careful monitoring during pregnancy. PMID:24715942

Dahiya, Pushpa; Bains, Ranjita

2014-01-01

353

Telemedicine in Stroke: Organizing a Network – Rationale and Baseline Principles  

Microsoft Academic Search

Telestroke is the specific term used for the application of telemedicine in stroke. It is a consultative modality that facilitates care of patients with acute stroke at underserved hospitals by specialists at stroke centers and can play a vital role in minimizing the overall medicosocial impact of stroke. Telestroke should not be viewed as a new form of stroke therapy,

Elisabeth Medeiros de Bustos; Fabrice Vuillier; Didier Chavot; Thierry Moulin

2009-01-01

354

Intensive Care Unit Telemedicine: Review and Consensus Recommendations  

Microsoft Academic Search

Intensive care unit telemedicine involves nurses and physicians located at a remote command center providing care to patients in multiple, scattered intensive care units via computer and telecommuni- cation technology. The command center is equipped with a workstation that has multiple monitors dis- playing real-time patient vital signs, a complete elec- tronic medical record, a clinical decision support tool, a

Joseph Cummings; Cathleen Krsek; SM Karl Matuszewski

355

A deployable telemedicine capability in support of humanitarian operations.  

PubMed

This paper describes how a military concept for telemedicine support in humanitarian crisis, the Medical Command, Control, Communication and Telemedicine Special Medical Augmentation Team (MC3T SMART TEAM), was transitioned from a theoretical concept into a functioning, operational entity. The European Regional Medical Command (ERMC) MC3T SMART TEAM successfully tested its capabilities during a military training exercise with the 212th mobile army surgical hospital (MASH). This was followed by successful real-life telemedicine support missions during a planned humanitarian support mission in Africa and then an emergency disaster support mission in Pakistan. While on these missions, the SMART team provided access to the Internet and e-mail by means of limited bandwidth mobile satellite equipment, established a working telemedicine process by introducing the staff to the United States Army's "Army Knowledge Online (AKO) Remote Consultation Program," and established a successful connection of the 212th's digital radiography system to the "Tri-Service Global Encrypted Picture Archiving and Communication System (PACS) and Teleradiology Network." PMID:17603836

Meade, Kenneth; Lam, David M

2007-06-01

356

A Web-based Correctional Telemedicine System with Distributed Expertise  

Microsoft Academic Search

Due to increasingly tougher and mandatory sentencing laws, the U.S. has experienced a sharp increase in the prison population during the last decade. Correctional facilities face unique challenges in providing health care to a population that has a history of physical, mental and psychological abuse. Telemedicine is an innovative way to bring health care to prisons in a safe and

Siva R. Sankaran; Tung X. Bui

2000-01-01

357

Mobile e-Health: The Unwired Evolution of Telemedicine  

Microsoft Academic Search

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

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

2003-01-01

358

Arizona TeleMedicine Network: System Procurement Specifications.  

ERIC Educational Resources Information Center

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

Atlantic Research Corp., Alexandria, VA.

359

Arizona TeleMedicine Network: Engineering Master Plan.  

ERIC Educational Resources Information Center

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

Atlantic Research Corp., Alexandria, VA.

360

Differential measurements selection for evaluation of telemedicine applications  

E-print Network

have no, or significantly lower, evaluation of satisfaction compared to other classes. A trend towards measurements for better economic analysis. Methods Results We use Chi-square tests and Fisher's exact tests the period 1999-2009. Cost measurement selection for economic analysis of telemedicine applications

Oakley, Jeremy

361

Hindawi Publishing Corporation International Journal of Telemedicine and Applications  

E-print Network

of quality is improved by enhancing accessibility to care for underserved populations, containing cost cardiac patients. This represents the evolution of e-health systems from traditional desktop telemedicine in pervasive and wearable biomedical sensor technologies would have a radical impact on future health

Kumar, Sunil

362

Towards grid-enabled telemedicine in Florence JACQ1  

E-print Network

between the participating medical sites. A web site to exchange diagnosis on diabetic retinopathy between two databases. Keywords: Telemedicine ­ GRID ­ Web services ­ Diabetic Retinopathy­ Ophthalmology was also deployed for remote diabetic retinopathy screening [9]. But with this technology, the user has

Paris-Sud XI, Université de

363

Teaching Computer Vision for telemedicine systems using OpenCV  

Microsoft Academic Search

This paper reports on experiences of teaching Computer Vision for robotic telemedicine cluster system, within the practice based ICTD subject within the undergraduate Software Engineering Program at the Faculty of Engineering, University of Technology Sydney (UTS). Topics described by this paper include shared experiences in designing and implementing Computer Vision subsystem and discusses successes, as well as common problems both

Zenon Chaczko; Robin Braun

2010-01-01

364

Telemedicine: The Assessment of an Evolving Health Care Technology.  

ERIC Educational Resources Information Center

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

Reich, Joel J.

365

STARPAHC space-oriented medical evaluation. [telemedicine system  

NASA Technical Reports Server (NTRS)

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

1979-01-01

366

Hindawi Publishing Corporation International Journal of Telemedicine and Applications  

E-print Network

Hindawi Publishing Corporation International Journal of Telemedicine and Applications Volume 2008 research efforts on the production of commercial mobile health systems based on Wireless Fidelity (Wi, Article ID 417870, 11 pages doi:10.1155/2008/417870 Research Article Performance Evaluation of an Enhanced

Vouyioukas, Demosthenes

367

An Overview of the AKAMAI Telemedicine Project: A Pacific Perspective  

Microsoft Academic Search

Project AKAMAI is a congressionally mandated, Department of Defense (DOD) medical research and development program sponsored by Tripler Army Medical Center (TAMC), aimed at applying and assessing the value of telemedicine technologies. Located in the Pacific Region, the project faces the challenge of extreme distances and significant time zone differences. Project AKAMAI is committed to applying emerging technology with a

F. Craig Floro; Rosemary Nelson; Victoria Garshnek

1999-01-01

368

Overview and status of the AKAMAI Telemedicine Evaluation Initiative  

Microsoft Academic Search

Project AKAMAI is a Federally funded program designed to augment health care delivery to DoD and beneficiaries in the Pacific Basin using telecommunications technology. The AKAMAI Evaluation Initiative is a systematic evaluation of the potential contribution of telemedicine technologies and processes in a health care delivery system. In this prospective study, patients are randomly allocated to usual care (UC) or

V. Garshnek; L. Harrison Hassell

1998-01-01

369

Telemedicine Imaging Collaboration System with Virtual Common Information Space  

Microsoft Academic Search

The computerization of the clinical record and the realization of the multimedia has brought improvement of the medical service in medical facilities. It is very important for the patients to obtain comprehensible informed consent. Therefore, the doctor should plainly explain the purpose and the content of the diagnoses and treatments for the patient. We propose and design a Telemedicine Imaging

Fumio Okuyama; Takenori Hirano; Yuusuke Nakabayasi; Hirohito Minoura; Shinji Tsuruoka; Yousuke Okayama

2006-01-01

370

Nurse case management. The coming together of theory and practice.  

PubMed

Newman proves that theory can be a practical approach to nursing care delivery by applying a theory to the new nursing role of the case manager. The illustration applies Newman's theory of health and nursing and looks at its implications for various aspects of provider interface. PMID:1922978

Newman, M; Lamb, G S; Michaels, C

1991-10-01

371

Impact of School Nurse Case Management on Students with Asthma  

ERIC Educational Resources Information Center

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

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

2004-01-01

372

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

ERIC Educational Resources Information Center

"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,…

Roessler, Richard T.; Rubin, Stanford E.

2006-01-01

373

Case Management Outcomes for Women Who Use Crack  

Microsoft Academic Search

Women who use crack are at risk for HIV in addition to problems surrounding their drug use. In this study, 149 crack using women participated in a case management intervention. The sample was predominantly African-American and Hispanic and averaged 42 years old. At follow-up, significant improvements were reported on drug and alcohol use, mental and emotional health, and employment. The

Karen F. Corsi; Deborah J. Rinehart; Carol F. Kwiatkowski; Robert E. Booth

2010-01-01

374

A Faculty Case Management Practice: Integrating Teaching, Service, and Research.  

ERIC Educational Resources Information Center

Describes the involvement of the University of Oklahoma College of Nursing as a case-management provider to a state program of home and community care for frail elderly. Discusses how faculty and student involvement integrates teaching, service, and research. (SK)

Jacobson, Sharol F.; MacRobert, Margo; Leon, Cheryl; McKennon, Evelyn

1998-01-01

375

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2011 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES...are reasonably related to the population being served and the case management...paid. (b) If the State limits qualified providers of...

2011-10-01

376

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2010 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES...are reasonably related to the population being served and the case management...paid. (b) If the State limits qualified providers of...

2010-10-01

377

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2014 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES...are reasonably related to the population being served and the case management...paid. (b) If the State limits qualified providers of...

2014-10-01

378

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2013 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES...are reasonably related to the population being served and the case management...paid. (b) If the State limits qualified providers of...

2013-10-01

379

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2012 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES...are reasonably related to the population being served and the case management...paid. (b) If the State limits qualified providers of...

2012-10-01

380

Management Science in Higher Education Institutions: Case Studies from Greece  

ERIC Educational Resources Information Center

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

Saiti, Anna

2010-01-01

381

Automated court case management in the prosecutor's office  

Microsoft Academic Search

During the early fall of 1977 the National District Attorneys Association and the Suffolk County District Attorney's Office, located in Boston, Massachusetts, completed a two-year cooperative project to design, implement and install a prototype, low cost, computer based prosecutor's case management system in the Suffolk office. The completed system, and the lessons which were learned during the development of this

Garrett H. Byrne

1977-01-01

382

The Software Prototype of Civil Court Case Management in Thailand  

Microsoft Academic Search

This research work proposes an idea on the design framework of the IT support for the judiciary system in Thailand. We have performed an in-depth study of the court workflow at the Central Intellectual Property and International Trade Court (CIPITC). Case Management System and Web services concepts were applied. We also considered the practicality of system deployment at the civil

Pornpen Rungruangpattana; Tiranee Achalakul

2008-01-01

383

Environmental management and firm performance: A case study  

Microsoft Academic Search

This study has as its aim to help to clarify the relationship between environmental management and economic performance by integrating it into a wider framework that includes the relationship between environmental strategy and firm performance, the latter being understood as the combination of environmental performance, competitive advantage and economic performance. A case study of the COATO farming cooperative showed us

Enrique Claver; María D. López; José F. Molina; Juan J. Tarí

2007-01-01

384

School Asthma Screening and Case Management: Attendance and Learning Outcomes  

ERIC Educational Resources Information Center

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

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

2013-01-01

385

Specifying Intensive Case Management: A Multiple Perspective Approach  

Microsoft Academic Search

“Intensive case management” (ICM) programs for people with serious mental illness are found widely throughout the United States. However, there is no standard definition or conceptualization of ICM. Despite these differences, ICM aspires to a set of common principles and core functions derived from the concept of continuity of care. This study attempted to identify the elements of ICM program

Richard W. Schaedle; Irwin Epstein

2000-01-01

386

Medical Training Skills Curriculum for Case Management Assistants.  

ERIC Educational Resources Information Center

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

Family Planning Council of Southeastern Pennsylvania, Philadelphia.

387

The Affordable Care Act, Medicare spending, and the case manager.  

PubMed

At first blush, it looks like there is welcome relief from the upward growth of Medicare spending. It is important for the case manager to look at the big picture, as there are other reasons for this downward trend, including recovery audit contractor "take backs" and cost shifting to hospitals and Medicare beneficiaries. PMID:23735963

Powell, Suzanne K

2013-01-01

388

Case Study Report: Agile Product Management at Planon  

E-print Network

in software development methodology of the last few years has been the introduction of agile principles. SinceCase Study Report: Agile Product Management at Planon K. Vlaanderen S. Brinkkemper T. Cheng S Abstract With the advent of agile development methods such as SCRUM, the unpredictable and dynamic process

Utrecht, Universiteit

389

The Case for Managed International Cooperation in Space Exploration  

E-print Network

The Case for Managed International Cooperation in Space Exploration By D. A. Broniatowski, G. Ryan Faith, and Vincent G. Sabathier Introduction International cooperation in space exploration has will accrue to those partners who choose to approach space exploration as a mutually beneficial endeavor

de Weck, Olivier L.

390

Evaluation of Michigan's Foster Care Case Management System  

ERIC Educational Resources Information Center

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…

Johnson, Kristen; Wagner, Dennis

2005-01-01

391

A case-based reasoning framework for workflow model management  

Microsoft Academic Search

In order to support efficient workflow design, recent commercial workflow systems are providing tem- plates of common business processes. These templates, called cases, can be modified individuallyor col- lectivelyinto a new workflow to meet the business specification. However, little research has been done on how to manage workflow models, including issues such as model storage, model retrieval, model reuse and

Therani Madhusudan; J. Leon Zhao; Byron Marshall

2004-01-01

392

Telemedicine in radiotherapy: a study exploring remote treatment planning, supervision and economics.  

PubMed

In January 2002, the departments of radiotherapy at the University Hospital of North Norway and the Norwegian Radium Hospital were connected through a 2 Mbit/s digital telecommunication line. The treatment planning systems at the two institutions were connected and videoconferencing units were installed. We explored the feasibility of remote treatment planning, supervision, second opinions and education. Tests involved two dummy cases and six patients. Remote simulation procedures were carried out for five patients. A cost-minimization analysis was performed. Treatment planning was not completely successful as the software could not handle plans including bolus or weighting between the fields. Remote supervision was possible. A common patient record and radiotherapy system, including digital imaging, digital prescription and approval forms and digital signature, were felt to be desirable. The threshold (break-even point) comparing the costs of telemedicine with those of transportation by air was 12 patients/year. Telemedicine in radiotherapy appears to be feasible, but some limitations must be overcome. PMID:16035967

Norum, Jan; Bruland, Øyvind S; Spanne, Oddvar; Bergmo, Trine; Green, Tor; Olsen, Dag R; Olsen, Jan H; Sjåeng, Elisabeth E; Burkow, Tatiana

2005-01-01

393

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

NASA Astrophysics Data System (ADS)

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

Maani, Rouzbeh; Camorlinga, Sergio; Eskicioglu, Rasit

2009-02-01

394

Chiropractic management of chronic idiopathic meralgia paresthetica: a case study  

PubMed Central

Objectives This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. Clinical Features A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Intervention and Outcomes Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. Conclusion In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient. PMID:22942840

Houle, Sébastien

2012-01-01

395

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

ERIC Educational Resources Information Center

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

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

2012-01-01

396

Three Principles for Determining the Relevancy of Store-and-Forward and Live Interactive Telemedicine: Reinterpreting Two Telemedicine Research Reviews and Other Research  

PubMed Central

Abstract The Agency for Healthcare Research and Quality sponsored two telemedicine research reviews. The latest review concluded that telemedicine is most relevant to specialties, such as psychiatry and neurology, where high levels of patient interaction are crucial to assessment. Telemedicine research studies cited in the reviews having positive findings in the specialties of ophthalmology, otolaryngology, obstetrics and gynecology, gastroenterology, and cardiology and more recent research in these areas are reviewed to identify criteria other than degree of interaction for determining the appropriateness of telemedicine interventions. These criteria include congruity or the extent that procedures used in telemedicine are similar to those of in-person examination, fidelity or the degree to which the information used for assessment in remote examinations is of similar quality to that used in-person, and reliability or the consistency with which information can be gathered and transmitted. PMID:23186085

Ackerman, Michael

2013-01-01

397

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

ERIC Educational Resources Information Center

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

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

2000-01-01

398

Data Mining for Autonomic System Management: A Case Study at FIU-SCIS  

E-print Network

Data Mining for Autonomic System Management: A Case Study at FIU-SCIS Technical Report: FIU system management and then present a case study on Autonomic System Manager: a software system we computing, self management, self protection, network and system management, anomaly detection 1

Sadjadi, S. Masoud

399

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

PubMed Central

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

Breen, Gerald-Mark; Matusitz, Jonathan

2009-01-01

400

Management challenges in a case of gender identity disorder.  

PubMed

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

Rathi, Anubhav; Bhatia, Manjeet Singh

2014-01-01

401

Implications for healthcare knowledge management systems: a case study.  

PubMed

The notion of incorporating knowledge management (KM) in the healthcare sector has recently witnessed a lot of interest, both from healthcare practitioners and scholars. Because KM for healthcare has just started to appear on the radar of healthcare stakeholders, there exists very limited research (particularly empirical data) to guide healthcare stakeholders, both from an academic and organizational perspective. This paper attempts to contribute to the adoption of KM in the clinical and healthcare sectors by collecting and analyzing data on technological, organizational and managerial perspectives on KM in these sectors. This paper provides an analysis of a case study which looks at current practices towards healthcare information management. PMID:17281542

Dwivedi, A N; Bali, R K; Naguib, R N G

2005-01-01

402

Management challenges in a case of gender identity disorder  

PubMed Central

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.

Rathi, Anubhav; Bhatia, Manjeet Singh

2014-01-01

403

Telemedicine in the Malaysian Multimedia Super Corridor: Towards Personalised Lifetime Health Plans  

Microsoft Academic Search

The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system—a distributed multi-module application for the periodic

Syed Sibte; Raza ABIDI; Zaharin YUSOFF

1999-01-01

404

The Theater Telemedicine Prototype Project: Multimedia E-Mail in the Pacific  

Microsoft Academic Search

The Theater Telemedicine Prototype Project (T2P2) initiated by the Pacific Medical Network (PACMEDNET) focuses on providing support for telemedicine clinical workflow in the Pacific. This region is characterized by many remote field sites having limited bandwidth requiring consults at a limited number of regional centers such as Tripler Army Medical Center (TAMC). This client-server telemedicine system utilizes commercial and government

Clayton Rasberry; Victoria Garshnek

1999-01-01

405

The Alaska experience using store-and-forward telemedicine for ENT care in Alaska.  

PubMed

This article discusses the development, evaluation, and growth of telemedicine in Alaska. Store-and-forward telemedicine has been used to deliver ear, nose, and throat (ENT) care to rural Alaska since 2002. It has proved valuable in the treatment of many conditions of the head and neck, and it is particularly well suited for the diagnosis and treatment of ear disease. Usage has grown steadily as telemedicine has become widely accepted. Store-and-forward telemedicine has been shown within the Alaska Native Health System to improve access for care and reduce wait times, as well as decrease travel-associated costs for patients. PMID:22032488

Kokesh, John; Ferguson, A Stewart; Patricoski, Chris

2011-12-01

406

Postanoxic myoclonus: two case presentations and review of medical management.  

PubMed

Postanoxic myoclonus is a rare manifestation after an anoxic event, with fewer than 150 cases reported in the literature. The condition is characterized by myoclonic jerks, which are worse on action than at rest, and postural lapses, ataxia, and dysarthria. The disability caused by postanoxic myoclonus can be profound, and treatment in the rehabilitation setting is exceptionally challenging. We present 2 patients who suffered from postanoxic myoclonus after an anoxic event, both of whom were successfully treated with a combination of levetiracetam, valproic acid, and clonazepam. These cases act as a framework for discussing the management of postanoxic myoclonus in the clinical setting. PMID:24060492

Budhram, Adrian; Lipson, David; Nesathurai, Shanker; Harvey, David; Rathbone, Michel P

2014-03-01

407

Role transition from caregiver to case manager, part 1.  

PubMed

This two-part article explores the process of role transition as it pertains to nurses moving from roles of caregivers to roles of case managers. Part 1 of the article presents a theoretical model that demonstrates the interplay of significant factors in the process of role transition and discusses how this model can be used to examine nurses experience of this transition. Part 2 presents findings from a qualitative study involving interview and focus group data contributed by nurses who have made the transition from caregiver to case manager. Data point to specific tensions experienced by these nurses, which are associated with time-task orientation, interactions and relationships, business culture and objectives, and self-image and professional identity. Recommendations for preparing and supporting nurses through this role are also offered. PMID:16317330

Schmitt, Nancy

2005-01-01

408

Applied game theory for the hospital manager. Three case studies.  

PubMed

This article reviews the more complex aspects of game theory than those presented in a recent HCM article. Following a basic overview of terminology and simplified examples, case studies are presented to show the hospital manager how game theory is a useful modeling strategy for predicting human interactions and the potential outcomes of certain decisions, especially economic ones. Understanding game theory provides the manager with an understanding of basic and advanced strategies that can be utilized to competitive advantage in the health care market (thus giving it applicability at the manager's clinical level of decision making), as well as grasping the "larger picture" of health care decision making at high levels, such as in professional societies and government. PMID:15192996

Dowd, Steven B

2004-01-01

409

Management of pediatric mandibular fracture: a case series.  

PubMed

A pediatric mandibular fracture can cause a child severe pain and the parent or caregiver extreme worry. While the pattern of fractures and associated injuries in children is similar to adults, the incidence is low. Due to a number of factors, including the anatomical complexity of the developing mandible in a child, management of such fractures differs from that of adults and can greatly challenge the pediatric dentist. Various treatment modalities of managing mandibular fracture are available, such as closed/open cap splint with circummandibular wiring, arch-bar fixation, and cementation of the cap splint. This article reviews 19 cases in the management of pediatric facial fracture using varied treatment methods. PMID:25199030

Agarwal, Ravi M; Yeluri, Ramakrishna; Singh, Chanchal; Chaudhry, Kalpna; Munshi, Autar K

2014-09-01

410

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

PubMed

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

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

2008-01-01

411

Surgical Management of Fractured Orthodontic Mini- Implant- A Case Report  

PubMed Central

The idea of absolute anchorage has always been an elusive goal for clinicians. Orthodontic mini-implants or temporary anchorage devices allow tooth movements previously thought to be impossible or difficult. Although extensive literature exists on use of temporary anchorage devices, their failures have been hardly focused upon, especially implant fracture. The following case report describes successful management of fractured orthodontic mini-implant. PMID:25738088

Jain, Anoop; Sumra, Nida

2015-01-01

412

Oral bullous lichen planus: Case report and review of management  

PubMed Central

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

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

2012-01-01

413

Management of haemangioma with sclerosing agent: a case report.  

PubMed

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

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

2013-01-01

414

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

E-print Network

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 ...

Qureshi, Asfandyar

415

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

E-print Network

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

Moussavi, Zahra M. K.

416

Intracranial epidermoid tumor; microneurosurgical management: An experience of 23 cases  

PubMed Central

Objectives: An intracranial epidermoid tumor is relatively a rare tumor, accounting for approximately 0.1% of all intracranial space occupying lesions. These are also known as pearly tumor due to their pearl like appearance. In this series, the localization of the tumor, presenting age and symptoms, imaging criteria for diagnosis, surgical management strategy with completeness of excision and overall outcome were studied prospectively. Here, we report our short experience of intracranial epidermoid as a whole. Materials and Methods: Between January 2006 to December 2010, 23 cases of intracranial epidermoid were diagnosed preoperatively with almost certainty by computed tomography (CT) and magnetic resonance imaging (MRI) of brain in plain, contrast and other relevant studies. All of them underwent operation in Dhaka Medical College Hospital and in some Private Hospital in Dhaka, Bangladesh. All patients were followed-up routinely by clinical examination and neuroimaging. Average follow-up was 39 (range-71-11months) months. Patients of the series were prospectively studied. Results: Supratentorial epidermoids were 04 cases and infratemporal epidermoids were 19 cases. Clinical features and surgical strategy varies according to the location and extension of the tumors. Age range was 19-71 years (37.46 years). Common clinical features were headache, cerebellar features, seizure, vertigo, hearing impairment and features of raised intracranial pressure (ICP). Investigation was CT scan or/+ MRI of brain in all cases. Pre-operative complete excision was 20 cases, but post-operative images showed complete excision in 17 cases. Content of tumor was pearly white/white material in all cases except one, where content was putty material. Re-operation for residual/recurrent tumor was nil. Complications included pre-operative mortality one case, persisted sixth nerve palsy in one case, transient memory disturbance one case, and extra dural hematoma one case. One senior patient expired three months after the operation from spontaneous intracerebral hemorrhage. Rest of the patients were stable and symptom/s free till last follow-up. Conclusion: In the management of such tumors, one should keep in mind that an aggressive radical surgery carrying a high morbidity and mortality and a conservative subtotal tumor excision is associated with a higher rate of recurrence, but earlier diagnosis and complete excision or near total excision of this benign tumor can cure the patient with the expectation of normal life. PMID:23741259

Chowdhury, Forhad Hossain; Haque, Mohammod Raziul; Sarker, Mainul Haque

2013-01-01

417

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

Code of Federal Regulations, 2011 CFR

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

2011-04-01

418

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

Code of Federal Regulations, 2013 CFR

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

2013-04-01

419

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

Code of Federal Regulations, 2014 CFR

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

2014-04-01

420

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

Code of Federal Regulations, 2012 CFR

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

2012-04-01

421

HIV case manager preparedness for practice in Ryan White CARE Act funded settings.  

PubMed

While current research on the factors affecting the HIV epidemic within the general population has considered the role of HIV case managers, much remains to be known about case management effectiveness and how it might be enhanced. This article presents the data from a statewide survey of case management professionals in Florida. The study focused on case managers' preparation for practice and barriers to successful practice. The study results reflect a very broad educational preparation in multiple disciplines with highly varied means of case manager training and orientation at entry to practice. Further, the results highlighted the existence of multiple barriers that challenge the ability of case managers to cope with the demands of case management practice in sites serving people living with HIV/AIDS who are socially and economically challenged. The article concludes with recommendations for changes in the system that would enhance the preparation of case management professionals for entry to practice. PMID:24117030

Whyte Iv, James; Eccles, David W; Whyte, Maria D; Pappas, Cara; Cesnales, Nicole I

2013-01-01

422

The simulation model of teleradiology in telemedicine project.  

PubMed

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

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

2015-01-01

423

Sustainable Waste Management; Case study of Nagpur INDIA Dr. Vivek S. Agrawal  

E-print Network

Sustainable Waste Management; Case study of Nagpur INDIA Dr. Vivek S. Agrawal cdcindia waste management is far from being satisfactory. The environmental and health hazards caused Municipal Solid Waste (Management and Handling) Rules 2000, under the Environmental Protection Act, 1986

Columbia University

424

Telemedicine use among burn centers in the United States: a survey.  

PubMed

Telemedicine has been increasingly used in a host of settings for over 20 years. Burns are well suited for evaluation by either synchronous ("interactive") video or asynchronous digital ("store and forward") imagery, but little information is available about telemedicine use in burn care. The authors surveyed U.S. burn center directors to assess their current use of, and interest in, telemedicine in clinical burn treatment. With Institutional Review Board approval, a web-based survey (surveymonkey.com) was created and sent to directors of 126 burn centers in the United States. Questions measured the use of telemedicine by burn centers and burn directors' attitudes toward telemedicine. Surveys were returned from 50 centers (40%). Directors of 42 units (84%) reported using telemedicine; 37 use it routinely. Interactive video communication was used by 18 centers, store and forward by 38 centers, and remote access to patient data by home computer or personal digital assistant in 41 centers. Uses included remote evaluation of acute burns for consultation, for help in determining the need for transfer, or for remote clinic follow-up. Users identified some problems with current telemedicine usage, including Health Insurance Portability and Accountability Act/compliance, licensure, and billing/collection issues. Importantly, 40 respondents (80%) indicated that they would like programming on telemedicine to be available at American Burn Association's annual meetings. Use of telemedicine is fairly widespread among U.S. burn centers, with volume and type of usage varying widely. Significant interest in learning more about telemedicine suggests strongly that telemedicine should be included in the annual program at the American Burn Association. PMID:22105096

Holt, Brennen; Faraklas, Iris; Theurer, Lou; Cochran, Amalia; Saffle, Jeffrey R

2012-01-01

425

Chiropractic management of breast-feeding difficulties: a case report  

PubMed Central

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

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

2011-01-01

426

Case management for dually diagnosed individuals involved in the criminal justice system  

Microsoft Academic Search

A case-management model for individuals with substance abuse and mental health disorders who are involved in the criminal justice system is described, based on the experience of a rural demonstration project. Detailed descriptions of case-management activities and the philosophy underlying this model of case management are provided. A major goal of these case-management services was to improve access to appropriate

Susan Harrington Godley; Rh. D; Mickey Finch; Linda Dougan; Maureen McDonnell; Melissa McDermeit; Angela Carey

2000-01-01

427

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

PubMed Central

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

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

2011-01-01

428

Medical electronic link (MEL): providing telemedicine on the World Wide Web.  

PubMed

Many tertiary care centers in the USA have attempted to implement interactive television (IATV) or dynamic telemedicine systems. The advantage these systems provide is real-time interaction. The biggest disadvantage is cost: expensive hardware, band-width and personnel. An alternative to IATV is Medical Electronic Link (MEL); a low cost, store-forward, internet-based physician consultation system. MEL allows physicians in remote locations to consult physicians at the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire by using the World Wide Web. The Benefits of MEL are low hardware and band-width costs, accessibility, a self-explanatory interface, convenience, and its use of the case record. This system has been implemented at a family practice clinic in Manchester, NH and at the Tribhuvan University Teaching Hospital in Kathmandu, Nepal. PMID:10168928

Moncur, J T; Rosen, J M; Zhu, S; Limonadi, F M

1997-01-01

429

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

E-print Network

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

Tappert, Charles

430

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

ERIC Educational Resources Information Center

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

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

2007-01-01

431

From case management to court clinic: examining forensic system involvement of persons with severe mental illness  

Microsoft Academic Search

The study examined the flow of a state mental health agency's case-managed clients into its forensic mental health court clinic systems for evaluation of competency to stand trial (CST) for a criminal offense. An analysis of merged encounter data from the case management and court clinic systems revealed that roughly 2% of the case-managed population were referred to court clinics

William H. Fisher; Ira K. Packer; Thomas Grisso; Melissa McDermeit; Julie-Marie Brown

2001-01-01

432

From Case Management to Court Clinic: Examining Forensic System Involvement of Persons with Severe Mental Illness  

Microsoft Academic Search

The study examined the flow of a state mental health agency's case-managed clients into its forensic mental health court clinic systems for evaluation of competency to stand trial (CST) for a criminal offense. An analysis of merged encounter data from the case management and court clinic systems revealed that roughly 2% of the case-managed population were referred to court clinics

William H. Fisher; Ira K. Packer; Thomas Grisso; Melissa McDermeit; Julie-Marie Brown

2000-01-01

433

Job Title Homeless Prevention Case Manager Employer/ Agency Humble Area Assistance Ministries  

E-print Network

Job Title Homeless Prevention Case Manager Employer/ Agency Humble Area Assistance Ministries Job Description The Homeless Prevention Case Manager will be responsible for case management as it relates to the agency's homeless prevention programs funded through ESG, United Way- Basic Needs and other sources

Azevedo, Ricardo

434

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

E-print Network

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

Sheridan, Scott

435

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

E-print Network

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

Sheridan, Scott

436

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

E-print Network

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

Sheridan, Scott

437

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

E-print Network

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

Sheridan, Scott

438

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

Microsoft Academic Search

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

George Kontaxakis; Stefan Walter; Georgios Sakas

2000-01-01

439

Case management insider. Managing length of stay using patient flow--Part 4.  

PubMed

Managing patient flow is a complex process that includes the daily management of patient throughput and capacity issues, and also the measurement and management of monthly data indicators. These indicators touch on every department and discipline in the hospital and should be readily shared and discussed. Because patient flow management is so complicated, it will require the active participation of a steering committee as well. The department of case management cannot manage patient flow alone. No department can. It is an interdisciplinary issue and the solutions must come from the interdisciplinary team. Be sure to keep track of your daily admissions and discharges, available beds and daily bottlenecks. At the same time, look for patterns and opportunities in the data you collect to continuously improve flow over time. Stay current with The Joint Commission standards on patient flow which can be found in the leadership section of the standards. Patient flow is an old problem with a new name. Reductions in payment, and the need to continuously manage length of stay require a deep dive look at all the elements affecting your hospital's flow. PMID:23755439

Cesta, Toni

2013-06-01

440

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

ERIC Educational Resources Information Center

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

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

2007-01-01

441

GIS and spatial analysis for costs and services optimization in neurological telemedicine  

Microsoft Academic Search

Telemedicine is an integrated, biomedical and psychosocial, secondary prevention intervention, where a specialized team guides the patient and his family in the course of the disease by reducing the stress of caregivers and allowing patients to stay longer at home, reducing, consequently, costs related to go to the specialist clinic. Teleneurology is a part of Telemedicine which uses modern communication

A. Bramanti; L. Bonanno; A. Celona; S. Bertuccio; A. Calisto; P. Lanzafame; P. Bramanti

2010-01-01

442

The multiple contexts of borders that impact telemedicine as a healthcare delivery solution  

Microsoft Academic Search

For five decades, telemedicine—the use of communication technologies to provide health care at a distance—has improved access to health care for individuals who have previously had limited access. With the increasing number of health challenges across the globe, such as growing costs and limited health resources in rural areas, telemedicine is poised to be a platform to improve these problems.

Pamela Whitten; Jennifer Cornacchione

2010-01-01

443

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

Code of Federal Regulations, 2010 CFR

...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)...

2010-01-01

444

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

Microsoft Academic Search

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

Riccardo Bellazzi; Stefania Montani; Alberto Riva; Mario Stefanelli

2001-01-01

445

A Comparison of Diabetes Education Administered Through Telemedicine Versus in Person  

Microsoft Academic Search

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

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

2003-01-01

446

Study quality and evidence of benefit in recent assessments of telemedicine  

Microsoft Academic Search

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

David Hailey; Arto Ohinmaa; Risto Roine

2004-01-01

447

Telemedicine for mountain climbers with high quality video and stethoscope sound transmission  

Microsoft Academic Search

An experimental telemedicine network is set up to provide telemedicine support to temporary mountain clinic on Japan Alps. The network is composed of long-range wireless LAN's and three CATV networks. It can simultaneously transmit MPEG-2 based video at 2 Mbps and digital stethoscope sound at 192 kbps, which provide enough resolution for doctors to diagnosis.

M. Nakamura; Yuying Yang; Y. Miura; M. Takizawa

2003-01-01

448

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

ERIC Educational Resources Information Center

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

Bangert, David; Doktor, Boert; Johnson, Erik

2001-01-01

449

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support  

Microsoft Academic Search

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

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

2003-01-01

450

Telemedicine Applied to Disaster Medicine and Humanitarian Response: History and Future  

Microsoft Academic Search

During the past decade, the military, space programs, and various governmental agencies have progressively developed telemedicine applications and tested them in real and simulated civilian disaster emergencies. This paper reviews the history of telemedicine activities during actual disasters and related situations, provides insight into issues that must be addressed, and summarizes innovations that are likely to improve future disaster outcomes.

Victoria Garshnek; Frederick M. Burkle Jr.

1999-01-01

451

Managing environmental sensitivity: an overview illustrated with a case report  

PubMed Central

While the adverse impact of certain environmental agents is well established and affect individuals in a predictable dose-dependent manner, the validity of some exposure syndromes, such as environmental sensitivity, attributed to the influence of environmental chemicals in low, usually harmless doses, is less certain. Diagnosis of environmental sensitivity is subjective, and both standard medical and complementary and alternative treatment often fails to provide clinically meaningful functional gains. Existing evidence suggests that in many individuals with these syndromes, psychosocial factors play a prominent role. In this article we present an approach to managing patients presenting with sensitivities to environmental agents that includes identifying and managing organic disease, obtaining a thorough biopsychosocial history, confirming a diagnosis, and developing a rehabilitative process that focuses on support and improvements in function. A case of multiple chemical sensitivity illustrates this approach. PMID:18516285

Busse, Jason W.; Reid, Steven; Leznoff, Arthur; Barsky, Arthur J.; Qureshi, Roohi; Guyatt, Gordon H.

2008-01-01

452

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

E-print Network

that power in a transparent information system, managed by an independent Information Manager and sharedPractical Knowledge Builds Projects: Case for Independent Construction Information Management MANAGEMENT David Gurley1 and Bill McManus2 ABSTRACT This paper argues that the management of information

Tommelein, Iris D.

453

Efficacy of telemedicine for thrombolytic therapy in acute ischemic stroke: a meta-analysis.  

PubMed

The aim of this study was to assess the benefits of telemedicine in the delivery of thrombolytic therapy for patients with acute ischemic stroke. We performed a meta-analysis using combinations of the following terms: telestroke, telemedicine, tissue plasminogen activator/t-PA, and acute ischemic stroke. The primary outcome was favorable outcome based on the modified Rankin score. Secondary outcomes were incidence of symptomatic intracranial hemorrhage and overall mortality. We found no significant difference in favorable outcome between the telemedicine and control groups, and no significant difference was found between these groups in the rate of symptomatic intracranial hemorrhage or overall mortality. Patients with acute ischemic stroke who were treated with intravenous thrombolysis had similar outcomes regardless of whether telemedicine was used or they were treated in-person at a medical facility. Telemedicine can be used to support hospitals with limited experience in administering thrombolytic therapy for stroke. PMID:25670675

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

2015-04-01

454

Continuous Case Management of a German Statutory Health Insurance  

PubMed Central

To support insured patients, especially those with chronic illnesses or disabilities, the German statutory health insurance Techniker Krankenkasse (TK) offers continuous case management (CCM) under a rehabilitation advisory program serving more than 150,000 insurees each year. Rehabilitation advisors provide individual counseling, generally by telephone. They inform patients about treatment and rehabilitation options, about health care providers, and about other TK services. In a key feature, the model coordinates care across different health care sectors. Through the CCM approach, TK not only assures the best possible care for its insurees, but also safeguards its long-term financial sustainability PMID:17288078

Hecke, Torsten L.; Erzberger, Melanie

2005-01-01

455

A case of error disclosure: a communication privacy management analysis.  

PubMed

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

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

2013-12-01

456

Anaesthetic management of a case of idiopathic intracranial hypertension  

PubMed Central

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

Butala, Bina P; Shah, Veena R

2013-01-01

457

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

PubMed

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

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

2013-09-01

458

[Cesarean scar pregnancy: a case report of conservative management].  

PubMed

A caesarean scar pregnancy is a rare type of ectopic pregnancy which engages the vital prognosis either by hemorrhage or by early uterine rupture. We report the case of a 38-years-old patient who presented an ectopic pregnancy developed inside a previous caesarean section scar. The diagnosis was made at eight weeks of gestation by ultra-sound and allowed a fast management. We chose a conservative medical treatment by methotrexate both systemic and in situ. A hemorrhagic complication occured in two months of the initial treatment, requiring an endovascular therapy as well. PMID:20227196

Maheut, L; Seconda, S; Bauville, E; Levêque, J

2010-05-01

459

Anaesthetic management in a case of huge plunging ranula  

PubMed Central

Plunging ranula is a rare form of mucous retention cyst arising from submandibular and sublingual salivary glands, which may occasionally become huge occupying the whole of the floor of the mouth and extending into the neck, thus, restricting the neck movement as well as disfiguring the normal airway anatomy. Without fiberoptic assistance, blind or retrograde nasal intubation remains valuable choices in this type of situation. Here, we present a case of successful management of airway by blind nasal intubation in a patient posted for excision of a huge plunging ranula.

Sheet, Jagabandhu; Mandal, Anamitra; Sengupta, Swapnadeep; Jana, Debaleena; Mukherji, Sudakshina; Swaika, Sarbari

2014-01-01

460

Hematological and surgical management in Glanzmann's thrombasthenia: a case report.  

PubMed

Glanzmann's thrombasthenia (GT) is a rare, congenital, and moderate to severe platelet disorder. The bleeding time is increased, due to lack of platelet aggregation, since the patients with GT have deficient or dysfunctional integrin membrane glycoproteins IIb and IIIa essential for platelet aggregation. Children with GT are mostly diagnosed very early in life due to the spontaneous and unexplained mucocutaneous bleeding. It is quite a challenging task when any surgery is indicated for children with GT. This case report is about the medical and surgical management of an 11-year-old girl diagnosed with Glannzmann's thrombasthenia who had to undergo a maxillary cyst enucleation. PMID:24739923

Gopalakrishnan, Anjana; Veeraraghavan, Ravi; Panicker, Prasanth

2014-01-01

461

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

NASA Astrophysics Data System (ADS)

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

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

2011-01-01

462

Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report  

PubMed Central

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

2014-01-01

463

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

PubMed Central

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

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

2014-01-01

464

Meta-case based realization of design rationale management systems  

SciTech Connect

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

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

1996-12-31

465

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

PubMed Central

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

Rusnak, James E.

1987-01-01

466

Delusional infestations: case series, differential diagnoses, and management strategies.  

PubMed

Physicians are not infrequently consulted by distraught patients with delusions of infestation who believe that they are infested with external or internal parasites and describe a crawling sensation of bugs or worms on or under their skin. Internet search engines were queried with the keywords as search terms to examine the latest articles on delusional infestations in order to describe presenting manifestations, differential diagnoses, and effective management strategies. The demographic and behavioral features of delusional infestations have remained constant and include: (1) onset in well-educated, middle-aged adults who are pet owners; (2) production of purported specimens of causative parasites; (3) pesticide overtreatment of themselves, their households, and pets; (4) excessive cleaning or vacuuming of households; (5) intense anger and resentment directed at physicians failing to confirm their self-diagnoses; and (6) sharing delusional symptoms with spouses or relatives. Although some reports have suggested that cases of delusional infestation are increasing today in the tropics, most studies have confirmed a stable incidence over time and similar disorder demographics worldwide. However, management strategies for delusional infestations have changed significantly over time with second generation, atypical antipsychotics offering safer adverse effect profiles and better prognoses than earlier therapies with first generation, typical antipsychotics. The most effective management strategies for delusional infestations include empathetic history-taking and active listening to the patient, careful exclusion of true parasitoses, and a therapeutic regimen that includes a second generation neuroleptic agent. PMID:25311458

Diaz, James H; Nesbitt, Lee T

2014-01-01

467

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

PubMed

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

Henry, Lucian

2015-03-01

468

Chiropractic management of postpartum pubic symphysis diastasis: A case report  

PubMed Central

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

Henry, Lucian

2015-01-01

469

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

PubMed

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