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1

Research Paper: 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  

Microsoft Academic Search

ContextTelemedicine is a promising but largely unproven technology for providing case management services to patients with chronic conditions and lower access to care.ObjectivesTo examine the effectiveness of a telemedicine intervention to achieve clinical management goals in older, ethnically diverse, medically underserved patients with diabetes.Design, Setting, and PatientsA randomized controlled trial was conducted, comparing telemedicine case management to usual care, with

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

2009-01-01

2

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.

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

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

2009-04-23

4

Critical to quality in telemedicine service management: application of DFSS (Design for Six Sigma) and SERVQUAL).  

PubMed

Telemedicine generally refers to the use of communications and information technologies for the delivery of health care. owever, telemedicine is not merely a simple combination of health care and technology. The researchers propose a systematic approach for assessing needs of telemedicine customers, called critical-to-quality (CTQ) in Six Sigma, with a purpose of continuous quality improvement. The combination approach using DFSS (Design for Six Sigma) and SERVQUAL (Service Quality Framework) was applied to define the critical quality attributes of telemedicine service management and to match them with the current telemedicine process. With a step-by-step procedure, telemedicine service process was reviewed and all the important CTQ candidates identified via a case study. The findings suggest that nurses need further understanding and research methods that will improve and manage the quality of health care service in various medical fields. PMID:19330973

Yun, Eun Kyoung; Chun, Kee Moon

5

Telemedicine and diabetes management: current challenges and future research directions.  

PubMed

Telemedicine is lying between fading and future. Several clinical studies and critical reviews have been published recently, but the results are inconclusive and the adoption of telemedicine interventions in clinical practice is slow. This article discusses some of the current problems related to the adoption of telemedicine systems and focuses on the information technology solutions that appear to be most promising for diabetes management in the near future. Context awareness, user modeling, intelligent dialogues, and integrated information systems are presented. Some potential future scenarios for the adoption of telemedicine, which combine novel technologies and new organizational models, are also discussed. Within those scenarios, telemedicine may prove to be a good instrument to support health care providers in the effective management and prevention of diabetes mellitus. PMID:19885183

Bellazzi, Riccardo

2008-01-01

6

Telemedicine and Diabetes Management: Current Challenges and Future Research Directions  

PubMed Central

Telemedicine is lying between fading and future. Several clinical studies and critical reviews have been published recently, but the results are inconclusive and the adoption of telemedicine interventions in clinical practice is slow. This article discusses some of the current problems related to the adoption of telemedicine systems and focuses on the information technology solutions that appear to be most promising for diabetes management in the near future. Context awareness, user modeling, intelligent dialogues, and integrated information systems are presented. Some potential future scenarios for the adoption of telemedicine, which combine novel technologies and new organizational models, are also discussed. Within those scenarios, telemedicine may prove to be a good instrument to support health care providers in the effective management and prevention of diabetes mellitus.

Bellazzi, Riccardo

2008-01-01

7

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

PubMed Central

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

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

2012-01-01

8

Assessing technological barriers to telemedicine: technology-management implications  

Microsoft Academic Search

Telemedicine, the use of information technology to deliver health care from one location to another, has the potential to increase the quality and access to health care and to lower costs. This growth of telemedicine installations is occurring even as the utilization rates for installed telemedicine projects are falling well below expectations. Drawing on data collected from three operational telemedicine

David L. Paul; Keri E. Pearlson

1999-01-01

9

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

PubMed

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

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

2013-01-01

10

Challenges in managing diffusion of telemedicine technology in South Africa  

Microsoft Academic Search

Technological progresses in the information, communication and telecommunication (ICT) industries and innovations telemedia industry have made telemedicine an increasingly viable health care delivery choice for emerging economies like South Africa. Simply stated telemedicine is the use of ICT technologies in conjunction with telemedia systems to provide health care services when distance separates the health professionals and patients. This paper discusses

Michael Ogembo Kachieng'a

2011-01-01

11

A retrospective study of the influence of telemedicine in the management of pediatric facial lacerations.  

PubMed

A study was carried out to determine the influence of telemedicine on management of facial lacerations in children. Proforma was designed, and information was collected retrospectively over a 4-month period. Of the 2524 telemedicine referrals, 27% (693/2524) were pediatric referrals. One hundred forty-five of these were children with facial lacerations, of which only 98 were admitted for possible surgical management. During the same period, a further 45 children were admitted to the pediatric ward through verbal referral. The average age of the children admitted was 4.85 years and male-to-female ratio was 2:1. Lacerations to the lips (42%) were the most common site of injury, and the majority sustained the injury as a result of a mechanical fall (42%). Among the telemedicine group, 86% had surgery, whereas in the nontelemedicine group it was 82%. On average, 2 to 3 photographs accompanied the referrals, and none of the patients who were treated conservatively by the referring centers following telemedicine referral and discussion with Queen Victoria Hospital required a re-referral. The results from this study confirm that clinical findings together with images from telemedicine provide adequate information to make clinical decisions in children with facial lacerations. PMID:23903670

Farook, Shahme Ahamed; Davis, Anika Kim Jap; Sadiq, Zaid; Dua, Radhika; Newman, Laurence

2013-08-01

12

Collaborative Activities in Virtual Settings: Case Studies of Telemedicine  

Microsoft Academic Search

This research examines virtual collaborative activities in the context of telemedicine. Collaborative activities consist of knowledge creation, discovery, and transfer. The findings indicate that teleconsultation and distance learning projects that involve primarily the transfer of explicit knowledge are not perceived as having a positive impact on remote site health care delivery, while those projects engaging in the creation and\\/or discovery

David L. Paul

2005-01-01

13

Case report: an example of international telemedicine success.  

PubMed

An 8-month old girl presented to the Angkor Hospital for Children in Siem Riep, Cambodia with fevers, bilateral eye discharge and an extensive body rash. The rash consisted of large, fluid-filled bullae and significant desquamation. The patient was admitted to the hospital and given intravenous cloxacillin for presumed bullous impetigo. Despite treatment with antibiotics, the skin lesions did not improve and the fevers continued. Telemedicine consultations were initiated by email between Angkor Hospital for Children and paediatric specialists in the USA. Several diagnoses were entertained throughout the subsequent collaborative dialogue. Ultimately, teleconsultation led to a diagnosis of chronic bullous dermatosis of childhood (CBDC), a rare sub-epidermal blistering disease. The child was started on appropriate medications. Within 24 hours, the lesions showed significant improvement and fevers resolved. By enabling advice from distant providers on diagnosis and treatment of paediatric patients, telemedicine may improve health care in developing countries. PMID:19471034

Froehlich, Wendy; Seitaboth, Soeung; Chanpheaktra, Ngoun; Pugatch, David

2009-01-01

14

Acompletely Decentralizedworkflow Management System for the Support of Emergency Telemedicine and Patient Monitoring  

Microsoft Academic Search

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

E. Kyriacou; G. Fakas; V. Pavlaki

2006-01-01

15

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.

Spaeder, Jeffrey A.

2002-01-01

16

Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people  

PubMed Central

Background Among indigenous populations in remote locations who are at increased risk for chronic diseases such as diabetes, telemedicine has the potential to improve access to health care services and thus may reduce adverse health outcomes. Yet few studies are available on how best to use telemedicine technology in reducing ethnic and racial health care disparities. Objective We examined perspectives of patients and providers in 2 indigenous populations in Alaska and Hawai'i about the use of telemedicine in primary care chronic disease management. Design Six focus groups with patients and providers at 2 sites (3 in Alaska and 3 in Hawai'i). Results Three broad themes were common to both sites: (a) benefits and barriers of using telemedicine; (b) building patient–provider relationships; and (c) elements of an acceptable telemedicine primary care encounter. Two key elements were endorsed by both patients and providers as important for an effective telemedicine encounter: (a) the initial patient–provider interaction should be face-to-face; and (b) patients must see the same provider on follow-up visits. Conclusion The use of telemedicine in chronic disease management has potential to improve patient care in remote indigenous populations and may supplement patient–provider relationships.

Hiratsuka, Vanessa; Delafield, Rebecca; Starks, Helene; Ambrose, Adrian Jacques; Mau, Marjorie Mala

2013-01-01

17

State of the art in telemedicine - concepts, management, monitoring and evaluation of the telemedicine programme in Alentejo (Portugal).  

PubMed

Alentejo - one of five Portuguese continental regions - faces major problems impacting the health and social system of the region. Here, the low population density, the low educational and income level as well as an aging population have to be mentioned. Faced with the task of ensuring equal access to healthcare for all its inhabitants, the regional health authorities created the telemedicine program. From 1998 until 2000, the program developed in an experimental fashion, with teleconsultations involving a number of providers: primary health care centers, regional hospitals, and central hospitals. Between 2000 and 2010, there were a total of 135,000 telemedicine acts including teleconsultations, teleradiology (computerised tomography and x-rays), ultrasound telemedicine and telepathology. Presently, the network comprises 20 health centers and 6 hospitals, covering 4 districts. The platform is composed of high resolution videoconferencing equipment, software with patients' clinical records, an image archive, and a number of peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are provided by fifteen medical specialties, across 3 district hospitals, ranging from neurology to pediatric surgery. In 2008, health authorities started the telelearning program, initially using point to point videoconferencing, and by the end of 2010, 848 healthcare professionals, across 52 locations, had participated in remote learning sessions, covering topics from chronic wound treatment, to infection control, to medical error. As of 2011, point to multipoint telelearning is also in operation. This paper provides an overview of the telemedicine program in Alentejo, including both infrastructure and operations. Preliminary results of an ongoing evaluation of the impact of teleconsultations on key indicators of the regional healthcare system are also presented (including current utilization and plans for future expansion). This article builds on the experience acquired throughout a decade of using telemedicine on an everyday basis, in a context of remarkable challenges in the delivery of accessible, equitable and quality healthcare services. PMID:22925783

Oliveira, Tiago Cravo; Branquinho, Maria José; Gonçalves, Luís

2012-01-01

18

Factors affecting frequency of patient use of Internet-based telemedicine to manage cardiovascular disease risk.  

PubMed

We examined the frequency of use by patients of a web-based reporting system to monitor and control cardiovascular disease (CVD) risk factors. A total of 192 patients with intermediate or high CVD risk were categorized into four quartiles based on their frequency of use of the telemedicine reporting system over one year. The lowest frequency users (Quartile I) averaged 17 reporting days in one year and the highest frequency users (Quartile IV) averaged 211 reporting days in one year. Factors associated with more frequent use were overall knowledge of CVD (P = 0.014), blood lipids (P = 0.017), smoking (P = 0.036), higher scores in medication self-efficacy (P = 0.016) and higher income (P = 0.002). All quartiles showed trends of decreasing systolic blood pressure from hypertensive (?140 mm Hg) to pre-hypertensive (<140) ranges. Patients were able to lower CVD risk with as few as two transmissions per month using the telemedicine system. Telemedicine reporting coupled with self-assessment of health status can promote a strong patient-provider partnership for managing the chronic risk factors of CVD. PMID:23666439

Kothapalli, Priya; Bove, Alfred A; Santamore, William P; Homko, Carol; Kashem, Abul

2013-05-10

19

Clinical management and patient outcomes among children and adolescents receiving telemedicine consultations for obesity.  

PubMed

Rural residents report lower likelihood of exercising, and higher rates of obesity, heart disease, and diabetes compared to their urban counterparts. Our goals were to (1) investigate the outcomes of telemedicine consultations for pediatric obesity on changes/additions to diagnoses, diagnostic evaluation or treatment, and (2) determine whether changes in diagnostic and management recommendations made by the consultant were associated with improvements in patient nutrition, activity level, and weight. We conducted a retrospective medical record review of patients referred to a University-affiliated Children's Hospital Pediatric Telemedicine Weight Management Clinic for a diagnosis of obesity. Of the 139 children and adolescents who received pediatric weight management consultations during the study period, 99 patients met inclusion criteria. Weight management consultations resulted in changes/additions to diagnoses in 77.8% of patients and changes/additions to diagnostic evaluation in 79.8% of patients. Of patients seen more than once, 80.7% showed improvement in clinical outcomes. Of patients seen more than once, 80.6% improved their diet, 69.4% increased activity levels, 21.0% showed slowing of weight gain or weight maintenance, and 22.6% showed weight reduction. Improvements in clinical outcomes were not associated with changes/additions to diagnoses (Odds Ratio [OR] = 0.98; 95% Confidence Interval [CI] = 0.25-3.98) and were weakly associated with changes/additions to diagnostic evaluations (OR = 2.23; 95% CI = 0.58-8.73). However, changes/additions to treatment were associated with improvement in weight status (OR = 9.0; 95% CI = 1.34-76.21). Obesity consultations were associated with changes/additions to diagnoses, diagnostic evaluation, and treatment. Treatment changes were associated with improvement in weight status. Telemedicine weight management consultations have the potential to result in modifications in patient care plans and outcomes. PMID:18578677

Shaikh, Ulfat; Cole, Stacey L; Marcin, James P; Nesbitt, Thomas S

2008-06-01

20

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

21

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

PubMed

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

Crowther, J B; Poropatich, R

1995-01-01

22

Telemedicine for recently discharged older patients.  

PubMed

Congestive heart failure, chronic obstructive pulmonary disease, diabetes, and hypertension are common causes of hospitalization in the elderly. Short-term postdischarge clinical outcomes regarding compliance, symptom control, readmission, functional status, and mortality rates are in need of improvement. This observational study documents the results of a home-based case-managed telemedicine (CMTM) program delivered over a 2-month period postdischarge. A population of 851, predominantly elderly (over age 60), recently discharged patients were enrolled in the program. They received a nurse visit up to 3 times/week and home telemedicine monitoring (weight, blood pressure, pulse rate, blood glucose, and oximeter recordings) on a daily basis. Patient education was provided by the nurse and reinforced through telemedicine. Compliance rates, quality of life parameters, patient satisfaction with telemedicine, and data regarding nine quality of care measures (QCM), hospital readmission, and mortality rates were documented. Patient demographics and outcomes of care were analyzed. There were 68% females and 56% African Americans. The readmission rate was 13% and mortality 2%. Treatment goals were met in 67%, patient compliance rate was 77%, and the average improvement in the nine QCM indicators was 66%. A majority of patients showed improved quality of health perception, better disease understanding, and high satisfaction rates with telemedicine. This is one of the larger observational studies in a predominantly elderly patient population enrolled in a CMTM program, to date. This model of care was well accepted by the elderly and produced excellent short-term clinical outcomes. PMID:20064067

Cardozo, Lavoisier; Steinberg, Joel

23

Telemedicine in neurology: Underutilized potential  

Microsoft Academic Search

increasing utilization of telemedicine; radiology and pathol- ogy being regarded as mature specialties and emergency medicine as maturing specialties compared to other evolv- ing specialties which include psychiatry, dermatology, cardi- ology and ophthalmology. Of the emergencies, status epi- lepticus and stroke have high potential for improving patient management. Administration of tPA was more frequent when carried out under telemedicine guidance.

U. K. Misra; J. Kalita; S. K. Mishra; R. K. Yadav

2005-01-01

24

Implementation of system intelligence in a three-tier telemedicine/PACS hierarchical storage management system  

NASA Astrophysics Data System (ADS)

Our tele-medicine/PACS archive system is based on a three-tier distributed hierarchical architecture, including magnetic disk farms, optical jukebox, and tape jukebox sub-systems. The hierarchical storage management (HSM) architecture, built around a low cost high performance platform [personal computers (PC) and Microsoft Windows NT], presents a very scaleable and distributed solution ideal for meeting the needs of client/server environments such as tele-medicine, tele-radiology, and PACS. These image based systems typically require storage capacities mirroring those of film based technology (multi-terabyte with 10+ years storage) and patient data retrieval times at near on-line performance as demanded by radiologists. With the scaleable architecture, storage requirements can be easily configured to meet the needs of the small clinic (multi-gigabyte) to those of a major hospital (multi-terabyte). The patient data retrieval performance requirement was achieved by employing system intelligence to manage migration and caching of archived data. Relevant information from HIS/RIS triggers prefetching of data whenever possible based on simple rules. System intelligence embedded in the migration manger allows the clustering of patient data onto a single tape during data migration from optical to tape medium. Clustering of patient data on the same tape eliminates multiple tape loading and associated seek time during patient data retrieval. Optimal tape performance can then be achieved by utilizing the tape drives high performance data streaming capabilities thereby reducing typical data retrieval delays associated with streaming tape devices.

Chao, Woodrew; Ho, Bruce K.; Chao, Johnny T.; Sadri, Reza M.; Huang, Lu J.; Taira, Ricky K.

1995-05-01

25

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

PubMed

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. PMID:11825159

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

2001-01-01

26

Business Case Analysis for Implementing and Optimizing Telemedicine at Fort Irwin.  

National Technical Information Service (NTIS)

Teleradiology, telepsychiatry, and teledermatology are three existing telemedicine services at Fort Irwin's Weed Army Community Hospital. This research study provides an analysis on the qualified and quantifiable financial costs and benefits of these serv...

D. L. Martin

2007-01-01

27

The role of telemedicine in the management of the pregnancy complicated by diabetes.  

PubMed

The use of technology to deliver health care over a distance has drawn considerable attention and shown dramatic growth over the last decade because of the possibility it has to reduce cost and improve access to modern medical care. Diabetes in pregnancy, which requires tight glycemic control in order to reduce perinatal complications, is a prime telemedicine intervention target. A review of the literature suggests that telemedicine, although not perfect, can potentially play a role in reducing patient visits and could improve quality of life without jeopardizing the outcome. PMID:23242646

Mastrogiannis, Dimitrios S; Igwe, Elena; Homko, Carol J

2013-02-01

28

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

PubMed

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

Rufo, Rebecca Zapatochny

29

Telemedicine in Australia. Recent developments.  

PubMed

There have been a number of important developments in Australia in the area of telemedicine. At the national level, the House of Representatives' Standing Committee on Family and Community Affairs has been conducting the Inquiry into Health Information Management and Telemedicine. The Australian Health Ministers' Advisory Council has supported the establishment of a working party convened by the South Australian Health Commission to prepare a detailed report on issues relating to telemedicine. State governments have begun a number of telemedicine projects, including major initiatives in New South Wales and Victoria and the extensive development of telepsychiatry services in Queensland. Research activities in high-speed image transmission have been undertaken by the Australian Computing and Communications Institute and Telstra, and by the Australian Navy. The matter of the funding of both capital and recurrent costs of telemedicine services has not been resolved, and issues of security and privacy of medical information are subjects to discussion. The use of the Internet as a universal communications medium may provide opportunities for the expansion of telemedicine services, particularly in the area of continuing medical education. A need has been recognized for the coordinated evaluation of telemedicine services as cost-benefit considerations are seen to be very important. PMID:9614732

Crowe, B L; McDonald, I G

1997-01-01

30

The Literature of Telemedicine  

Microsoft Academic Search

A specialized body of telemedicine\\/telehealth literature has developed in recent years, fueled by research and the development of telemedicine as a field of study.This bibliometric study examines the publishing and citing patterns of telemedicine literature indexed by the Telemedicine Information Exchange (TIE), an online database maintained by the Telemedicine Research Center (TRC) with major support from the National Library of

Teresa S. Welsh

2005-01-01

31

The integration of new communication technologies to form virtual organizations: a case study of a prison telemedicine program  

Microsoft Academic Search

Videoconferencing technologies can provide healthcare organizations with innovative ways to deliver clinical consultations. The prison environment is one application where telemedicine can create economic efficiencies, Unfortunately, many relationships cannot be built on a technical infrastructure alone. Effective implementation of telemedicine technologies to create virtual clinics requires attention to the development of relationships among members of the telemedicine network. The paper

Jeanine W. Turner

1998-01-01

32

A scalable telemedicine architecture for under developed countries. A case study: Democratic Republic of Congo  

Microsoft Academic Search

Telemedicine, defined as the use of telecommunications technologies to provide medical information and services, is electronic transfer of medical data being able to include the sound and the images to practice remote medicine. In under developed countries, as the Democratic Republic of Congo, the capability to remote monitor patients that live in villages or small rural town, is a \\

S. Kidiamboko; A. Mancini; S. Longhi; L. Spalazzi

2008-01-01

33

A connectivity management system for vehicular telemedicine applications in heterogeneous networks  

Microsoft Academic Search

Wireless access technologies such as UMTS with HSPA extensions, WiMAX, and Flash-OFDM and the convergence towards next generation heterogeneous networks enable the realization of always best connected scenarios. As the resulting heterogeneous networks become easier to access and more reliable to depend on, novel telemedicine services such as vehicular emergency applications emerge. Due to their life-critical characteristics, these applications require

Frank Steuer; Thomas Geithner; Thomas Kaschwig; Kaan Bür; Sahin Albayrak

2008-01-01

34

[Responsibility in telemedicine].  

PubMed

Telemedicine networks raise a number of legal issues that concern patients, health professionals and data managers alike. Patients must be informed, and, in France, can freely choose the persons who treat them. Individual patients' healthcare information must be kept strictly confidential. All healthcare professionals have a right to equal consideration, and must retain their independence within the network. Their responsibility can be engaged, and this calls for specific guidelines. The data manager is a new actor in the healthcare system. Whether an individual or an organization, the data manager must store sensitive information in precise conditions. PMID:17001866

Esper, Claudine

2006-02-01

35

Preliminary experience of shared clinical management between Milan and Pointe Noire using the INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS): telemedicine between Milan and Africa.  

PubMed

This paper describes preliminary experience in shared clinical management of patients located in Pointe Noire, Africa, and a referral center, Sacco University Hospital, located in Milan, Italy. The employed infrastructure INteractive TeleConsultation Network for Worldwide HealthcAre Services (INCAS) jointly developed by CEFRIEL (Center of Excellence For Research, Innovation, Education & Industrial Labs partnership) and ENI (Ente Nazionale Idrocarburi) is based on commercial off-the-shelf technology. This minimizes maintenance problems, while permitting a simple and friendly sharing of data using the telephone and e-mail for store-and-forward applications. The critical aspect of the flow of events comprising the exchange of information is discussed. In 60% of cases, only one telemedicine consultation was required. In the remainder 40%, a number of telemedicine consultations were required for appropriate management of clinical cases. The project demonstrated flexibility as documented by the wide range of pathologies that can be dealt with it. Finally the possibility of using shared clinical management as a learning tool is highlighted by the steep and rising learning curve. We conclude, however, that the patient, although handled in a "virtual" manner, should be viewed as very "real," as some of them elected to close the gap physically between Pointe Noire and Milan, and chose to be treated at the referral site. PMID:15689647

Malacarne, Mara; Lesma, Alessandro; Madera, Angelo; Malfatti, Eugenio; Castelli, Alberto; Lucini, Daniela; Pizzinelli, Paolo; Pagani, Massimo

2004-01-01

36

Case management.  

PubMed

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

Rosenstein, A H; Propotnik, T

1997-03-01

37

Use of telemedicine to assist ophthalmologists in developing countries for the diagnosis and management of four categories of ophthalmic pathology  

PubMed Central

Introduction: The diagnosis and treatment plans proposed by ORBIS Telemedicine partners, all of whom were ophthalmologists, via Cyber-Sight, in four ophthalmic sub-specialty categories were compared to those suggested by expert mentors. Methods: Records of referrals of patients via Cyber-Sight to mentors with a diagnosis of: glaucoma, pediatric cataract, external disease, and disorders related to the ocular adnexa requiring oculo-plastic treatment were reviewed. Records recalled from the Cyber-Sight electronic archives included: medical history, images of clinical findings, partner diagnosis, partner treatment plan, mentor diagnosis, and mentor treatment plan. Partners’ diagnosis and treatment plans were compared to those of the mentors. Based on results of prior studies, mentor opinions were those considered valid (Helveston et al 2001). Results: A total of 135 cases were reviewed: 70 external disease, 42 oculo-plastics, 16 glaucoma, and 7 pediatric cataract. The partner’s diagnosis agreed with that of the mentor in: glaucoma 81%, pediatric cataract 86%, external disease 76%, and oculo-plastics 86%. Partners were considered to have suggested the correct treatment plan in: glaucoma 56%, pediatric cataract 71%, external disease 70%, and oculo-plastics 60%. Mentors provided additional comments and suggestions for further study in more than three-quarters of the cases. Discussion: If one considers that the mentors are correct in each case, they offered a different diagnosis in 18% of cases. For treatment, mentors offered an alternate plan in more than a quarter of cases. The basis for considering the mentors being more accurate in diagnosis and treatment planning after viewing pictures and reading history than the partners who actually saw and examined the patients is based on personal experience of the authors. This includes a study done by one of them (EMH) demonstrating that experts when asked to view cases presented via telemedicine agreed nearly 100% on diagnosis and by a like amount on the method of treatment. In addition to this, results of this present study are similar to those for strabismus; a condition that was studied earlier (Helveston et al 2001). Still to be determined is whether this type of consultation changes outcome of treatment.

BenZion, Itay; Helveston, Eugene M

2007-01-01

38

Current challenges in telemedicine  

Microsoft Academic Search

There are a number of challenges that have to be addressed before full-scale implementation of telemedicine technologies can be achieved. These challenges include cost and resource concerns, technical issues, legal issues, lack of awareness of telemedicine and, previously unsuccessful trials using telemedicine technology. This paper will address these challenges and suggest ways in which they can be overcome. The 'MEDASHIP'

Toral Patel

2002-01-01

39

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support  

PubMed Central

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

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

2003-01-01

40

Improving the Cost-Effectiveness of a Healthcare System for Depressive Disorders by Implementing Telemedicine: A Health Economic Modeling Study.  

PubMed

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

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

2013-06-01

41

Making grandma's data secure: a security architecture for home telemedicine.  

PubMed Central

Home telemedicine presents special challenges for data security and privacy. Experience in the Informatics for Diabetes Education And Telemedicine (IDEATel) project has demonstrated that data security is not a one-size-fits-all problem. The IDEATel users include elderly patients in their homes, nurse case managers, physicians, and researchers. The project supports multiple computer systems that require a variety of user interactions, including: data entry, data review, patient education, videoconferencing, and electronic monitoring. To meet these various needs, a number of different of security solutions were utilized, including: UserID/Password, PKI certificates, time-based tokens, IP filtering, VPNs, symmetric and asymmetric encryption schemes, firewalls and dedicated connections. These were combined in different ways to meet the needs of each user groups.

Starren, J.; Sengupta, S.; Hripcsak, G.; Ring, G.; Klerer, R.; Shea, S.

2001-01-01

42

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

43

Telemedicine development: setting the record straight.  

PubMed

When a topic so synonymous with advanced technology as telemedicine needs a written history, perhaps a discipline has come of age. Telemedicine has had an oral history among visionaries and technophiles over the last thirty years or so. Tales of grand projects, technical failures and fabulous successes abound at telemedicine meetings. One is reminded of the film footage of early efforts at flight where extravagant engineering approaches failed time and time again until the elegant solution of the Wright brothers took to the air on the beach at Kitty Hawk in December 1903. It is hard to imagine the frustration and excitement of initial efforts at telemedicine or manned flight when current expectations are for information on demand and on time departures. However, from very early efforts in telemedicine the vision was consistent: overcome the huge liability of distance in patient care by creating an electronic continuum between the site of need and the site of expertise. The vision continues to strive toward technical transparency and clinical results, which assure a patient that no matter who, no matter where, no matter when medicine will care for you with consistent professionalism. Technology took us from the patient home to the technology-rich hospital. Perhaps technology will transfer the majority of patient management back to the comforts of home, convenience of workplace or the exigencies of travel and mobility. PMID:15747958

Merrell, Ronald C

2004-01-01

44

Telemedicine Network Expansion.  

National Technical Information Service (NTIS)

Memorial Hermann Hospital's resources of specialty physicians and highly acclaimed Level I trauma center is able to offer comprehensive consultative services to its extensive rural hospital affiliates. Telemedicine may serve as a solution to increase acce...

S. Allen J. Choi

2004-01-01

45

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

46

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

47

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

48

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

49

Design and development of a multimedia database for emergency telemedicine.  

PubMed

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

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

1998-09-01

50

Bringing the Artificial Pancreas Home: Telemedicine Aspects  

PubMed Central

The design and implementation of telemedicine systems able to support the artificial pancreas need careful choices to cope with technological requirements while preserving performance and decision support capabilities. This article addresses the issue of designing a general architecture for the telemedicine components of an artificial pancreas and illustrates a viable solution that is able to deal with different use cases and is amenable to support mobile-health implementations. The goal is to enforce interoperability among the components of the architecture and guarantee maximum flexibility for the ensuing implementations. Thus, the design stresses modularity and separation of concerns along with adoption of clearly defined protocols for interconnecting the necessary components. This accounts for the implementation of integrated telemedicine systems suitable as short-term monitoring devices for supporting validation of closed-loop algorithms as well as devices meant to provide a lifelong tighter control on the patient state once the artificial pancreas has become the preferred treatment for patients with diabetes.

Lanzola, Giordano; Capozzi, Davide; Serina, Nadia; Magni, Lalo; Bellazzi, Riccardo

2011-01-01

51

Emergency department-based telemedicine  

Microsoft Academic Search

Although many studies have been published concerning clinical telemedicine, little information is available about emergency department (ED)-based telemedicine programs. An ED-based telemedicine program was initiated in April 1996 involving the National Cheng Kung University Hospital (NCKUH) and the Provincial Peng-Hu Hospital (PPHH) under a pilot project supported by the Department of Health. This is the first telemedicine program for remote

Chin-Hsien Chi; In Chang; Wei-Ping Wu

1999-01-01

52

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

53

"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

54

Evaluation of an off-the-shelf mobile telemedicine model in emergency department wound assessment and management.  

PubMed

We examined the agreement between a videoconference-based evaluation and a bedside evaluation in the management of acute traumatic wounds in an emergency department. Adult and paediatric patients with acute wounds of various severities to the face, trunk and/or extremities presenting to the emergency department within 24 hours of injury were enrolled. Research assistants transmitted video images of the wound to an emergency physician using a laptop computer. The physician completed a standard wound assessment form before conducting a bedside evaluation and then completing a second assessment form. The primary outcome measure was wound length and depth. We also assessed management decision-making. A total of 173 wounds were evaluated. The correlation coefficient between video and bedside assessments was 0.96 for wound length. The mean difference between the lengths was 0.02 cm (SD 0.91). Management of the wound would have been the same in 94% of cases. The agreement on wound characteristics and wound management ranged from 84-100%. The highest correlation was 0.92 in suture material used and the lowest correlation was 0.64 in wound type. The ability of video images to distinguish between a minor and non-minor wound, and predicting the need for hospital management, had high degrees of sensitivity and specificity. The study showed that wound characteristics and management decisions appear to correlate well between video and bedside evaluations. PMID:23470449

Van Dillen, Christine; Silvestri, Salvatore; Haney, Marisa; Ralls, George; Zuver, Christian; Freeman, Dave; Diaz, Lissa; Papa, Linda

2013-03-07

55

Mobile telemedicine: a survey study.  

PubMed

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

Lin, Chin-Feng

2010-04-27

56

Telemedicine in otolaryngology.  

PubMed

More research is needed in otolaryngology telemedicine, but it would be a mistake to stop at only determining if telemedicine is as good as an in-person exam. The digital image recorded in a telemedicine encounter can be manipulated to increase diagnostic information not currently available. Radiologists currently take a chest radiograph in which a chest mass or the tip of an nasogastric tube is difficult to visualize, and by inverting the gray scale or viewing other digital manipulations of that image, the mass or tube tip becomes obvious. Examples in otolaryngology might include images of the larynx manipulated to better demonstrate the inflamed tissue of reflux, or images of the tympanic membrane manipulated to better demonstrate early retraction. Despite dramatic and likely continued decreases, equipment cost is still an issue. Current research points to good consumer acceptance, and certainly with each new generation the technology is more readily accepted. As Nesbitt [4] points out, it is certainly not difficult to look to the future and see ubiquitous broadband with video as common as telephone, or even extreme broadband enabling robotics and virtual reality TV with three-dimensional touch. Robotics and genomics will eventually play a greater role in telemedicine and our lives in general. Applications for remote diagnosis in biologic warfare defense and homeland security are currently raising interest in telemedicine. Telemedicine will be combined with new technological advances such as virtual "fly-through" computerized axial tomography examinations. Instead of performing an exploratory tympanotomy, surgeons will use computer programs to "fly through" and examine all aspects of a patient's middle or even inner ear. Spectral imaging of the eardrum, larynx, or oropharynx will immediately identify bacteria without cultures, or gram stain, and potential malignancy without biopsy. By measuring fluorescence emitted from an oropharynx illuminated with a specific visible or nonvisible light spectrum, spectral imaging will be able to provide instant identification of bacteria or evidence of malignant changes. The underlying principles of a successful business model must continue to be applied, with the most critical ingredient for telemedicine's success being the filling of specific health care needs. As long as the need is there, telemedicine in otolaryngology will advance. PMID:12687742

Holtel, Michael R; Burgess, Lawrence P A

2002-12-01

57

Feasibility and Effectiveness of Home Care Telemedicine in Patients with Heart Failure in Thuringia  

Microsoft Academic Search

\\u000a Home Care Telemedicine is a rapidly developing application in clinical medicine where medical information is transferred via\\u000a telephone or Internet for the purpose of disease management.\\u000a \\u000a \\u000a We provide a 24 month follow up on Home Care Telemedicine in 90 elder patients with chronic heart failure compared with an\\u000a age matched control group. The telemedicine group got a mobile 12-channel ECG

M. Goernig; A. Kwetkat; B. Brehm; K. Fidorra; A. Roth; H. R. Figulla; U. Leder

58

Integrating telemedicine and telehealth: putting it all together.  

PubMed

Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care organizations. Telemedicine programs should perform ongoing assessments of activities, ranging from service usage to quality of service assessments, to ongoing analyses of financial performance. The financial assessments should include evaluations of costs and benefits, coding issues, reimbursement, account receivables, bad debt and network utilization. Long-range strategic planning for a telemedicine and telehealth program should be carried out on an on-going basis and should include the program's governing board. This planning process should include goal setting and the periodic updating of the program's vision and mission statements. There can be additional special issues for multi-organization telemedicine and telehealth programs. For example, authority management can require the use of innovative approaches tailored to the realities of the organizational structures of the participating members. Inter-institutional relations may introduce additional issues when competing health care organizations are utilizing shared resources. Branding issues are preferably addressed during the initial planning of a multi-organizational telemedicine and telehealth program. Ideally, public policy regarding telemedicine and telehealth within a service region will complement the objectives of telemedicine and telehealth programs within that service area. PMID:18305320

Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

2008-01-01

59

[Diabetes case management].  

PubMed

Diabetes case management and self-care education can effectively improve patient clinical outcomes and quality of life. Diabetes case management should be provided by an interdisciplinary team. Diabetes education has evolved from its previous focus on "teaching proper content" to "achieving successful patient outcomes" in line with the current emphasis in health education on patient-centered goals. Behavioral changes are facilitated based on these goals. Behavioral change directed at successful diabetes self-care was adopted as one of the desired outcomes of diabetes case management. The American Association of Diabetes Educators developed seven diabetes self-care behaviors as behavior objectives and evaluation indicators of diabetes education. These indicators include healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks. The process of diabetes case management includes assessment, expected outcome identification, planning, implementation, evaluation, and documentation. In Taiwan, the Diabetes Share Care Network has promoted the advantages and techniques of diabetes case management. Based on network recommendations, the improvement program of National Health Insurance payment for diabetes medical treatment under the Bureau of National Health Insurance now provides package payment and requires quality interdisciplinary care and case management. PMID:19319800

Yeh, Mei Chang

2009-04-01

60

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

61

TELEMEDICINE or MEDICAL TELEPRESENCE?  

Microsoft Academic Search

Similar to virtual reality (VR), telemedicine became a concept so broad that it literally lost its meaning. In VR we have virtual offices that are nothing more than word processing, spreadsheets, graphics, or other forms of software available to the employees working away from their offices. There is nothing virtual about it other than substitution of one environment (office) for

Dag K. J. E. von Lubitza; Benjamin Carrasco; Timothy Pletcher; Caleb Poirier

62

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

63

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

64

Hageseth's principle of extraterritorial jurisdiction and international telemedicine.  

PubMed

At what point does an international telemedicine transaction create a sufficient commercial nexus to allow one country the authority to impose its laws on a foreign telemedicine providers? Some light on this matter was shed by the US case of Hageseth versus Superior Court. The authority for extraterritorial jurisdiction is found in the US Constitution, which requires the states to cooperate in matters of law enforcement. Similar cooperation from foreign nations cannot be expected. Unless a defendant is charged with a capital offence, nations are rarely willing to extradite their citizens. As the unlicensed practice of medicine is not a capital offence, it is unlikely that an unlicensed telemedicine provider would be extradited to the US. Because low-volume unlicensed offshore telemedicine providers are unlikely to be extradited or to be subject to trade sanctions, they may be able to operate beyond the law. PMID:18776071

McLean, Thomas R; McLean, Alexander B

2008-01-01

65

Telemedicine and telepharmacy: current status and future implications.  

PubMed

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

Angaran, D M

1999-07-15

66

A literature review of email-based telemedicine.  

PubMed

A structured analysis of peer-reviewed literature about the delivery of health services by email was undertaken for this review. A total of 185 articles were included in the analysis. These articles were thematically categorised for medical specialty, participants, sub-topic, study design and service-delivery application. It was shown that email-based telemedicine can be practiced in a large number of medical specialties and has application in primary consultation, second opinion consultation, telediagnosis and administrative roles (e.g. e-referral). Email has niche applications in low-bandwidth, image-based specialties (e.g. dermatology, pathology, wound care and ophthalmology) where attached digital camera images were used for telediagnosis. Diagnostic accuracy of these images was the predominant topic of research and results show email as a valid means of delivering these medical services. Email is also often used in general practice as an adjunct for face-to-face consultation. Further, a number of organisations have significantly improved the efficiency of their outpatient services when using email as a triage or e-referral system. Email-based telemedicine provides specialist medical opinion in the majority of reviewed services and is most likely to be instigated by the patient's primary care giver. However, email-consultations between patient and primary care and patient and secondary care are not uncommon. Most email services are implemented using ordinary email. However, a number of organisations have developed purpose-written email applications to support their telemedicine service due to impediments of using ordinary email. These impediments include lack of management tools for: the allocation and auditing of cases for a timely response and the co-ordination of effort in a multi-clinician, multi-disciplinary service. The ability to encrypt ordinary email thereby securing patient confidentiality is also regarded as difficult when using ordinary email. Hence, alternative web-based email applications where the encryption can be implemented using the more user-friendly HTTPS have become popular. Much of the reviewed literature is descriptive or anecdotal and hence, suffers from lack of conclusive results regarding positive patient outcomes. This may account for email-based telemedicine generally being regarded as underutilised. However, the potential is well recognised. PMID:21191155

Caffery, Liam J; Smith, Anthony C

2010-01-01

67

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.

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

2012-01-01

68

Telemedicine by mobile communication.  

PubMed

A concept of mobile telemedicine has been proposed to provide emergency care in a moving vehicle. The practicality of this technique was investigated through technical considerations required to realize mobile telemedicine. Some problems with this technique were identified, and measures to resolve the problems were devised. Then, theoretical analysis verified the feasibility of the proposed technique. Different multiplexing techniques for the multiple medical data transmission by mobile communication were investigated. An experimental system that can simultaneously transmit color images, an audio signal, three-channel ECGs, and blood pressure from a moving vehicle to a fixed station was developed. Experiments on the transmission of multichannel medical data from a moving ambulance, a navigating ship, and a flying aircraft were conducted. The results of these experiments verified the practical feasibility of the proposed technique. In the practical application of this technique, there may be some legal problems: for example, whether medical treatment through a communication medium would be legally acceptable or not, and whether the transmission of medical data violates the protection of personal privacy. However, considering the emergency nature of this technique and the significance of the results, both problems seem to be either legally or technically solvable. This application of mobile communication to telemedicine is not confined to merely a proposal to use new techniques. It can also bring about a methodological change in the concept of conventional telemedicine by changing it from static to dynamic, and by enlarging its scope from a local area to a global or cosmic area. It may also have an impact on conventional emergency medicine in that it will open up a new field of application that applies to moving vehicles. PMID:10429900

Shimizu, K

69

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

70

Integrated Telemedicine System in Andalusia  

Microsoft Academic Search

The design of the Andalusian Public Healthcare System fulfils two main objectives: universal cover and quality healthcare. Our aim is to adequately provide for the healthcare needs of all citizens throughout the entire region. Telemedicine plays an important part in achieving these objectives and assures every citizen access to adequate healthcare regardless of geographical location. Our concept of Telemedicine is

C. Gonzalez

2002-01-01

71

Review of telemedicine projects in Taiwan.  

PubMed

Taiwan is a heavily populated country, with a small land area and many mountains and isolated islands. Because medical resources are unequally distributed, high quality accessible medical care is a major problem in rural areas. Medical personnel are unwilling to practice in rural areas because of fear of isolation from peers and lack of continuing medical education (CME) in those areas. Telemedicine provides a timeless and spaceless measure for teleconsultation and education. The development of telemedicine in Taiwan began under the National Information Infrastructure (NII) Project. Distance education and teleconsultation were the first experimental projects during the initiation research stage. The cost and effectiveness of the hardware and network bandwidth were evaluated. In the promotion research stage, applications in different medical disciplines were tested to promote multipoint videoconference, electronic journals and VOD. Investigation of user satisfaction put on more emphasis on improving application functions. In 1998, a new Cyber Medical Center (CMC) international collaboration project was begun, integrating technologies of multimedia, networking, database management, and the World Wide Web. The aim of the CMC is to create a multimedia network system for the management of electronic patient records, teleconsultation, online continuing medical education, and information services on the web. A Taiwan mirror site of Virtual Hospital and two international telemedicine trials through Next Generation Internet (NGI) were done at the end of 1998. In the future, telemedicine systems in Taiwan are expected to combine the Internet and broadband CATV, ADSL, and DBS networking to connect clinics, hospitals, insurance organizations, and public health administrations; and, finally, to extend to every household. PMID:11311666

Chen, H S; Guo, F R; Chen, C Y; Chen, J H; Kuo, T S

2001-05-01

72

Social Impact Analysis of the Effects of a Telemedicine Intervention to Improve Diabetes Outcomes in an Ethnically Diverse, Medically Underserved Population: Findings From the IDEATel Study.  

PubMed

Objectives. We examined the social impact of the telemedicine intervention effects in lower- and higher-socioeconomic status (SES) participants in the Informatics for Diabetes Education and Telemedicine (IDEATel) study. Methods. We conducted a randomized controlled trial comparing telemedicine case management with usual care, with blinded outcome evaluation, in 1665 Medicare recipients with diabetes, aged 55 years or older, residing in federally designated medically underserved areas of New York State. The primary trial endpoints were hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol, and systolic blood pressure levels. Results. HbA1c was higher in lower-income participants at the baseline examination. However, we found no evidence that the intervention increased disparities. A significant moderator effect was seen for HbA1c (P?=?.004) and systolic blood pressure (P?=?.023), with the lowest-income group showing greater intervention effects. Conclusions. Lower-SES participants in the IDEATel study benefited at least as much as higher-SES participants from telemedicine nurse case management for diabetes. Tailoring the intensity of the intervention based on clinical need may have led to greater improvements among those not at goal for diabetes control, a group that also had lower income, thereby avoiding the potential for an innovative intervention to widen socioeconomic disparities. PMID:23488491

Shea, Steven; Kothari, Dhruva; Teresi, Jeanne A; Kong, Jian; Eimicke, Joseph P; Lantigua, Rafael A; Palmas, Walter; Weinstock, Ruth S

2013-03-14

73

Sleep Telemedicine: A Survey Study of Patient Preferences  

PubMed Central

Telemedicine is an increasingly recognized option for cost-effective management of chronic conditions. We surveyed Sleep Clinic patients about their experiences and preferences regarding different forms of telemedicine. Adult Sleep Clinic patients seen between 2009 and 2011 received a brief survey either by postal mail (n = 156) or, for those with an available email address, electronically (n = 282). The overall response rate was 28.1% (n = 123 responses), with email response rates being higher than postal mail responses. The most commonly reported barriers to in-person physician visits were parking cost (44%), time away from work/school (34%), and cost of gas (26%). Whereas 89% of respondents indicated using telephone and 55% of respondents indicated using email to communicate with providers, none reported experience with video telemedicine. Despite this lack of experience, over 60% reported feeling comfortable or willing to try it. Of those who were uncomfortable about video telemedicine, the two main reasons were that in-person visits feel more natural (48%) and that the doctor might need to perform an examination (24%). More than half of respondents reported willingness to pay a copay for a video visit. Video telemedicine represents a feasible option for chronic sleep disorders management.

Kelly, Jessica M.; Schwamm, Lee H.; Bianchi, Matt T.

2012-01-01

74

Emergency department-based telemedicine.  

PubMed

Although many studies have been published concerning clinical telemedicine, little information is available about emergency department (ED)-based telemedicine programs. An ED-based telemedicine program was initiated in April 1996 involving the National Cheng Kung University Hospital (NCKUH) and the Provincial Peng-Hu Hospital (PPHH) under a pilot project supported by the Department of Health. This is the first telemedicine program for remote offshore island service in Taiwan. The program is synchronous in nature to the practice of telemedicine. The role of the emergency physician includes giving initial suggestions, arranging consultations, coordination, and the organization of other medical tasks, such as accompanying some of the transfers. During the 12-month period, this system was used in 275 consultations, including 24 specialty and/or subspecialty department/sections, and more than 100 members of the medical staff have participated in this project since. In a survey, 89.4% of physicians in the PPHH and 82.2% of the physicians in NCKUH rated the system as very comfortable to work with and satisfactory. According to these observations, an ED-based telemedicine program is a feasible method for carrying out remote consultations. Successful development of the partnership and program of telemedicine is based on the active participation and coordination of the medical personnel and technicians between the cooperating hospitals. PMID:10452445

Chi, C H; Chang, I; Wu, W P

1999-07-01

75

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

76

Using Telemedicine and Wireless Technology to Improve Diabetic Outcomes in Poorly Controlled Patients.  

National Technical Information Service (NTIS)

Diabetes mellitus is a condition that lends itself to the use of telemedicine and technology because its management relies heavily on the collection, sharing, and interpretation of blood glucose data by the patient and healthcare provider. We studied whet...

R. A. Vigersky

2002-01-01

77

Telemedicine in oncology: European perspective.  

PubMed

Telemedicine in oncology or teleoncology integrates many so far well-known telemedicine elements such as teleconsultation, telesupport, telesurgery and telerobotics, teleeducation, and many others and is integral part of many disciplines such as internal medicine, surgery, dermatology, but also dentistry and psychooncology/psychiatry. Changes in ICT, new developments in oncology, the need to think and work interdisciplinarily, geographic and economic challenges as well as the transgression of sectoral boundaries as elements of modern teleoncology. Whereas the northern parts of Europe show a well-developed telemedicine infrastructure with a growing tendency to incorporate teleoncology for documentation, data analysis and quality assurance, in more southern countries this process is still underway and often marked by project status. Modern technology using xDSL and other terrestrial network lines but also satellite connectivity is at hand to cover a wide variety of telemedicine applications and services from which teleoncology benefits. More and more specifically designed software applications can be used to assess the medical workflow of an oncological patient and determine a life-long oncological electronic patient record. The trend, however, goes to the systemic integration of single applications and services into clinical information systems with a telemedicine approach. Although past evaluations of telemedicine applications and services have shown very positive results, only the right financial funding determines their survival and wide-spread usability in daily routine medical use. Formerly identifiable barriers for this use nowadays can be overcome more easily. PMID:18305335

Mohr, Markus

2008-01-01

78

Valuation of Online Continuing Medical Education and Telemedicine in Taiwan  

Microsoft Academic Search

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 networks, and both the acceptability of this branch of medical care and the perceptions of

Fuhmei Wang

2008-01-01

79

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

80

Telemedicine in northern Quebec.  

PubMed Central

Television transmission of diagnostic and educational information can help to improve specialized medical care in remote and underserviced areas. This paper describes a pilot study in which the Canadian satellite Anik-B was used to link the James Bay area in northern Quebec with two large Montreal teaching hospitals. Broad-band real-time television was well suited for tele-education and teleconsultation activities. A much less costly method, using narrow-band slow-scan television, was also examined, but it requires improvements. The technology of telemedicine is in place, but its future use is impeded by the prohibitive costs of operating an efficient two-way broad-band television system for several remote health care sites. A solution to this problem may be an intermediate-band system combining some of the low-cost features of narrowband slow-scan television with the interactive high-resolution advantages of broad-band real-time television.

Roberge, F. A.; Page, G.; Sylvestre, J.; Chahlaoui, J.

1982-01-01

81

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

82

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

83

A clinical and educational telemedicine link between Bulgaria and Greece.  

PubMed

During its transition to a market economy, Bulgaria benefited from foreign aid provided by Greece. One of the projects was the clinical and educational telemedicine link between the Medical University of Varna in Bulgaria and the Faculty of Medicine of Aristotle University of Thessaloniki in Greece. This began in 1997. In terms of the educational activities, the Bulgarian side of the network supports: an electronic classroom equipped with personal workstations, multimedia projectors and videoconference facilities; electronic design and publishing activities; Web hosting and mail server activities; and satellite communications. Communications are via ISDN. The main clinical experience has been remote consultations in immunology. This experience (admittedly limited) demonstrates that telemedicine can be used to provide assistance to remote colleagues. In addition, the use of telemedicine can greatly improve the quality of care available to travellers and migrant workers in cases where the patient cannot communicate with the attending physician because of a language barrier. PMID:14728745

Anogianakis, George; Ilonidis, George; Anogeianaki, Antonia; Milliaras, Spyros; Klisarova, Anelia; Temelkov, Temel; Vlachakis-Milliaras, Emmanuel

2003-01-01

84

Evaluating Telemedicine Systems Success: A Revised Model  

Microsoft Academic Search

Broadly, telemedicine refers to the use of information and telecommunication technologies to distribute information and\\/or expertise necessary for healthcare service provision, collaboration and\\/or delivery among geographically separated participants, including physicians and patients. Evaluation of telemedicine systems success or effectiveness is a fundamental challenge to healthcare organizations. A review of previous telemedicine research suggests a focused evaluation approach, thus offering limited

Paul Jen-hwa Hu

2003-01-01

85

Telemedicine and spaceflight.  

PubMed

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

Grigoriev, Anatoly I; Orlov, Oleg I

2002-07-01

86

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

87

Telemedicine in neurosurgical emergency: Indian perspective  

PubMed Central

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.

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

2012-01-01

88

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

2013-03-01

89

Telemedicine experience in the Brazilian Amazon  

PubMed Central

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

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

2012-01-01

90

BAMC-DACH Pediatric Sub-Specialty Telemedicine Healthcare Program.  

National Technical Information Service (NTIS)

Tricare Region 6 Preexisting Telemedicine Model: Tricare Region 6 solution to telemedicine was in place based on an adult telemedicine software model, Apollo/CNSI (dermatology; neurology) installed at a host of remote bases (Sheppard AFB; Dyess AFB; Corpu...

S. C. Inscore

2001-01-01

91

NASA's telemedicine testbeds: Commercial benefit  

Microsoft Academic Search

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

Charles R. Doarn; Raymond Whitten

1998-01-01

92

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.

93

A clinical and educational telemedicine link between Bulgaria and Greece.  

PubMed

During its transition to a free economy, Bulgaria benefited from foreign aid provided by Greece. One of the projects was the clinical and educational telemedicine link between the Medical University of Varna in Bulgaria and the Faculty of Medicine of Aristotle University of Thessaloniki in Greece. This began in 1997. In terms of the educational activities, the Bulgarian side of the network supports (a) electronic design and publishing activities, (b) web hosting and mail server activities and (c) satellite communications. In addition it supports an electronic classroom equipped with personal workstations, multimedia projectors and videoconference facilities. Communications are via the ISDN network. In terms of its telemedicine activities, the network provides remote medical assistance to "language handicapped" travellers and to migrant workers in both countries. The main clinical experience is remote consultations in immunology. This admittedly limited experience demonstrates that telemedicine can be used to provide assistance to remote colleagues. In cases where the patient cannot communicate with the attending physician, the use of telemedicine can greatly improve the quality of care available to travellers and migrant workers. PMID:15544232

Anogianakis, George; Ilonidis, George; Anogeianaki, Antonia; Milliaras, Spyros; Klisarova, Anelia; Temelkov, Temel; Vlachakis-Milliaras, Emmanuel

2004-01-01

94

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.; Kim, Yongmin

2001-05-01

95

A Review of Telemedicine Services in Finland  

Microsoft Academic Search

\\u000a Telemedicine is gaining popularity due to the provision of ubiquitous health care services that is a fundamental need for\\u000a every socialized society. In this paper, telemedicine services in Finland are discussed, as well as how they came into existence,\\u000a how they are funded, evaluated, and what are their impacts on health care systems and society. Telemedicine services like\\u000a teleradiology, telelaboratory,

Vikramajeet Khatri; Carrie B. Peterson; Sofoklis Kyriazokos; Neeli R. Prasad

96

Telemedicine in stroke care and rehabilitation.  

PubMed

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

Morales-Vidal, Sarkis; Ruland, Sean

97

Testing a top-down strategy for establishing a sustainable telemedicine program in a developing country: the Arizona telemedicine program-u.s. Army-republic of panama initiative.  

PubMed

Abstract Objective: Many developing countries have shown interest in embracing telemedicine and incorporating it into their healthcare systems. In 2000, the U.S. Army Yuma Proving Ground (YPG) initiated a program to assist the Republic of Panama in establishing a demonstration Panamanian rural telemedicine program. YPG engaged the Arizona Telemedicine Program (ATP) to participate in the development and implementation of the program. Materials and Methods: The ATP recommended adoption of a "top-down" strategy for creating the program. Early buy-in of the Panamanian Ministry of Health and academic leaders was regarded as critical to the achievement of long-term success. Results: High-level meetings with the Minister of Health and the Rectors (i.e., Presidents) of the national universities gained early program support. A telemedicine demonstration project was established on a mountainous Indian reservation 230 miles west of Panama City. Today, three rural telemedicine clinics are linked to a regional Ministry of Health hospital for teleconsultations. Real-time bidirectional videoconferencing utilizes videophones connected over Internet protocol networks at a data rate of 768 kilobits per second to the San Felix Hospital. Telepediatrics, tele-obstetrics, telepulmonology, teledermatology, and tele-emergency medicine services became available. Telemedicine services were provided to the three sites for a total of 1,013 cases, with numbers of cases increasing each year. These three demonstration sites remained in operation after discontinuation of the U.S. involvement in September 2009 and serve as a model program for other telemedicine initiatives in Panama. Conclusions: Access to the assets of a partner-nation was invaluable in the establishment of the first model telemedicine demonstration program in Panama. After 3 years, the Panamanian Telemedicine and Telehealth Program (PTTP) became self-sufficient. The successful achievement of sustainability of the PTTP after disengagement by the United States fits the Latifi-Weinstein model for establishing telemedicine programs in developing countries. PMID:23931731

Vega, Silvio; Marciscano, Ivette; Holcomb, Michael; Erps, Kristine A; Major, Janet; Lopez, Ana Maria; Barker, Gail P; Weinstein, Ronald S

2013-08-09

98

The Research Agenda in ICU Telemedicine  

PubMed Central

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

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

2011-01-01

99

[Telemedicine--technology, application, evaluation and prospect].  

PubMed

With the information society drawing near, the pattern of medical treatment is changing. Telemedicine is now carrying out many purposes such as family health care, first aid, expert consultation, long-distance intervene and learning communication in it's particular mode. This article will enter into some engineering-technology methods of medical information transmission (including data, sound and image), introduce several application field of telemedicine , evaluate the potential benefit, virtue and some problems which are likely to arise in the implement of telemedicine, and forecast the development of telemedicine in the future. PMID:11542718

Wang, B H; He, P

1999-08-01

100

Video technologies in district telemedicine centre  

NASA Astrophysics Data System (ADS)

The activity is directed on research of the problems of video information usage in telemedicine. Creation of a telemedical network in Russia. Definition of medical technologies operating video information. The classification and list of video technologies in telemedicine. The problems of designing telemedical centers to make allowance for telemedicine used for treatment of patients, formation and improvement of professional skill of medical staff in Russia are esteemed. The minimization of the cost of district centers of telemedicine with usage of video technologies is designed.

Galitsyn, Igor A.; Degtyarev, Vladimir M.

2005-04-01

101

The safety and effectiveness of minor injuries telemedicine  

PubMed Central

Objectives: To determine the safety of minor injuries telemedicine compared with on-site specialist care, current practice, and a robust gold standard, and to assess the clinical effectiveness of this new technique. Methods: Patients presenting to a peripheral hospital within 10 days of injury were separately assessed by each of: an emergency medicine specialist based at a district general hospital using telemedicine, a second on-site emergency medicine specialist, and an on-site general practitioner (representing current practice). The primary outcome measure was discrepancies between these three medical assessments and a gold standard. All patients were subsequently randomised to follow one of the independent treatment plans generated by the above assessments. Secondary outcomes were recovery and further use of healthcare services measured seven days after recruitment, and consultation duration. Results: 600 patients were recruited over a 12 month period. Overall, 73 discrepancies were identified, with 12 important over-treatments and 11 important under-treatments. No consultation modality was clearly superior to any other, and there were no statistically significant differences in the secondary outcomes of clinical effectiveness measured at seven days. The mean duration of a telemedicine consultation (6.0 min) was almost twice as long as an on-site specialist (3.1 min) or on-site general practitioner consultation (3.4 min) (p<0.0001 in both cases). Conclusions: Minor injuries telemedicine is safe and clinically effective, providing care that is equivalent to specialist on-site assessment and the current practice of treatment by a general practitioner. There is no evidence that telemedicine provides superior care, and there are a number of process issues that may impede successful implementation of this new technique.

Benger, J; Noble, S; Coast, J; Kendall, J

2004-01-01

102

The reliability and acceptability of telemedicine for patients with schizophrenia in Korea.  

PubMed

We conducted a pilot study to evaluate telemedicine for patients with schizophrenia. The telemedicine system was connected over the ordinary telephone network at 33 kbit/s. A computer-based patient record was used to view patient summaries and to allow nursing notes to be entered at the patient's home. Fifteen patients with schizophrenia were assessed over the telemedicine system and 15 patients were assessed face to face, using the Brief Psychiatric Rating Scale (BPRS). Our low-bandwidth telemedicine system appeared to be as reliable as higher-bandwidth ISDN systems. In addition, the patients' acceptance of the telemedicine interview, in terms of comfort, ease of self-expression, quality of interpersonal relationship and usefulness, was good in most cases. The only factors significantly affecting the patients' level of acceptance of their particular type of interview were the assessment type (i.e. whether the patient had had a telemedicine assessment or not) and their BPRS score. Since the system was of low cost and was easy to interface with a notebook computer, it could be used support other home-health nursing services. PMID:10824375

Chae, Y M; Park, H J; Cho, J G; Hong, G D; Cheon, K A

2000-01-01

103

Case Studies in Broadcast Management.  

ERIC Educational Resources Information Center

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

Coleman, Howard W.

104

Anesthesia case management for thyroidectomy.  

PubMed

An intimate knowledge of the anatomy, physiology, pathophysiology, pharmacology, and specific issues related to anesthesia case management for thyroidectomy is essential to provide high-quality care. Airway management may be difficult despite a normal airway examination due to impingement of a thyroid mass on the laryngeal and tracheal structures. Anesthetists must be prepared to use emergency airway adjuncts in case a patient cannot be ventilated or intubated. Because sympathetic nervous system hyperactivity is associated with increased amounts of thyroid hormone, it is essential that all patients having an elective thyroidectomy be in a euthyroid state before surgery. There are multiple preoperative antithyroid medication regimens that effectively treat thyroid hormone hypersecretion. However, although a rare event, thyroid storm can still occur during the perioperative period. Anesthetic considerations and surgical complications are presented. PMID:20583462

Elisha, Sass; Boytim, Michael; Bordi, Sandy; Heiner, Jeremy; Nagelhout, John; Waters, Ed

2010-04-01

105

Cognitive human factors for telemedicine systems.  

PubMed

The recent integration of telephony systems with information and communication technology (ICT) enables the development of innovative tools for telemedicine. The dissemination and widespread acceptance of telephone-based care monitoring systems challenge the researcher to deal with the cognitive factors involved in the patient-physician interaction, and the way they should be to shape up the technological solutions. This paper proposes a model that describes the impact of socio-cognitive factors in the complex process of health care management. The model has been used to design and develop a telephone system for the management of hypertensive patient within the EU funded Homey project. The knowledge existed in a widely accepted guideline for the care of hypertension has been represented and augmented through the proposed cognitive model. The final product is an intelligent system able to manage an adaptive dialogue. It monitors patients' adherence and increases their involvement by promoting self-care through frequent virtual visits, which is complementary to the traditional face-to-face encounters with their primary care physicians. PMID:15360958

Piazza, Matteo; Giorgino, Toni; Azzini, Ivano; Stefanelli, Mario; Luo, Roger

2004-01-01

106

Telemedicine: history, applications, and impact on librarianship.  

PubMed Central

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

Zundel, K M

1996-01-01

107

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.

2012-01-01

108

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.

Martinez-Alcala, Claudia I.; Munoz, Mirna; Monguet-Fierro, Josep

2013-01-01

109

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

110

The telemedicine and teleconsultation system application in clinical medicine.  

PubMed

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

Chang, T; Lee, J; Wu, S

2004-01-01

111

Telemedicine: legal and licensure issues  

NASA Astrophysics Data System (ADS)

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

Wood, Michael B.; Whelan, Leo J.

1995-10-01

112

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.

113

Education for Effective Case Management Practice.  

ERIC Educational Resources Information Center

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

Dickerson, Pamela S.; Mansfield, Jerry A.

2003-01-01

114

Case research in operations management a  

Microsoft Academic Search

This paper reviews the use of case study research in operations management for theory development and testing. It draws on the literature on case research in a number of disciplines and uses examples drawn from operations management research. It provides guidelines and a roadmap for operations management researchers wishing to design, develop and conduct case-based research.

Chris Voss; Nikos Tsikriktsis; Mark Frohlich; M S Sridhar

2002-01-01

115

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

116

Improving telemedicine onboard Norwegian ships and drilling platforms. A study of intersectoral co-operation in Maritime Medicine  

Microsoft Academic Search

Background: Using telemedicine to provide health services for seafarers represents a special case of intersectoral co-operation. Since 2006, several North Sea drilling platforms and internationally operating Norwegian merchant ships have used onboard telemedicine equipment continuously. Experience gained through this new technology has improved intersectoral co-operation regarding seafarers' health care. Aim: This study aimed to analyze the need for intersectoral co-operation

Monika Petra Puskeppeleit

117

Cost-Benefit Analysis of Shipboard Telemedicine.  

National Technical Information Service (NTIS)

Telemedicine (TM) is an umbrella term that covers various technologies used to transmit information for health services. TM uses electronic information and communication technologies to provide and support health care when distance separates the participa...

F. E. Garcia P. H. Stoloff J. E. Thomason D. S. Shia

1997-01-01

118

Evaluation of Telemedicine Satisfaction Among Naval Radiologists.  

National Technical Information Service (NTIS)

The focus of this study was to assess levels of satisfaction and experience among radiologists using teleradiology and other telemedicine technologies at the Naval Medical Center, San Diego (NMCSD). This study was conducted using a survey administered to ...

B. Bohannan C. Strychacz T. Melcer

2003-01-01

119

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

120

A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists  

PubMed Central

Background One way to tackle health inequalities in resource-poor settings is to establish links between doctors and health professionals there and specialists elsewhere using web-based telemedicine. One such system run by the Swinfen Charitable Trust has been in existence for 13 years which is an unusually long time for such systems. Objective We wanted to gain some insights into whether and how this system might be improved. Methods We carried out a survey by questionnaire of referrers and specialists over a six months period. Results During the study period, a total of 111 cases were referred from 35 different practitioners, of whom 24% were not doctors. Survey replies were received concerning 67 cases, a response rate of 61 per cent. Eighty-seven per cent of the responding referrers found the telemedicine advice useful, and 78% were able to follow the advice provided. As a result of the advice received, the diagnosis was changed in 22% of all cases and confirmed in a further 18 per cent. Patient management was changed in 33 per cent. There was no substantial difference between doctors and non-doctors. During the study period, the 111 cases were responded to by 148 specialists, from whom 108 replies to the questionnaire were received, a response rate of 73 per cent. About half of the specialists (47%) felt that their advice had improved the management of the patients. There were 62 cases where it was possible to match up the opinions of the referrer and the consultants about the value of a specific teleconsultation. In 34 cases (55%) the referrers and specialists agreed about the value. However, in 28 cases (45%) they did not: specialists markedly underestimated the value of a consultation compared to referrers. Both referrers and specialist were extremely positive about the system which appears to be working well. Minor changes such as a clearer referral template and an improved web interface for specialists may improve it.

Patterson, Victor; Wootton, Richard

2013-01-01

121

A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists.  

PubMed

Background: One way to tackle health inequalities in resource-poor settings is to establish links between doctors and health professionals there and specialists elsewhere using web-based telemedicine. One such system run by the Swinfen Charitable Trust has been in existence for 13 years which is an unusually long time for such systems. Objective: We wanted to gain some insights into whether and how this system might be improved. Methods: We carried out a survey by questionnaire of referrers and specialists over a six months period. Results: During the study period, a total of 111 cases were referred from 35 different practitioners, of whom 24% were not doctors. Survey replies were received concerning 67 cases, a response rate of 61 per cent. Eighty-seven per cent of the responding referrers found the telemedicine advice useful, and 78% were able to follow the advice provided. As a result of the advice received, the diagnosis was changed in 22% of all cases and confirmed in a further 18 per cent. Patient management was changed in 33 per cent. There was no substantial difference between doctors and non-doctors. During the study period, the 111 cases were responded to by 148 specialists, from whom 108 replies to the questionnaire were received, a response rate of 73 per cent. About half of the specialists (47%) felt that their advice had improved the management of the patients. There were 62 cases where it was possible to match up the opinions of the referrer and the consultants about the value of a specific teleconsultation. In 34 cases (55%) the referrers and specialists agreed about the value. However, in 28 cases (45%) they did not: specialists markedly underestimated the value of a consultation compared to referrers. Both referrers and specialist were extremely positive about the system which appears to be working well. Minor changes such as a clearer referral template and an improved web interface for specialists may improve it. PMID:24063752

Patterson, Victor; Wootton, Richard

2013-09-23

122

Case management programs in primary care  

Microsoft Academic Search

To review the impact of case management programs on health care resource use; their impact on patient satisfaction, quality\\u000a of life, and functional status (patient-centered outcomes); and their cost-effectiveness, we reviewed the English language\\u000a literature utilizing the following MEDLINE and Health-STAR headings: case management, patient care planning, patient-centered\\u000a care, disease management, care management, and managed care programs. Bibliographies of relevant

Jeffrey A. Ferguson; Morris Weinberger

1998-01-01

123

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

124

Wearable devices for telemedicine applications.  

PubMed

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

Scheffler, M; Hirt, E

2005-01-01

125

Telemedicine for new neurological outpatients: putting a randomized controlled trial in the context of everyday practice.  

PubMed

In a retrospective review, the telemedical management of 65 outpatients from a randomized controlled trial (RCT) of telemedicine for non-urgent referrals to a consultant neurologist was compared with the management of 76 patients seen face to face in the same trial, with that of 150 outpatients seen in the neurology clinics of district general hospitals and with that of 102 neurological outpatients seen by general physicians. Outcome measures were the numbers of investigations and of patient reviews. The telemedicine group did not differ significantly from the 150 patients seen face to face by neurologists in hospital clinics in terms of either the number of investigations or the number of reviews they received. Patients from the RCT seen face to face had significantly fewer investigations but a similar number of reviews to the other 150 patients seen face to face by neurologists (the disparity in the number of investigations may explain the negative result for telemedicine in that RCT). Patients with neurological symptoms assessed by general physicians had significantly more investigations and were reviewed significantly more often than all the other groups. Patients from the RCT seen by telemedicine were not managed significantly differently from those seen face to face by neurologists in hospital clinics but had significantly fewer investigations and follow-ups than those patients managed by general physicians. The results suggest that management of new neurological outpatients by neurologists using telemedicine is similar to that by neurologists using a face-to-face consultation, and is more efficient than management by general physicians. PMID:12396855

Chua, Richard; Craig, John; Esmonde, Thomas; Wootton, Richard; Patterson, Victor

2002-01-01

126

Do Telemedicine Wound Care Specialist Consults Meet the Needs of the Referring Physician? A Survey of Primary Care Providers  

PubMed Central

The purpose of our study was to determine the factors that influence the use of telemedicine consultation by primary care physicians (PCPs) in the management of patients with problem wounds. A short questionnaire was administered to thirty-six PCPs who referred to our Wound Care Program within one year. Participants were asked to rate the importance of specific concerns and benefits regarding the role of wound care surgical specialist (WCSS) and the use of telemedicine consults prior to possible face-to-face consultation. Sixty percent of respondents felt comfortable with telemedicine consultation based on recommendations alone. The total number of patients referred for telemedicine consult was 230, and face-to-face consultation with a WCSS was offered and arranged for 30% of patients. The perception of shared decision making, streamlining patient care, and an opportunity for followup were all highly ranked benefits. The majority of PCPs (93%) agreed that telemedicine wound care consult is a useful tool in their practice and would continue to use the telemedicine consult service.

Dobke, Marek K.; Bhavsar, Dhaval; Herrera, Fernando

2011-01-01

127

Telemedicine and Rural Health Care Applications Telemedicine and Rural Health Care Applications Telemedicine and Rural Health Care Applications Telemedicine and Rural Health Care Applications Telemedicine and Rural Health Care Applications  

Microsoft Academic Search

ABSTRACT ABSTRACT ABSTRACT ABSTRACT Queensland, Centre for Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right Online Health, Australia. circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and Correspondence:

Smith AC; Bensink M; Armfield N; Stillman J; Caffery L; Anthony C. Smith

2005-01-01

128

42 CFR 440.168 - Primary care case management services.  

Code of Federal Regulations, 2010 CFR

... 2009-10-01 false Primary care case management services. 440.168 Section 440...Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case management...

2009-10-01

129

42 CFR 440.168 - Primary care case management services.  

Code of Federal Regulations, 2010 CFR

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

2010-10-01

130

Case management of malaria: Diagnosis.  

PubMed

Laboratory diagnosis of malaria in South Africa has traditionally relied on microscopic examination of stained blood films. More recently, rapid diagnostic tests (RDTs) have been introduced into routine use, and molecular methods like polymerase chain reaction are useful in certain situations. As with all laboratory tests, each technique has its advantages and disadvantages. Microscopy and RDTs, if appropriately quality assured, are adequate for clinical case management. For elimination, active surveillance will need to be expanded substantially, with wider use of more sensitive diagnostic nucleic acid amplification techniques, and/or serology. To facilitate surveillance activities, techniques suitable for field or near-field use would be ideal. A long-running external quality assessment programme in South Africa has shown some deficiencies in the quality of malaria diagnosis in routine laboratories. Quality systems across the spectrum of diagnostic facilities in South Africa need strengthening, to ensure progress towards elimination.  PMID:24079635

Frean, J; Poonsamy, B; Shandukani, B; Moonasar, D; Raman, J

2013-08-29

131

75 FR 27375 - Postal Rate Case Management  

Federal Register 2010, 2011, 2012, 2013

...PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission...management of an anticipated exigent postal rate case. It has scheduled a technical conference...establish procedures for handling exigent rate cases. Docket No. RM2007-1, October...

2010-05-14

132

Child Protective Services Case Management Project.  

National Technical Information Service (NTIS)

The Child Protective Service (CPS) Case Management Project was initiated in Region 7 of the Texas Department of Human Services (DHS) to develop a model for case management in child protective services. A review of social work literature related to case ma...

1985-01-01

133

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.

134

Enterprise Risk Management Solutions: A Case Study.  

National Technical Information Service (NTIS)

In recent years, financial risk management has received increasing attention from managers in both private and public enterprises, regulatory agencies, and elected officials. The purpose of this research is to prepare a case study of a firm that seeks to ...

D. C. Hays

2008-01-01

135

The Role of Service Oriented Architecture in Telemedicine Healthcare System  

Microsoft Academic Search

Interoperability in telemedicine system is one of the major concern in telemedicine health care system. It is difficult to design exact and flexible interoperable architecture in telemedicine which transmit data and exchange information between systems to systems. The Service Oriented Architecture (SOA) is playing major role in the development of such system which helps to exchange the information between similar

Asadullah Shaikh; Muniba Shoukat Memon; Nasrullah Memon; Muhammad Misbahuddin

2009-01-01

136

Swedish–Lithuanian telemedicine Litmed project in otolaryngology  

Microsoft Academic Search

Telemedicine is becoming a reality as a result of improvements in technology and telecommunications. The task of the otolaryngological part of the pilot international telemedicine Litmed project was devoted to the establishment of telemedicine training and demonstration facilities in cooperation between the Departments of Otolaryngology of the Kaunas University of Medicine (Lithuania) and the Lund University (Sweden). The main areas

Virgilijus Uloza; Lars-Olof Almquist; Roland Rydell; Owe Svensson; Ingrida Uloziene

2003-01-01

137

Case Management with Hurricane Katrina Survivors: Perspectives of Case Managers and Supervisors  

Microsoft Academic Search

Disaster case management is an important but under-researched aspect of disaster recovery. This study explored the perspectives of case managers and supervisors about the needs of Hurricane Katrina survivors. Telephone interviews with 168 case managers and supervisors in 32 states identified client motivation and availability of resources as key factors in successful cases. Conversely, lack of client motivation perceived or

Holly Bell; Elissa Madden; Elisa Vinson Borah; Laura Lein; Julie Beausoleil

2010-01-01

138

Proceedings of the Mayo Telemedicine Symposium Including 'Telemedicine and Access to Care': A Consensus Conference (1st). Held Simultaneously (Broadcast Live) from Mayo Medical Centers in Rochester, Minnesota, Jacksonville, Florida and Scottsdale, Arizona on October 1-3, 1993. Abstract, Executive Summary and Conference Proceedings.  

National Technical Information Service (NTIS)

Contents: Telemedicine and Access to Care: A Consensus Conference; Managed Competition in the Rural Environment; A New Agenda for Health Care in the New Millennium; The 'Star Trek' Health Care System; Electronic House Calls: 21st Century Health Care Servi...

R. McGee

1994-01-01

139

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

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

141

Telemedicine Expanding the Scope of Health Care Information  

PubMed Central

Abstract The definition of health information is growing to include multimedia audio, video, and high-resolution still images. This article describes the telemedicine program at East Carolina University School of Medicine, including the telemedicine applications presently in use and the virtual reality applications currently under development. Included are the major design criteria that shape the telemedicine network, some of the lessons learned in developing the network, and a discussion of the future of telemedicine, including efforts to incorporate telemedicine within a fully integrated health information system.

Balch, David C.; Tichenor, John M.

1997-01-01

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 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

144

Managing change through management development: an industry case study  

Microsoft Academic Search

Purpose – The purpose of this paper is to explore the interconnections between management development and change management within the context of an industry case study. To develop strategies for how management development practices might better support the management of change. Design\\/methodology\\/approach – Using a constructivist methodology, one-to-one interviews were conducted with two groups: a randomly chosen cross-section of middle

Chris Shanley

2007-01-01

145

Design and customization of telemedicine systems.  

PubMed

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

2013-05-15

146

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

147

Value Bases of Case Management Evaluation.  

ERIC Educational Resources Information Center

|Some of the confusion surrounding evaluations of case management results from lack of clarity about value frames used to arrive at judgments of the merit of case management. Six value frames commonly applied to human service evaluation are reviewed, and the relevance of each perspective is examined. (SLD)|

Kirkhart, Karen E.; Ruffolo, Mary Carmel

1993-01-01

148

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…

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

2009-01-01

149

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

150

USING STRATEGIC MANAGEMENT STUDY CASES IN ROMANIA  

Microsoft Academic Search

The paper discuss the use of study case in the teaching of strategic management and the translation of the method from United States to Romania. Some technical aspects of American experience in strategic management case researching are underlined, with a focalised approach on financial analysis and their informational context. The basic weaknesses of the method are also analysed in order

Bacanu Bogdan

2008-01-01

151

Telemedicine can make healthcare greener.  

PubMed

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

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

2010-03-01

152

Telemedicine using mobile satellite communication.  

PubMed

With a view to providing paramedical care within moving vehicles, a telemedicine technique using mobile satellite communication was proposed. With this technique, the diagnosis from a specialist and the emergency care under his/her instructions would be available on the spot without unnecessary delay. The characteristic problems of this technique were identified as: channel capacity, size of the system, reliability of vital sign transmission, real-time operation and electromagnetic interference. Measures against these problems were devised, and their effectiveness was analyzed. A data format was designed and an experimental system was developed. The system can simultaneously transmit a color image, an audio signal, 3 channels ECG and blood pressures from a mobile station to a ground station. It can transmit an audio signal and error control signals from a ground station to a mobile station in a full duplex mode. Fundamental transmission characteristics were measured in a fixed station. Finally, experiments of medical data transmission were conducted with a navigating ship and an aircraft flying an international route. The measured threshold values of C/N(o) to guarantee satisfactory data reception were well below the lower boundary of C/N(o) of the communication link. Consequently, the feasibility of this technique was verified. PMID:8070809

Murakami, H; Shimizu, K; Yamamoto, K; Mikami, T; Hoshimiya, N; Kondo, K

1994-05-01

153

Low-cost telemedicine in the developing world.  

PubMed

The Swinfen Charitable Trust uses digital cameras and email to provide specialist advice to doctors in developing countries. The first telemedicine link was set up in July 1999. By the end of a year there were three links to hospitals in Bangladesh, Nepal and the Solomon Islands. Initially the consultants, all of whom give their advice free of charge, were from the UK, but now are worldwide. At present there are 12 links in operation, including one on Tristan da Cunha, and two links approved and awaiting equipment. The advice given by the consultants has been found to be helpful to the referring doctors and to benefit their patients. Failures have been due to the use of obsolescent equipment, computer viruses, lack of communication with the referring hospital before setting up a link, and referring doctors not chasing up their own referrals. Problems yet to be solved include the unreliability of the Internet, certain medicolegal issues and assessing the quality of medical consultants. In future there will be the problem of managing a rapidly growing telemedicine network. PMID:12661626

Swinfen, R; Swinfen, P

2002-01-01

154

The Implementation of Telemedicine within a Community Cancer Network  

PubMed Central

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

London, Jack W.; Morton, Daniel E.; Marinucci, Donna; Catalano, Robert; Comis, Robert L.

1997-01-01

155

Case management: developing practice through action research.  

PubMed

This article is a report of an action research study carried out with community nurses to help develop case management within their practice. Using action research principles, nurses reviewed and analysed their current practice and developed recommendations for further embedding case management as a means of supporting patients with complex care needs in their own homes. Findings indicate that a number of factors can influence the community nurse's ability to implement case management. These factors include approaches to case finding, availability of resources and interprofessional working. Important considerations for nurses were the influence of the context of care, the geographical location and the health needs of the local patient population, which meant that case management may need to be adapted to meet local circumstances. PMID:24005490

Smith, Annetta; Mackay, Seonaid; McCulloch, Kathleen

2013-09-01

156

Seahawk: telemedicine project in the Pacific Northwest  

NASA Astrophysics Data System (ADS)

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

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

1995-05-01

157

Developing prison telemedicine systems: the Greek experience.  

PubMed

Prison telemedicine systems operate in circumstances in which the provision of medical care is very expensive. In 1999 the Greek Ministry of Justice decided to use telemedicine to improve health services in the largest prison in Greece (Korydallos Prison, in Athens). The Nikea Hospital in Piraeus undertook to support the effort in order: to enable prison paramedics and guards to call for remote evaluation of inmates when the prison's doctors were off duty; to provide second opinions; and to allow screening and primary care coverage for inmates through teleconsultations with Nikea Hospital specialists. For 12 months following installation, intensive 'hands-on' training on the use of the system was offered to the staff of both the Korydallos Prison and the Nikea Hospital. In all, 400 physicians, nurses and paramedics were trained. Despite all this effort, there were serious operational problems related either to prison bureaucracy or to the inflexibility of the Greek national health system, which annulled the effectiveness of the prison telemedicine system. The experience suggests that prison telemedicine is a viable option if freed from bureaucratic and labour-related obstacles, and can improve the quality of care available to prisoners. PMID:14728746

Anogianakis, George; Ilonidis, George; Milliaras, Spyros; Anogeianaki, Antonia; Vlachakis-Milliaras, Emmanuel

2003-01-01

158

EVALUATING TELEMEDICINE TECHNOLOGIES IN RURAL SETTINGS  

Microsoft Academic Search

Changes in health care policies, demographics, and technology have presented new opportunities for the delivery of medical care services and information to rural communities. Telemedicinethe use of electronic information and communications technologies to provide and support health care when distance separates the participantshas significantly impacted the delivery of rural health care services. This paper presents an overview of the telemedicine

Susan M. Capalbo; Christine N. Heggem

1999-01-01

159

Enabling Technology for Telemedicine and Telehealth.  

National Technical Information Service (NTIS)

Telemedicine is a growing field and has to face various challenges like its integration to the medical practice and to the health care system, its economic implication and its social impact. This paper will focus on the technological aspects of Telemedici...

B. Solaiman J. M. Cauvin J. Puentes C. Le Guillou G. Brunet

2001-01-01

160

The effect of telemedicine in critically ill patients: systematic review and meta-analysis  

PubMed Central

Introduction Telemedicine extends intensivists' reach to critically ill patients cared for by other physicians. Our objective was to evaluate the impact of telemedicine on patients' outcomes. Methods We searched electronic databases through April 2012, bibliographies of included trials, and indexes and conference proceedings in two journals (2001 to 2012). We selected controlled trials or observational studies of critically ill adults or children, examining the effects of telemedicine on mortality. Two authors independently selected studies and extracted data on outcomes (mortality and length of stay in the intensive care unit (ICU) and hospital) and methodologic quality. We used random-effects meta-analytic models unadjusted for case mix or cluster effects and quantified between-study heterogeneity by using I2 (the percentage of total variability across studies attributable to heterogeneity rather than to chance). Results Of 865 citations, 11 observational studies met selection criteria. Overall quality was moderate (mean score on Newcastle-Ottawa scale, 5.1/9; range, 3 to 9). Meta-analyses showed that telemedicine, compared with standard care, is associated with lower ICU mortality (risk ratio (RR) 0.79; 95% confidence interval (CI), 0.65 to 0.96; nine studies, n = 23,526; I2 = 70%) and hospital mortality (RR, 0.83; 95% CI, 0.73 to 0.94; nine studies, n = 47,943; I2 = 72%). Interventions with continuous patient-data monitoring, with or without alerts, reduced ICU mortality (RR, 0.78; 95% CI, 0.64 to 0.95; six studies, n = 21,384; I2 = 74%) versus those with remote intensivist consultation only (RR, 0.64; 95% CI, 0.20 to 2.07; three studies, n = 2,142; I2 = 71%), but effects were statistically similar (interaction P = 0.74). Effects were also similar in higher (RR, 0.83; 95% CI, 0.68 to 1.02) versus lower (RR, 0.69; 95% CI, 0.40 to 1.19; interaction, P = 0.53) quality studies. Reductions in ICU and hospital length of stay were statistically significant (weighted mean difference (telemedicine-control), -0.62 days; 95% CI, -1.21 to -0.04 days and -1.26 days; 95% CI, -2.49 to -0.03 days, respectively; I2 > 90% for both). Conclusions Telemedicine was associated with lower ICU and hospital mortality among critically ill patients, although effects varied among studies and may be overestimated in nonrandomized designs. The optimal telemedicine technology configuration and dose tailored to ICU organization and case mix remain unclear.

2012-01-01

161

A PDA-based flexible telecommunication system for telemedicine applications.  

PubMed

Technology has been used to deliver health care at a distance for many years. Telemedicine is a rapidly growing area and recently there are studies devoted to prehospital care of patients in emergency cases. In this work we have developed a compact, reliable, and low cost PDA-based telecommunication device for telemedicine applications to transmit audio, still images, and vital signs from a remote site to a fixed station such as a clinic or a hospital in real time. This was achieved based on a client-server architecture. A Pocket PC, a miniature camera, and a hands-free microphone were used at the client site and a desktop computer running the Windows XP operating system was used as a server. The server was located at a fixed station. The system was implemented on TCP/IP and HTTP protocol. Field tests have shown that the system can reliably transmit still images, audio, and sample vital signs from a simulated remote site to a fixed station either via a wired or wireless network in real time. The Pocket PC was used at the client site because of its compact size, low cost and processing capabilities. PMID:17272162

Nazeran, Homer; Setty, Sunil; Haltiwanger, Emily; Gonzalez, Virgilio

2004-01-01

162

Iowa Case Management for Rural Drug Abuse  

PubMed Central

Objective The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. Conclusion Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.

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

2011-01-01

163

Iowa Case Management for Rural Drug Abuse.  

PubMed

OBJECTIVE: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. METHOD: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. RESULTS: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. CONCLUSION: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time. PMID:22065018

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

2009-07-01

164

The patient's perspective in the Dutch National Technical Agreement on Telemedicine.  

PubMed

In 2007, the Dutch National Technical Agreement (NTA) for Telemedicine was established. Telemedicine deals with care processes. The goals of Telemedicine were defined broadly, including quality of life in non-medical terms as seen from the patient's perspective: 1) independence, 2) self-reliance; 3) participation in society and social life and 4) self-determination (autonomy through freedom of choice) for the care consumer and his environment. Quality aspects were defined at three levels:1) patient level Telemedicine must be in line with his needs. 2) level of information provision, such as: patient's rights in information control were also defined in the NTA: the care consumer has ultimate control over his own data. The care consumer decides who, in which functional capacity within the care process, is entitled to access which data at which level (reading) and is entitled to process it in some way: making additions, changes or possibly deleting (writing). On request, the healthcare provider must allow the care consumer access to his own data as quickly as possible and/or provide a copy of (part of) the record.3) level of business processes, e.g.it is important that the care process is designed on the basis of statutory requirements for the allocation and registration of the roles, rights and obligations of all actors concerned. For quality assurance, the processes must be defined on the basis of the function that they perform in the achievement of the goals (intended outcome), from the starting situation (input). The intended outcome means that the needs or requirements of the involved parties are fulfilled. The quality of the Telemedicine service must be assured in a cyclical and ongoing process. This can best be done by developing a quality management system based on indicators and criteria for quality. PMID:18560064

Meijer, Wouter J

2008-01-01

165

42 CFR 441.18 - Case management services.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 2012-10-01 false Case management services. 441.18 Section...SERVICES General Provisions § 441.18 Case management services. (a) If a State plan provides for case management services (including...

2012-10-01

166

Outage management: A case study  

SciTech Connect

Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

Haber, S.B.; Barriere, M.T. (Brookhaven National Lab., Upton, NY (United States)); Roberts, K.H. (California Univ., Berkeley, CA (United States). Walter A. Haas School of Business)

1992-01-01

167

Outage management: A case study  

SciTech Connect

Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission`s (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

Haber, S.B.; Barriere, M.T. [Brookhaven National Lab., Upton, NY (United States); Roberts, K.H. [California Univ., Berkeley, CA (United States). Walter A. Haas School of Business

1992-09-01

168

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

169

URBAN STORMWATER MANAGEMENT AND TECHNOLOGY: CASE HISTORIES  

EPA Science Inventory

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

170

In what circumstances is telemedicine appropriate in the developing world?  

PubMed Central

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

Wootton, Richard; Bonnardot, Laurent

2010-01-01

171

Telemedicine and diabetes: achievements and prospects.  

PubMed

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 the type of diabetes. In type 1 diabetes (T1DM) associated with complex insulin regimens, the goal of TM is to help patients achieve better control of their blood glucose levels through accurate adjustment of insulin doses. In type 2 diabetes (T2DM), while therapeutic adjustments may be necessary, improvement in blood glucose control is based primarily on behavioural changes (reduced calorie and carbohydrate intakes, increased physical activity). Many TM studies focusing on management of blood glucose levels have been published, but most failed to demonstrate any superiority of TM vs traditional care. While previously published meta-analyses have shown a slight advantage at best for TM, these meta-analyses included a mix of studies of varying durations and different populations (both T1DM and T2DM patients, adults and children), and tested systems of inconsistent quality. Studies published to date on TM suggest two currently promising approaches. First, handheld communicating devices, such as smartphones, loaded with software to apply physicians' prescriptions, have been shown to improve glycaemic control. These systems provide immediate assistance to the patient (such as insulin-dose calculation and food choice optimization at meals), and all data stored in the smartphone can be transmitted to authorized caregivers, enabling remote monitoring and even teleconsultation. These systems, initially developed for T1DM, appear to offer many possibilities for T2DM, too. Second, systems combining an interactive Internet system (or a mobile phone coupled to a remote server) with a system of communication between the healthcare provider and the patient by e-mail, texting or phone calls have also shown certain benefits for glycaemic control. These systems, primarily aimed at T2DM patients, generally provide motivational support as well. Although the individual benefits of these systems for glycaemic control are fewer than with smartphones, their widespread use should be of particular value for overcoming the relative shortage of doctors and reducing the health costs associated with a disease of such epidemic proportions. PMID:21889388

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

2011-09-01

172

Mapping the literature of case management nursing  

PubMed Central

Objectives: Nursing case management provides a continuum of health care services for defined groups of patients. Its literature is multidisciplinary, emphasizing clinical specialties, case management methodology, and the health care system. This study is part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association. The study identifies core journals cited in case management literature and indexing services that access those journals. Methods: Three source journals were identified based on established criteria, and cited references from each article published from 1997 to 1999 were analyzed. Results: Nearly two-thirds of the cited references were from journals; others were from books, monographs, reports, government documents, and the Internet. Cited journal references were ranked in descending order, and Bradford's Law of Scattering was applied. The many journals constituting the top two zones reflect the diversity of this field. Zone 1 included journals from nursing administration, case management, general medicine, medical specialties, and social work. Two databases, PubMed/MEDLINE and OCLC ArticleFirst, provided the best indexing coverage. Conclusion: Collections that support case management require a relatively small group of core journals. Students and health care professionals will need to search across disciplines to identify appropriate literature.

White, Pamela; Hall, Marilyn E.

2006-01-01

173

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.

Jones, Mary Gardiner

1997-01-01

174

Telemedicine: licensing and other legal issues.  

PubMed

The growth of information technology and telecommunications has created promising opportunities for better, faster, more accessible, barrier-free health care; telemedicine (TM). The feasibility of many TM projects depends on resolving legal issues. Mastering technical issues or providing training remain important benchmarks for implementation of TM, but legal issues constrain progress. This article identifies the key legal issues, maps current legislation, and offers a forecast of necessary steps to expedite the dissemination of TM. PMID:22032489

Siegal, Gil

2011-12-01

175

Hippocrates: an integrated platform for telemedicine applications.  

PubMed

This paper describes 'Hippocrates', an integrated platform for telemedicine applications. Hippocrates allows computer supported co-operative work based on patient data folders consisting of selected diagnostic images, annotation text, patient history and other information. All data transferred is encrypted to ensure confidentiality and integrity. It operates on a local level over TCP/IP LAN environment and on a remote level over public ISDN lines. PMID:9922948

Makris, L; Kopsacheilis, E V; Strintzis, M G

176

Feasibility of telemedicine intervention for childhood depression  

Microsoft Academic Search

Context: Childhood depression is associated with high short-term and long-term morbidity. Cognitive-behavioural therapy (CBT) for depression has been supported as an effective treatment in the traditional clinic setting. But many families face barriers to depression treatment, including distance to providers, provider shortages, stigma, and other challenges. Telemedicine or interactive televideo offers an innovative way to provide therapy at a distance.

Eve-Lynn Nelson; Martha Barnard; Sharon Cain

2006-01-01

177

Quantitative telemedicine ratings in Batten disease  

PubMed Central

Objective: To determine if remote administration of the Unified Batten Disease Rating Scale (UBDRS) Physical Impairment subscale by telemedicine is reliable and feasible across a broad range of disease severity. Methods: For the majority (n = 10) of subjects, the examination was performed by a nonphysician who had been trained to perform the examination but not to score the subjects. A trained rater scored the subjects via live video; a second trained rater performed a separate examination in person and scored that examination. For 3 telemedicine evaluations, examinations were performed and scored by a trained rater while a second trained rater simultaneously scored the subjects via live video. Reliability was determined by intraclass correlation coefficient (ICC). Results: Subjects (n = 13) represented a wide range of disease severity. Remote administration of the UBDRS Physical Impairment subscale had high interrater reliability across all subjects (ICC = 0.94). When only the subjects (n = 10) who had been examined by the nonphysician and scored remotely were included in the analysis, the reliability was unchanged (ICC = 0.95). Conclusions: The UBDRS Physical Impairment subscale is reliable and feasible for remote administration. Telemedicine has the potential to be a useful tool in rare neurologic disease research and clinical assessment.

Cialone, J.; Augustine, E.F.; Newhouse, N.; Vierhile, A.; Marshall, F.J.

2011-01-01

178

Reflections on pain management: a case study.  

PubMed

This article discusses issues relating to pain management at the end of life. Through reflections on a case study of a single patient many aspects of pain management are highlighted. These include difficulties in assessing pain, the need to respect patient autonomy, out-of-hours concerns and the possible role of integrated care pathways. The need to be aware of the potential value of non-pharmaceutical approaches is also discussed. PMID:14593283

Cunliffe, Jill

2003-10-01

179

Minnesota Case Management Study: Project Report Number 88-2.  

ERIC Educational Resources Information Center

This survey collected extensive data from 770 county case managers, case manager supervisors, consumers, and service providers in Minnesota in order to provide a comprehensive description of case management practices serving individuals with developmental disabilities. The survey report describes current case management practices, identifies…

McAnally, Patricia L.; Linz, Mary Hubbard

180

Self-regulation training for chronic pain: can it be done effectively by telemedicine?  

PubMed

The purpose of this project was to test the efficacy of behavioral telemedicine interventions designed to teach self-regulation skills to chronic pain patients who had not previously been treated. The study sought to determine whether there were differences in outcome and consumer satisfaction with the pain management intervention when delivered by conventional face-to-face methods, by telephone only, and by closed circuit TV (CCTV). We found that self-regulation techniques can be readily taught via behavioral telemedicine interventions. The primary methodologic weakness of the study is that a single experienced clinician provided all of the interventions. Thus, it is not known at this time how well the intervention can be generalized to other clinicians. In addition, there was no control on the administration of the protocols across conditions. PMID:12626105

Appel, Philip R; Bleiberg, Joseph; Noiseux, John

2002-01-01

181

Telemedicine in the care of the end-stage renal disease patient.  

PubMed

Interactive video was used to monitor patients undergoing hemodialysis in a rural community over a 55-mile distance. Between April of 1991 and April 1993, the Texas Telemedicine Project sponsored the contact and record management. During this period, 1,500 patient contacts were documented. After the termination of the Texas Telemedicine Projects, the transmission lines were maintained between the central dialysis center and the satellite facility. Between 1993 and 1996, another 12,000 patient contacts were made. Dialysis monitoring accounted for approximately 80% of contacts, and 20% were nondialysis (primary care) contacts. This report discusses the historical and recent developments of interactive video medical care delivery and technical and medical implications of this emerging medium. PMID:9792083

Moncrief, J W

1998-10-01

182

Current trends and future challenges in wireless telemedicine system  

Microsoft Academic Search

With an increase in population, providing basic health care to the people, especially in rural areas is the main objective of health administrators. A remote telemedicine system is the possible way to solve this problem with the support of new advanced technologies. This paper discusses the state of the art and the major issues in wireless telemedicine systems such as

Sujitha Juliet Devaraj; Kirubakaran Ezra

2011-01-01

183

A Generic Task-Driven Multi-Agent Telemedicine System  

Microsoft Academic Search

Pervasive telemedicine is an emerging research discipline, which focuses on the development and the application of ubiquitous computing technology for healthcare purposes. However, the current telemedicine systems lack to be self adaptable to handle different types of data such as vital biosignals, images, video and textual data. In addition, they do not use the full capabilities of the computing devices

Ebrahim Nageba; Jocelyne Fayn; Paul Rubel

2007-01-01

184

Telemedicine: a new frontier for effective healthcare services  

Microsoft Academic Search

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

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

185

Telemedicine: A Pilot Study in Nursing Home Residents  

Microsoft Academic Search

Background: Telemedicine has been applied successfully in various fields of medicine. This mode of health care delivery may potentially be useful in supporting frail nursing home residents who require multidisciplinary geriatric services. Objective: To assess the feasibility of telemedicine in providing geriatric services to nursing home residents, and whether this mode of care resulted in increased productivity and savings. Methods:

Elsie Hui; Jean Woo; Magnus Hjelm; Y. T. Zhang; H. T. Tsui

2001-01-01

186

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

187

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

188

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

189

Clinical case management in the Army medical department.  

PubMed

Clinical case management is a system that has the potential to improve the efficiency and effectiveness of health care delivery. Given this potential, the Army Medical Department (AMEDD) is examining this process as a means to achieve goals of quality care and cost effectiveness. In this article, the authors describe the concept of case management, the AMEDD system of clinical case management, the implementation of clinical case management in the AMEDD, and the role of the case manager. PMID:7824146

Jennings, B M; Brosch, L R

1994-08-01

190

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

PubMed Central

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

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

2011-01-01

191

The added value of video for consultations in telemedicine for minor injuries work.  

PubMed

We examined the decisions made about transfer of patients with minor injuries, when telemedicine support was provided to the remote nurses in two different ways: the telemedicine doctor either used a video link, or a telephone call with viewing of digital X-ray images (a low resolution version of Picture Archiving and Communications Systems [PACS]). A quasi-randomized study design was used, with a panel of 20 emergency medicine doctors who independently reviewed previously-stored consultations using the two modalities. In total, 60 case reviews were conducted during five sessions, representing 33 different cases from the routine workload of Minor Treatment Centres in Scotland. More experienced doctors transferred fewer patients than less experienced doctors. The proportion of patients transferred was higher when PACS was used than when video was used in most of the cases. A mixed effects logistic regression model was fitted to the data. The estimated odds for patient transfer were 56% lower when video was used instead of PACS (odds ratio 0.44, 95% confidence interval 0.20, 0.93). Although the cost implications are not yet known, video support for local decision-making should remain the preferred method of telemedicine for minor injuries work. PMID:22036927

Mair, Fiona; McClusky, Christine; Wilsgaard, Tom; Wootton, Richard

2011-10-28

192

[Management of giant inguinal hernias: five cases].  

PubMed

In Africa, difficulties in health care access and illiteracy promote the development of giant inguinal hernias. Management of these hernias can be very challenging, according to the risk of replacing the intestines into the abdominal cavity. We report five cases in Senegal. PMID:23448670

Diop, B; Sall, I; Ba, P A; Konaté, I; Sy, A; Wane, Y; Sarré, S M

193

Towards managing quality cost: A case study  

Microsoft Academic Search

One of the most effective tools for evaluating the success of a quality management programme is the measurement of quality costs (prevention, appraisal and failure costs). The application of the concept of quality costs originated in the early 1950s. A systematic approach is needed for measuring quality costs. This paper describes a case study to capture quality costs in a

S. B. Jaju; R. P. Mohanty; R. R. Lakhe

2009-01-01

194

Client Management Classification Strategies for Case Supervision  

Microsoft Academic Search

This article describes the client management classification (CMC) system. CMC is a comprehensive classification approach consisting of three major components: an objectively scored structured interview; strategies for supervising different types of clients; and a case planning process that stresses practical behavioral objectives. The classification group and supervision strategies are described, stressing implications for both correctional institutions and the correctional field.

Kenneth Lerner; Gary Arling; S. Christopher Baird

1986-01-01

195

"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

196

Screening for Diabetic Retinopathy: The First Telemedicine Approach in a Primary Care Setting in Bahrain  

PubMed Central

Purpose: To develop an integrated diabetic retinopathy screening program that uses telemedicine. Materials and Methods: In this evaluation of diagnostic technology, six telemedical screening units were established to cover all regions of Bahrain. The units were equipped with a digital fundus camera at the primary health care clinic. Fundus photographs were transmitted via the Internet to a centralized reading center. A retinal specialist at the reading center assessed the images. Results: From 2003 to 2009, 17,490 diabetic patients were screened. Of the screened patients, 20% were diagnosed with diabetic retinopathy. Of these cases, 31% required treatment. Conclusion: Telemedicine-based screening program is a feasible and efficient means of detecting diabetic retinopathy and providing treatment.

Al Alawi, Ebtisam; Ahmed, Ahmed Abdulla

2012-01-01

197

Changes to CMS Reimbursement Rules for Intraoperative Neurophysiological Monitoring: Implications for Telemedicine.  

PubMed

Abstract Intraoperative neurophysiological monitoring (IONM) is used as an adjunct for surgeries that pose risk to nervous system structures. IONM is performed by a technologist in the operating room and is overseen by a highly trained fellowship-trained physician clinical neurophysiologist. Telemedicine has allowed the professional oversight component to be done remotely, with reimbursement for multiple simultaneous cases. Recent changes to Current Procedure Terminology coding and Medicare reimbursement policies provide options only for exclusive 1:1 technologist:oversight physician billing. This policy change may create profound repercussions in the practice of telemedicine by actively discouraging the leveraging of highly specialized and scarce expertise through on-site physician extenders. PMID:23952785

Ney, John P

2013-08-17

198

[Malignant priapism: conservative management of a case].  

PubMed

Priapism is an urological emergency which requires investigation, especially to differentiate between ischemic and non-ischemic priapism. Initial management is carried out through aspiration and gasometry of blood from the corpus cavernosum. We report the case of a 69-year-old patient with urothelium carcinoma of the bladder T2 G3 and metastasis in urethra/corpus cavernosum who requested an emergency consultation because of edema and a penile erection lasting several days. Due to the poor prognosis and the imaging test, a conservative management was carried out. PMID:23648508

Tienza, A; Merino, I; Velis, J M; Algarra, R; Hernández, M D; Robles, J E

199

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

PubMed

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

Lam, David M; Poropatich, Ronald K

2008-11-01

200

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

201

Institutionalizing Telemedicine Applications: The Challenge of Legitimizing Decision-Making  

PubMed Central

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements— rationality, fairness, and efficiency—that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications—benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators’ perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.

Lettieri, Emanuele

2011-01-01

202

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

203

10 CFR 2.332 - General case scheduling and management.  

Code of Federal Regulations, 2010 CFR

...2009-01-01 2009-01-01 false General case scheduling and management. 2.332 Section 2.332...Adjudicatory Hearings § 2.332 General case scheduling and management. (a) Scheduling order . The presiding officer shall,...

2009-01-01

204

Case Managers’ Experiences of Personal Growth: Learning from Consumers  

Microsoft Academic Search

This study examines aspects of case managers’ perceived personal growth in their work with consumers. Using a sample of 98\\u000a case managers, the psychometric properties of a brief self-report measure of personal growth of case managers were examined.\\u000a The Case Manager Personal Growth Scale (CMPG) showed good reliability and construct validity as evidenced by negative correlations\\u000a with scores on professional

Catherine H. Stein; Scott A. Craft

2007-01-01

205

Diversity in Case Management Modalities: The Summit Model  

Microsoft Academic Search

Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a

Gregory A. Peterson; I. Delores Drone; Mark R. Munetz

1997-01-01

206

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…

Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

2012-01-01

207

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

208

Quantitative 3-D Imaging Topogrammetry for Telemedicine Applications.  

National Technical Information Service (NTIS)

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 ...

B. R. Altschuler

1994-01-01

209

Telemedicine Improves Care for Kids Seen in Rural ERs  

MedlinePLUS

... page, please enable JavaScript. Telemedicine improves care for kids seen in rural ERs (*this news item will ... Reuters Health. "It's a great way to leverage technology to improve the quality of care that we ...

210

Noninvasive and Cuffless Measurements of Blood Pressure for Telemedicine.  

National Technical Information Service (NTIS)

This paper presents a new method for obtaining the blood pressure readings noninvasively with telemedicine application. Through the pulse transit time technique, the systolic, diastolic, and mean blood pressures can be predicted using the time interval be...

K. W. Chan K. Hung Y. T. Zhang

2001-01-01

211

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

2011-11-18

212

Environmental conflict management. [Three case studies  

SciTech Connect

As we enter the 1980s, increasing and competing demands for dwindling supplies of natural resources are creating more and more environmental conflicts, and these conflicts are becoming increasingly complex and severe. Most, if not all, environmental controversies involve technical questions, and it is easy to assume that if technical solutions can be identified, a conflict will be resolved. Our experience indicates that problems are a mixture of substantive issues, personal motives, and current and past relationships. To be effective, conflict management strategy must address all of these areas. While accurate and consistent data are essential to understanding technical issues, efforts to solve environmental problems in terms of purely technical criteria often cause more conflicts than they resolve. Ways to incorporate personal concerns and relationship problems into the development of a conflict-management strategy are discussed. Three case studies are provided to illustrate ideas suggested in the paper.

Carpenter, S.L.; Kennedy, W.J.D.

1980-01-01

213

Constructing an Intelligent CSCW System in Telemedicine with IM  

Microsoft Academic Search

In medical care fare, a sophisticated and user friendly information exchange system can promote the workflow efficiencies significantly. In this paper, the CSCW(Computer Supported Cooperative Work) technology, IM (Instant Messaging) in Telemedicine is discussed, and a novel telemedicine solution is introduced. The new solution is based on IM, using the XMPP (Extensible Messaging and Presence Protocol) protocol and Jini technology.

Shuyi Wang; Fei Shang

2007-01-01

214

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

215

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

216

Jail recidivism in a forensic case management program.  

PubMed

This article explores the factors related to jail recidivism among clients receiving case management services who were seriously mentally ill, homeless, and former inmates in a large urban jail. The authors interviewed six case managers about 51 clients and examined the use of treatment stipulations as a condition of probation, clients' major diagnostic and behavioral problems, and case management strategies. Clients whose case managers actively sought legal stipulations to case management as a condition of probation and parole were more likely to return to jail. Implications for service planning and future research are discussed. PMID:7557720

Solomon, P; Draine, J

1995-08-01

217

Diversity in case management modalities: the Summit model.  

PubMed

Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner. PMID:9211044

Peterson, G A; Drone, I D; Munetz, M R

1997-06-01

218

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

Microsoft Academic Search

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

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

2007-01-01

219

Telemedicine: where is technology taking us?  

PubMed

Five years ago, a few zealots in Switzerland, at the CERN Laboratory, were contemplating using the Internet for hypertext and for transfer of still images, recorded sounds, and compressed video files. Five years later, the World Wide Web defines a set of standards for packaging and routing information over the Internet that involve millions of people and personal computers and that allowed a start-up Netscape to enjoy a capitalization of more than $2 billion when it sold stock to the public recently. Now, video-conferencing and multimedia electronic mail over the Internet are the fascinations of engineers at NASA, and the MBONE Information Web, the province of technophiles with UNIX workstations. Five years from now, you may be participating in telemedicine sessions frequently, from your workstation, and think nothing of it. PMID:10153011

Ruffin, M

1995-12-01

220

[Military telemedicine: a network of networks].  

PubMed

Military telemedicine is a form of collaborative medicine based on the use of communication and information networks. It is more a network of networks than of independent systems. It comprises electronic medical files, epidemiological networks, and surgical and medical databases. Each system must be able to communicate with the others, thereby enabling the development of remote consultation, expertise and assistance. This requires networking between the army, the navy, and the air force communication networks, especially during special operations conducted abroad. We must also develop interoperability with systems in other countries, and with the French civilian health service. This means respecting the general rules governing these networks. The military health network is unique, in that it focuses on battlefield injuries. In addition, the French military health service operates under a single headquarters, governing nurses, paramedics and physicians. PMID:17001864

Menu, Jean-Pierre; Comtet, Gérald; Di Giusto, Vincent; Colomb, François; de Saint-Julien, Jacques

2006-02-01

221

Quick management of accidental tritium exposure cases.  

PubMed

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

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

2012-02-20

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

A Case of Telecommunications (Mis)Management; [and] A Case of Telecommunications (Mis)Management: Case Analysis.  

ERIC Educational Resources Information Center

Presents a series of analyses of a case involving implementing a new voice-mail system, noting a newly appointed manager's failure to obtain feedback about the planned transition and evaluate user needs; successful introduction of any new technology is variable and suggests a degree of incrementalism; and four major issues arising in similar cases…

Fin, T. Andrew; Rogers, Priscilla S.; Taylor, James R.

1999-01-01

224

Medical outreach to Armenia by telemedicine linkage.  

PubMed

Telemedicine, an electronic mode of transmitting medical information interactively between remote sites, was launched as an educational support for a 3-year-old medical partnership between Boston University School of Medicine and Emergency Hospital, of Yerevan, Armenia. Emergency Hospital is the first site in Armenia to have an audiographic teleconference capability linking it to a major medical center. Emergency Hospital and Boston University School of Medicine share the remote connection in order to allow educational conferences, peer consultations, and distance learning to take place, thus enhancing the partnership's aims to improve the emergency and trauma care system of Yerevan. To date, eight teleconferences have been transmitted linking 100 physicians, nurses and hospital administrators. The teleconference program provides, in effect, a formal continuing medical education program for Emergency Hospital. It is a key tool of low-cost technology transfer with the potential of broadening resources over the wide territory of the 15 republics of the former Soviet Union. The telemedicine system is comprised of Optel Communications' Remote Viewing System computer hardware and software plus two dedicated AT&T telephone lines. The system has been in use at Boston University School of Medicine for live voice and still image transmission between international sites since 1987. This level of technology suited environmental conditions in Armenia, marked by frequent power outages and unreliability of local telephone connections. A protocol for presentations was established governing length of time, number of visuals per session, visual format, compatibility with interpretive services, congruence with project mission, and adaptability to local conditions that was shown to provide clear and concise delivery of the information necessary. This paper reports the process of development, installation, and initial use of the technology in one nation of the post-Soviet world. PMID:8798949

Screnci, D; Hirsch, E; Levy, K; Skawinski, E; DerBoghosian, M

1996-04-01

225

Use of mobile telemedicine for cervical cancer screening  

PubMed Central

Summary Visual inspection of the cervix with application of 4% acetic acid (VIA) is an inexpensive alternative to cytology-based screening in areas where resources are limited, such as in many developing countries. We have examined the diagnostic agreement between off-site (remote) expert diagnosis using photographs of the cervix (photographic inspection with acetic acid, PIA) and in-person VIA. The images for remote evaluation were taken with a mobile phone and transmitted by MMS. The study population consisted of 95 HIV-positive women in Gaborone, Botswana. An expert gynaecologist made a definitive positive or negative reading on the PIA results of 64 out of the 95 women whose PIA images were also read by the nurse midwives. The remaining 31 PIA images were deemed insufficient in quality for a reading by the expert gynaecologist. The positive nurse PIA readings were concordant with the positive expert PIA readings in 82% of cases, and the negative PIA readings between the two groups were fully concordant in 89% of cases. These results suggest that mobile telemedicine may be useful to improve access of women in remote areas to cervical cancer screening utilizing the VIA `see-and-treat' method.

Quinley, Kelly E; Gormley, Rachel H; Ratcliffe, Sarah J; Shih, Ting; Szep, Zsofia; Steiner, Ann; Ramogola-Masire, Doreen; Kovarik, Carrie L

2013-01-01

226

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

Code of Federal Regulations, 2010 CFR

RUS, through the Telecommunications Program, makes grants and loans to furnish and improve telemedicine services and distance learning services in rural areas. (a) The Assistant Administrator, Telecommunications Program, directs and coordinates the distance learning and telemedicine...

2009-01-01

227

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

Code of Federal Regulations, 2010 CFR

RUS, through the Telecommunications Program, makes grants and loans to furnish and improve telemedicine services and distance learning services in rural areas. (a) The Assistant Administrator, Telecommunications Program, directs and coordinates the distance learning and telemedicine...

2010-01-01

228

Retrospective Evaluation of Telemedicine in Remote Naval Populations Seeking Specialty Care.  

National Technical Information Service (NTIS)

Telemedicine technologies, such as lnternet and live videoteleconferencing (vTC), have great potential to provide specialized health care for naval personnel in remote situations at sea or onshore. A retrospective evaluation was conducted on telemedicine ...

T. Mlecer B. Crann D. Hunsaker W. Deniston L. Caola

2000-01-01

229

The Active Ingredients of Effective Case Management: A Research Synthesis  

Microsoft Academic Search

As we move to managed care, the nature and roleof case management is in flux and undetermined. Based onthe outcome research, this paper seeks to identify thecommon elements of effective case management practice to guide its development under the newfinancing schema.

Charles A. Rapp

1998-01-01

230

Nurse case management and general practice: implications for GP consortia  

PubMed Central

Background Case management is widely promoted as a means of ensuring continuity of care, improving patient outcomes, and achieving efficient management of resources. Community matrons have been introduced recently as specialists in the case management of patients with multiple complex problems. Aim To understand how nurse case managers are seen by GPs and NHS managers. Setting (1) Telephone interviews with 41 community nurse managers recruited from 10 English strategic health authorities and two Welsh health boards; (2) face-to-face interviews with 12 nurse case managers, 12 GPs and five NHS community service managers in three study sites with different population and practitioner characteristics. Method Semi-structured individual interviews, by telephone or face to face. Results Attitudes among GPs to nurse case managers were shaped by perceptions of the quality of community nursing on the one hand and the perceived benefit of case management as a method of reducing hospital use on the other. The dominant mood was scepticism about the ability of nurse case managers to reduce hospital admissions. Community matrons were seen as staff who were imposed on local health services, sometimes to detrimental effect. Conclusion The introduction of case management and community matrons may disrupt existing communities of practice and be perceived negatively, at least in areas where good working relationships between nurses and GPs have developed. Commissioners should be aware of the potential resistance to changes in skill mix and role in nursing services, and promote innovation in ways that minimise disruption to functional communities of practice.

Iliffe, Steve; Drennan, Vari; Manthorpe, Jill; Gage, Heather; Davies, Sue L; Massey, Helen; Scott, Cherill; Brearley, Sally; Goodman, Claire

2011-01-01

231

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

Microsoft Academic Search

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

Michael A. Edwards; Arvind C. Patel

2003-01-01

232

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

2013-01-01

233

WiMAX supported telemedicine as part of an integrated system for e-medicine  

Microsoft Academic Search

This paper presents an overview of the wireless telemedicine components of an integrated system for e-medicine that we propose and implement in the Republic of Macedonia. A short introduction to telemedicine and its evolution is presented. The new wireless broadband technologies enabled creation of telemedicine services previously only possible via cable connections. The novel wireless technologies enable provision of advanced

Ivan Chorbev; Martin Mihajlov; Ilija Jolevski

2008-01-01

234

A Field Trial of 2 Telemedicine Camera Systems in a Family Practice  

Microsoft Academic Search

revious reports of telemedicine consultations have demonstrated that the technology is effective but inefficient. Little attention has been directed to the use of telemedicine in a primary care practice, especially the use of the medical peripheral devices. We used a functioning primary care practice as a telemedicine test bed, providing unselected pa- tients in the study group. The goal was

William J. Crump; Ravi Kumar; Glenn Orsak; Thom Pfeil

1998-01-01

235

Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) Project : Technical Implementation  

Microsoft Academic Search

The Columbia University Informatics for Diabetes Education and Telemedicine IDEATel) project is a four-year demonstration project funded by the Centers for Medicare and Medicaid Services with the overall goal of evaluating the feasibility, acceptability, effectiveness, and cost-effectiveness of telemedicine. The focal point of the intervention is the home telemedicine unit (HTU), which provides four functions: synchronous videoconferencing over standard telephone

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

2002-01-01

236

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

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

Illustrative cases of unorthodox tinnitus management.  

PubMed

Bone remodeling disorders have been identified as potential candidates for the etiology underlying some forms of otologic disease. Here, four clinical cases are presented to demonstrate a novel approach to tinnitus management that focuses on two fundamental etiologic bases. First, is the effect of bone remodeling abnormalities of the otic capsule and second, the effect of blood sugar and insulin abnormalities upon the function of the inner ear and self-reports of tinnitus. This report presents the effect of treatment directed at bone remodeling abnormalities of the otic capsule and abnormalities of blood sugar and insulin. The treatment effects led to a substantial reduction in subjective tinnitus. These findings suggest a potential convergence between bone pathophysiology and some forms of tinnitus. PMID:23571305

Brookler, Kenneth H

239

Graves? orbitopathy: Management of difficult cases  

PubMed Central

Management of Graves? ophthalmopathy (GO) is based on three pillars: to stop smoking, to restore and maintain euthyroidism, and to treat the eye changes according to severity and activity of GO. Difficulties are frequently encountered in each of these three management issues. The advice to discontinue smoking is straightforward, but just a small minority of smokers is able to quit smoking. Detailed information on how smoking adversely affects the outcome of Graves? disease may convince patients they have to stop smoking right away. Controversy exists on the most appropriate treatment of Graves? hyperthyroidism in the presence of GO. 131I therapy is associated with a risk of about 15% for worsening of GO; a preventive course of steroids is indicated in the presence of risk factors (smoking, biochemically severe hyperthyroidism, high level of TSH receptor antibodies, active GO). Alternatives are thyroidectomy or long-term treatment with antithyroid drugs, which apparently are rather neutral with respect to the course of GO. Mild GO is not always perceived as being mild by the patients themselves. Selenium improves mild GO. Moderate-to-severe GO is preferably treated with intravenous methylprednisolone pulses, but serious side effects and relapsing GO do occur. After steroid failure combination therapy with low-dose oral prednisone with either cyclosporine or retrobulbar irradiation can be effective. Dysthyroid optic neuropathy is best treated with IV pulses, followed by orbital decompression if visual functions do not improve. In resistant cases, rituximab might be considered, although failures of this drug are also described.

Wiersinga, Wilmar M.

2012-01-01

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

Case Management Outcomes and Measures: A Social Work Source Book.  

National Technical Information Service (NTIS)

The purpose of the document is to delineate outcomes that healthcare managers can use to evaluate the impact of case management on patient care and health care service utilization. Outcomes presented in the document were selected because they appeared in ...

B. S. Bialk

1997-01-01

242

Case management services for adolescent substance abusers: a program description.  

PubMed

A case management model for adolescent substance abusers whose problems are severe enough to warrant residential treatment is presented, based on the experience of a demonstration project. The five integral functions of case management (assessment, planning, linking, advocacy, and support) are described within the framework of each phase of an adolescent's treatment program (screening, residential treatment, and continuing care). Detailed descriptions of case management activities and the philosophy underlying case management are addressed. The integrated client tracking and program evaluation monitoring system developed for the case management project is described, and evaluation data are presented. Among the advantages case managers are able to offer to the entire treatment process include encouragement of family involvement in the youth's recovery; providing support; tracking substance abuse relapse episodes following treatment; connecting the youth with school, work, and community resources; and helping youth to fulfill legal obligations. PMID:7966501

Godley, S H; Godley, M D; Pratt, A; Wallace, J L

243

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

244

Does clinical case management improve outpatient addiction treatment  

Microsoft Academic Search

This project evaluated whether clinical case managers (CCMs) could increase access and utilization of social services in the community; and thereby improve outcomes of addiction treatment. No case management (NoCM)—patients received standard, group-based, abstinence-oriented, outpatient drug abuse counseling, approximately twice weekly. Clinical case management (CCM)—patients were treated in the same programs but also were assigned a CCM who provided access

A. Thomas McLellan; Teresa A. Hagan; Marvin Levine; Kathleen Meyers; Frank Gould; Mark Bencivengo; Jack Durell; Jerome Jaffe

1999-01-01

245

The case manager: an essential link in quality care.  

PubMed

The role of case manager is often untapped or underutilized. Nursing case management is recognized by accrediting entities as a unique specialty practice and, when consistently applied, is the holistic implementation of the nursing process focused on an individual's needs, coupled with a commitment to the role of advocate and educator. Case managers on multidisciplinary teams help ensure continuity of care and consistency of communication; they are invaluable advocates for patients navigating the complexities of the current health care system. PMID:19715093

McCullough, Lynn

2009-01-01

246

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

247

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

248

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

249

Integrated telemedicine workstation for intercontinental grand rounds  

NASA Astrophysics Data System (ADS)

The Telemedicine Spacebridge to Moscow was a series of intercontinental sessions sponsored jointly by NASA and the Moscow Academy of Medicine. To improve the quality of medical images presented, the MDIS Project developed a workstation for acquisition, storage, and interactive display of radiology and pathology images. The workstation was based on a Macintosh IIfx platform with a laser digitizer for radiographs and video capture capability for microscope images. Images were transmitted via the Russian Lyoutch Satellite which had only a single video channel available and no high speed data channels. Two workstations were configured -- one for use at the Uniformed Services University of Health Sciences in Bethesda, MD. and the other for use at the Hospital of the Interior in Moscow, Russia. The two workstations were used may times during 16 sessions. As clinicians used the systems, we modified the original configuration to improve interactive use. This project demonstrated that numerous acquisition and output devices could be brought together in a single interactive workstation. The video images were satisfactory for remote consultation in a grand rounds format.

Willis, Charles E.; Leckie, Robert G.; Brink, Linda; Goeringer, Fred

1995-04-01

250

Randomised controlled trial of telemedicine for new neurological outpatient referrals  

PubMed Central

OBJECTIVE—To test the hypothesis that telemedicine for new patient referrals to neurological outpatients is as efficient and acceptable as conventional face to face consultation.?METHODS—A randomised controlled trial between two groups: face to face (FF) and telemedicine (TM). This study was carried out between a neurological centre and outlying clinics at two distant hospitals linked by identical medium cost commercial interactive video conferencing equipment with ISDN lines transmitting information at 384 kbits/s. The same two neurologists carried out both arms of the study.? Of the 168 patients who were suitable for the study, 86 were randomised into the telemedicine group and 82 into the face to face group. Outcome measures were (1) consultation process: (a) number of investigations; (b) number of drugs prescribed; (c) number of patient reviews and (2) patient satisfaction: (a) confidence in consultation; (b) technical aspects of consultation; (c) aspects surrounding confidentiality. Diagnostic categories were also measured to check equivalence between the groups: these were structural neurological, structural non-neurological, non-structural, and uncertain.?RESULTS—Diagnostic categories were similar (p>0.5) between the two groups. Patients in the telemedicine group had significantly more investigations (p=0.001). There was no difference in the number of drugs prescribed (p>0.5). Patients were generally satisfied with both types of consultation process except for concerns about confidentiality and embarrassment in the telemedicine group (p=0.017 and p=0.005 respectively).?CONCLUSION—Telemedicine for new neurological outpatients is possible and feasible but generates more investigations and is less well accepted than face to face examination.??

Chua, R; Craig, J; Wootton, R; Patterson, V

2001-01-01

251

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

252

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

253

Computer-Based Case Management for the Elderly.  

ERIC Educational Resources Information Center

|Notes that economic, demographic, and political factors pressure health care providers into improving discharge planning and long-term care services for clients. Examines the application of computer technology to case management and describes a computerized, hospital-based case management program for the elderly. (Author/NB)|

Blazyk, Stan; And Others

1987-01-01

254

Computer-Based Case Management for the Elderly.  

ERIC Educational Resources Information Center

Notes that economic, demographic, and political factors pressure health care providers into improving discharge planning and long-term care services for clients. Examines the application of computer technology to case management and describes a computerized, hospital-based case management program for the elderly. (Author/NB)

Blazyk, Stan; And Others

1987-01-01

255

Integrating Behavior Change Theory into Geriatric Case Management Practice  

Microsoft Academic Search

Case management practices have continued to grow despite a lack of clear evidence of their efficacy. With the expanding segment of the elderly population, there is a critical need to develop and identify programs that will address the many needs of the aging. Geriatric Case Management has been the avenue selected by many health care providers to address these issues,

Susan Enguidanos

2001-01-01

256

 psychological distress in australian case managers working with the unemployed  

Microsoft Academic Search

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

Richard Goddard; Wendy Patton; Peter Creed

257

Knowledge Management and Higher Education: A UK Case Study  

Microsoft Academic Search

This paper presents the initial findings of a case study conducted at seven Higher Education Institutions within the United Kingdom. The Case Study utilizes Stankosky's Knowledge Management (KM) pillars to enterprise learning - leadership, organization, technology and learning - as a lens to investigate and understand Knowledge Management practices and perceptions within Higher Education Institutions, looking at challenges of implementation

Desireé Joy Cranfield; John Taylor

2008-01-01

258

[Case management applied to the treatment of alcohol dependence].  

PubMed

This article aims is to conceptualize and describe the main steps in case management applied to the treatment of alcohol dependence. It is important to note the case manager functions, the importance of the first appointment, check the motivation to the treatment, some goals and activities suggestions for adherence reinforcement. PMID:15729449

Figlie, Neliana Buzi; Laranjeira, Ronaldo

2005-01-04

259

Transportation Asset Management Case Studies. Economics in Asset Management: The New York Experience.  

National Technical Information Service (NTIS)

The Transportation Asset Management Case Study Series is the result of a partnership between State departments of transportation and the Federal Highway Administrations (FHWAs) Office of Asset Management. FHWA provides the forum from which to share inform...

2007-01-01

260

Transportation Asset Management Case Studies. Bridge Management: Experiences of California, Florida, and South Dakota.  

National Technical Information Service (NTIS)

The Transportation Asset Management Case Study series is the result of a partnership between State departments of transportation and the Federal Highway Administration (FHWA) Office of Asset Management. FHWA provides the forum from which to share informat...

2007-01-01

261

Choosing to live with home dialysis-patients' experiences and potential for telemedicine support: a qualitative study  

PubMed Central

Background This study examines the patients' need for information and guidance in the selection of dialysis modality, and in establishing and practicing home dialysis. The study focuses on patients' experiences living with home dialysis, how they master the treatment, and their views on how to optimize communication with health services and the potential of telemedicine. Methods We used an inductive research strategy and conducted semi-structured interviews with eleven patients established in home dialysis. Our focus was the patients' experiences with home dialysis, and our theoretical reference was patients' empowerment through telemedicine solutions. Three informants had home haemodialysis (HHD); eight had peritoneal dialysis (PD), of which three had automated peritoneal dialysis (APD); and five had continuous ambulatory peritoneal dialysis (CAPD). The material comprises all PD-patients in the catchment area capable of being interviewed, and all known HHD-users in Norway at that time. Results All of the interviewees were satisfied with their choice of home dialysis, and many experienced a normalization of daily life, less dominated by disease. They exhibited considerable self-management skills and did not perceive themselves as ill, but still required very close contact with the hospital staff for communication and follow-up. When choosing a dialysis modality, other patients' experiences were often more influential than advice from specialists. Information concerning the possibility of having HHD, including knowledge of how to access it, was not easily available. Especially those with dialysis machines, both APD and HHD, saw a potential for telemedicine solutions. Conclusions As home dialysis may contribute to a normalization of life less dominated by disease, the treatment should be organized so that the potential for home dialysis can be fully exploited. Pre-dialysis information should be unbiased and include access to other patients' experiences. Telemedicine may potentially facilitate a communication-based follow-up and improve safety within the home setting, making it easier to choose and live with home dialysis.

2012-01-01

262

Rural telemedicine: satellites and fiber optics.  

PubMed

Rural America Telemedicine requires very high bandwidth to provide timely transmission of large data sets. These resources may take decades to appear because of the economics of low population densities and costly installation, and the historically low rate of bandwidth improvement available from the common communication providers. Satellites provide the natural choice for communication between the rural primary care centers and the tertiary care hospital. Furthermore recent improvements in technologies have substantially reduced the costs of ground stations. A network of satellite ground stations with symmetric bandwidth connected by satellite is the architecture of choice. Analysis of multi-station satellite access clearly argues for distributed non-random methods and hence for appropriate handling of TCP data streams. However the overhead in delay of Satellite based TCP, as required for Internet access, substantially increases the transmission time and hence cost. Simulations of TCP/IP data over satellite links show a substantial reduction in transmission times. Initial business models show that the transmission cost per second is 60 times that of telephone lines while the increase in speed is nearly 3000 fold, effecting a 50 fold cost savings. But over decades, the infrastructure can be expected to improve. In particular speculative fiber optic installations in power lines and along major highways are betting on future traffic. These so-called dark fibers take advantage of synergistic installations. Their small size, ease of manipulation and gigantic bandwidths (in terabytes) allows for economic installation in anticipation of future use. Thus for rural America a strategy can evolve in which satellites provide an intermediate solution to high speed data communication while the terrestrial fiber-optic infrastructure catches up. PMID:11347427

Tyrer, H W; Wiedemeier, P D; Cattlet, R W

2001-01-01

263

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…

Atlantic Research Corp., Alexandria, VA.

264

Hybrid signal processing technologies for next generation wireless telemedicine systems  

Microsoft Academic Search

No study to date has addressed the integration issues of the wavelet-based compression techniques with the design and functionality issues of mobile telemedicine systems for real-time medical data transmission over cellular channels. This paper addresses such new hybrid methodologies, namely new wavelet compression methods integrated with the modular telecommunication design blocks and relevant hardware DSP structures for enhanced integrated wireless

R. S. H. Istepanian

1999-01-01

265

Wiring a medical school and teaching hospital for telemedicine  

Microsoft Academic Search

The planning and installation of a telemedicine system for communication within a teaching hospital and its academic and hospital units with a capacity for accommodation of up to 400 video-stations is described. The system is intended for improving the communication between patients and health professionals, and between the health professionals themselves. It also provides the basis for improving pre-graduate teaching,

N. M Hjelm; J. C. K Lee; D Cheng; C Chui

2001-01-01

266

Wiring a medical school and teaching hospital for telemedicine  

Microsoft Academic Search

The planning and installation of a telemedicine system for communication within a teaching hospital and its academic and hospital units with a capacity for accommodation of up to 400 video-stations is described. The system is intended for improving the communication between patients and health professionals, and between the health professionals themselves. It also provides the basis for improving pre-graduate teaching,

N. M. Hjelm; J. C. K. Lee; D. Cheng; C. Chui

2002-01-01

267

Legal and ethical challenges of telemedicine and e-health  

NASA Astrophysics Data System (ADS)

This invited paper aims to examine how telemedicine and e- health will develop over the coming years and, in particular, to assess what legal and ethical barriers may lie in the way of this development. A description of the key principles and concepts involved in telemedicine and e- health and a short historical overview of their evolution over the past century is followed by consideration of why empirical research into 'Info-ethics' and other deontological and legal issues relating to telemedicine and e-health are so important. Five evolving health telematics applications are examined in some detail: electronic health records; the transmission of visual media in disciplines such as teleradiology, teledermatology, telepathology and teleopthalmology; telesurgery and robotics; the use of call centers and decision-support software and, of course, the growing role of the Internet in healthcare. These care discussed in the light of their moral, ethical and cultural implications for clinicians, patients and society at large. Telemedicine and e-health present unique opportunities for both patients and clinicians where they are implemented in direct response to clear clinical needs. But excessive reliance upon technology will damage the traditional clinician-patient relationships and we must therefore avoid complacency regarding the risk and responsibilities - many of which are as yet unknown - that distant medical intervention, consultation and diagnosis carries.

Stanberry, Benedict

2002-08-01

268

A systematic review of technical evaluation in telemedicine systems.  

PubMed

We conducted a systematic review of the literature to critically analyse the evaluation and assessment frameworks that have been applied to telemedicine systems. Subjective methods were predominantly used for technical evaluation (59 %), e.g. Likert scale. Those including objective measurements (41%) were restricted to simple metrics such as network time delays. Only three papers included a rigorous standards based objective approach. Our investigation has been unable to determine a definitive standards-based telemedicine evaluation framework that exists in the literature that may be applied systematically to assess and compare telemedicine systems. We conclude that work needs to be done to address this deficiency. We have therefore developed a framework that has been used to evaluate videoconferencing systems telemedicine applications. Our method seeks to be simple to allow relatively inexperienced users to make measurements, is objective and repeatable, is standards based, is inexpensive and requires little specialist equipment. We use the EIA 1956 broadcast test card to assess resolution, grey scale and for astigmatism. Colour discrimination is assessed with the TE 106 and Ishihara 24 colour scale chart. Network protocol analysis software is used to assess network performance (throughput, delay, jitter, packet loss). PMID:17946758

Thiyagarajan, C A; Clarke, M

2006-01-01

269

Problems and Our Solutions for Implementing Telemedicine Systems  

Microsoft Academic Search

There are several problems on the practical use of telemedicine, for example, the difficulties involved in promoting communication between medical facilities, uncooperative clinicians, and the absence of high-speed circuits and high-resolution CRT. From the Japanese point of view, we suggest ways to resolve these problems. We will analyze and propose scenarios for realizing successful communications among medical institutions, medical communication

Isao Nakajima; Yuhwsuke Sawada; Tsukasa Ashihara; Yoshihiro Takashima

1999-01-01

270

Trust, Trait Theory, and Collaboration in Telemedicine: A Circumplex Perspective  

Microsoft Academic Search

More than a process-automating tool, telemedicine is increasingly recognized for its ability to facilitate collaboration and knowledge creation between disparate healthcare providers. As trust is being demonstrated to affect positively the collaborative effort of practitioners and the concomitant, as well as subsequent impact on quality of health care delivery (1), the questions arise, What are the interpersonal traits of practitioners

Houghton G. Brown; Marshall Scott Poole; Thomas Lee Rodgers; Kim Van Walsum

2003-01-01

271

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.

272

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

273

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.

274

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.

275

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

276

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

277

A Case Study in Issues Management.  

ERIC Educational Resources Information Center

The use of issues management as an organizational process and its relationship to the more comprehensive notion of strategic planning are discussed, and its application to the establishment of a new school of communications at Penn State examined. (MSE)

Lozier, G. Gregory; And Others

1986-01-01

278

Efficacy of Case Management in the Military.  

National Technical Information Service (NTIS)

Managed care is a comprehensive approach to the delivery of health care designed to efficiently direct quality health care within a cost-contained environment. The overall goal is to achieve optimal patient outcomes within fiscally responsible time frames...

F. D. Anderson

1997-01-01

279

Cases on the Middle-Level Line Manager.  

National Technical Information Service (NTIS)

A teacher's manual for a modular course in middle - level management is presented. The course, consisting of eight separate series of decisionmaking cases, together with teaching notes, is appropriate for graduate level courses in public administration, m...

J. R. Russell

1977-01-01

280

The case for case studies in management research  

Microsoft Academic Search

It is commonly asserted that qualitative research in the organizational sciences lacks the rigor and objectivity of the quantitative approach. Case studies, while commonly used for educational purposes, have been viewed in a less favorable light in terms of research. This paper suggests that case studies represent an important research track in organizational science, not only as a method of

Eric Patton; Steven H. Appelbaum

2003-01-01

281

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

282

Management of dental implant fractures. A case history.  

PubMed

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

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

2009-01-01

283

An Overview of Potential Factors for Effective Telemedicine Transfer to Sub-Saharan Africa  

Microsoft Academic Search

This paper gives an overview of core factors mitigating effective transfer of TeleMedicine to Sub-Saharan Africa (SSA) as a capability for improving the extremely poor state of healthcare delivery systems in that region of the world. Using specific examples of TeleMedicine applications, such as in TeleRadiology and health education, the paper highlights the importance of TeleMedicine in SSA. It then

Peter Meso; Victor Wacham A. Mbarika; Sanjay Prakash Sood

2009-01-01

284

Wireless telemedicine services as part of an integrated system for e-medicine  

Microsoft Academic Search

This paper presents an overview of the wireless telemedicine components of an integrated system for e-medicine that we propose and implement in the Republic of Macedonia. The introduction of new wireless broadband technologies enabled creation of telemedicine services previously only possible via cable connections. WiMAX and Wi-Fi are the wireless technologies used to implement our telemedicine functionalities. They are shortly

I. Chorbev; M. Mihajlov

2008-01-01

285

Classroom Management Styles in Context: Two Case Studies.  

ERIC Educational Resources Information Center

Classroom management is defined as the organization of the classroom as a learning environment; the management of student discipline, order, and care; the grouping of students for different tasks and patterns of interaction; and the individualization of student learning. This paper reports on two Swedish case studies of contrasting classroom…

Stensmo, Christer

286

Management accounting system integration in corporate mergers : A case study  

Microsoft Academic Search

The objective of this longitudinal case study is to study management control problems in corporate mergers and acquisitions. This is executed by analysing the post acquisition merger processes of two companies of equal size, but with different cultures and management accounting systems (MAS). It is argued that the MAS evolution in such a context may differ significantly from other types

Markus Granlund

2003-01-01

287

Data management for genomic mapping applications: A case study  

SciTech Connect

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

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

1992-05-01

288

Town centre management (TCM): a case study of Achmore  

Microsoft Academic Search

Town centre vitality and viability is of importance to a range of stakeholders: users, producers and intermediaries. Within the stakeholder grouping of intermediaries, town centre management (TCM) is a co-ordinated response – of public and private sectors – through which the town centre “product” can be managed and developed. Utilising evidence from a range of Scottish town centres, this case

Andrew Paddison

2003-01-01

289

Making the Case for Construction Waste Management  

Microsoft Academic Search

Construction and demolition activities generate a large portion of the total solid waste stream in the United States and have a significant impact on the environment. To reduce this environmental impact, some contractors have implemented construction waste management plans on their projects in order to divert construction and demolition debris from landfill disposal. Yet there are still many contractors who

Hazem Elzarka

290

Management of Sternal Fractures: 239 Cases  

Microsoft Academic Search

A review of the management of 239 patients with sternal fractures in a busy trauma center between October 1989 and May 2000 was undertaken to determine the incidence, significance, morbidity, and mortality of this injury. There were 140 men and 99 women with a mean age of 50.3 years (range, 15 to 93 years). Sternal fractures accounted for 8% of

Konstantinos Potaris; John Gakidis

291

A case for monster media [knowledge management  

Microsoft Academic Search

People with irreplaceable knowledge retire, move on, or pass-on every day. Only after their knowledge is gone is the loss recognized. Sometimes, however, a thoughtful manager will recognize the significance of the loss of an employee's knowledge and will do something to preserve that endangered knowledge. For example, Larry Whinery, one of the last men in the country (USA) who

2000-01-01

292

The research agenda in ICU telemedicine: a statement from the Critical Care Societies Collaborative.  

PubMed

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

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

2011-07-01

293

[Varying effect of telemedicine in the treatment of chronic obstructive pulmonary disease--a systematic review].  

PubMed

A systematic review of existing evidence on the efficiency of telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) was performed. A systematic literature search was conducted in five relevant databases followed by evaluation of methodology and results in selected studies. Nine RCT trials of varying quality were identified. The selected studies were mostly multimodal with telemedicine as part of a more complex intervention. Benefits of using telemedicine solutions for patients with COPD are not yet clear, but in some multimodal studies with telemedicine as part of the solution a positive effect on hospital admissions, emergency room visits and contacts to primary care may be seen. Larger studies are needed. PMID:22469162

Jakobsen, Anna Svarre; Laursen, Lars Christian; Schou, Lone; Emme, Chistina; Phanareth, Klaus Viengpheth

2012-04-01

294

Case Studies of Household Waste Management.  

National Technical Information Service (NTIS)

This report documents the results of case studies of waste treatment in two separate communities. The report is divided into studies of Stinson Beach, California and Dexter, Oregon. Background information is given about Stinson Beach and the agencies invo...

R. Howard W. Balson D. Owen P. A. Owen G. Sauer

1981-01-01

295

ACUTE MANAGEMENT CONCEPTS OF THE ACROMIOCLAVICULAR JOINT: A CASE REPORT  

PubMed Central

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

2012-01-01

296

Ranking Taiwanese management journals: A case study  

Microsoft Academic Search

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

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

2008-01-01

297

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

PubMed

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

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

2005-01-01

298

Case Management in Colorado: Establishment of State Practice.  

National Technical Information Service (NTIS)

This project was designed to enhance long term care development through the establishment of a case management system for the newly formed Single Entry Point system in the state. The major activity of the project was a statewide comparative study of case ...

J. C. Bell

1994-01-01

299

Combining Cases and Computer Simulations in Strategic Management Courses  

Microsoft Academic Search

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

Rex C. Mitchell

2004-01-01

300

Conservative management of regional odontodysplasia: case report.  

PubMed

Regional odontodysplasia is an uncommon developmental anomaly affecting a localized area of the dentition. The affected teeth are often grossly malformed and develop abscess soon after eruption. Although extractions are often required, in some milder cases the teeth may be retained for a long period. The treatment plan should be based on the degree of involvement as well as functional and esthetic needs in each case. This article describes a conservative treatment approach in a 10-year-old boy with regional odontodysplasia. PMID:17049109

Cho, Shiu-yin

2006-10-01

301

Management of a case of arhinia.  

PubMed

Arhinia is a rare condition characterised by the congenital absence of nasal structures, with different patterns of presentation, and often associated with other craniofacial or somatic anomalies. To date, about 30 surviving cases have been reported. We report the case of a female patient aged 6 years, who underwent internal and external nose reconstruction using a staged procedure: a nasal airway was obtained through maxillary osteotomy and ostectomy, and lined with a local skin flap and split-thickness skin grafts; then the external nose was reconstructed with an expanded frontal flap, armed with an autogenous rib framework. PMID:19401274

Brusati, R; Donati, V; Marelli, S; Ferrari, M

2009-04-26

302

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

303

Effects of case management after severe head injury.  

PubMed Central

OBJECTIVES--To examine the effects of early case management for patients with severe head injury on outcome, family function, and provision of rehabilitation services. DESIGN--Prospective controlled unmatched non-randomised study for up to two years after injury. SETTING--Four district general hospitals and two university teaching hospitals, each with neurosurgical units, in east central, north, and north east London and its environs. SUBJECTS--126 patients aged 16-60 recruited acutely and sequentially after severe head injury. All received standard rehabilitation services in each of the six hospitals and districts: case management was also provided for the 56 patients admitted to three of the hospitals. MAIN OUTCOME MEASURES--Standard measures of patients' physical and cognitive impairment; disability and handicap; and affective, behavioural, and social functioning and of relatives' affective and social functioning. Relatives' perception of burden; changes in patients' and relatives' housing, financial, vocational, recreational, and medical needs; and ongoing requirements for care and support; and the amount and type of paramedical input provided were assessed with structured questionnaires. RESULTS--For a given severity of injury, case management increased the chance and range of contact with inpatient and outpatient rehabilitation services. However, duration of contact was not increased by case management, and there was no demonstrable improvement in outcome in the case managed group. Any trends were in favour of the control group and could be accounted for by group differences in initial severity of injury. CONCLUSIONS--Widespread introduction of early case management of patients after severe head injury is not supported, and early case management is not a substitute for improvement in provision of skilled and specialist rehabilitation for patients.

Greenwood, R. J.; McMillan, T. M.; Brooks, D. N.; Dunn, G.; Brock, D.; Dinsdale, S.; Murphy, L. D.; Price, J. R.

1994-01-01

304

Evaluation of two mobile telemedicine systems in the emergency room.  

PubMed

Two different prototype mobile telemedicine systems were constructed for use in the emergency room. They could transmit physiological signals as well as video pictures and sound. One device, the mobile emergency bed (MEB), was powered by battery and had a wireless connection to the local-area network (LAN). For the other, the mobile emergency server (MES), a patient monitor, video-camera and microphone were connected by a radio-frequency link to a server. A functional evaluation and a clinical evaluation (by 12 emergency doctors in six emergency centres) were performed on both prototypes. The bandwidth and the video quality of the MEB were better than those of the MES, because of the digital transmission of the wireless LAN. The MES was better for directing patient treatment and teleconsultation; the MEB was better for static patients in the emergency centre. In general, the MES was more suitable for practical emergency telemedicine work. PMID:14728772

Yoo, Sun K; Park, In-Cheol; Kim, Seung-Ho; Jo, Jin-Ho; Chun, Hye Jung; Jung, Suck-Myung; Kim, Dong-Keun

2003-01-01

305

A virtual educational strategy on telemedicine and medical simulation.  

PubMed

Medical services in Columbia are scarce in many regions, not only because of accessibility problems and costs, but also because of difficulties in access to medical knowledge. We envision a long-term strategy for virtual education programs, based upon communication technologies that could be developed by private and government institutions. The diffusion of telemedicine concepts, applications, and technologies are critical for propagating medical knowledge. This paper describes the virtual education experiences at the Pontificia Universidad Javeriana. PMID:16149897

Vélez Beltrán, Jorge Alberto; Newball, Andres Adolfo Navarro

2005-08-01

306

Worldwide Trends in Universal Service Funds and Telemedicine  

Microsoft Academic Search

A survey of recent worldwide trends in Universal Service Funds (USFs) and the assistance provided for their application indicates\\u000a that industrialized countries and developing nations alike have offered or plan to offer tax-relief measures or reimbursement\\u000a for communications costs incurred by telemedicine programs, thus finding a way to actively apply USFs in rural areas. There\\u000a are three main systems used

Isao Nakajima

2010-01-01

307

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

PubMed Central

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

2011-01-01

308

Utilization of the American Telemedicine Association's Clinical Practice Guidelines.  

PubMed

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

Krupinski, Elizabeth A; Antoniotti, Nina; Bernard, Jordana

2013-09-19

309

Nonsurgical management of two unusual cases of dens in dente.  

PubMed

The management of two unusual cases of dens invaginatus in a maxillary and a mandibular lateral incisor with a periradicular lesion are reported. The patient presented with pain and localized swelling. Despite the complex anatomy and diagnosis of dens invaginatus, nonsurgical root canal treatment was performed successfully. Furthermore essential clinical considerations and treatment options are suggested. Early diagnosis and management are important to avoid complications. PMID:16327141

Gupta, R; Tewari, S

310

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

311

Case Management Approaches for In-Home Care  

Microsoft Academic Search

Restructuring healthcare delivery systems within limited budgets presents multiple management challenges. As hospitals have downsized, the demand for in-home services has increased. The involvement of multiple provider agencies and professionals has heightened duplication and fragmentation of services and has complicated the need to develop client-focused, evidence-based approaches. In response to these challenges, community-based case management has burgeoned.

Carol L. McWilliam; Moira Stewart; Kathy Desai; Terrance Wade; Joanne Galajda

2000-01-01

312

Blood pressure control in a hypertension telemedicine intervention: does distance to primary care matter?  

PubMed

Although telemedicine may help overcome geographic access barriers, it is unknown whether rural patients receive greater benefits. In a secondary analysis of 503 veterans participating in a hypertension telemedicine study, the authors hypothesized that patients with greater travel distances would have greater improvements in 18-month systolic blood pressure (SBP). Patients were categorized by telemedicine exposure and travel distance to primary care, derived from zip codes. Comparisons were (1) usual care (UC), distance <30 miles (reference); (2) UC, distance ?30 miles; (3) telemedicine, distance <30 miles; (4) telemedicine, distance ?30 miles. Compared with patients receiving UC, distance <30 miles (intercept=127.7), no difference in 18-month SBP was observed in patients receiving UC, distance ?30 miles (0.13 mm Hg, 95% confidence interval [-6.6 to 6.8]); telemedicine, distance <30 miles (-1.1 mm Hg [-7.3 to 5.2]); telemedicine, distance ?30 miles (-0.80 mm Hg [-6.6 to 5.1]). Although telemedicine may help overcome geographic access barriers, additional studies are needed to identify patients most likely to benefit. PMID:24088280

Bowen, Michael E; Bosworth, Hayden B; Roumie, Christianne L

2013-07-23

313

UNWIRED E-MED: the next generation of wireless and internet telemedicine systems  

Microsoft Academic Search

The movement of telemedicine to wireless and mo- bile Internet applications is imminent in the next few years. This migration from desktop platforms to wireless and mobile config- urations will have a significant impact on future healthcare de- livery systems and their globalization. Recent telecommunications and biomedical computing advances will significantly enhance the current methodologies of telemedicine and telecare systems.

Swamy Laxminarayan; Robert S. H. Istepanian

2000-01-01

314

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

315

Maternal response to high-risk obstetric telemedicine consults when perinatal prognosis is poor.  

PubMed

This is a qualitative descriptive study evaluating the maternal response after the woman has learned her pregnancy has a poor prognosis via telemedicine rather than in a traditional, face-to-face, consultation method. In general, telemedicine was positively viewed by the participants; however, the experience may be markedly improved by implementing several simple changes in the overall consultative process. PMID:23635010

Wyatt, Stephanie N; Rhoads, Sarah J; Green, Angela L; Ott, Rachel E; Sandlin, Adam T; Magann, Everett F

2013-05-02

316

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

Code of Federal Regulations, 2013 CFR

...Agriculture 11 2013-01-01 2013-01-01 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)...

2013-01-01

317

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

318

A Telemedicine Network Using Secure Techniques and Intelligent User Access Control  

Microsoft Academic Search

This paper reports the development and design of the State of Santa Catarina's telemedicine network in Brazil. The resources concentration, like hospitals and clinical staff, in Brazilian large cities have been a problem in public healthcare policies improvement. Telemedicine technology for large scale telediagnostic, processing of routine outpatient examinations, the electronic delivery of examinations results integrated with the decision process

Jader Wallauer; Aldo Von Wangenheim; Rafael Andrade; Douglas Dyllon Jeronimo De Macedo

2008-01-01

319

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

320

Telemedicine: An Inquiry in the Economic and Social Dynamics of Communications Technologies in the Medical Field  

Microsoft Academic Search

The health care industry in the United States has been experiencing substantial and ever increasing cost pressures. At the same time, many forces are revolutionizing the way health care is financed and delivered. Telemedicine, in this respect, offers significant potential for addressing some of the challenges faced by the health care industry. However, despite the fact that Telemedicine technology has

Francis Pereira; Elizabeth Fife; Antonio A. Schuh

1997-01-01

321

Home Telemedicine: A Home Health Care Agency Strategy for Maximizing Resources  

Microsoft Academic Search

American Nursing Care (ANC) conducted retrospective chart reviews to assess the potential of new home telemedicine technology as a way to control health care costs. Using the functionality of the Home Assisted Nursing Care (HANC) network as the home telemedicine system, ANC estimated that 31 % of a selected group of home health care patients and 67% of the patients

Theresa M. Crist; Stephen B. Kaufman; Kathleen R. Crampton

1996-01-01

322

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

323

Qualitative case studies in operations management: Trends, research outcomes, and future research implications  

Microsoft Academic Search

Our study examines the state of qualitative case studies in operations management. Five main operations management journals are included for their impact on the field. They are in alphabetical order: Decision Sciences, International Journal of Operations and Production Management, Journal of Operations Management, Management Science, and Production and Operations Management. The qualitative case studies chosen were published between 1992 and

Mark Barratt; Thomas Y. Choi; Mei Li

2011-01-01

324

A decade of case management: A methodological review of outcome research  

Microsoft Academic Search

The last decade has witnessed a burgeoning interest in case management services to people with severe mental illness. While the literature on case management is proliferating, there remains a paucity of rigorously designed outcome research. This paper provides a methodological review of that outcome research on case management, which found that the term case management is used to describe a

Ronna Chamberlain; Charles A. Rapp

1991-01-01

325

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

326

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

327

Pre-experience Perceptions About Telemedicine Among African Americans and Latinos in South Central Los Angeles  

PubMed Central

Abstract This study explores perceptions about telemedicine among urban underserved African American and Latino populations. Telemedicine has been advanced as a vehicle to increase access to specialty care among the urban underserved, yet little is known about its acceptability among these populations. We conducted 10 focus groups with African American and Latino participants (n?=?87) in urban Los Angeles in order to explore perceptions about this novel type of care. We found that concerns about telemedicine varied between the two racial/ethnic groups. These findings have implications for important issues such as adoption of telemedicine, patient satisfaction, and doctor–patient interaction. It will be critical to consider perceptions of this healthcare innovation in the development of strategies to market and implement telemedicine among urban, underserved African American and Latino populations.

Hamilton, Alison; Baker, Richard

2009-01-01

328

Case I: Managing people--the case of the frustrated faculty member.  

PubMed

Managing people is a continuing leadership challenge. The foundation discipline for managing people relates to human resource management and faculty development in academic settings. In human resource management, administrators are challenged to balance the needs of individuals and the expectations of the organization for the mutual benefit of both. A primary goal of management is to lead and develop people and manage the organization in alignment with the mission and vision of the organization. The purpose of this paper is, first, to present an overview of human resource management and faculty development fundamentals including motivating, mentoring, and performance counseling. Second, a hypothetical case is presented for readers to apply theory to situation. Finally, the case is analyzed by reviewing central issues and the management concepts that may apply to the scenario. These include managing resources, mentoring, motivation, and development. In this case-based analysis, Dr. Orsten is a junior faculty member employed in a developing school. With a shortage of faculty in her field, she succumbs to the pressures of teaching and administration at the expense of her own professional advancement through research. The tenure clock is ticking, however, and Dr. Orsten has serious doubts about her ability to redirect her priorities and earn tenure. Dr. Hightower, the Associate Dean, also faces a dilemma: there is a shortage of faculty in Dr. Orsten's specialty, and the system is poised to exercise the "up-or-out" option. PMID:12014567

Glickman, Gerald N; Comer, Robert W; Filler, Steven J; Fine, James Burke

2002-04-01

329

Integrating Telemedicine in Urban Pediatric Primary Care: Provider Perspectives and Performance  

PubMed Central

Abstract Background: Health-e-Access, an urban telemedicine service, enabled 6,511 acute-illness telemedicine visits over a 7-year period for children at 22 childcare and school sites in Rochester, NY. Objectives: The aims of this article were to (1) describe provider attitudes and perceptions about efficiency and effectiveness of Health-e-Access and (2) assess hypotheses that (a) providers will complete a large proportion of the telemedicine visits attempted and (b) high levels of continuity with the primary care practice will be achieved. Design/Methods: This descriptive study focused on the 24-month Primary Care Phase in the development of Health-e-Access, initiated by the participation of 10 primary care practices. Provider surveys addressed efficiency, effectiveness, and overall acceptability. Performance measures included completion of telemedicine visits and continuity of care with the medical home. Results: Among survey respondents, the 30 providers who had completed telemedicine visits perceived that decision-making required slightly less time and total time required was slightly greater than for in-person visits. Confidence in diagnosis was somewhat less for telemedicine visits. Providers were comfortable collaborating with telemedicine assistants and confident that communications met parent needs. Among the 2,554 consecutive telemedicine visits attempted during the Primary Care Phase, 2,475 (96.9%) were completed by 47 providers. For visits by children with a participating primary care practice, continuity averaged 83.2% among practices (range, 28.1–92.9%). Conclusions: Providers perceived little or no advantage in efficiency or effectiveness to their practice in using telemedicine to deliver care; yet they used it effectively in serving families, completing almost all telemedicine visits requested, providing high levels of continuity with the medical home, and believing they communicated adequately with parents.

Wood, Nancy; Herendeen, Neil; ten Hoopen, Cynthia; Denk, Larry; Neuderfer, Judith

2010-01-01

330

[Surgical management of cutaneous pathomimia. A report case].  

PubMed

Cutaneous pathomimia is a behaviour disorder witch interest the skin. In some cases, self-mutilation can be serious and require a surgical treatment. Case report: A 60 year old woman consults for extensive scar interesting the face and the scalp and realising the aspect of burn face in cicatricle level. The treatment consisted on excision and skin graft. The patient was addressed to Psychodermatology consultation. Authors show the place of plastic surgery in management of cutaneous pathomimia. PMID:15939522

Moussaoui, A; Fejjal, N; Cantaloube, D

2005-06-06

331

Role of occlusion in endodontic management: report of two cases.  

PubMed

The two clinical cases reported demonstrate that traumatic occlusion can play a role in the initiation and progression of pulp and periradicular inflammation. The symptom of persistent pain did not subside after the commencement of endodontic treatment. Traumatic occlusion was identified in both cases to be the main cause and hence occlusal adjustment was performed. This resulted in the gradual resolution of the symptoms. The findings suggest that occlusal trauma is often overlooked in the diagnosis and management of endodontic diseases. PMID:15633800

Yu, Christine Y

2004-12-01

332

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

333

Wikis for Knowledge Management: Business Cases, Best Practices, Promises, & Pitfalls  

Microsoft Academic Search

This chapter describes how wikis and related tools can be used for knowledge management (KM), and describes processes and best practices for creating and deploying wiki-based KM systems. In particular, we consider the business cases from multiple perspectives, including: participating in KM systems; initiating KM projects; and developing wiki platforms. Thus, the chapter seeks to help readers understand what KM

Clif Kussmaul; Roger Jack

334

Stryker Mobile Gun System: A Case Study on Managing Complexity.  

National Technical Information Service (NTIS)

This case study analyzes how the Stryker Mobile Gun System (MGS) program managed complexity. The MGS is one of the ten variants of the Stryker series of vehicles that equip the Army's Stryker Brigade Combat Teams. These brigades were created by the Army C...

C. C. Ayers

2009-01-01

335

A Comprehensive Case Management Program To Improve Palliative Care  

Microsoft Academic Search

Objective: The objective of this study was to evaluate the impact of comprehensive case management (CM) and expanded insurance benefits on use of hospice and acute health care services among enrollees in a national health plan. Study Design: Retrospective cohort design with three intervention groups, each matched to a historical control group. Methods: Intervention groups were health plan enrollees who

Claire M. Spettell; Wayne S. Rawlins; Randall Krakauer; Joaquim Fernandes; Mary E. S. Breton; Wayne Gowdy; Sharon Brodeur; Maureen MacCoy; Troyen A. Brennan

2009-01-01

336

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

337

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

338

Coplink: a case of intelligent analysis and knowledge management  

Microsoft Academic Search

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

Roslin V. Hauck; Hsinchun Chen

1999-01-01

339

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

340

Common Intake Case Management Pilot Implementation: Procedures Manual.  

National Technical Information Service (NTIS)

A manual is presented for the implementation of a common intake and case management system for human services in a three-county area of Michigan. The system includes the processes required to provide services to meet client needs and the processes require...

1970-01-01

341

Healthcare supply chain management in Malaysia: a case study  

Microsoft Academic Search

Purpose – The purpose of this paper is to evaluate inventory management in the private healthcare sector in Malaysia, with a particular focus on the distribution of medicines from a wholesaler to clinics. Currently, there are issues with service levels to clinics that need addressing. Design\\/methodology\\/approach – The paper adopts a case study approach, with data collected through process mapping,

Noorfa Haszlinna Mustaffa; Andrew Potter

2009-01-01

342

Management and outcome of 200 cases of fetomaternal alloimmune thrombocytopenia  

Microsoft Academic Search

BACKGROUND: Fetomaternal alloimmune thrombocy- topenia (FMAIT) is the commonest cause of severe thrombocytopenia in term neonates but its management remains controversial. STUDY DESIGN AND METHODS: A 7-year prospec- tive observational study of 200 cases of FMAIT evalu- ated the relationship between human platelet antigen (HPA) antibody specificity, clinical presentation, morbid- ity, mortality, and therapeutic interventions in the ante- natal and

Cedric Ghevaert; Kate Campbell; Jill Walton; Graham A. Smith; Dave Allen; Lorna M. Williamson; Willem H. Ouwehand; Edmund Ranasinghe

2007-01-01

343

Implementation of case management for batterer program participants.  

PubMed

Among the recommendations for improving batterer counseling is additional services for African American men, which might be obtained through case management that includes individual intake screening, service identification, service contact review, and follow-up calls. A formative evaluation of a case management project was conducted through direct observations of procedures, semistructured interviews with staff, and tabulation of referrals (N = 202). The men's impressions and recommendations were collected through subsample phone interviews ( n = 72). Most men were referred for job or financial assistance, and few were referred for substance abuse or mental health problems. Barely half of referred men were contacted in the supportive case management phone calls. The average number of referrals per man increased over time, as did referral contacts. Interviews suggest, however, that the referral system had little impact. The case management was not implemented as designed primarily because of time constraints during intake and staff shortcomings. A fuller implementation would cost much more in terms of staffing, supervision, and administration. PMID:18212341

Gondolf, Edward W

2008-02-01

344

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

345

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

346

Managing a socially constructed technology: the case of CT scanning  

Microsoft Academic Search

The effective management of technology must recognize that technology is embedded in social processes and that technology is shaped by both technical and social forces. This paper illustrates the study of technology through an examination of the interaction of these scientific, engineering, professional and social practices. Specifically we examine the case of computed tomography (CT) scanning, introduced in 1972 by

J.-C. Spender

1995-01-01

347

Case report: exfoliative cheilitis managed with antidepressant medication.  

PubMed

Exfoliative cheilitis is an unsightly and uncommon, chronic superficial inflammatory disorder that affects the vermilion zone of the lips. This case report describes the presentation of exfoliative cheilitis in a young man, and his subsequent management with antidepressant medication. The differential diagnosis of chronic exfoliative cheilitis is outlined. PMID:15612458

Leyland, Leila; Field, E Anne

2004-11-01

348

Managing educational change: a case of two leadership approaches  

Microsoft Academic Search

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

Alice Chow

2012-01-01

349

Allocative efficiency of case managers for the elderly.  

PubMed Central

This study presents an analysis of the allocative efficiency of case managers for the community-based elderly in an environment in which case management and a range of home and community-based services were available and directly linked to a mandatory preadmission screening program for nursing home applicants. We collected data for a one-year follow-up period on client placement, health and functional status, informal support, and use of health and social services for clients in two urban and two rural counties that participated in the Minnesota Pre-Admission Screening/Alternative Care Grants Program (PAS/ACG). We found that among those receiving ACG-supported services, the relationship between variation in the level of support for home and community-based services and the length of time elderly clients remained in the community suggested that case managers were allocating home and community-based services in a reasonably efficient manner. This finding offers support for using case managers to target services to the elderly.

Davidson, G; Moscovice, I; McCaffrey, D

1989-01-01

350

Management of Federally Sponsored Libraries: Case Studies and Analysis.  

ERIC Educational Resources Information Center

|This book provides insight into how managers of federally sponsored libraries view their roles and carry out their duties. Seven federally supported libraries were selected to serve as case studies. These libraries represent a cross-section of various types, and the nine chapters are written by librarians from these facilities. The discussion…

Missar, Charles D., Ed.

351

Magic from Social Networks that Talk to Management: Four Cases  

ERIC Educational Resources Information Center

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

Sugarman, Barry

2010-01-01

352

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.

353

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

ERIC Educational Resources Information Center

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

Noble, Charles

1997-01-01

354

Translating childhood tuberculosis case management research into operational policies.  

PubMed

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

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

2011-08-01

355

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.

Houle, Sebastien

2012-01-01

356

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

PubMed Central

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

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

2012-01-01

357

The relational nature of case manager resource allocation decision making: an illustrated case.  

PubMed

We used ethnographic methods in the tradition of Spradley (1979) and constant comparative analysis to explore case manager resource allocation decision making. We interviewed; observed and shadowed 11 case managers within a children's home care program in a regional health authority in western Canada as they went about their daily work over a 5-month period. Our findings provide knowledge about the little-understood set of processes at the micro level of resource allocation. Although the case manager considers many factors, reported elsewhere (Fraser, Estabrooks, Allen, & Strang, 2009), they balance and weigh these factors within a relational context. The purpose of this article is to use Jenna's story as a case example to illustrate how the case manager balances and weighs the factors that influence their resource allocation decisions within this context. Jenna's story demonstrates the complex and multidimensional processes that are embedded in the relational nature of resource allocation decisions. We discuss home care case manager resource allocation decisions as viewed through the lens of relational ethics. PMID:20839480

Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

2010-01-01

358

Evaluation method for determining management priorities for special case waste  

SciTech Connect

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

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

1990-08-01

359

"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

360

Perinatal management of cardiac tumors: a case series.  

PubMed

Primary cardiac tumours in the foetuses and neonates are uncommon. Foetuses with cardiac tumour have risk for heart failure and hydrops fetalis. Therefore, an early decision for delivery should be made in the evidence of foetal compromise. Early neonatal care varies on tumour size, type, location and obstructive features. Antenatal detection of foetal cardiac tumours ensures better prenatal and postnatal management. We describe our 5- year experience in managing 5 cases of primary cardiac tumours from 1st January 2006 to 31st December 2010. PMID:24145275

Amelia, A; Mohd Nizam, M B

2013-08-01

361

IP telephony--new horizon for telemedicine and e-health.  

PubMed

Internet Protocol (IP) based networks are increasingly being used as alternatives to the traditional circuit-switched networks for carrying voice traffic. IP telephony is taking a firm hold in the world telecommunication market for a wide range of applications including telemedicine. The merits of IP telephony for telemedicine lie in cost-savings and new applications and functionalities it may render. In this paper, we try to discuss and analyze the implications of IP telephony on the evolution and deployment of telemedicine and e-health. PMID:12118811

Zhao, Yongguo; Yagi, Yukako; Nakajima, Isao; Juzoji, Hiroshi

2002-08-01

362

Rural telemedicine networks using store-and-forward Voice-over-IP.  

PubMed

Store and forward Voice-over-IP is a suggested solution for supporting Telemedicine at rural health clinics in developing countries. Solutions described to date are designed to support communication by establishing point-to-point connectivity between two sites. In this paper we present an approach for creating scalable Telemedicine networks based on Delay Tolerant Networking. This holds potential for allowing Telemedicine networks to be created that can enable sharing of Teleconsultation and other medical information among a large number of locations in areas that cannot be served by existing solutions. PMID:19745352

Scholl, Jeremiah; Lambrinos, Lambros; Lindgren, Anders

2009-01-01

363

[Extravascular lung water: from genes to telemedicine].  

PubMed

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

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

2013-04-01

364

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

PubMed

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

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

365

Using information technology to improve the management of chronic disease.  

PubMed

Information and communications technology (ICT) is increasingly being used in management of chronic illness to facilitate shared services (virtual health networks and electronic health records), knowledge management (care rules and protocols, scheduling, information directories), as well as consumer-based health education and evidence-based clinical protocols. Common applications of ICT include home monitoring of vital signs for patients with chronic disease, as well as replacing home visits by nurses in person with telemedicine videophone consultations. A patient-managed Home Telecare System with integrated clinical signs monitoring, automated scheduling and medication reminders, as well as access to health education and daily logs, is presented as an example of ICT use for chronic disease self-management. A clinical case study demonstrates how early identification of adverse trends in clinical signs recorded in the home can either avoid hospital readmission or reduce the length of hospital stay. PMID:12924970

Celler, Branko G; Lovell, Nigel H; Basilakis, Jim

2003-09-01

366

A case study of project management practices in virtual settings: lessons from working in and managing virtual teams  

Microsoft Academic Search

In this paper we report a case study examining the communication processes engaged in by virtual project teams and their management. Twenty-two teams, using widely available groupware to communicate, work together, share documents, discuss ideas, and solve problems, designed and implemented a database. These teams were managed by a geographically-distributed management team. The case study is analyzed qualitatively and quantitatively,

Catherine M. Beise; Traci A. Carte; Chelley Vician; Laku Chidambaram

2010-01-01

367

Combining community case management and intermittent preventive treatment for malaria.  

PubMed

Employment of members of the community to treat malaria is a promising approach to the management of this infection in areas where access to treatment is difficult. Intermittent preventive treatment (IPT) of malaria has recently been shown to be a highly effective way of reducing morbidity from malaria in children living in areas of seasonal malaria transmission, and it can be delivered efficiently by community volunteers. Therefore, we suggest that in areas where malaria transmission is seasonal, and IPT an appropriate malaria intervention in children, community volunteers could be employed to deliver IPT during the peak malaria-transmission season and also to provide community case management during this period and during the rest of the year when occasional cases of malaria continue to occur. PMID:21802363

Greenwood, Brian; Bojang, Kalifa; Tagbor, Harry; Pagnoni, Franco

2011-07-27

368

Telemedicine in Primary Health: The Virtual Doctor Project Zambia  

PubMed Central

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO]. This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront.

2011-01-01

369

Deployable teleradiology and telemedicine for the US military.  

PubMed

The US military has been an effective proponent of digital imaging and teleradiology for the past 15 years. A digital imaging network that can eliminate the use of X-ray film can make the requirements simpler for military medicine. X-ray film requires the storage of new, unexposed films that have a fixed shelf life, and the storage and use of chemicals and water for processing. In some deployed situations, the chemical discharge has to be collected and shipped out of the deployed area. The technology of electronic imaging is therefore intrinsically important to military medicine. In December of 1995, the US government started to deploy 20000 US troops to Bosnia-Herzegovina as part of NATO's peace keeping operation (IFOR). A full complement of medical support facilities was to be established in the Bosnia region and Hungary where the deployment was staged. Primetime III was a project to deploy telemedicine and teleradiology capabilities linking these medical treatment facilities (MTF). The deployment of telemedicine was not the responsibility of our engineering team. This paper deals with the deployable teleradiology (DEPRAD) system that was installed by the ISIS Center at a number of facilities for filmless radiology and teleradiology services. PMID:9803994

Mun, S K; Levine, B; Cleary, K; Dai, H

370

Project RavenCare: global multimedia telemedicine in Alaska  

NASA Astrophysics Data System (ADS)

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

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

1995-05-01

371

Design and deployment of hybrid-telemedicine applications  

NASA Astrophysics Data System (ADS)

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

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

2004-12-01

372

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

PubMed

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

2012-07-01

373

Developing a Measure of Prenatal Case Management Dosage  

Microsoft Academic Search

Recently, federal funding was designated through the Patient Protection and Affordable Care Act giving states the opportunity\\u000a to expand their prenatal case management programs (PCM) through home visitation. Studies evaluating the effect of PCM on birth\\u000a outcomes have shown little or no positive results. One suggested reason for these findings is a lack of attention in the assessment\\u000a of dosage.

Jaime C. SlaughterL; L. Michele Issel

374

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

SciTech Connect

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

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

2011-01-01

375

Supplementation of a successful pediatric neuro-oncology telemedicine-based twinning program by e-mails.  

PubMed

There is a growing gap between developing and developed countries in the availability of treatment for pediatric subspecialties. Twinning and telemedicine are effective ways to improve the quality of healthcare in developing countries. We evaluated the impact of e-mail exchanges on the development of a neuro-oncology twinning program between the King Hussein Cancer Center (KHCC), Amman, Jordan, and the Hospital for Sick Children, Toronto, Canada. We conducted a retrospective review of all e-mail communications between KHCC and the Hospital for Sick Children from August 2003 to December 2005 for subject, attachments, and responses. Over a period of 29 months, 356 e-mail exchanges (average, 12.3/month) occurred. Subjects discussed were specific consults (88), videoconferencing (65), general neuro-oncological questions (54), personal (45), exchange visits related (44), research projects related (28), articles or treatment guidelines (21), and Web site translation (11). Our study suggests that e-mails promote effective communication between twinning partners and enable discussion of complex cases, organization of teleconferences and workshops, aid other research activities, and further personal relationships between partners. Use of e-mail in telemedicine can be especially useful to improve the quality of care for children with cancer in developing countries. PMID:19929233

Qaddoumi, Ibrahim; Bouffet, Eric

2009-12-01

376

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

2013-10-01

377

Welfare Reform: Bibliographies of Case Management and Agency/Client Contracting.  

National Technical Information Service (NTIS)

This report develops bibliographies on the subjects of case management and agency/client contracting for the Committee's use in considering proposed welfare legislation. The bibliographies identify 109 literature citations for case management as applied i...

1988-01-01

378

The use of TeleMedicine in the Treatment of Pediatric Obesity: Feasibility and Acceptability  

PubMed Central

Objective To assess the feasibility of conducting empirically supported family based pediatric obesity group treatment via telemedicine. Methods Seventeen families were randomly assigned to one of two conditions (physician visit, TeleMedicine). Measures included feasibility, satisfaction, and intervention outcome measures such as BMI percentile, and nutrition and activity behaviors. Measures were completed at baseline, post-treatment, and at one-year follow-up. Results Analyses indicate that both feasibility and satisfaction data regarding the TeleMedicine intervention were positive. Intervention outcome indicates no change in BMI percentile or nutrition and activity behaviors for either treatment group. Conclusions A behavioral family-based weight loss intervention delivered via TeleMedicine was well received by both parents and providers. Due to the small sample size, null findings regarding intervention outcome should be interpreted with caution. Future research should focus on methods to increase the impact of this intervention on key outcome variables.

Davis, Ann McGrath; James, Rochelle L.; Boles, Richard E.; Goetz, Jeannine R.; Belmont, John; Malone, Brett

2010-01-01

379

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

380

Management of Two Cases of Recurrent Anal Carcinoma  

PubMed Central

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

Klimant, Eiko; Markman, Maurie

2013-01-01

381

Management of two cases of recurrent anal carcinoma.  

PubMed

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

Klimant, Eiko; Markman, Maurie

2013-09-12

382

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.

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

2011-01-01

383

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

PubMed

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

Berek, B; Canna, M

1994-01-01

384

TeleMedMail: free software to facilitate telemedicine in developing countries.  

PubMed

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

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

2001-01-01

385

Implementation of in-home telemedicine in rural kansas: answering an elderly patient's needs.  

PubMed

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, C C

386

The role of telemedicine in CPAP compliance for patients with obstructive sleep apnea syndrome  

Microsoft Academic Search

The objective of this study was to compare continuous positive airway pressure (CPAP) use, functional status, and client satisfaction in obstructive sleep apnea syndrome (OSAS) patients randomized to either telemedicine support or traditional care. In our university-affiliated sleep disorders center, patients with OSAS who were initiating CPAP therapy were randomized to receive telemedicine support vs traditional follow-up care for 30 days.

Yvonne Taylor; Arn Eliasson; Teotimo Andrada; David Kristo; Robin Howard

2006-01-01

387

Telemedicine may help change the face of medical care in eastern Canada.  

PubMed

Pilot projects in eastern Canada that use personal computers and telephone lines to link patients and rural physicians with specialists in urban centres indicate that telemedicine may be a cost-effective adjunct to clinical medicine. Dermatology, radiology, cardiology and oncology are among the areas that have been tested in Nova Scotia. Although physicians say telemedicine may have many useful applications, such as providing efficient continuing medical education for doctors in remote communities, they say it must respect traditional referral patterns. PMID:9099171

Robb, N

1997-04-01

388

Pediatric asthma case management: A review of evidence and an experimental study design  

Microsoft Academic Search

Asthma is a complex disease that involves physiological, environmental, and psychosocial factors. This paper reviews childhood asthma case management by social service professionals, lay health workers, and nurses, and it presents a new randomized controlled study using nurse case management in a local community coalition. Evidence suggests the common factor for success involves case managers spending time contacting and patiently

Amanda Schulte; Jeanne Musolf; John R Meurer; Jennifer H Cohn; Kevin J Kelly

2004-01-01

389

Case Management Approaches in Coordinated Community-Oriented Long-Term Care Demonstrations.  

ERIC Educational Resources Information Center

|Describes variations in case management approaches based on a national evaluation of Medicaid 1115 and Medicare 222 community-based care demonstrations. Presents the costs of producing case management services for selected programs. Less professionalization and less specialization of case management functions are associated with lower service…

Capitman, John A.; And Others

1986-01-01

390

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

391

What is a case manager? The perspective of persons with borderline personality disorder  

Microsoft Academic Search

Background: Case management services have expanded to include persons with diagnoses other than schizophrenia. Attention has been directed toward persons with chronic, nonpsychotic disorders—in particular, persons with personality disorders. However, to date, the nature and effects of case management for persons with personality disorders are relatively unknown. Objectives: The purpose of this study was to explore case management services from

Nadine Nehls

2001-01-01

392

Elementary School Counselors' Perception of Their Role and Function as Case Managers in Chicago Public Schools  

Microsoft Academic Search

The purpose of this research is to understand how elementary school counselors perceive the role and function of case manager in Chicago Public Schools. In this expanded role, elementary school counselors must continue their traditional counseling duties and incorporate case management activities as a part of their responsibilities. The case managers coordinate the special education program for students with disabilities.

Debra J. Franklin

2010-01-01

393

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

394

Telemedicine for the Diabetic Foot: A Model for Improving Medical Care, Developing Decision Support Systems, and Reducing Medical Cost  

Microsoft Academic Search

\\u000a The main purpose of this chapter is to discuss the place of telemedicine in the modern medicine, its present and future application\\u000a in the clinical medicine. It covers aspects of clinical telemedicine practice, technical advances, principles and practices,\\u000a health policy and regulation, and health services research dealing with clinical effectiveness, efficacy, and safety of telemedicine\\u000a and its effects on quality,

Adriana Fodor; Eddy Karnieli

395

Telemedicine System Using a High-Speed Network: Past, Present, and Future  

PubMed Central

There is no doubt that telecommunication saves a great deal of time and expense when exchanging information, and recent technological advances have increased its popularity in business and educational applications. Telemedicine is a rapidly developing application of clinical medicine in which medical information is transferred via the Internet or another communication network for the purpose of consultations, and sometimes also for remote medical procedures or examinations. A telemedicine system can also be applied to medical education. Many doctors and medical students could benefit from telementoring and tele-education based on videoconferencing systems. However, telemedicine in general has not yet become popular in clinical practice or medical education. In our university, we have used a telemedicine system to educate doctors and medical students since 2003. Since our first telemedical conference with Kyushu University Hospital on February 12, 2003 when we have regularly performed telemedical conferences. Here we introduce a general methodology for telemedicine, our experiences of medical conferencing using telemedicine, and future possible directions.

Lee, Hang Lak; Choi, Ho Soon; Shimizu, Shuji

2009-01-01

396

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

SciTech Connect

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

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

1999-05-17

397

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.

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

2008-01-01

398

77 FR 41986 - Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services  

Federal Register 2010, 2011, 2012, 2013

...outcomes. Case management involves the...members of the health care team. Quality...the cost of health care, case management has proven its...determine the health care priorities...the PHN case management program...

2012-07-17

399

Remote Measurements of Heart and Respiration Rates for Telemedicine  

PubMed Central

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

Qian, Yi; Tsien, Joe Z.

2013-01-01

400

A novel telemedicine system for monitoring congestive heart failure patients.  

PubMed

Congestive heart failure is a widespread cardiac disease in western countries. At present, the main measure for monitoring the level of pulmonary edema in telemedicine systems is weight, which is not a reliable indicator. The authors propose a novel bioimpedance telemedical system to monitor these patients. The system measures the resistivity of each lung using optimization methods and transmits the measurements via a modem to a call center. Preliminary results show that the measured resistivity values among healthy young patients are consistent and reproducible within 48 hours. The mean resistivity values in patients with pulmonary congestion were lower than those of the healthy patients: 887 [Omega*cm]+/-117 vs 1244 [Omega*cm]+/-87 (P<.01). The system is noninvasive, safe, and portable. It retrieves unique information correlated with the amount of fluid in the lungs and transmits the data to a medical call center in order to improve the diagnostics and treatment of congestive heart failure. PMID:18983286

Radai, Michal M; Arad, Marina; Zlochiver, Sharon; Krief, Haim; Engelman, Tzvika; Abboud, Shimon

401

Experience in the application of Java Technologies in telemedicine  

PubMed Central

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

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

2002-01-01

402

Remote measurements of heart and respiration rates for telemedicine.  

PubMed

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

Zhao, Fang; Li, Meng; Qian, Yi; Tsien, Joe Z

2013-10-08

403

Fetal breathing transmission in phonocardiographic monitoring telemedicine systems.  

PubMed

The phonocardiographic monitoring of fetal heart activity due to its passive nature enables extremely long measuring times providing thus the possibility of fetal breathing recovery. The long monitoring time is required because of the temporary appearing of breathing movement. However, the long measurement time and consequently the large amount of data to be transmitted to the hospital's computer centre may be costly on mobile phone network. To keep monitoring costs low an appropriate data compression should be applied assuring the transmission of all important features of the detected acoustic signal. The present work summarizes the results of the extension of the novel telemedicine system with measurement of breathing periodicity and the achieved compression level of acquisited data. The Golomb-Rice compression is applied for lossless transmission of the segmented beat cycles considering the importance of the given segments in order to obtain the most accurate transfer of beat-to-beat time and all irregular heart sounds. PMID:17946292

Kovács, F; Horváth, Cs; Török, M; Hosszú, G

2006-01-01

404

Pilot study results: the psychiatric RN case manager.  

PubMed

1. It is important to examine client and staff satisfaction with the RN case management (RNCM) model to enhance the quality of care in psychiatric settings. 2. Ninety-two percent of clients surveyed ranked the RNCM care as "excellent" or "above average." Clients valued most the humanistic role of the RNCM and repeatedly commented on the importance of the nurse being caring, genuine, and supportive. 3. RNCMs expressed high satisfaction with their role, which they described as collaborative with the psychiatrist, yet also professional and independent. Psychiatrists expressed a high degree of confidence that clients were receiving excellent care by competent nurse professionals. PMID:1494142

Van Dongen, C J; Jambunathan, J

1992-11-01

405

Requiring case management meetings to be conducted outside the clinic.  

PubMed

In this Open Forum a psychiatric health care consumer recounts his experience with his state's requirement to hold case management meetings outside of the clinic. Over time, the author found that meeting elsewhere amounted to being put on public display, and he felt embarrassed and powerless to change the situation. Requiring people with psychiatric disorders to meet outside a clinical setting may violate the Health Insurance Portability and Accountability Act and human rights. This New Hampshire state policy needs to be changed because it undermines treatment and reinforces the stigma that many consumers already feel because of their disability. PMID:21969649

Strickler, David Charles

2011-10-01

406

Perioperative management of undiagnosed placenta percreta: case report and management strategies  

PubMed Central

Placenta percreta is a rare pregnancy disorder in which the placenta penetrates the uterine myometrium and can invade surrounding organs. Because the rate of cesarean sections is increasing in developed countries, the incidence of placenta percreta is also rising. This condition significantly increases the risk of maternal and fetal morbidity and mortality, and is currently the most common indication for peripartum hysterectomy. Multidisciplinary management in a specialized center capable of providing massive transfusions can improve outcomes for the mother and baby. This team should include a surgeon specialized in pelvic surgery, an anesthesiologist experienced in obstetrics, a skilled urologist, a neonatologist, a blood bank team capable of administering multiple blood products, and an intensive care facility where the patient can be monitored. In this report, we present the case of a patient with preoperatively undiagnosed placenta percreta and discuss the relevant management methods. We also discuss the relevant obstetric and anesthetic management methods, as well as diagnostic and transfusion protocols.

Sivasankar, Chitra

2012-01-01

407

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

408

Case management insider. Managing length of stay using patient flow--Part 3.  

PubMed

As lengths of stay shorten across the country, opportunities to continue to reduce length of stay become more difficult to identify. Monitoring care progression processes is the foundation of patient flow and requires daily point of care monitoring as well as data analysis retrospectively. Each case management department should create a patient flow infrastructure that includes daily monitoring and correction as well as a database that allows for collection of information that can be used later for analysis and performance improvement. In next month's issue of Case Management Insider, we will review a couple of different patient flow report cards that can be used to monitor delays and bottlenecks across the continuum of care. PMID:23662362

Cesta, Toni

2013-05-01

409

Telemedicine for the Medicare Population: Pediatric, Obstetric, and Clinician-Indirect Home Interventions. Evidence/Report/Technology Assessment Number 24, Supplement.  

National Technical Information Service (NTIS)

The goal of this report is to extend our original evidence report on the efficacy of telemedicine by extending the assessment to the pediatrics and obstetrics populations along with receiving home telemedicine where the health care provider was involved i...

W. Hersh

2001-01-01

410

Knowledge Management Systems and Organizational Change Management: The Case of Siemens ShareNet  

Microsoft Academic Search

Earlier research has shown the interdependence of Knowledge Management Systems’ (KMS) implementations and corporate cultures.\\u000a This study builds on and extends this research by exploring how knowledge-intensive corporate cultures can be established.\\u000a Employing a case study approach, we analyze the (successful) implementation of Siemens Information and Communication Networks\\u000a (ICN) group division’s ShareNet, a global knowledge sharing network for the sales

Hauke Heier; Susanne Strahringer

2006-01-01

411

What is case management in palliative care? An expert panel study  

PubMed Central

Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent.

2012-01-01

412

Contradictions in Case ManagementClient-Centered Theory and Directive Practice with Frail Elderly  

Microsoft Academic Search

New long-term care legislation and managed care legitimate case management for gatekeeping and advocacy for frail elderly. Qualitative in-depth interviews with case managers who are social workers and nurses were used to address the question: To what extent is client-centered theory reflected in case management practice? Differences between reported client-centered theory and directive practice were identified by five themes: (a)

Elizabeth Clemens; Terrie Wetle; Michael Feltes; Benjamin Crabtree; Deborah Dubitzky

1994-01-01

413

Dynamics of Successful Program Management: The Case of Army TACMS.  

National Technical Information Service (NTIS)

Project Management has evolved as a successful tool to manage complex weapon systems. As budgets decline, Department of Defense project managers are challenged to improve their skills and competencies for successful project management. While the current l...

P. R. Myrick

1993-01-01

414

Hospital waste management in Libya: a case study.  

PubMed

In Libya, as in many developing countries, little information is available regarding generation, handling and disposal of hospital waste. This fact hinders the development and implementation of hospital waste management schemes. The specific objective of this study is to present an appraisal of the current situation regarding hospital waste management in Libya. Procedures, techniques, methods of handling, and disposal of waste are presented, as well as the amounts and compositions of hospital waste. This research was conducted in the form of a case study. Fourteen different healthcare facilities in three cities, Tripoli, Misurata, and Sirt, all located in the northwestern part of Libya, were selected for investigation. The investigation showed that the hospitals surveyed had neither guidelines for separated collection and classification, nor methods for storage and disposal of generated waste. This deficiency indicates the need for an adequate hospital waste management strategy to improve and control the existing situation. The average waste generation rate was found to be 1.3 kg/patient/day, comprised of 72% general healthcare waste (non-risk) and 28% hazardous waste. The average general waste composition was: 38% organic, 24% plastics, and 20% paper. Sharps and pathological elements comprised 26% of the hazardous waste component. PMID:19036572

Sawalem, M; Selic, E; Herbell, J-D

2008-11-25

415

Case managers optimize patient safety by facilitating effective care transitions.  

PubMed

In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery. Effective communication and collaboration between disciplines is key to the promotion of patient safety, and ultimately the avoidance of life-threatening medical errors. Across the healthcare continuum and within hospitals in particular, patients are routinely transferred from one service to another, from one level of care to another, or from one provider to another. As patients are stabilized and transitioned through the hospital system, there are multiple hand-offs of care or care transitions that can often expose the patient to fragmented service and increase the risk of communication breakdown. Ineffective hand-offs can result in a disruption of continuity between one level of care and the next. In a culture that places a strong emphasis on patient safety, case managers can facilitate opportunities that ease care transitions whereby a change in venue is no longer perceived as a disruption in the flow of care but rather is viewed as a coordinated changeover where cautious and comprehensive communication sets the tone for the continued delivery of safe and effective healthcare. PMID:17413671

Carr, Dana Deravin

416

A case study of type 2 diabetes self-management  

PubMed Central

Background It has been established that careful diabetes self-management is essential in avoiding chronic complications that compromise health. Disciplined diet control and regular exercise are the keys for the type 2 diabetes self-management. An ability to maintain one's blood glucose at a relatively flat level, not fluctuating wildly with meals and hypoglycemic medical intervention, would be the goal for self-management. Hemoglobin A1c (HbA1c or simply A1c) is a measure of a long-term blood plasma glucose average, a reliable index to reflect one's diabetic condition. A simple regimen that could reduce the elevated A1c levels without altering much of type 2 diabetic patients' daily routine denotes a successful self-management strategy. Methods A relatively simple model that relates the food impact on blood glucose excursions for type 2 diabetes was studied. Meal is treated as a bolus injection of glucose. Medical intervention of hypoglycaemic drug or injection, if any, is lumped with secreted insulin as a damping factor. Lunch was used for test meals. The recovery period of a blood glucose excursion returning to the pre-prandial level, the maximal reach, and the area under the excursion curve were used to characterize one's ability to regulate glucose metabolism. A case study is presented here to illustrate the possibility of devising an individual-based self-management regimen. Results Results of the lunch study for a type 2 diabetic subject indicate that the recovery time of the post-prandial blood glucose level can be adjusted to 4 hours, which is comparable to the typical time interval for non-diabetics: 3 to 4 hours. A moderate lifestyle adjustment of light supper coupled with morning swimming of 20 laps in a 25 m pool for 40 minutes enabled the subject to reduce his A1c level from 6.7 to 6.0 in six months and to maintain this level for the subsequent six months. Conclusions The preliminary result of this case study is encouraging. An individual life-style adjustment can be structured from the extracted characteristics of the post-prandial blood glucose excursions. Additional studies are certainly required to draw general applicable guidelines for lifestyle adjustments of type 2 diabetic patients.

Wu, Hsin-i

2005-01-01

417

Evaluation of a case management service to reduce sickness absence  

PubMed Central

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

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

2013-01-01

418

Oral anticoagulation: challenges in the case-management setting.  

PubMed

By understanding barriers, providing education, and advocating appropriate treatment, case managers play an essential role in the prevention and treatment of thromboembolic disorders. Yet, thromboembolic events such as stroke and deep-vein thrombosis still result in substantial morbidity and mortality despite the availability of effective prophylactic anticoagulation therapy. Although oral warfarin, because of its established efficacy, remains the mainstay in the prevention and treatment of thromboembolic disorders associated with atrial fibrillation, a common antecedent, it is fraught with enduring impediments that hinder effectiveness, safety, and use. With a narrow therapeutic widow, optimal treatment relies on maintaining a tight international normalized ratio (INR) range, usually between 2.0 and 3.0. Lacking intensive anticoagulation clinic monitoring, patients are often outside the therapeutic range, compromising efficacy or safety. Furthermore, the need for frequent and demanding INR monitoring, a slow onset of action, and an elevated risk for drug-drug and food-drug interactions conspire to undermine the use of warfarin, especially in high-risk groups, such as the elderly. Unquestionably, well-tolerated, convenient, and effective alternatives to oral warfarin are needed to improve the management of patients in need of anticoagulation therapy. Several new oral anticoagulants are in development, but only one, ximelagatran, has completed Phase-III development and awaits Food and Drug Administration (FDA) approval. An oral direct thrombin inhibitor, ximelagatran, appears to offer a profile quite different from warfarin: a wide therapeutic window that obviates routine drug-level monitoring and twice-daily oral administration with minimal drug interactions; however, transient liver enzyme elevations remain an unresolved issue. As case managers typically work with those who present with clinical or psychosocial challenges, or both, this treatment approach may provide an alternative that would enhance patient outcomes. PMID:15685010

Lowery, Sandra; Haley, Kathleen; Bussey, Henry I

419

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

ERIC Educational Resources Information Center

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

Arthur, Gwen, Ed.

420

IWALT 2000 Panel - 2 Telemedicine and Tele - Education Remote Tele-Education as an Alternative to Telemedicine Aboard the Aircraft Carrier USS GEORGE WASHINGTON  

Microsoft Academic Search

Purpose: A method of Basic tele-education as an alternative to telemedicine on the aircraft carrier USS GEORGE WASHINGTON is described. Aircraft carriers are often deployed for months, with limited medical specialty services. This method was developed to increase access to images by specialists at the medical center where patients would be seen once at port. Methods: Radiologic images were imported

William Sneeder

421

A case of normotensive pheochromocytoma with management dilemma  

PubMed Central

Introduction: We report an unusual case of normotensive pheochromocytoma detected incidentally, presenting a pre-operative management problem. Case Note: A 40-year-old lady with vague abdominal symptoms was initially discovered with a left adrenal incidentaloma by ultrasound abdomen, which was also revealed in computed tomography (CT). After exclusion of all the causes with possible necessary investigations, pheochromocytoma was confirmed with elevated 24 hour urinary metanephrine and normetanephrine. Her blood pressure was in low to normotensive range all throughout. She was attempted to be prepared with combined alpha and beta blockade but could not tolerate this regimen due to symptomatic hypotension. Subsequently, surgical preparation was planned cautiously with alpha-adenergic blockade only. With intensive monitoring, she underwent uneventful left adrenalectomy, and surgical pathology was consistent with pheochromocytoma. Conclusion: This case illustrates an unusual presentation of normotensive pheochromocytoma as adrenal incidentaloma. Pre-operative preparation in these patients can be achieved with alpha-adrenergic blockade, adequate hydration, and liberal salt intake.

Roy, Mukut; Sengupta, Nilanjan; Sahana, Pranab Kumar; Giri, Debasis; Das, Chanchal

2012-01-01

422

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

PubMed

We studied maritime telemedicine and its potential for improvement. Twenty-four people representing 13 different shipping companies and maritime public authorities were interviewed. They covered all areas of the Norwegian maritime sector except for offshore installations. The morbidity pattern reported differed between the groups: on cruise liners and ferries the major problems were due to coronary heart disease, while on merchant ships, navy vessels and in the fishing fleet the major problems were accidents. Voice and fax systems were available in all cases. However, the Emergency Medical Dispatch Centres did not offer an email service and did not use faxes in the maritime setting. Radio Medico Norway was the only assistance provider offering two-way transfer of digital pictures. The interviewees suggested a number of areas for improvement; these included having a single emergency telephone number to call for help, email systems with the possibility of digital picture attachments, wireless communication systems on board and a standard CD-ROM reference work for medical guidance/education. PMID:12396854

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

2002-01-01

423

Imager Evaluation of Diabetic Retinopathy at the Time of Imaging in a Telemedicine Program  

PubMed Central

OBJECTIVE To evaluate the ability of certified retinal imagers to identify presence versus absence of sight-threatening diabetic retinopathy (stDR) (moderate nonproliferative diabetic retinopathy or worse or diabetic macular edema) at the time of retinal imaging in a telemedicine program. RESEARCH DESIGN AND METHODS Diabetic patients in a primary care setting or specialty diabetes clinic received Joslin Vision Network protocol retinal imaging as part of their care. Trained nonphysician imagers graded the presence versus absence of stDR at the time of imaging. These gradings were compared with masked gradings of certified readers. RESULTS Of 158 patients (316 eyes) imaged, all cases of stDR (42 eyes [13%]) were identified by the imagers at the time of imaging. Six eyes with mild nonproliferative diabetic retinopathy were graded by the imagers to have stDR (sensitivity 1.00, 95% CI 0.90–1.00; specificity 0.97, 0.94–0.99). CONCLUSIONS Appropriately trained imagers can accurately identify stDR at the time of imaging.

Cavallerano, Jerry D.; Silva, Paolo S.; Tolson, Ann M.; Francis, Taniya; Tolls, Dorothy; Patel, Bina; Eagan, Sharon; Aiello, Lloyd M.; Aiello, Lloyd P.

2012-01-01

424

The Need for a Systemic Approach to Change Management—A Case Study  

Microsoft Academic Search

Change is now a constant feature of organizational life, but the effectiveness of change management initiatives is often open to question. By reflecting on a case of change management involving a Higher Education Institution (HEI), this paper argues that, to be more effective, organizational change must be managed systemically. The paper first provides a systemic conceptual underpinning to change management,

Guangming Cao; Steve Clarke; Brian Lehaney

2004-01-01

425

Telemedicine in a rural gero-psychiatric inpatient unit: comparison of perception/satisfaction to onsite psychiatric care.  

PubMed

Telemedicine in a rural, gero-psychiatric inpatient unit is a groundbreaking concept. The use of telemedicine in rural communities, both inpatient and outpatient, is a significant way to provide specialty care that might otherwise only be available in urban areas. Establishing its credibility through perception/satisfaction studies and clinical outcome studies is therefore crucial. This paper outlines an initial attempt to provide some of the necessary data. A review of the literature reveals limited data to demonstrate the impact of telemedicine on inpatient healthcare satisfaction and perceived outcomes as compared to traditional, on-site physician practice. None of the literature addresses the use of telemedicine in an inpatient gero-psychiatric unit. The McCurtain Memorial Hospital is a pioneer in the use of telemedicine to provide acute gero-psychiatric care in a community-based inpatient setting. Pre- and post-Patient/Family Satisfaction Survey data for a period ranging 12 months prior to inception of telemedicine and 12 months postinception were aggregated and analyzed. The results indicate that there is a positive correlation between telemedicine and the patient/family satisfaction with and perception of benefits of treatment. It must be noted that patient/family perception of outcome and actual measures of clinical outcome are not the same. Clinical outcome data must also be collected to fully assess the success of telemedicine in this arena. PMID:18570569

Holden, Dwight; Dew, Elizabeth

2008-05-01

426

Using Telemedicine to Provide Pediatric Subspecialty Care to Children With Special Health Care Needs in an Underserved Rural Community  

Microsoft Academic Search

Objective. For children with special health care needs (CSHCN) that live in rural, medically underserved communities, obtaining subspecialty care is a challenge. Telemedicine is a means of improving access to these children by addressing rural physician shortages and geographic barriers. This article reports a medical- needs assessment of parents\\/guardians with CSHCN and the status of a telemedicine program for CSHCN

James P. Marcin; Jeff Ellis; Roland Mawis; Eule Nagrampa; Thomas S. Nesbitt; Robert J. Dimand

2004-01-01

427

Assessment, Case Management, and Post-Training Assistance for TAA Participants. An Occasional Paper Prepared as Part of the Evaluation of the Trade Adjustment Assistance Program. Final Report.  

National Technical Information Service (NTIS)

Partial Contents: Assessment, case management, and post-training assistance for TAA participants (Introduction, Assessment and Case Management During Rapid Response, Assessment and Case Management for Non-Training Customers, Assessment and Case Management...

2009-01-01

428

Water resources management: case study of Sharkia governorate, Egypt  

NASA Astrophysics Data System (ADS)

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

Mohamed, Y. A.; Rashad, M.

2012-06-01

429

Laparoscopic management of early primary peritoneal pregnancy: a case report  

PubMed Central

Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intra-uterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

Koo, Hwa Seon; Bae, Ju Youn; Kang, Inn Soo; Koong, Mi Kyoung; Kim, Hye Ok; Cha, Sun Hwa; Choi, Min Hye; Kim, Ji Young

2011-01-01

430

Management of extra oral sinus cases: a clinical dilemma.  

PubMed

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

Mittal, Neelam; Gupta, Pooja

2004-07-01

431

Burns from illegal drug manufacture: case series and management.  

PubMed

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

Porter, C J W; Armstrong, J R

432

Telemedicine licensure in the United States: the need for a cooperative regional approach.  

PubMed

The extraordinary successes and refinement of modern telemedicine applications in recent years have been diminished somewhat by the anachronistic licensure laws of the 50 state jurisdictions that limit the practice of medicine to specific state geographic boundaries. This approach is deficient when applied to telemedicine because, with the advent of the Internet and modern technological advances, differences in space and time are rendered nearly meaningless. It is recommended in this paper that the practice of telemedicine be handled differently than the practice of face-to-face medicine, as related to licensure. Although it may be argued persuasively that a national licensure model for telemedicine should be advanced, the political and constitutional hurdles may be too great to overcome. It is therefore recommended that a voluntary, regional geographic approach be instituted by jurisdictions already demonstrating a commonality of interests, such as through the Southern Governors' Association or the Western Governors' Association. The benefits to be derived from this approach would include improving access to healthcare and medical specialists, enhancing the quality and timeliness of care, cutting medical costs by moving information instead of people, securing patients' access to medical records and information, and facilitating commercial export of American telemedicine services. PMID:17489700

Cwiek, Mark A; Rafiq, Azhar; Qamar, Aamna; Tobey, Charles; Merrell, Ronald C

2007-04-01

433

Amino acid management of Parkinson's disease: a case study  

PubMed Central

An extensive list of side effects and problems are associated with the administration of l-dopa (l-3, 4-dihydroxyphenylalanine) during treatment of Parkinson’s disease. These problems can preclude achieving an optimal response with l-dopa treatment. Purpose: To present a case study outlining a novel approach for the treatment of Parkinson’s disease that allows for management of problems associated with l-dopa administration and discusses the scientific basis for this treatment. Patients and methods: The case study was selected from a database containing 254 Parkinson’s patients treated in developing and refining this novel approach to its current state. The spectrum of patients comprising this database range from newly diagnosed, with no previous treatment, to those who were diagnosed more than 20 years before and had virtually exhausted all medical treatment options. Parkinson’s disease is associated with depletion of tyrosine hydroxylase, dopamine, serotonin, and norepinephrine. Exacerbating this is the fact that administration of l-dopa may deplete l-tyrosine, l-tryptophan, 5-hydroxytryptophan (5-HTP), serotonin, and sulfur amino acids. The properly balanced administration of l-dopa in conjunction with 5-HTP, l-tyrosine, l-cysteine, and cofactors under the guidance of organic cation transporter functional status determination (herein referred to as “OCT assay interpretation”) of urinary serotonin and dopamine, is at the heart of this novel treatment protocol. Results: When 5-HTP and l-dopa are administered in proper balance along with l-tyrosine, l-cysteine, and cofactors under the guidance of OCT assay interpretation, the long list of problems that can interfere with optimum administration of l-dopa becomes controllable and manageable or does not occur at all. Patient treatment then becomes more effective by allowing the implementation of the optimal dosing levels of l-dopa needed for the relief of symptoms without the dosing value barriers imposed by side effects and adverse reactions seen in the past.

Hinz, Marty; Stein, Alvin; Uncini, Thomas

2011-01-01

434

The Case for Chronic Disease Management for Addiction  

PubMed Central

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

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

2009-01-01

435

Dyskeratosis Congenita- Management and Review of Complications: A Case Report  

PubMed Central

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

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

2013-01-01

436

[Combined management of pancreatic injury after airgunshot--case report].  

PubMed

Pancreatic trauma is a big diagnostic and therapeutic challenge for physicians. Because of retroperitoneal localization pancreas is protected from damages. Isolated pancreatic injury is rare. Usually it is connected with a multiple trauma. Damages of the other organs mask the symptoms of pancreas disorders and delay the diagnosis. On the other hand the prognosis is strictly connected with the state of the other organs. Early diagnosis and precise evaluation of the trauma extensiveness determines the appropriate method of the treatment. Surgery is a main therapy but the combined method of management is often necessary, including endoscopy. Computed tomography (CT) is the first diagnostic method showing the pancreatic parenchymas damage and its complications. Endoscopic Retrograde Cholangiopancreatography (ERCP) is the best tool to show the major ductal injury. The status of the major pancreas duct determines surgery management. Often the placement of stents is required. This therapy can save the patient from pancreatectomy. In this article was depicted a case of 19th patient with pancreatic injury who sustained airgun shot. Despite laparotomy and surgery external drainage the pancreatocutaneous fistula appeared. It was successfully treated by endoscopic placement of stent during ERCP. PMID:19606704

Babski, Pawe?; Dziekiewicz, Miros?aw; Gil, Jerzy; Wojtu?, Stanis?aw; Maruszy?ski, Marek

2009-05-01

437

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

Microsoft Academic Search

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

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

1999-01-01

438

Social Work Service Practice Guidelines, Number 2: Social Work Case Management.  

National Technical Information Service (NTIS)

Practice Guidelines intended to establish standards for VA Social Work Case Management practitioners; to reinforce a systematic approach to the provision of care; to provide guidance to social workers and VA managers on how social work fits into the healt...

B. S. Bialk

1995-01-01

439

Linking the power of information technology and case management interventions: an assessment of recent medical-management trends.  

PubMed

Imagine a case manager screening a large employer group of 20,000 participants and within less than a couple of minutes: Your first reaction may be one of disbelief. You might think, "Yes, maybe in 2020." However, the reality is that this type of information exchange in the context of case management (CM) is happening today, and it is revolutionizing the medical-management system as we once knew it. This article highlights some of the key changes that have recently occurred in the medical-management field and that are creating a paradigm shift in how CM services will be rendered in the future. PMID:16720257

Carneal, Gary; Gervais, Mary Ellen

440

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

PubMed

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

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

2013-03-01

441

A descriptive analysis of Community Support Program case managers serving the chronically mentally ill  

Microsoft Academic Search

This article presents a description of case managers who serve community-based chronically mentally ill (CMI) persons through the Community Support Program (CSP). Information is presented on case managers' demographic characteristics, education, job training, job history, current job activities, and locus of employment. Data were generated through the Case Manager Background Questionnaire, a 23-item self-administered instrument developed in conjunction with the

Ingrid D. Goldstrom; Ronald W. Manderscheid

1983-01-01

442

The Development and Use of an Interactive Case-Mix Management System  

PubMed Central

A study was undertaken to understand the information needs for case-mix management. The results of the study were used in the development of an interactive case-mix management system on a microcomputer. The system has been installed in 16 hospitals. The results of this effort will be helpful now for case-mix management as well as in future information handling projects.

Van De Moortel, Victor; More, Roy

1984-01-01

443

Knowledge Management in Preserving Ecosystems: The Case of Seoul  

ERIC Educational Resources Information Center

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

Lee, Jeongseok

2009-01-01

444

Fisheries Management Costs: The Case of Baltic Salmon Fishery  

Microsoft Academic Search

The objective of this paper is to examine the costs of managing the Baltic salmon fishery. To achieve we first review the theoretical framework about the costs of managing fisheries. Second, we describe the management system governing the Baltic salmon fishery. Finally, we estimate the costs of managing the Baltic salmon fishery based on the available data.

Aleksandar Shivarov; Soile Kulmala; Marko Lindroos

2005-01-01

445

Uncompressed video image transmission of laparoscopic or endoscopic surgery for telemedicine.  

PubMed

Traditional narrowband telemedicine cannot provide quality dynamic images. We conducted videoconferences of laparoscopic and endoscopic operations via an uncompressed video transmission technique. A superfast broadband Internet link was set up between Shanghai in the People's Republic of China and Fukuoka in Japan. Uncompressed dynamic video images of laparoscopic and endoscopic operations were transmitted by a digital video transfer system (DVTS). Seven teleconferences were conducted between June 2005 and June 2007. Of the 7 teleconferences, 5 were live surgical demonstrations and 3 were recorded video teleconsultations. Smoothness of the motion picture, sharpness of images, and clarity of sound were benefited by this form of telemedicine based upon DVTS. Telemedicine based upon DVTS is a superior choice for laparoscopic and endoscopic skill training across the borders. PMID:18578684

Huang, Ke-Jian; Qiu, Zheng-Jun; Fu, Chun-Yu; Shimizu, Shuji; Okamura, Koji

2008-06-01

446

Telemedicine in extreme conditions: supporting the Martin Strel Amazon Swim Expedition.  

PubMed

Slovenian Martin Strel, the Guinness world record holder in ultra marathon swimming, recently set a new world record by swimming the entire Amazon River. Over a 66-day period beginning in Atalaya, Peru, he swam to the Atlantic Ocean at Belém, Brazil. This record-breaking swim was part of the Amazon Swim Expedition. This entire mission was supported by a comprehensive medical team, the Amazon Virtual Medical Team (AVMT), which provided medical support using telemedicine. The AVMT, a multinational volunteer group of specialists, physicians, and telemedicine experts, provided medical support 24/7 in some of the most remote, dangerous, basin. The AVMT was directed basin. The AVMT was directed by Dr. Rifat Latifi and expedition team physician, Dr. Mateja de Leonni Stanonik, who was aboard the boat during the entire expedition. The expedition provided a unique opportunity to promote telemedicine and e-health in over 17 communities in the Amazon basin. PMID:19199853

Latifi, Rifat; Stanonik, Mateja de Leonni; Merrell, Ronald C; Weinstein, Ronald S

2009-01-01

447

Iowa's National Laboratory for the study of Rural Telemedicine: a description of a work in progress.  

PubMed Central

As the federal administration advances the idea of the "information superhighway," many disciplines are being challenged to find ways to use advanced telecommunications to improve access to information, enhance learning opportunities, and achieve higher levels of international competitiveness. Telemedicine, the use of communications technology in the practice of medicine, may change the way rural health care is provided by improving access to medical information, diagnostic tools, and consultations. The information and health care services required by health care professionals are rapidly changing, and dissemination of this information to isolated practitioners has proven to be difficult. By providing support electronically from a central site, the most current information is more readily available. Using test-bed hospitals in rural and urban settings, the National Library of Medicine-funded National Laboratory for the Study of Rural Telemedicine at the University of Iowa is currently developing the necessary infrastructure to support targeted projects studying how telemedicine applications can be made more effective and readily available.

Kienzle, M; Curry, D; Franken, E A; Galvin, J; Hoffman, E; Holtum, E; Shope, L; Torner, J; Wakefield, D

1995-01-01

448

Approaches to Teaching: Adapting Cases in Operations Management for Use in the Technical Writing Classroom.  

ERIC Educational Resources Information Center

|Describes how technical writing teachers can adapt existing operations management cases for the writing classroom by recognizing communication gaps and filling them with appropriate writing scenarios. (ARH)|

Morrow, John

1988-01-01

449

A Web Application to Support Telemedicine Services in Brazil  

PubMed Central

This paper describes a system that has been developed to support Telemedicine activities in Brazil, a country that has serious problems in the delivery of health services. The system is a part of the broader Tele-health Project that has been developed to make health services more accessible to the low-income population in the northeast region. The HealthNet system is based upon a pilot area that uses fetal and pediatric cardiology. This article describes both the system’s conceptual model, including the tele-diagnosis and second medical opinion services, as well as its architecture and development stages. The system model describes both collaborating tools used asynchronously, such as discussion forums, and synchronous tools, such as videoconference services. Web and free-of-charge tools are utilized for implementation, such as Java and MySQL database. Furthermore, an interface with Electronic Patient Record (EPR) systems using Extended Markup Language (XML) technology is also proposed. Finally, considerations concerning the development and implementation process are presented.

Barbosa, Ana Karina P.; de A. Novaes, Magdala; de Vasconcelos, Alexandre M. L.

2003-01-01

450

Transmission of olfactory information for tele-medicine  

SciTech Connect

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

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

1995-01-01

451

An overview of recent end-to-end wireless medical video telemedicine systems using 3G.  

PubMed

Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven. PMID:21097209

Panayides, A; Pattichis, M S; Pattichis, C S; Schizas, C N; Spanias, A; Kyriacou, E

2010-01-01

452

Case-management for Patients with Schizophrenia in Iran: A Comparative Study of the Clinical Outcomes of Mental Health Workers and Consumers’ Family Members as Case Managers  

Microsoft Academic Search

The objective of this study was to evaluate the effectiveness of case-management services and the feasibility of considering\\u000a the Consumers’ Family Members (CFM) as service providers in Iran as a developing country. Three trained case-managers were\\u000a allocated into each group (Mental Health Worker-MHW and CFM), providing 12 months of home-visit services for 129 individuals\\u000a with schizophrenia. Burden, knowledge, quality of life

Seyed Kazem Malakouti; Marzieh Nojomi; Lili Panaghi; Narjes Chimeh; Yasaman Mottaghipour; Mohammad Taghi Joghatai; Ahmad Ali Noorbala; Jafar Bolhari

2009-01-01

453

Effectiveness of case management with severely and persistently mentally ill people.  

PubMed

This meta-analytic review synthesizes the findings of 24 published studies dealing with the effectiveness of case management with the severely and persistently mentally ill. Summative findings were: (1) Overall, case management interventions are effective--75% of the clients who participate in them do better than the average client who does not; (2) The estimated preventive fraction (e.g., prevention of re-hospitalization) among clients who experience relatively intense case management service (case loads of 15 or less, 89%) is nearly 30% greater than that estimated among similar clients receiving less intensive service; and (3) Various case management practice models did not differ significantly on estimated effectiveness. Important questions concerning the differential effectiveness of case management by specific program, worker, client, and client-worker relationship characteristics remain to be answered. PMID:9607161

Gorey, K M; Leslie, D R; Morris, T; Carruthers, W V; John, L; Chacko, J

1998-06-01

454

HIPAA Business Associate Contracts: the value of contracts for case managers.  

PubMed

Case Managers are in the middle of the upcoming HIPAA regulation changes, with the issuance of the Final Privacy Rule. Every case obliges case managers to work with Individually Identifiable Health Information (IIHI) and Protected Health Information (PHI). The purpose of this article is to provide case managers in all practice settings with a clear understanding of a "Business Associate," of a "Covered Entity," and of the specifics of a Business Associate Contract. This information will demonstrate how case managers can benefit from the use of these contracts in their business life. As an essential component of an organization's compliance plan, Business Associate Contracts can become a sword or a shield. This article is particularly helpful to case managers in independent practice, as well as those who work for Covered Entities. PMID:12555038

Muller, Lynn S

455