Sample records for telemedicine case management

  1. Telemedicine for wound management

    PubMed Central

    Chittoria, Ravi K.

    2012-01-01

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

  2. A qualitative study of the experiences and satisfaction of direct telemedicine providers in diabetes case management.

    PubMed

    Sandberg, Jonathan; Trief, Paula M; Izquierdo, Roberto; Goland, Robin; Morin, Philip C; Palmas, Walter; Larson, Carly D; Strait, James G; Shea, Steven; Weinstock, Ruth S

    2009-10-01

    Telehealth interventions are feasible and efficacious. While patients are the focus of both quantitative and qualitative studies that assess their response to telehealth, little is known about the view of providers of telehealth services. The purpose of this study was to better understand the experiences of providers and the factors that they perceive to contribute to the success of telehealth interventions as well as to their own satisfaction. Face-to-face or telephone interviews were conducted with 10 diabetes educators (nurses and dietitians) who served as providers of a telemedicine case management intervention for older adults who have diabetes. Qualitative analyses revealed that providers were very satisfied with their experience and felt their efforts with patients were generally successful. Providers also identified a number of unique benefits to telehealth interventions. These included opportunities for more frequent contact with patients, greater relaxation and information due to the ability to interact with the patients in their own homes, increased ability to reach the underserved, more timely and accurate medical monitoring, and improved management of data. The primary disadvantages of telehealth they identified were technology problems and a concern about the lack of physical contact with patients. Findings illustrate providers' perspectives on the unique advantages of telehealth and offer insight as to how to make telehealth interventions more effective, as well as more satisfying for those who do the day-to-day work of providing the interventions. PMID:19780691

  3. 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

    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

    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

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

    PubMed

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

    2015-08-01

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

  5. An ontology-based telemedicine tasks management system architecture

    Microsoft Academic Search

    Ebrahim Nageba; Jocelyne Fayn; Paul Rubel

    2008-01-01

    The recent developments in ambient intelligence and ubiquitous computing offer new opportunities for the design of advanced Telemedicine systems providing high quality services, anywhere, anytime. In this paper we present an approach for building an ontology-based task-driven telemedicine system. The architecture is composed of a task management server, a communication server and a knowledge base for enabling decision makings taking

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

    PubMed

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

    2008-01-01

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

  7. Telemedicine.

    PubMed

    Dorman, T

    2000-09-01

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

  8. An ontology-based telemedicine tasks management system architecture.

    PubMed

    Nageba, Ebrahim; Fayn, Jocelyne; Rubel, Paul

    2008-01-01

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

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

    PubMed

    Rubin, Mark N; Demaerschalk, Bart M

    2014-01-01

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

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

    PubMed Central

    Spaeder, Jeffrey A.

    2002-01-01

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

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

    PubMed

    Kyriacou, E; Fakas, G; Pavlaki, V

    2006-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Identity-management factors in e-health and telemedicine applications.

    PubMed

    Savastano, Mario; Hovsto, Asbjorn; Pharow, Peter; Blobel, Bernd

    2008-01-01

    Reliable identification is essential in e-health and telemedicine applications. This necessitates a secure and trustworthy method of communication and collaboration between parties, which depends on common acceptance. This in turn is related to privacy and ethical matters. Different technologies, including biometrics and RFID, allow high levels of security and safety in identifying both human beings and goods. However, the diffusion of standards relating to identity management in e-health is far from satisfactory. In order to support standardization in e-health, the European Commission funded the BioHealth project. This project has proved to be useful in promoting standards and creating awareness among the stakeholders. PMID:18852323

  14. The management and policy challenges of the globalisation effect of informatics and telemedicine.

    PubMed

    Rigby, M

    1999-01-01

    Managers and policy makers face new and as yet unrecognised challenges--particularly loss of control--through the application of new information technologies in healthcare. Whilst informatics and telemedicine are important developments, the potential for adverse organisational and societal effects should be recognised and anticipated. Health organisations are frequently seen as circumscribed networks, and these in turn form local alliances with related organisations. Information technologies are frequently construed as relating to operational systems within organisations, not least electronic patient record systems and diagnostic systems. These can then be linked to new generation health business systems, to provide accurate management information at low additional cost. However, this pair of assumptions is now seriously flawed, due to the effects of the latest developments in health informatics and telemedicine. In particular, telecommunications and Internet technologies render ineffectual previous external barriers of distance and national boundaries, whilst within the organisation the combination of knowledge bases with information technologies creates tendencies towards internal autonomy. Organisational and national policy control of health care face direct and radical challenges through perverse effects of otherwise beneficial developments, and early action is needed. PMID:10346288

  15. Telemedicine in neurosurgical daily practice.

    PubMed

    Schulmeyer, F J; Brawanski, A

    1999-01-01

    Telemedicine has been in daily practice at our neurosurgical department for five years. In our experience the standard personal computer-based telemedicine systems Medicom and especially RADO Look are reliable, easy to use, and of high quality performance. Telemedicine makes possible better patient management at regional hospitals and the avoidance of patient transports. Therefore treatment costs in neurosurgical patients can be highly reduced. PMID:10747528

  16. Success and failure: a case study of two rural telemedicine projects.

    PubMed

    Whitten, Pamela; Adams, Inez

    2003-01-01

    We studied two rural telemedicine projects in the state of Michigan: one that enjoyed success and steady growth in activity, and one that experienced frustration and a lack of clinical utilization. Multiple data collection strategies were employed during study periods, which lasted approximately one year. Both projects enjoyed a grassroots approach and had dedicated project coordinators. However, the more successful project benefited from resources and expertise not available to the less successful project. In addition, the more successful project possessed a more formalized organizational structure for the telemedicine application. A comparison of the two projects leads to a simple conclusion. Telemedicine programmes are positioned within larger health organizations and do not operate in a vacuum. It is crucial that the organization in which it is intended to launch telemedicine is examined carefully first. Each organization operates within a larger environment, which is often constrained by fiscal, geographical and personnel factors. All these will affect the introduction of telemedicine. PMID:12877772

  17. Watermarking - a new way to bring evidence in case of telemedicine litigation.

    PubMed

    Coatrieux, Gouenou; Quantin, Catherine; Allaert, François-André; Auverlot, Bertrand; Roux, Christian

    2011-01-01

    When dealing with medical data sharing, in particular within telemedicine applications, there is a need to ensure information security. Being able to verify that the information belongs to the right patient and is from the right source or that it has been rerouted or modified is a major concern. Watermarking, which is the embedding of security elements, such as a digital signature, within a document, can help to ensure that a digital document is reliable. However, at the same time, questions arise about the validity of watermarking-based proof. In this paper, beyond the technical aspects, we discuss the legal acceptability of watermarking in the context of telemedicine applications. PMID:21893821

  18. Applications of Telemedicine and Telecommunications to Disaster Medicine

    PubMed Central

    Garshnek, Victoria; Burkle, Frederick M.

    1999-01-01

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

  19. Development of a telemedicine model for emerging countries: a case study on pediatric oncology in Brazil.

    PubMed

    Hira, A Y; Nebel de Mello, A; Faria, R A; Odone Filho, V; Lopes, R D; Zuffo, M K

    2006-01-01

    This article discusses a telemedicine model for emerging countries, through the description of ONCONET, a telemedicine initiative applied to pediatric oncology in Brazil. The ONCONET core technology is a Web-based system that offers health information and other services specialized in childhood cancer such as electronic medical records and cooperative protocols for complex treatments. All Web-based services are supported by the use of high performance computing infrastructure based on clusters of commodity computers. The system was fully implemented on an open-source and free-software approach. Aspects of modeling, implementation and integration are covered. A model, both technologically and economically viable, was created through the research and development of in-house solutions adapted to the emerging countries reality and with focus on scalability both in the total number of patients and in the national infrastructure. PMID:17947134

  20. Telemedicine Program

    NASA Technical Reports Server (NTRS)

    1996-01-01

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

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

    PubMed

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

    2015-06-01

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

  2. Evaluating telemedicine systems and services.

    PubMed

    Taylor, Paul

    2005-01-01

    The evaluation of telemedicine involves attempts to answer a wide range of questions involved in making decisions about safety, about practicality and about utility. Roughly speaking, if we wish to provide a telemedicine service we should first establish that it is safe, next that it is practical and finally that it is worthwhile. In establishing safety, most laboratory studies of telemedicine have a common structure, and consist of the following steps: (1) selection of cases; (2) interpretation; (3) comparison with a gold standard; (4) statistical analyses. Most of the studies to establish the practicality of telemedicine have been carried out as demonstrations, to show that a proposed application can be implemented in a chosen setting. In terms of utility, telemedicine has been used to improve the efficiency of an existing service or to make an existing service available to a new community. One of the difficulties is that the vendors of relatively expensive telemedicine systems and services disseminate much of the information on the topic. We have to focus not on the glamorous technology but on the underlying issue of how the participants in health care (patients, general practitioners, specialists) can communicate more effectively, using the range of technological options open to them. Ensuring that the most appropriate technology is used in the most effective way should be the primary aim of telemedicine research. There is now sufficient evidence for us to be confident that telemedicine is a safe alternative to conventional care in a variety of situations and for a number of clinical conditions. Reliable evidence that it is a practical and cost-effective alternative is, at the time of writing, harder to find. PMID:15969791

  3. The future of telemedicine--take the organizational challenge!

    PubMed

    Aas, I H Monrad

    2007-01-01

    Implementation of telemedicine has not been as rapid as was expected in the 1990s. Diffusion of technologies can be complex and is known to be influenced by many factors. Organizational problems are crucial for the future of telemedicine, but have been gravely underestimated. When a telemedicine service is established we have a virtual organization. Internal organizational consequences of telemedicine are very common and more effective use of the technology is likely to require organizational changes. For different applications of the technology there are similarities, and differences, in internal organizational consequences. Organizational matters connected with telemedicine are dealt with in a new book, The Organizational Challenge for Health Care from Telemedicine and E-health, the full text of which is available via the Internet. In the book, solutions are outlined for common organizational problems in telemedicine. Managers must actively lead organizational changes. Replacing simplified optimism with realism may be very important for the future of telemedicine. PMID:18078546

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

    PubMed

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

    2001-01-01

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

  5. Telemedicine and beyond.

    PubMed

    Voran, David

    2015-01-01

    There is a resurgence of interest in telemedicine fueled by technology advancements and impending changes in reimbursement. Understanding various types of telemedicine helps separate hype from fact. This paper discusses the various forms of telemedicine; reviews telemedicine policy and regulatory status with emphasis in our [Missouri and Kansas] region; lists legislative, interstate licensing and reimbursement initiatives; and discusses future telemedicine trends with special attention to mobile devices. PMID:25958658

  6. Patient perspectives of telemedicine quality

    PubMed Central

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

    2015-01-01

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

  7. Using Telemedicine to Conduct Behavioral Assessments

    PubMed Central

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

    2006-01-01

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

  8. Telemedicine: Pediatric Applications.

    PubMed

    Burke, Bryan L; Hall, R W

    2015-07-01

    Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine's current use bears testimony to its effectiveness and potential. Telemedicine's widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits. PMID:26122813

  9. Information on telemedicine.

    PubMed

    Brown, Nancy A

    2005-01-01

    Although the practice of telemedicine is still not considered part of mainstream health care, there has been a steady growth in information about telemedicine since 1999. The increasing body of literature about telemedicine, the staying power of various telemedicine societies and Websites, and the growing number of well-attended conferences about telemedicine all attest that interest in and the practice of telemedicine worldwide are very much alive and well. Searching for information has also become easier with the advent of better and faster search engines, particularly Google. Nonetheless, many Websites are out of date and the semantic confusion between 'telemedicine' and other terms such as 'telehealth' means that considerable perseverance is required to sift the wheat from the chaff. There is a wide variety of both electronic and print resources that have proven to be reliable sources of information. These include: the Internet (Web), books and reports, journals and trade magazines, telemedicine societies and conferences. While telemedicine cannot yet be considered to be part of mainstream health care, it has become a more familiar part of health terminology worldwide. PMID:15901438

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

    E-print Network

    McSharry, Patrick E.

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

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

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  12. Nuclear telemedicine

    NASA Astrophysics Data System (ADS)

    Morrison, R. T.; Szasz, I. J.

    1990-06-01

    Diagnostic nuclear medicine patient images have been transniitted for 8 years from a regional conununity hospital to a university teaching hospital 700 kiloinetres away employing slow scan TV and telephone. Transruission and interpretation were done at the end of each working day or as circumstances required in cases of emergencies. Referring physicians received the nuclear medicine procedure report at the end of the completion day or within few minutes of completion in case of emergency procedures. To date more than 25 patient studies have been transmitted for interpretation. Blinded reinterpretation of the original hard copy data of 350 patient studies resulted in 100 agreement with the interpretation of transmitted data. This technique provides high quality diagnostic and therapeutic nuclear medicine services in remote hospitals where the services of an on-site nuclear physician is not available. 2. HISTORY Eight years ago when the nuclear medicine physician at Trail Regional Hospital left the Trail area and an other could not be recruited we examined the feasibility of image transmission by phone for interpretation since closing the department would have imposed unacceptable physical and financial hardship and medical constraints on the patient population the nearest nuclear medicine facility was at some 8 hours drive away. In hospital patients would have to be treated either based purely on physical findings or flown to Vancouver at considerable cost to the health care system (estimated cost $1500.

  13. Managing Case Managers: Case Management in Service Integration. Resource Brief.

    ERIC Educational Resources Information Center

    Marks, Ellen L.

    As the case management approach has become increasingly popular, a new phenomenon has emerged. A client may have several case managers, each employed by a different project, and these managers may not be aware of each other. The National Center for Children in Poverty has recently conducted research on case management in service integration…

  14. American Telemedicine Association

    MedlinePLUS

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

  15. Telemedicine development: setting the record straight.

    PubMed

    Merrell, Ronald C

    2004-01-01

    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

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

    PubMed Central

    Wootton, Richard; Liu, Joanne; Bonnardot, Laurent

    2014-01-01

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

  17. Telemedicine in the Solomon Islands: 2006 to 2009.

    PubMed

    Martiniuk, Alexandra; Negin, Joel; Hersch, Fred; Dalipanda, Tenneth; Jagilli, Rooney; Houasia, Patrick; Gorringe, Lilijana; Christie, Annie

    2011-01-01

    Telemedicine has been used in the Solomon Islands since 2000. We used quantitative and qualitative methods to examine telemedicine use in the Solomon Islands from January 2006 to June 2009. During the study period 66 telemedicine cases were submitted to the store and forward telemedicine system being used there. These included orthopaedic, oncology, cardiothoracic, infectious, congenital, gastroenterology and dermatology cases. Most cases (52%) were submitted by doctors at the National Referral Hospital (NRH) in Honiara. The majority of responses came from the NRH (27%). A final, firm recommendation regarding patient diagnosis and/or care was given for 46% of the cases. Interviews were conducted with 23 stakeholders in the Solomon Islands and in Australia to better understand the current and future use of telemedicine. The interviews identified the fragility of the Solomon Islands infrastructure, including the lack of training, as the largest barrier to the future use of telemedicine. The best use of telemedicine appears to be case sharing within the Solomon Islands, with connections to clinicians in other countries as a secondary benefit when particular expertise is required. PMID:21628420

  18. Telemedicine, virtual reality, and surgery

    NASA Technical Reports Server (NTRS)

    Mccormack, Percival D.; Charles, Steve

    1994-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  20. Mobile telemedicine: a survey study.

    PubMed

    Lin, Chin-Feng

    2012-04-01

    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

  1. Network basics for telemedicine.

    PubMed

    Gemmill, Jill

    2005-01-01

    Early telemedicine networks employed dedicated telecommunications circuits (e.g. leased digital lines) in which the sender and receiver were connected by a private circuit. More recently, the Internet has become widely available for general use, including telemedicine. The Internet was engineered to permit network paths to be shared by all users, so data transmission is fundamentally different from traditional, circuit-switched networks. Early telemedicine applications demonstrated the feasibility of Internet Protocol transmission. The basic performance criteria to use in evaluating newer digital communications technologies that carry both voice and data are: (1) bandwidth; (2) packet loss; (3) end-to-end delay; (4) jitter; (5) privacy and security. Network engineering involves performance trade-offs between the hardware, architecture, security and the budget available. A telemedicine application may be running over a network whose design is entirely under the user's control, or the application may employ some part of the Internet whose design is unknown to the user. If an application is not running to satisfaction, then a network engineer should be consulted. PMID:15829050

  2. Telemedicine in otolaryngology

    Microsoft Academic Search

    David Goldenberg; Barry L. Wenig

    2002-01-01

    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

  3. Integrating telemedicine and telehealth: putting it all together.

    PubMed

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

    2008-01-01

    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

  4. Thyroid cancer: possible role of telemedicine Ruolo della telemedicina nella gestione di pazienti con carcinoma tiroideo

    Microsoft Academic Search

    G. GIBELLI; B. GIBELLI; F. NANI

    SUMMARY Telemedicine is extremely useful when distance could hinder diagnostic procedures, disease management, or when severe side-effects may occur in patients not within easy reach of medical care and requiring prompt action and specifi c therapies. Telemedicine has been successfully adopted in the management of chronic patients, particularly in those with cardiologic or oncologic diseases. In the treatment of differentiated

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

    E-print Network

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

    2009-01-01

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

  6. [Case management education in nursing].

    PubMed

    Liu, Wen-I; Edwards, Helen; Courtney, Mary

    2008-06-01

    In Taiwan, few articles have been published that describe case management education for nurses. This article reviews case management literature and aims to introduce case management definitions, a comparison between the nursing process and the case management process, current case management educational programs and core content for case management education. Finally, suggestions identified from the literature review for Taiwanese nursing education will be discussed. On the basis of evidence of case management's effectiveness in saving health costs and providing better quality of care, case management strategies are currently being implemented in a variety of settings with different populations under a range of conditions. Case management services are assisted by knowledgeable and skilled healthcare professionals called case managers. With their background of professional knowledge and skills and their familiarity with the nursing process, nurses have been the main case managers. A case manager's educational preparation is the key to successful case management. In other countries, many formal and informal case management educational programs have become available to prepare the nursing profession for the demands of the job market. Six essential knowledge areas and three categories of skills are identified for case management education. Developing a formal case management education program in nursing schools and offering continuing professional education for nurse case managers are suggested for Taiwanese nursing education to prepare nurses for case management. Collaboration between nursing academia and nursing practice might be considered an effective strategy to promote the development of case management practice in nursing. PMID:18543189

  7. The evolution of telemedicine and nano-technology

    NASA Astrophysics Data System (ADS)

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

    2012-10-01

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

  8. Effect of telemedicine on patients' diagnosis and treatment.

    PubMed

    Bynum, Ann B; Cranford, Charles O; Irwin, Cathy A; Banken, Joseph A

    2006-01-01

    We conducted a post-consultation survey during 1998-2002 (n = 412 consultations) in the Rural Hospital Telehealth Project run by the University of Arkansas for Medical Sciences. Changes in the patient's diagnosis and treatment plan as a result of the telemedicine session were assessed. There were 47 consultants, who conducted 2-82 consultations each. The teleconsultants established a diagnosis in 74 consultations. This was 26% of the 286 respondents. Of the 63 respondents for cases where there was a prior diagnosis and a change was applicable, 17 consultants (27%) reported that there was a change in the patient's diagnosis. The consultants established a patient treatment plan in 139 consultations. This was 52% of the 268 respondents. Of the 123 respondents for cases where there was a prior treatment plan and a change was applicable, 82 (67%) consultants reported a change in the treatment plan. The changes in diagnosis and management imply benefits for the rural population in Arkansas as a result of the use of telemedicine. PMID:16438778

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

    PubMed Central

    2014-01-01

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

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

    PubMed

    Amadi-Obi, Ahjoku; Gilligan, Peadar; Owens, Niall; O'Donnell, Cathal

    2014-01-01

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

  11. Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study.

    PubMed

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

    2015-03-01

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

  12. Telemedicine: socio-ethical considerations in the Indian milieu.

    PubMed

    Sharma, Luv K; Rajput, Meena

    2009-01-01

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

  13. Telemedicine in Alentejo.

    PubMed

    Oliveira, Tiago Cravo; Bayer, Steffen; Gonçalves, Luís; Barlow, James

    2014-01-01

    Alentejo covers a third of Portugal, yet it is home to only 5% of the population. Residents of the region are poorer, older, and less educated than the rest of the country. There is a shortage of physicians in several specialties. The low population density, a concentration of specialized services, and a poor public transportation network all create barriers to access. Telemedicine was introduced in 1998 to help address these challenges. In this article, we provide an overview of the program and its current status, focusing on infrastructure, services, and activity volume. We also discuss the impact the program has had from the perspectives of patients and healthcare professionals. From 1998 to 2011, there were 132,546 episodes of service using telemedicine, including real-time teleconsultations, teleradiology, teleultrasound, and telepathology. At present, the network includes 20 primary care units and five hospitals, covering almost 30,000 km(2) and 500,000 people. Units have high-resolution videoconferencing equipment, access to patients' clinical records, an image archive, and peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are available in 15 medical specialties and areas, ranging from neurology to pediatric surgery. In 2008, regional health authorities started a tele-education program, and by the end of 2011, 876 healthcare professionals, across 52 locations, had participated in remote learning sessions. More than a decade since telemedicine was introduced in Alentejo, it is now an integral part of everyday service provision. A comprehensive assessment of the costs and consequences of the program is currently underway. PMID:24180419

  14. Telemedicine in Alentejo

    PubMed Central

    Bayer, Steffen; Gonçalves, Luís; Barlow, James

    2014-01-01

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

  15. 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 Central

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

    2013-01-01

    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

  16. Case Management Services. Chapter 7.

    ERIC Educational Resources Information Center

    1996

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

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

    PubMed

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

    2014-09-01

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

  18. A review of Scottish telemedicine.

    PubMed

    Maclean, J R; Brebner, J A; Norman, J N

    1995-01-01

    Telemedicine services have been provided from Scotland for many years. Initial activities centred on the provision of health care to workers on the oil installations in the North Sea, to mixed-gas divers supporting the oil industry, and to scientific staff in British Antarctic Territory. Other Scottish research work has contributed to space medicine. The remote location of much of the Scottish population is currently the reason for much telemedicine research. This paper reviews the past quarter of a century of telemedicine in Scotland and identifies the principles that have led to success in some challenging locations. The same principles can be expected to apply when telemedicine services are provided more generally. PMID:9375111

  19. Information issues in telemedicine systems.

    PubMed

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

    1995-01-01

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

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

    E-print Network

    McSharry, Patrick E.

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

  1. Hierarchical Model Based LAN Architecture & VSAT-based WAN for a National Telemedicine Network in a Developing Country: Case of Ethiopia

    Microsoft Academic Search

    Fikreyohannes Lemma; Mieso K. Denko; Samuel Kinde Kassegne

    Due to difficult terrain and limited transportation infrastructures, developing countries continue to suffer from the absence of extended and adequate medical and healthcare services. This inadequacy in basic health services is often accompanied by very low patient-doctor ratios. It has been suggested that telemedicine offers a basis for a cost-effective health-care system in geographical remote areas in such developing countries

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

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

  3. Coastal Management case study

    NSDL National Science Digital Library

    Anne Jefferson

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

  4. Chapter 1 Introduction 1.1 Telemedicine

    E-print Network

    Qi, Xiaojun

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

  5. Telemedicine in neurosurgical emergency: Indian perspective.

    PubMed

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

    2012-04-01

    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

  6. Secure mobile agent for telemedicine based on P2P networks.

    PubMed

    Hsu, Wen-Shin; Pan, Jiann-I

    2013-06-01

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

  7. Clinical aspects of telemedicine

    NASA Technical Reports Server (NTRS)

    Merrell, Ronald C.

    1991-01-01

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

  8. A surgical telemedicine clinic in a correctional setting.

    PubMed

    Lavrentyev, Vladimir; Seay, Arden; Rafiq, Azhar; Justis, Deborah; Merrell, Ronald C

    2008-05-01

    The telemedicine network between Virginia Commonwealth University Health System (VCUHS) and the Department of Corrections in Virginia has seen a steady increase in the number of disciplines involved in consultation. Hardware integration and methodologies between VCUHS and correctional facilities were supported by Polycom videoconferencing technology. During consults, a VCUHS-based surgeon was provided with patient records, picture archiving and communication system images, and laboratory data or text reports sent by fax. A registered nurse at the correctional site assisted the surgeon at VCUHS. Electronic stethoscope and dermascope were also used for physical examination of inmates. Preoperative encounters included physical examination and informed consent from video. Electronic scheduling and preoperative orders were issued at the time of consultation. Of the 55 consultations completed this past year, 27 were followed by surgical procedures. In one case, the referral diagnosis was corrected and one case required minor change in diagnosis at an in-person examination on the day of surgery. Twenty patients had postoperative examination by telemedicine, and five of these required a second follow-up telemedicine visit. All patients confirmed their informed consent and acknowledged their surgeon upon first meeting face to face at the hospital. Telemedicine consultation for general surgery is an effective asset and can limit patient transfer. PMID:18570570

  9. Telemedicine in the Federated States of Micronesia.

    PubMed

    Rutstein, D

    2000-09-01

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

  10. A generic task-driven multi-agent telemedicine system.

    PubMed

    Nageba, Ebrahim; Fayn, Jocelyne; Rubel, Paul

    2007-01-01

    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 on which they run. Unfortunately, the existing telemedicine systems do not pay enough attention to the quality level of their offered services nor offer adequate resources management for meeting bandwidth and end-to-end communication delays. In this paper we propose an information and communication architecture of a generic telemedicine system based on a knowledge base and intelligent agents interacting each with the other in a synergetic way to perform several medical tasks for a high level of quality of service (QoS). The medical assistance to skiers and high mountains resorts residents will be used in particular as an example of applicability scenario and models personalization. PMID:18002809

  11. Web-based home telemedicine system for orthopedics

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

    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.

  12. Telemedicine in the service of peace.

    PubMed

    Shanit, Dan; Striebel, Werner; Michelson, Georg; Ayed, Saida; Al Assi, Samer; Belfair, Nadav; Ben-Simon, Guy; Hamida, Fafani; Kanawati, Charlie; Lifshitz, Tova; Madia, Ghassan; Rafi, Mostafa; Tahat, Atef; Treister, Giora; Tucktuck, Khalid; Zaghloul, Khalid

    2002-01-01

    Ophthalmology is well suited to telemedicine, since optical and imaging devices provide the basis for virtually all ophthalmic patient evaluations. We established the Middle East Ophthalmology Network among ophthalmologists working in 10 major ophthalmology centres in Israel, Jordan, Morocco, the Palestinian Authority and Tunisia. The project offered some 50 physicians around the Middle East the opportunity to benefit from sharing clinical consultation for diagnosis and management decisions beyond physical and political boundaries. In the first year, over 100 consultations took place. The system overcame some of the constraints imposed by the uneven distribution of medical resources and expertise in the region, reduced professional isolation, encouraged more collaboration between physicians and offered peace dividends from cooperation between physicians across the political divide. PMID:12217146

  13. Telemedicine: experience at SGPGIMS, Lucknow.

    PubMed

    Kapoor, L; Mishra, S K; Singh, Kartar

    2005-01-01

    Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) located in Lucknow, capital of Uttar Pradesh, a state in Northern India, is a tertiary level referral academic medical center involved in teaching and training of super specialist medical professionals with 22 academic departments. It is the first tertiary care hospital in public healthcare sector in India to adopt Information Technology (IT) for healthcare delivery. The Hospital Information System (HIS) was implemented in 1998 to record, store, process and retrieve health data of all the patients. This software was developed in-house in collaboration with Center for Development of Advanced Computing (C- DAC), Pune. Later in the year 1999, telemedicine activities were initiated in the form of testing the concept and technology. The first research grant was availed of in the year 2001, which helped in creating an infrastructure for telemedicine. Regular tele-healthcare and tele-educational services were introduced for the postgraduate students of medical colleges of Orissa. These services have now been extended to educate the doctors of other medical colleges and community centers in other states. Besides, the Institute is associated with organizational activities and in policy initiatives of the government. All the activities are in project mode and are being financially supported by government agencies such as Indian Space Research Organisation (ISRO) and Department of Information Technology. Looking at the need of skilled manpower in the field of telemedicine and e-health, a school of telemedicine is coming up in the campus, which will also provide core infrastructure for research and development. PMID:16388175

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

    PubMed

    2015-07-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. CSCW Based Telemedicine on the Internet

    Microsoft Academic Search

    Seok-soo Kim; Dae-joon Hwang

    2001-01-01

    This paper proposes a telemedicine system which is a CBM-based real-time interactive telemedicine system using a personal computer on the Internet. This system presents an intelligent remote medical examination system for both online and offline modes to transcend time and space on the Web. It can be used by anybody and is cheaper than existing remote medical examination systems. The

  17. Case management: a model of CNS practice.

    PubMed

    Trinidad, E A

    1993-07-01

    Case management has been widely implemented as a new health care delivery model. The case manager has the pivotal role in the model. The CNS, having the clinical expertise, clinical judgment, and leadership, best suits the case manager's role. As a case manager, the CNS enacts the five role components: expert practitioner, educator, consultant, researcher, and manger. Case management, therefore, can be considered as a model of CNS advanced practice. PMID:8348464

  18. Case Studies in Broadcast Management.

    ERIC Educational Resources Information Center

    Coleman, Howard W.

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

  19. Telemedicine for Epilepsy Support in Resource-Poor Settings

    PubMed Central

    Patterson, Victor

    2014-01-01

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

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

    PubMed

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

    2015-02-01

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

  1. An architecture for naval telemedicine.

    PubMed

    Chimiak, W J; Rainer, R O; Chimiak, J M; Martinez, R

    1997-03-01

    Navy fleets have a defined overall objective for mission readiness impacted by the health of personnel aboard the ships. Medical treatment facilities on the ships determines the degree of mission readiness. This paper describes the concepts and technologies necessary to establish a Naval telemedicine system, which can drastically improve health care delivery. It consists of various combinations of the following components: Fleet Naval Medical Consultation and Diagnostic Centers, Shipboard Naval Medical Consultation and Diagnostic Centers (hospital ship or combatant ships with medical specialists on board), and Remote Medical Referring Centers such as a ship, a small Naval station annex, or a field hospital. This Naval telemedicine architecture delivers clinical medicine and continuing medical education (CME) by means of computers, video-conferencing systems, or telephony to enhance the quality of care through improved access to research, medical and nonmedical imaging, remote consultations, patient clinical data, and multimedia medical education programs. It integrates the informatics infrastructure and provides a medical telepresence among participants. PMID:11020812

  2. Towards grid-enabled telemedicine in Africa

    E-print Network

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

    2006-01-01

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

  3. Virtual doctor's office telemedicine delivery system 

    E-print Network

    Sainath, Paavana

    2002-01-01

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

  4. The telemedicine information exchange: an online resource.

    PubMed

    Brown, N A

    1998-09-01

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

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

    PubMed Central

    Patterson, Victor; Wootton, Richard

    2013-01-01

    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

  6. Design of a multimedia PC-based telemedicine network for the monitoring of renal dialysis patients

    NASA Astrophysics Data System (ADS)

    Tohme, Walid G.; Winchester, James F.; Dai, Hailei L.; Khanafer, Nassib; Meissner, Marion C.; Collmann, Jeff R.; Schulman, Kevin A.; Johnson, Ayah E.; Freedman, Matthew T.; Mun, Seong K.

    1997-05-01

    This paper investigates the design and implementation of a multimedia telemedicine application being undertaken by the Imaging Science and Information Systems Center of the Department of Radiology and the Division of Nephrology of the Department of Medicine at the Georgetown University Medical Center (GUMC). The Renal Dialysis Patient Monitoring network links GUMC, a remote outpatient dialysis clinic, and a nephrologist's home. The primary functions of the network are to provide telemedicine services to renal dialysis patients, to create, manage, transfer and use electronic health data, and to provide decision support and information services for physicians, nurses and health care workers. The technical parameters for designing and implementing such a network are discussed.

  7. [Current capabilities of telemedicine in anaesthesiology].

    PubMed

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

    2015-03-01

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

  8. Increasing quality through telemedicine in the intensive care unit.

    PubMed

    Kalb, Thomas H

    2015-04-01

    This article explores the hypothesis that a telemedicine intensive care unit (Tele-ICU) platform is uniquely suited to facilitate quality performance improvement (PI). This article addresses some substantial hurdles to overcome that may limit the effectiveness of a Tele-ICU platform to achieve PI objectives. Lastly, this article describes the author's experience with a PI project to improve ventilator management conducted via a Tele-ICU hub interacting with 11 geographically dispersed ICUs. Using this example to illustrate the concepts, the author hopes to shed some light on the successes and lessons learned so as to generate best-practice guidelines for Tele-ICU-directed PI initiatives. PMID:25814453

  9. REPETE2: A next generation home telemedicine architecture.

    PubMed

    Lai, Albert M; Nieh, Jason; Starren, Justin B

    2007-01-01

    As the availability of home broadband increases, there is an increasing need for a broadband-based home telemedicine architecture. A home tele-medicine architecture supporting broadband and remote training is presented. PMID:18694118

  10. Nurses' role in disease case management.

    PubMed

    Stolte, C M

    1996-12-01

    The escalating cost of chronic disease and the increasing age of the US population calls for a new healthcare model. Disease management systems may be the answer to these changing demands. The nurse case manager as educator, planner, and administrator can ensure the best use of resources in a disease management model. This article explores the role of nurse case management in a disease management model. PMID:10163203

  11. Some virtual reality and telemedicine applications useful for long duration spaceflight from a systems engineering perspective.

    PubMed

    Holland, D; Barfield, W

    1999-01-01

    This paper presents a review of virtual reality, telemedicine, and systems engineering design concepts that relate to the human performance of mission tasks during long duration spaceflight. A Mini-Case Study of the MIR/Progress collision is discussed and serves to highlight some of the key issues. We review some physiologic changes which occur as a result of long duration spaceflight, discuss issues associated with performing required mission tasks, and integrate concepts from telemedicine and virtual reality as possible methods and technologies to alleviate some of the deleterious effects of extended space missions. PMID:10538344

  12. Robust tissue classification for reproducible wound assessment in telemedicine environments

    E-print Network

    Boyer, Edmond

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

  13. Towards grid-enabled telemedicine in Florence JACQ1

    E-print Network

    Paris-Sud XI, Université de

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

  14. Differential measurements selection for evaluation of telemedicine applications

    E-print Network

    Oakley, Jeremy

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

  15. Telemedicine in the context of the National Broadband Network

    E-print Network

    Heiser, Gernot

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

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

    E-print Network

    Rosen, Jacob

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

  17. CNS to case manager: broadening the scope.

    PubMed

    Meisler, N; Midyette, P

    1994-11-01

    A clinical nurse specialist's role capitalizes on five role components: manager, clinician, consultant, educator, and researcher. Although the case manager's responsibilities also encompass these areas, priorities differ. A clear definition of both roles is essential when considering a transition from clinical nurse specialist to case manager. PMID:7970405

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

    PubMed Central

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

    2012-01-01

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

  19. Telemedicine in India: the Apollo story.

    PubMed

    Ganapathy, Krishnan; Ravindra, Aditi

    2009-01-01

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

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

    Microsoft Academic Search

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

    2010-01-01

    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

  1. Patient safety systems for case management.

    PubMed

    Greenberg, Liza

    2004-01-01

    Patient safety is an important concern of many healthcare stakeholders, including patients, providers, employers, health plans, and insurers. In 2003, URAC conducted a qualitative study to examine the role of utilization management programs as part of a systemic approach to promoting patient safety. Many of URAC's findings are applicable to case management as well. URAC found that most medical management companies address patient safety indirectly, as part of a global quality management program. Even so, the study identified a number of strengths that could be deployed by medical management organizations to more systematically promote patient safety. For example, case management organizations use decision support tools to assist frontline practitioners in conducting assessments and tracking interventions. Such systems could be programmed to flag safety concerns and guide interventions. The study also found that commonly used case management assessment protocols could be adapted to routinely assess for high priority safety concerns. URAC concluded that each stage of the medical management process offers opportunities for data collection and clinical interface to promote patient safety. Case managers have key positions interfacing between patients, providers, and the healthcare system. Development of safety indicators and training of staff are key elements needed to effectuate a safety program in medical management. Case management leaders in each organization and at the national level should make patient safety a priority, and define the processes for implementing safety systems wherever case management is practiced. PMID:15540075

  2. Applicability of Telemedicine in Bangladesh: Current Status and Future Prospects

    E-print Network

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

    2009-01-01

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

  3. Iowa Case Management for Rural Drug Abuse

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  4. Role restructuring: nurse, case manager, and educator.

    PubMed

    Smith, G B; Danforth, D A; Owens, P J

    1994-01-01

    A quality improvement team of nursing managers and staff nurses planned and implemented a new delivery system that combines a team nursing method of care delivery and a unit-based case manager. The new unit-based case manager role is unique because in addition to case management, the role is also responsible for the education of staff on an assigned unit and meeting the educational needs of patients/families. The role has proved to be cost effective and has improved patient outcomes. This model is an effective delivery system for hospitals with limited resources for bedside care. PMID:7777213

  5. Educational supply chain management: a case study

    Microsoft Academic Search

    Antonio K. W. Lau

    2007-01-01

    Purpose – The purpose of this paper is to implement the philosophy of supply chain management in the current higher education environment so as to suggest innovative management ideas in higher education management. Design\\/methodology\\/approach – This paper conducted an in-depth case study approach in a university. This study follows Yin's approach to interview the personnel of a supply chain department

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 2012-10-01 false Primary care case management services. 440.168...PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case...

  8. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 2014-10-01 false Primary care case management services. 440.168...PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case...

  9. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 2011-10-01 false Primary care case management services. 440.168...PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case...

  10. 42 CFR 440.168 - Primary care case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 2013-10-01 false Primary care case management services. 440.168...PROVISIONS Definitions § 440.168 Primary care case management services. (a) Primary care case management services means case...

  11. Disaster case management and individuals with disabilities

    E-print Network

    Stough, Laura

    2010-01-01

    management are to integrate and coordi- nate services across different service delivery systems and to provide for continuity of care on behalf of an individual or group of individuals (Moxley, 1989). Case management may also incor- porate advocacy functions...’s quality of life (Hall, Carswell, Walsh, Huber, & Jampoler, 2002). Research on case management has found mixed results with respect to its cost effectiveness (see Mueser, Bond, Drake, & Resnick, 1998; Mullahy & Jensen, 2004), but the bulk of the evidence...

  12. Telepointer technology in telemedicine: a review.

    PubMed

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

    2013-01-01

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

  13. The virtual hospital: the emergence of telemedicine

    Microsoft Academic Search

    Danny Petrasek; Alan Barr; Krishna V. Palem

    2010-01-01

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

  14. Seahawk: telemedicine project in the Pacific Northwest

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

  15. Telepointer technology in telemedicine : a review

    PubMed Central

    2013-01-01

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

  16. Adoption of routine telemedicine in Norway: the current picture

    PubMed Central

    Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

    2014-01-01

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

  17. A PDA-based flexible telecommunication system for telemedicine applications.

    PubMed

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

    2004-01-01

    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

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

    PubMed Central

    2012-01-01

    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. PMID:22809335

  19. Mental health case management: Characteristics, job function, and occupational stress

    Microsoft Academic Search

    Joseph G. Hromco; John S. Lyons; Robert E. Nikkel

    1995-01-01

    Although case management is an important component of treatment for persons with major mental illnesses, little is known about who works in case management, what functions are performed and how much occupational stress case managers experience. Mental health case managers (CM's) throughout the state of Oregon (N=216) completed an inventory of case management functions and the job dissatisfaction and occupational

  20. Application of a low cost telemedicine link to the diagnosis of neonatal congenital heart defects by remote consultation

    PubMed Central

    Mulholland, H; Casey, F; Brown, D; Corrigan, N; Quinn, M; McCord, B; Rogers, J; Craig, B

    1999-01-01

    OBJECTIVE—To determine whether accurate remote echocardiographic diagnosis of congenital heart disease could be achieved using a low cost telemedicine system.?DESIGN—Echocardiographic images obtained by a paediatrician from neonates suspected of having congenital heart disease were transmitted by a telemedicine link across two integrated service digital network (ISDN) lines to a regional paediatric cardiology unit for interpretation by a consultant paediatric cardiologist. The "tele-echo" diagnosis was verified by the paediatric cardiologist on direct consultation and echocardiography.?SETTING—Neonatal unit of Altnagelvin Hospital, Londonderry (a district general hospital) and the regional paediatric cardiology department, Royal Belfast Hospital for Sick Children.?MAIN OUTCOME MEASURES—Accuracy of the diagnosis made using the telemedicine link; impact on patient management.?RESULTS—Between September 1995 and September 1997 echocardiographic images were transmitted on 63 patients. A diagnosis was made in 61 (97%) (transmitted images were unsatisfactory in two). Congenital heart disease was diagnosed in 42 patients. Fourteen patients with major congenital heart disease were accurately diagnosed within 24 hours of admission using the telemedicine link and were transferred to the regional paediatric cardiology unit. A further 28 with less serious congenital heart disease continued to be managed at the district general hospital. Congenital heart disease was excluded in 19. Follow up consultation confirmed accurate diagnosis or exclusion of congenital heart disease in 57 (93%). There were four inaccurate diagnoses (6.3%; three undetected small ventricular septal defects and one pulmonary stenosis).?CONCLUSIONS—Transmitted images were of sufficient quality to allow confirmation or exclusion of major congenital heart disease. The telemedicine link facilitated early diagnosis and initiation of appropriate management in patients with complex congenital heart disease and avoided the need for transfer in those where significant congenital heart disease was excluded.???Keywords: congenital heart disease; telemedicine PMID:10409539

  1. Telemedicine Application in the Care of Diabetes Patients: Systematic Review and Meta-Analysis

    PubMed Central

    Marcolino, Milena Soriano; Maia, Junia Xavier; Alkmim, Maria Beatriz Moreira; Boersma, Eric; Ribeiro, Antonio Luiz

    2013-01-01

    Background The impact of telemedicine application on the management of diabetes patients is unclear, as the results are not consistent among different studies. The objective of this study is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the impact of telemedicine interventions on change in hemoglobin A1c (HbA1c), blood pressure, LDL cholesterol (LDL-c) and body mass index (BMI) in diabetes patients. Methods Electronic databases MEDLINE, Cochrane Central Register of Controlled Trials and LILACS were searched to identify relevant studies published until April 2012, supplemented by references from the selected articles. Study search and selection were performed by independent reviewers. Of the 6.258 articles retrieved, 13 RCTs (4207 patients) were included. Random effects model was applied to estimate the pooled results. Results Telemedicine was associated with a statistically significant and clinically relevant absolute decline in HbA1c level compared to control (mean difference -0.44% [-4.8 mmol/mol] and 95% confidence interval [CI] -0.61 to -0.26% [-6.7 to -2.8 mmol/mol]; p<0.001). LDL-c was reduced in 6.6 mg/dL (95% CI -8.3 to -4.9; p<0.001), but the clinical relevance of this effect can be questioned. No effects of telemedicine strategies were seen on systolic (-1.6 mmHg and 95% CI -7.2 to 4.1) and diastolic blood pressure (-1.1 mmHg and 95% CI -3.0 to 0.8). The 2 studies that assessed the effect on BMI demonstrated a tendency of BMI reduction in favor of telemedicine. Conclusions Telemedicine strategies combined to the usual care were associated with improved glycemic control in diabetic patients. No clinical relevant impact was observed on LDL-c and blood pressure, and there was a tendency of BMI reduction in diabetes patients who used telemedicine, but these outcomes should be further explored in future trials. PMID:24250826

  2. The influence of economic performance on telemedicine provision.

    PubMed

    Wang, Fuhmei

    2009-03-01

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

  3. In what circumstances is telemedicine appropriate in the developing world?

    PubMed Central

    Wootton, Richard; Bonnardot, Laurent

    2010-01-01

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

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

    E-print Network

    Boyer, Edmond

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

  5. Wearable Yagi microstrip antenna for telemedicine applications

    Microsoft Academic Search

    Haider R. Khaleel; Hussain M. Al-Rizzo; Daniel G. Rucker; Taha A. Elwi

    2010-01-01

    This paper presents a button shaped antenna based on a microstrip Yagi array. The proposed antenna is suitable for Wireless Body Area Network (WBAN) and telemedicine applications operating at 2.45 GHz. Antenna properties, such as far-field radiation patterns, coupling coefficient, measured by the scattering parameter S11, and gain are provided. Moreover, the simulated performance of the proposed antenna is compared

  6. Quality control in Telemedicine. “CE-Label”

    Microsoft Academic Search

    Ferrer-Roca O.

    2011-01-01

    The European Directive for Medical Devices (MDs) and equipment, the DIR 2007\\/47\\/EC, aims at achieving the goal of quality of medical delivery at a distance, providing comparable demands in telemedicine or distance support as in face-to-face healthcare. The transposition into Spanish law of the EU directive was the Royal Decree RD-1591\\/2009, dated 16 October 2009, which regulates the use of

  7. Approaches to economic evaluation in telemedicine.

    PubMed

    Bergmo, Trine S

    2012-06-01

    External validity or generalizability is a major challenge in the economic evaluation of telemedicine. There are two possible ways of increasing generalizability: the first is to use a pragmatic trial design so it better reflects normal patient caseload and everyday practice. The second is to use existing data from the literature and decision modelling to estimate the expected costs and outcomes of different alternatives. The first will increase generalizability to other patients than those in the trial and the second will increase generalizability from place to place. The objective and role of the evaluation will decide the most appropriate evaluation approach. Pragmatic trials should be used in studies where the objective is to provide measurements of costs and outcomes for a specific group of patients in a particular setting. This approach is highly relevant in telemedicine evaluations where the objective is to support local investments strategies and reimbursement systems. Decision modelling provides an overall structure for a decision problem and a formal analysis of the implications of different decisions. Modelling can simulate a trial or mimic a current system or a system that decision makers would like to use. Modelling is a useful approach when decisions need to be made about whether to invest in telemedicine within a broader context. PMID:22619374

  8. Authentication and digital signature USB device for telemedicine applications

    Microsoft Academic Search

    Alfredo Espitia; Karen Ortega; Eduardo Romero; I. Jaramillo

    2008-01-01

    The main objective of this project was to design, develop and validate a digital signature in a security device for telemedicine applications. Medical domain requires high security conditions for archiving since the information to be protected contains images, diagnosis, personal information of the patients and physicians involved in the telemedicine process. The developed strategy consists in a USB device which

  9. Successful Adoption of a School-Based Telemedicine System

    ERIC Educational Resources Information Center

    Mackert, Michael; Whitten, Pamela

    2007-01-01

    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…

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

    Microsoft Academic Search

    SungHye Hong; SangYong Kim; Jungchae Kim; DongKyu Lim; SeokMyung Jung; DongKeun Kim; Sun K. Yoo

    2009-01-01

    The telemedicine system aims at monitoring patients remotely without limit in time and space. However the existing telemedicine systems exchange medical information simply in a specified location. Due to increasing speed in processing data and expanding bandwidth of wireless networks, it is possible to perform telemedicine services on personal digital assistants (PDA). In this paper, a telemedicine system on PDA

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

    PubMed

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

    2014-08-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    E-print Network

    Tappert, Charles

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

  14. Prevention of Diabetes in Rural India with a Telemedicine Intervention

    PubMed Central

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

    2012-01-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...false General case scheduling and management. 2.332 Section 2.332 Energy NUCLEAR REGULATORY COMMISSION AGENCY RULES...Hearing Management for NRC Adjudicatory Hearings § 2.332 General case scheduling and management. (a)...

  16. 10 CFR 2.332 - General case scheduling and management.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...false General case scheduling and management. 2.332 Section 2.332 Energy NUCLEAR REGULATORY COMMISSION RULES OF...Hearing Management for NRC Adjudicatory Hearings § 2.332 General case scheduling and management. (a)...

  17. 10 CFR 2.332 - General case scheduling and management.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...false General case scheduling and management. 2.332 Section 2.332 Energy NUCLEAR REGULATORY COMMISSION AGENCY RULES...Hearing Management for NRC Adjudicatory Hearings § 2.332 General case scheduling and management. (a)...

  18. Clinical case management in the Army medical department.

    PubMed

    Jennings, B M; Brosch, L R

    1994-08-01

    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

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

    PubMed Central

    2013-01-01

    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

  20. Case Management of Adolescents with Chronic Disease.

    ERIC Educational Resources Information Center

    Lankard, Bettina A.

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

  1. Gardening waste management - case study: Tehran - Iran

    Microsoft Academic Search

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

    2010-01-01

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

  2. [Hospital without borders--visions of telemedicine].

    PubMed

    Brismar, B

    1995-01-01

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

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

    PubMed

    Cesta, Toni

    2015-03-01

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

  4. A telemedicine health care delivery system

    NASA Technical Reports Server (NTRS)

    Sanders, Jay H.

    1991-01-01

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

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

    E-print Network

    Stough, Laura

    2011-01-01

    BRAIN INJURY PROFESSIONAL18 This article, submitted for inclusion in an upcoming issue of Re- habilitation Psychology, investigates the long-term recovery of in- dividuals with disabilities following Hurricane Katrina through data collected from... of Results The results section of this article suggest that considerable barriers DISASTER CASE MANAGEMENT Case Management and Individuals with Disabilities Following Hurricane Katrina By laura M. StouGh, Phd, aMy n. SharP, Phd, Curt deCker, Jd and na...

  6. Enhancing case management through computerized patient files.

    PubMed

    Custer, M L

    1993-05-01

    The need for developing an organizational system for managing a large patient specialty population prompted the use of a computerized data entry and retrieval system. The use of a computerized system has facilitated patient case management, chart organization, and development of accessible data for research. Patient data fields (topic headings) are used for: (1) storing specific categories of patient data, (2) compiling lists for management and research, and (3) referring physician and patient/family contact information. Various lists can be compiled from the field data base in order to develop research and patient management lists. Patient management lists are used to track a patient's progress, provide quality assurance of care, and contribute researchable data. Also, patient information can be transferred automatically from the computerized daily management system into a computerized form letter. Individualized patient letters may be generated. Laboratory and test information from the last clinic or hospital visit can be mailed to families along with a handwritten personalized interpretation of their results by the CNS or physician. PMID:8343931

  7. The Science Manager's Guide to Case Studies

    SciTech Connect

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

    2001-09-24

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

  8. Weed Management in Alfalfa Stands Dr. Case R. Medlin

    E-print Network

    Weed Management in Alfalfa Stands Dr. Case R. Medlin Assistant Professor of Weed Science Purdue Weed ManagementWeed ManagementWeed ManagementWeed ManagementWeed Management Purdue Extension WS-11-W Weed infestations can reduce the yield, quality, and longevity of alfalfa stands. Low soil p

  9. Arogyasree: An Enhanced Grid-Based Approach to Mobile Telemedicine

    PubMed Central

    Kailasam, Sriram; Kumar, Santosh; Dharanipragada, Janakiram

    2010-01-01

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

  10. Tavarua : a mobile telemedicine system using WWAN striping

    E-print Network

    Carlisle, Jennifer (Jennifer Nicole)

    2007-01-01

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

  11. Telemedicine in the NHS for the millennium and beyond.

    PubMed Central

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

    1998-01-01

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

  12. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    42 Public Health 4 2011-10-01...2011-10-01 false Case management services. 441...441.18 Public Health CENTERS FOR MEDICARE...reasonably related to the population being served and the case management services...

  13. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    42 Public Health 4 2010-10-01...2010-10-01 false Case management services. 441...441.18 Public Health CENTERS FOR MEDICARE...reasonably related to the population being served and the case management services...

  14. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    42 Public Health 4 2012-10-01...2012-10-01 false Case management services. 441...441.18 Public Health CENTERS FOR MEDICARE...reasonably related to the population being served and the case management services...

  15. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    42 Public Health 4 2014-10-01...2014-10-01 false Case management services. 441...441.18 Public Health CENTERS FOR MEDICARE...reasonably related to the population being served and the case management services...

  16. 42 CFR 441.18 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    42 Public Health 4 2013-10-01...2013-10-01 false Case management services. 441...441.18 Public Health CENTERS FOR MEDICARE...reasonably related to the population being served and the case management services...

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

    SciTech Connect

    Craft, Richard Layne, II

    2004-05-01

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

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

    ERIC Educational Resources Information Center

    Lang, Joyce; Kragthorpe, Candice

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

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

    ERIC Educational Resources Information Center

    Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

    2012-01-01

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

  20. Diversity in Case Management Modalities: The Summit Model

    Microsoft Academic Search

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

    1997-01-01

    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

  1. Use of mobile telemedicine for cervical cancer screening

    PubMed Central

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

    2013-01-01

    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. PMID:21551217

  2. Telemedicine Networks of EHAS Foundation in Latin America.

    PubMed

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

    2014-01-01

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

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

    E-print Network

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

    2005-03-22

    Telehospice® (TH) utilizes telemedicine technology to provide care at the end of life. A bistate project was launched in 1998 to study the use of home-based telemedicine for routine hospice care. Videophones were deployed for telenursing visits...

  4. Reshaping Health Care Delivery for Adolescent Parents: Healthy Steps and Telemedicine

    E-print Network

    Nelson, Eve-Lynn; Citarelli, Melissa; Cook, David J.; Shaw, Pamela

    2004-07-09

    Healthy Steps over Telemedicine uses telemedicine technology to bring child development services to adolescent parents in an urban school district. Videoconferencing units link teen parents at a Kansas City high school to developmental specialists...

  5. The Interaction Between Safety Culture and Uncertainty Over Device Behaviour: The Limitations and Hazards of Telemedicine

    E-print Network

    Johnson, Chris

    and Hazards of Telemedicine C.W. Johnson; Dept of Computing Science, Univ. of Glasgow, Scotland, G12 9QQ. This paper argues that such uncertainty threatens the introduction of `telemedicine'. We are interested

  6. Adoption of intensive care unit telemedicine in the United States

    PubMed Central

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

    2013-01-01

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

  7. Use of telemedicine in disaster and remote places

    PubMed Central

    Ajami, Sima; Lamoochi, Parisa

    2014-01-01

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

  8. Quick management of accidental tritium exposure cases.

    PubMed

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

    2012-07-01

    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

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

    PubMed Central

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

    2015-01-01

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

  10. Reconceptualizing case management in theory and practice: a frontline perspective.

    PubMed

    Yarmo Roberts, Deborah

    2002-08-01

    'Case management' in the health and social service sector is controversial, highly political and saturated with conflicting agendas among stakeholders. Research was conducted recently to explore the role of case managers in three evolving, Australian-based, long-term care, case management models. The findings have relevance to countries worldwide that contend with delivering quality care that is cost effective. The research captures the perspectives of 51 open-ended interviews with front-line case managers who have first-hand knowledge of the models' effect on their clients and on their own roles. Contrary to the rhetoric that case management is client-centred, case management is concluded to be 'system centred' based on a unilateral approach taken by each of the three models. Case managers had a limited ability to attain necessary services for clients. Success was dependent on the range of case managers' skills and experience, relationship with the client, degree of job satisfaction, level of influence in the health and social system and ability to collaborate with relevant professionals. The relationship between the three primary influences (system, model, client) affecting case managers' pursuit of achieving appropriate client services was also reviewed. A reconceptualized multidimensional approach, or 'neo-process-centred' case management, is proposed. The revised approach can be applied to existing and new models and has direct implications for policy makers, management and practitioners aspiring to improve client care within existing constraints. PMID:12184835

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

    E-print Network

    Sahay, Sundeep

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

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

    E-print Network

    Chen, Yu

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

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

    E-print Network

    Paris-Sud XI, Université de

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

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

    E-print Network

    Paris-Sud XI, Université de

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

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

    E-print Network

    Yang, Junfeng

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

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

    E-print Network

    Kumar, Sunil

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

  17. Telemedicine using VoIP combined with a Store and Forward Approach

    E-print Network

    Blake, Edwin

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

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

    E-print Network

    Blake, Edwin

    The Role of Outcome Mapping in Developing a Rural Telemedicine System William D. TUCKER1 , Edwin H@cs.uct.ac.za Abstract: We describe the use of Outcome Mapping to guide the design of a rural telemedicine consultation Technology for Development project. Keywords: ICT design methodology, telemedicine, telehealth, Outcome

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

    E-print Network

    Mihaylova, Lyudmila

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

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

    E-print Network

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

  1. Models to Extend the Scope of Usability Testing for Telemedicine Systems

    E-print Network

    Stevens, Perdita

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

  2. Mobile Telemedicine Sensor Networks with Low-Energy Data Query and

    E-print Network

    Wu, Hongyi

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

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

    ERIC Educational Resources Information Center

    Mansouri-Rad, Parand

    2012-01-01

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

  4. Barriers, Legal Issues, Limitations and Ongoing Questions in Telemedicine Applied to Stroke

    Microsoft Academic Search

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

    2009-01-01

    The use of telemedicine services, such as telestroke, is still highly fragmented and its deployment in an integrative healthcare system is challenging. Factors impeding the growth of telemedicine include confidence and malpractice issues, technical advances, reimbursement, licensing, credentialing costs, cost effectiveness, and legal issues. These barriers, limitations and requirements in the routine use of telemedicine are reviewed, in addition to

  5. Research Note An Empirical Chart Analysis of the Suitability of Telemedicine for Hospice Visits

    Microsoft Academic Search

    GARY C. DOOLITTLE; PAMELA WHITTEN; MICHAEL MCCARTNEY; DAVID COOK; NIAMAN NAZIR

    Telehospice® (TH) utilizes telemedicine technology to provide care at the end of life. A bi- state project was launched in 1998 to study the use of home-based telemedicine for routine hospice care. Videophones were deployed for telenursing visits and evaluations by social workers. In order to determine what proportion of home hospice visits could be performed using currently available telemedicine

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

    E-print Network

    Zhu, Hong

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

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

    PubMed

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

    2001-01-01

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

  8. The Spacebridge to Russia Project: internet-based telemedicine.

    PubMed

    Angood, P B; Doarn, C R; Holaday, L; Nicogossian, A E; Merrell, R C

    1998-01-01

    The National Aeronautics and Space Administration (NASA) has been a pioneer in telemedicine since the beginning of the human spaceflight program in the early 1960s. With the rapid evolution in computer technology and equally rapid development of computer networks, NASA and the Department of Surgery in Yale University's School of Medicine created a telemedicine testbed with the Russia Space Agency, the Spacebridge to Russia Project, using multimedia computers connected via the Internet. Clinical consultations were evaluated in a store-and-forward mode using a variety of electronic media, packaged as digital files, and transmitted using Internet and World Wide Web tools. These systems allow real-time Internet video teleconferencing between remotely located users over computer systems. This report describes the project and the evaluation methods utilized for monitoring effectiveness of the communications. The Spacebridge to Russia Project is a testbed for Internet-based telemedicine. The Internet and current computer technologies (hardware and software) make telemedicine readily accessible and affordable for most health care providers. Internet-based telemedicine is a communication tool that should become integral to global health care. PMID:10220470

  9. Defining the parameters of case management in a managed care setting.

    PubMed

    Carneal, G; D'Andrea, G

    2001-01-01

    The authors explore how case management evolved from utilization review in order to address the lack of flexibility of basic utilization review. They examine case management's widely diverse state regulatory oversight as well as its lack of a clear definition. The authors then suggest three mechanisms that might be used to devise a universal definition of case management. For the purposes of this article, the authors use the term case management in connection with health benefits plans. PMID:11252397

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

    ERIC Educational Resources Information Center

    McLean, Gary N.

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

  11. Telemedicine in the Indian context: an overview.

    PubMed

    Ganapathy, K

    2004-01-01

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

  12. Mental health telemedicine programmes in Australia.

    PubMed

    Lessing, K; Blignault, I

    2001-01-01

    A national survey of mental health telemedicine programmes was conducted and data collected on their catchment areas, organizational structure, equipment, clinical and non-clinical activity, and use by populations who traditionally have been poorly served by mental health services in Australia. Of 25 programmes surveyed, information was obtained for 23. Sixteen programmes had dealt with a total of 526 clients during the preceding three months. Of these, 397 (75%) were resident in rural or remote locations at the time of consultation. Thirty-seven (7%) were Aboriginals or Torres Strait Islanders. Only 19 (4%) were migrants from non-English-speaking backgrounds. The programmes provided both direct clinical and secondary support services. Overall, the number of videoconferencing sessions devoted to clinical activity was low, the average being 123 sessions of direct clinical care per programme per year. Videoconferencing was also used for professional education, peer support, professional supervision, administration and linking families. The results of the study suggest that telehealth can increase access to mental health services for people in rural and remote areas, particularly those who have hitherto been poorly served by mental health services in Australia. PMID:11747632

  13. Barriers and opportunities to the widespread adoption of telemedicine: a bi-country evaluation.

    PubMed

    Vimarlund, Vivian; Le Rouge, Cynthia

    2013-01-01

    Recognizing that current practices for healthcare delivery are no longer sustainable, OECD governments are focusing more and more on how to leverage ICT to facilitate superior healthcare delivery. One such possibility is the use of Telemedicine. A major goal of telemedicine today is to develop next-generation telemedicine tools and technologies. However, key "classic" barriers continue to challenge widespread telemedicine adoption by health care organizations. These barriers include technology, financial, legal/standards, business strategy, and human resources issues. This comparative study explores the current status of barriers and opportunities to the widespread adoption of telemedicine in two different countries: Sweden, and USA. PMID:23920707

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

    PubMed Central

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

    2014-01-01

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

  15. Indian Space Research Organization and telemedicine in India.

    PubMed

    Bhaskaranarayana, A; Satyamurthy, L S; Remilla, Murthy L N

    2009-01-01

    Telemedicine in India is spearheaded by the Indian Space Research Organization (ISRO) and has matured beyond technology demonstration to enter an operational phase in its history. This article attempts to bring out the evolution and development of telemedicine in India: the genesis, the approach followed, the stakeholders involved, and the results so far, with an outline for the future. ISRO has coupled its prowess in satellite communication technology with medical science and information technology to project specialty healthcare to the doorsteps of the rural, remote, and distant populace across the country. Having set the telemedicine program as a model for benefiting society with advances in modern technology, India is advancing to international dimensions the proven domestic program to people in other parts of the globe. More specifically, the article attempts to bring out the role played by ISRO, its vision, goals, and partners in the program along with the technology and observed impact. PMID:19659415

  16. Converging pathways: a journey toward quality case management.

    PubMed

    2005-01-01

    Development of case management as a profession surged in the latter part of the last century, due in large part to the birth in 1990 of two quality-focused organizations. In that year, URAC was established to improve the quality and the accountability of organizations conducting utilization review, but, in later years, it expanded to accreditation of organizations conducting many medical management components, such as case management and disease management. Today the organization has 17 accreditation programs. PMID:16243664

  17. [The development and use of databases in case management].

    PubMed

    Wang, Chiu-Wen

    2009-04-01

    Case management is a case-centered care model that leverages multi-disciplinary teamwork to provide quality and cost-effective patient care. To ensure care continuity and timeliness, it is necessary to automate case management systems. A case management database is essential to system efficiency; helping avoid double data entries and ensuring data confidentiality and system security. The database can also support data analysis and programming designed to generate useful statistics and automatic reminders. Identifying critical database functions is the first step in database development. Once a database has been established, it can be applied to functions throughout the case management process, including case screening, care related data retrieval, patient record storage, quality monitoring, insurance reimbursement and research. An effective information automation system will ensure the accuracy and timeliness of information as well as enhance case management quality and efficiency. PMID:19319801

  18. The first telemedicine link for the British Forces.

    PubMed

    Vassallo, D J; Buxton, P J; Kilbey, J H; Trasler, M

    1998-10-01

    In January 1998 a telemedicine link was established between the Hospital Squadron (from 22 Field Hospital) in Sipovo, Bosnia and the Royal Hospital Haslar, United Kingdom (UK). This link uses a high resolution digital camera, laptop computer, satellite telephone and a landline to obtain specialist opinions in radiology, dermatology, plastic surgery, orthopaedics, urology, ophthalmology, pathology and maxillo-facial surgery. This is the Defence Medical Services' first such link from an operational scenario. As such, this pilot study provides a useful testbed to enable clinicians in the three services to gain experience in this developing field, and to help determine the military applications of telemedicine. PMID:9819718

  19. The potential for telemedicine and telecare in Deptford.

    PubMed

    Jardine, I; Clough, K; Navein, J

    2000-01-01

    We carried out a study to explore the potential of telemedicine and telecare to improve health-care for the population served by a health centre based in Deptford in south-east London. A wide range of potentially useful telemedicine and telecare applications was identified, nine of which could provide some immediate benefit. Other requiring new approaches to the delivery of care involved some reengineering of services. Some suggestions focused on the need to integrate information technology with service provision. Other suggestions raised strategic questions, the most important of which concerned the routes of access to health-care. PMID:10793980

  20. A strategy for the development of secure telemedicine applications.

    PubMed Central

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

    1997-01-01

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

  1. Functional evaluation of telemedicine with super high definition images and B-ISDN.

    PubMed

    Takeda, H; Matsumura, Y; Okada, T; Kuwata, S; Komori, M; Takahashi, T; Minatom, K; Hashimoto, T; Wada, M; Fujio, Y

    1998-01-01

    In order to determine whether a super high definition (SHD) image running at a series of 2048 resolution x 2048 line x 60 frame/sec was capable of telemedicine, we established a filing system for medical images and two experiments for transmission of high quality images were performed. All images of various types, produced from one case of ischemic heart disease were digitized and registered into the filing system. Images consisted of plain chest x-ray, electrocardiogram, ultrasound cardiogram, cardiac scintigram, coronary angiogram, left ventriculogram and so on. All images were animated and totaled a number of 243. We prepared a graphic user interface (GUI) for image retrieval based on the medical events and modalities. Twenty one cardiac specialists evaluated quality of the SHD images to be somewhat poor compared to the original pictures but sufficient for making diagnoses, and effective as a tool for teaching and case study purposes. The system capability of simultaneously displaying several animated images was especially deemed effective in grasping comprehension of diagnosis. Efficient input methods and creating capacity of filing all produced images are future issue. Using B-ISDN network, the SHD file was prefetched to the servers at Kyoto University Hospital and BBCC (Bradband ISDN Business chance & Culture Creation) laboratory as an telemedicine experiment. Simultaneous video conference system, the control of image retrieval and pointing function made the teleconference successful in terms of high quality of medical images, quick response time and interactive data exchange. PMID:10384469

  2. Facility management practices in higher education buildings : A case study

    Microsoft Academic Search

    Sarel Lavy

    2008-01-01

    Purpose – Facility management (FM) is important to the business success of companies and organizations. Nowadays, teaching FM is often spread over several disciplines, including architecture, management, business, and construction. The purpose of this paper is to present a case study completed by a team of three graduate students in the course “Introduction to Facility Management,” offered by a large

  3. What makes a knowledge management system work: a case study

    E-print Network

    Paris-Sud XI, Université de

    What makes a knowledge management system work: a case study Thomas Martine Tech-CICO, University why a knowledge management system, if conceived strictly from the point of view of organizational, an engineer, a product, a procedure) [3]. Doing knowledge management, then, consists in identifying

  4. Telemedicine Imaging Collaboration System with Virtual Common Information Space

    Microsoft Academic Search

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

    2006-01-01

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

  5. Teaching Computer Vision for telemedicine systems using OpenCV

    Microsoft Academic Search

    Zenon Chaczko; Robin Braun

    2010-01-01

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

  6. Heart sound and electrocardiogram recording devices for telemedicine environments

    Microsoft Academic Search

    H. L. Koekemoer; C. Scheffer

    2008-01-01

    There is currently a worldwide trend to bring healthcare services as close as possible to the patient, either through home healthcare systems, or telemedicine. There is thus a general need for equipment that can capture patient data electronically for automated review or analysis by a medical practitioner. This paper presents prototype systems that were developed with the ultimate aim for

  7. DATA WAREHOUSE MANAGEMENT SYSTEM A CASE STUDY

    Microsoft Academic Search

    DARKO KRULJ; MILUTIN CUPIC; MILAN MARTIC; MILIJA SUKNOVIC

    In the last decade data warehouses have become the basis for support in business decision making. This paper will show our framework for the data warehouse management system as well as advantages and disadvantages of this approach in relation to the other data warehouse management systems. Many approaches to the development of data warehouse emphasize the importance of meta data

  8. Walking a tightrope: case management services and outpatient commitment.

    PubMed

    Sullivan, W Patrick; Carpenter, Jenneth; Floyd, Destinee F

    2014-01-01

    Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice. PMID:25222837

  9. The case for case studies in management research

    Microsoft Academic Search

    Eric Patton; Steven H. Appelbaum

    2003-01-01

    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

  10. Telemedicine in Surgery: What are the Opportunities and Hurdles to Realising the Potential?

    PubMed

    Raison, Nicholas; Khan, Muhammad Shamim; Challacombe, Ben

    2015-07-01

    Since the first telegraphic transmission of an electrocardiogram in 1906, technological developments have allowed telemedicine to flourish. It has become a multi-billion pound industry encompassing many areas of medical practice and education. Telemedicine is now widely used in surgery from performing operations to teaching and can be divided into three main components; telesurgery, telementoring and teleconsultation. Developments across these fields have led to remarkable achievements such as intercontinental telesurgery and telementoring. However, barriers to the further implementation of telemedicine remain. In this review, the developments and recent advances of telemedicine across the three domains are discussed together with the challenges and limitations that need to be overcome. PMID:26025497

  11. Case-Based Problem Solving for Knowledge Management Systems

    Microsoft Academic Search

    Irma Becerra-fernandez; David W. Aha

    1999-01-01

    Case Based Reasoning (CBR) is an intelligent systems methodology that enables information managers to increase efficiency and reduce cost by substantially automating processes (i.e., diagnosis, scheduling, or design). By identifying and ranking the relevance between a new case and previously encountered cases (i.e., stored in the case base), CBR systems can capture and share all of an organizationÕs related knowledge

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

    NASA Technical Reports Server (NTRS)

    Hesselgesser, Connie

    2001-01-01

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

  13. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES...in gaining access to needed medical, social, educational, and...that case managers provide in assisting eligible individuals obtain services...determine the need for any medical, educational, social,...

  14. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES...in gaining access to needed medical, social, educational, and...that case managers provide in assisting eligible individuals obtain services...determine the need for any medical, educational, social,...

  15. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES...in gaining access to needed medical, social, educational, and...that case managers provide in assisting eligible individuals obtain services...determine the need for any medical, educational, social,...

  16. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES...in gaining access to needed medical, social, educational, and...that case managers provide in assisting eligible individuals obtain services...determine the need for any medical, educational, social,...

  17. 42 CFR 440.169 - Case management services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES...in gaining access to needed medical, social, educational, and...that case managers provide in assisting eligible individuals obtain services...determine the need for any medical, educational, social,...

  18. Review of continuing professional education in case management for nurses.

    PubMed

    Liu, Wen-I; Edwards, Helen; Courtney, Mary

    2009-07-01

    Nineteen studies evaluating the effectiveness of continuing professional education programs in case management for nurses were reviewed. The studies were examined in terms of their educational focus and strategies, evaluative methods, and effectiveness. The programs assessed either focused on the provision of new knowledge or skills, or aimed to teach specific case management delivery models. The most appropriate program length appears to be at least 16 h. A combination of learning strategies, incorporating interactive lectures and small group discussions, are often used in case management educational programs and are associated with positive learning outcomes. The majority of these studies did not have a control group. Future evaluative studies need to incorporate larger sample sizes, a variety of evaluation methods and a control group in order to provide a valid measure of the effectiveness of continuing professional education in case management for nurses. PMID:19111941

  19. XML and the VITAL standard: the document-oriented approach for open telemedicine applications.

    PubMed

    Anagnostaki, A; Pavlopoulos, S; Koutsouris, D

    2001-01-01

    This paper describes an effort to create a common, document-oriented architecture for the interchange of medical data in healthcare telemedicine applications. Key components are: The VITAL standard specifying a common (medical device independent) representation of Vital Signs Information and the Extensible Markup Language (XML) specifying the document specifications form, an architecture that, in aggregate, define the semantics and structural constraints necessary for the exchange of vital signs and related medical data. The modelling and design technique for the described application has been the Unified Modelling Language (UML). The XMI (XML Metadata Interchange Format) of the Object Management Group (OMG) provided the meta-model for this application, for sharing objects using XML, via the transfer of the application's UML model to XML documents and DTDs. PMID:11604709

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

    PubMed

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

    2001-10-01

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

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

    SciTech Connect

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

    1992-05-01

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

  2. Innovative Stormwater Management in New Development: Planning Case Study1

    E-print Network

    Pitt, Robert E.

    A-1 Appendix Innovative Stormwater Management in New Development: Planning Case Study1 Brian W development, with housing to support the employment generated by the airport expansion. The stormwater element of this planning effort included the development of a Master Stormwater Management Plan (MSMP) for the annexed area

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

    E-print Network

    Abidi, Syed Sibte Raza

    A Knowledge Management Framework to Morph Clinical Cases with Clinical Practice Guidelines Fehmida University, Halifax, Nova Scotia, Canada Abstract In this paper we present a knowledge management framework that allows the automatic linking/mapping of contextually and functionally similar medical knowledge that may

  4. Relational Embeddedness and Learning: The Case of Bank Loan Managers

    E-print Network

    Kuzmanovic, Aleksandar

    Relational Embeddedness and Learning: The Case of Bank Loan Managers and Their Clients Brian Uzzi · Ryon Lancaster Kellogg Graduate School of Management, and Department of Sociology, Northwestern is that networks shape knowledge trans- fer and learning processes by creating channels for knowledge trade

  5. Evaluation of two mobile telemedicine systems in the emergency room.

    PubMed

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

    2003-01-01

    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

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

    E-print Network

    Qureshi, Asfandyar

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

  7. Draugen HSE-case - occupational health risk management

    SciTech Connect

    Glas, J.J.P.; Kjaer, E.

    1996-12-31

    The Draugen HSE-Case serves as a risk management tool. Originally, risk management included only major safety hazards to personnel, environment and assets. Work Environment risks such as ergonomics, psycho-social factors and exposure to chemicals and noise, was not given the same attention. The Draugen HSE-Case addresses this weakness and extends all work environment risks. In order to promote line responsibility and commitment, relevant personnel is involved in the Case development. {open_quotes}THESIS{degrees}, a software application, is used to systematize input and to generate reports. The Draugen HSE-case encompasses: HSE risk analyses related to specific activities; Control of risk related to work environment; Established tolerability criteria; Risk reducing measures; Emergency contingency measures; and Requirements for Competence and Follow-up. The development of Draugen HSE-Case is a continuous process. It will serve to minimize the potential of occupational illnesses, raise general awareness, and make occupational health management more cost-effective.

  8. Telemedicine: capabilities of telecommunications in clinical practice in Russia.

    PubMed

    Buravkov, S V

    1999-01-01

    Successful implementation of telemedicine services depends on an adequate telecommunications infrastructure. At present the main infrastructure in Russia and the countries of the former Soviet Union consists of analogue telephone lines. These are sufficient for e-mail and access to the World Wide Web but do not provide sufficient bandwidth for the transmission of realtime teleconsultations. ISDN lines and fibre optic cables are becoming more widespread in the major cities but have yet to be installed in the regions. PMID:10534833

  9. The simulation model of teleradiology in telemedicine project.

    PubMed

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

    2015-01-01

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

  10. Who killed the virtual case file? [case management software

    Microsoft Academic Search

    H. Goldstein

    2005-01-01

    This paper discusses how the FBI's $170 million Virtual Case File (VCF) IT project became one of the most highly publicized software failure in history. According to a report by the US Department of Justice's inspector general, VCF's failure may be attributed to several factors including poorly defined and slowly evolving design requirements, overly ambitious schedules, and the lack of

  11. The CNS as trauma case manager: a new frontier.

    PubMed

    Daleiden, A L

    1993-11-01

    The care of the trauma patient requires highly specialized skills to meet the clinical and financial challenges that face the health care practitioner caring for this patient population. The role of the trauma case manager in a community hospital setting incorporates the roles of expert clinician, educator, consultant, researcher, and manager into daily practice utilizing a multidisciplinary care delivery process. This process provides the link between quality of care and cost-effective care. Trauma case management is an ideal role for a CNS. PMID:8261358

  12. WRITING REFLECTIVE CASE STUDIES FOR THE ENGINEERING MANAGEMENT JOURNAL (EMJ)

    Microsoft Academic Search

    Timothy Kotnour; Rafael Landaeta

    This paper's intent is to help authors write reflective case studies for the Engineering Management Journal (EMJ). We offer a process to convert an applied research project with an organization to an EMJ manuscript. Writing a reflective case study is a process of abstracting experiences into approaches, processes, tools, challenges, and \\

  13. Nucleating the development of telemedicine to support healthcare workers in resource-limited settings: a new approach.

    PubMed

    Wootton, Richard; Wu, Wei-I; Bonnardot, Laurent

    2013-10-01

    Collegium Telemedicus (CT) offers a new approach to the problem of starting a store-and-forward telemedicine network for use in low resource settings. The CT organization provides a no-cost template to allow groups to start a network without delay, together with a peer-support environment for those operating the networks. A new group needs only to supply a Guarantor (who accepts responsibility for the work of the network) and a Coordinator (who operates the telemedicine network, allocating cases and ensuring that they are responded to). Communication takes place via secure messaging, which has several advantages over plain email, e.g. all the data are stored centrally, which means that they can be read from a hand-held device such as a smart phone, but do not need to be stored on that device. Users can access the system with a standard web browser. In the first three months, seven networks were established on the CT system by university groups in the US, the UK, Australia and New Zealand, and by a large, multinational humanitarian organisation. In the most active network, there were 86 telemedicine cases in the first three months, i.e. an average submission rate of 7 cases/week. The CT system appears to fulfil its aim of assisting doctors who wish to help colleagues in other countries by improving their access to specialist opinions, while allowing them to maintain control over the new network's use and development. The long term aim of the CT organization is to provide a means of improving the quality of health care at the point of delivery in low resource settings. PMID:24218356

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

    E-print Network

    Tappert, Charles

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

  15. A meta-analysis of telemedicine success in Africa.

    PubMed

    Wamala, Dan S; Augustine, Kaddu

    2013-01-01

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

  16. A meta-analysis of telemedicine success in Africa

    PubMed Central

    Wamala, Dan S.; Augustine, Kaddu

    2013-01-01

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

  17. Effects of case management after severe head injury.

    PubMed Central

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

    1994-01-01

    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. PMID:8180536

  18. A CASE STUDY OF ENVIRONMENTAL DATA MANAGEMENT

    EPA Science Inventory

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

  19. Role of Arab Telemedicine Society in Support of e-Health

    Microsoft Academic Search

    A. El Matri

    2008-01-01

    The Arab Telemedicine Society (ATS) has been founded under the umbrella of the Arab Medical Union in October 1999 after the recommendations of the First International Telemedicine Symposium for the Arab World Africa and Europe held in Tunis,Tunisia one year earlier.. Founding members were representatives of 6 arab countries (Algeria, Egypt, Jordan, Kuwait, Morocco and Tunisia. Its goal is to

  20. From flying doctor to virtual doctor: an economic perspective on Australia's telemedicine experience.

    PubMed

    van Gool, K; Haas, M R; Viney, R

    2002-01-01

    Current funding mechanisms can impede the efficient use and integration of telemedicine services. Telemedicine has developed in Australia against a background of complex funding arrangements and interwoven health-care responsibilities. These impediments are not unique to telemedicine but are accentuated by its ability to cover different locations, clinical areas and purposes. There is also a link between economic evaluation and funding mechanisms for telemedicine. While economic evaluations provide important information for the efficient allocation of resources, the funding environment in which telemedicine is established is also crucial in ensuring that services are efficient. Given these complexities, should telemedicine be funded? We conclude that this will depend on: the objectives and priorities of the health system; the efficiency of telemedicine relative to that of other forms of health-care delivery; and the funding environment. In terms of resource allocation processes, the optimum scenario is likely to be where the decision to invest in telemedicine services is made taking local needs into account, but where considerations such as market structure and network compatibility are examined on a broader scale and balanced against the principles of efficiency and equity. PMID:12396851

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

    Microsoft Academic Search

    Francis Pereira; Elizabeth Fife; Antonio A. Schuh

    1997-01-01

    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

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

    Microsoft Academic Search

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

    2010-01-01

    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

  3. Six-month programme on lifestyle changes in primary cardiovascular prevention: a telemedicine pilot study

    Microsoft Academic Search

    Palmira Bernocchi; Doriana Baratti; Emanuela Zanelli; Silvana Rocchi; Massimo Salvetti; Anna Paini; Simonetta Scalvini

    2011-01-01

    Background: Technology and information systems enabling transmission of patients’ data and ability to provide and exchange professional support remotely to the general practitioners can improve quality and continuity of care.Design: We set up a programme of primary prevention in 27 patients at risk for cardiovascular diseases by using Telemedicine Service for 6 months.Methods: Telemedicine Service enlisted the involvement of physicians

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  5. CNS roles in implementation of a differentiated case management model.

    PubMed

    Brubakken, K M; Janssen, W R; Ruppel, D L

    1994-03-01

    As advanced nursing practitioners and consultants, CNSs are leaders in affecting changes in nursing practice. During implementation of Primm's model of differentiated case management at Community Memorial Hospital, Menomonee Falls, Wisconsin, the CNSs enacted the roles of implementation consultant, researcher, direct care provider, educator, and performance and project evaluation consultant. The CNSs were committed to initiating and maintaining change, and facilitating momentum to incorporate the differentiated levels of staff nurse practice. We describe CNS roles in this process as well as outcomes seen after implementation of differentiated case management. PMID:7882245

  6. Tetanus Managed in a Peripheral Hospital - A Case Report and a Review of Management

    Microsoft Academic Search

    R. K. S. WHITTA

    Tetanus has become increasingly uncommon. However, with many people failing to maintain adequate levels of immunisation it will continue to present sporadically, with patients who are affected frequently requiring intensive care management. A case of tetanus, and its management in a peripheral hospital in New Zealand, is described. Current treatment options are reviewed. (Critical Care and Resuscitation 2001; 3: 163-169)

  7. Effective case research in operations management: a process perspective

    Microsoft Academic Search

    Ian Stuart; D. McCutcheon; R. Handfield; R. McLachlin; D. Samson; M S Sridhar

    2002-01-01

    Despite many calls for case-based operations management research, the successful publication rate of such articles in top-tier journals has been less than stellar. A five step case-based research and dissemination process is presented. Guidance is given to future researchers for each step in the process. In addition, areas of weakness are examined and discussed in detail. Future potential research questions

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

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

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

    PubMed

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

    2002-04-01

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

  10. Case Studies in Managing School Library Media Centers.

    ERIC Educational Resources Information Center

    Callison, Daniel; Morris, Jacqueline

    Thirty-two case studies illustrating problem areas and situations that develop in the modern environment of the electronic school library media program are presented for use by library science students and library/media center managers. Based on input from practicing librarians at the elementary and secondary levels, the studies are designed to…

  11. Transsexuals and workplace diversity : A case of “change” management

    Microsoft Academic Search

    J. M. Barclay; L. J. Scott

    2006-01-01

    Purpose – The purpose of this paper is to examine the key issues involved in situations within the workplace when an employee goes through gender reassignment, in order to consider how such situations might be managed more effectively. Design\\/methodology\\/approach – It analyses a case study from a national public sector organisation in the UK where a transsexual person went through

  12. Project management: a case study of a successful ERP implementation

    Microsoft Academic Search

    Fergal Carton; Frederic Adam; David Sammon

    2008-01-01

    Purpose – The success rate of enterprise resource planning (ERP) implementations is not high in view of the sums invested by organisations in these applications. It has often been indicated that a combination of inadequate preparedness and inappropriate project management have been responsible for the low-success rate of ERP implementations. The purpose of this paper is to present a case

  13. Functional Vagal Paraganglioma: A Case Report Illustrating Diagnosis and Management

    PubMed Central

    Hornbeek, Heidi; Iyer, N. Gopalakrishna; Carlson, Diane L.; Stambuk, Hilda E.; Ryder, Mabel; Ganly, Ian

    2010-01-01

    We report a case of functional vagal paraganglioma to illustrate the biochemical and radiological imaging tests important in diagnosis and to highlight the importance of a multidisciplinary team approach to manage the preoperative, perioperative, and postoperative effects of catecholamine secretion from these tumors. PMID:21772811

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  16. The Case for Improvisation in Information Security Risk Management

    E-print Network

    Boyer, Edmond

    and particularly information security practitioners to rely on various normative theories as frameworks that can) that give rise to the inconsistent application of normative theories in information securityThe Case for Improvisation in Information Security Risk Management Kennedy Njenga,1 , Irwin Brown2

  17. Orthodontic Management of Silver-Russell Syndrome. A Case Report

    PubMed Central

    Ioannidou-Marathiotou, Ioulia; Sluzker, Ariel; Athanasiou, Athanasios E

    2012-01-01

    This case report describes the orthodontic management of a 10-year-old female with Silver-Russell syndrome by means of gradual expansion of the mandibular dental arch using removable appliances and subsequent comprehensive treatment of malocclusion by means of fixed appliances. PMID:22927891

  18. The Case for Managed International Cooperation in Space Exploration

    E-print Network

    de Weck, Olivier L.

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

  19. Evolving Trends in Maternal Fetal Medicine Referrals in a Rural State Using Telemedicine

    PubMed Central

    Magann, Everett F.; Bronstein, Janet; McKelvey, Samantha S.; Wendel, Paul; Smith, Dora M; Lowery, Curtis L.

    2013-01-01

    Objective To determine maternal fetal medicine (MFM) referral trends in a Medicaid population over time. Study Design Sixteen clinical guidelines and 23 clinical conditions were identified where co-management/consultation with MFM specialist is recommended. Linked Medicaid claims and birth certificate data for 2001–2006 were used to identify pregnancies with these conditions and whether they received co-management/consultation from a MFM specialist. Results Between 2001 and 2006, there were 108,703 pregnancies with delivery of 110,890 neonates. Forty five percent had one or more of the conditions identified for co-management/consultation. Overall pregnancies receiving MFM contact remained unchanged at 22.2% in 2001 and 22.1% in 2006. However, face to face contacts decreased from 14.6% (2001) to 8.7% (2006) while telemedicine consults increased from 7.6% (2001) to 13.3% (2006). Health departments were most likely and family practitioners least likely to refer to MFM (p< 0.001). Pregnancy complications leading to MFM referrals include cardiac complications, renal disease, systemic disorders, PPROM, suspected fetal abnormalities, and cervical insufficiency. Conclusion Referral of high risk pregnancies to MFMs varies with the level of expertise at the primary prenatal site. Increased contact between MFMs and local providers increased MFM referrals. PMID:22821508

  20. Evaluation method for determining management priorities for special case waste

    SciTech Connect

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

    1990-08-01

    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.

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

    PubMed

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

    2010-05-01

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

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

    PubMed Central

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

    2013-01-01

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

  3. Project RavenCare: global multimedia telemedicine in Alaska

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-05-01

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

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

    E-print Network

    Rosen, Jacob

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

  6. Child Protective Services Case Management Project. Final Report: Innovations in Protective Services.

    ERIC Educational Resources Information Center

    Texas State Dept. of Human Resources, Austin.

    One of seven reports in the Innovations in Protective Services series, this document reports on the development of a model of case management that clarified what is expected from Child Protective Service (CPS) specialists. By conducting a literature review, studying the role of the CPS case manager, and developing a case management model, the Case

  7. Management challenges in a case of gender identity disorder

    PubMed Central

    Rathi, Anubhav; Bhatia, Manjeet Singh

    2014-01-01

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

  8. Dental management in an encephalotrigeminal angiomatosis patient: a case report.

    PubMed

    Prashanthi, C; Reddy, Sujatha S; Majumdar, Kuhu

    2014-09-01

    Sturge-Weber Syndrome (SWS) is a rare, non-hereditary, congenital neuro cutaneous disorder characterized by vascular hamartomatous proliferations affecting classically, the leptomeninges and the skin of the face and may be associated with glaucoma, seizures and mental retardation. Intraoral findings are variable. A case of Roach type II Sturge Weber syndrome is reported here that did not show any neurological disorder but revealed a prominent angiomatous enlargement of the ipsilateral maxillary gingiva. SWS is a condition where dental management and surgical procedures of the patient can be risky, thus a sound knowledge of the disease and its management protocols better equips the clinician to avoid serious complications. PMID:25284546

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

    PubMed Central

    Lee, Pei-Yi; Chang, Tsue-Rung

    2015-01-01

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

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

    SciTech Connect

    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

    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.

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

    PubMed

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

    2014-03-01

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

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

    E-print Network

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

    2002-01-01

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

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

    E-print Network

    Malik, Shaheen, 1974-

    2003-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1996-05-01

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

  15. Management of Pediatric Traumatic Macular Holes – Case Report

    PubMed Central

    Azevedo, S.; Ferreira, N.; Meireles, A.

    2013-01-01

    Purpose To report and describe the clinical course of four pediatric traumatic macular hole (TMH) cases and respective management. Case Report Four pediatric patients with macular hole following blunt ocular trauma underwent early pars plana vitrectomy, with consecutive hole closure. Initial visual acuity was <20/400 or worse in all patients. After surgery, all patients had visual acuity improvement, with final visual acuity being <20/50 in 2 of the patients by the end of the follow-up. Macular hole closure was achieved in all patients with a single procedure, and anatomical success was confirmed by optical coherence tomography until the end of the follow-up. Conclusions Although spontaneous closure of TMH is not uncommon, especially in pediatric patients, early pars plana vitrectomy seems to be a safe and effective choice in pediatric TMH management. The risk/benefit ratio of surgery seems to be better than observation. PMID:23898288

  16. Role transition from caregiver to case manager--Part II.

    PubMed

    Schmitt, Nancy

    2006-01-01

    This two-part article explores the process of role transition as it pertains to nurses moving from roles of caregivers to roles of case managers. Part 1 of the article presented a theoretical model that demonstrated the interplay of significant factors in the process of role transition and discussed how this model could be used to examine nurses' experience of this transition. Part 2 presents findings from a qualitative study involving interview and focus group data contributed by nurses who have made the transition from caregiver to case manager. Data point to specific tensions experienced by these nurses, which are associated with time-task orientation, interactions and relationships, business culture and objectives, and self-image and professional identity. Recommendations for preparing and supporting nurses through this role are also offered. PMID:16444121

  17. Role transition from caregiver to case manager, part 1.

    PubMed

    Schmitt, Nancy

    2005-01-01

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

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

    PubMed Central

    Jain, Anoop; Sumra, Nida

    2015-01-01

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

  19. Experiences in case management of diarrhoea in large hospitals.

    PubMed

    Patwari, A K

    1995-06-01

    Scientific basis for oral rehydration therapy (ORT) has revolutionized the concepts and management of diarrheal diseases during the last 25 years. ORT is the only therapy needed in the majority of diarrhea cases. Sometimes, however, in more severe or complicated cases, the judicious use of IV therapy and antimicrobial agents is called for. This approach should form the practical guidelines for the management of diarrhea in hospitals. Indeed, such therapy practiced in Indian hospitals has resulted in fewer diarrhea-related hospital admissions and lower average expenditure per patient. Savings from the reduction in the use of IV fluid and antibiotics have been used to supply oral rehydration solution packets to mothers for use at home. Managing the more severe and complicated cases, large referral hospitals still play a central role in the practice and promotion of standard diarrhea case management (SDCM). Medical colleges and teaching hospitals have an additional responsibility to train doctors, nurses, and health workers in SDCM. The first full-fledged diarrhea training and treatment unit (DTTU) in the country was established in Kalawati Saran Children's Hospital in January 1989. That later served as the National Training Center for training key personnel from other medical colleges and large hospitals in SDCM. The Ministry of Health and Family Welfare trained senior physicians, pediatricians, hospital administrators, and senior nursing personnel from medical colleges, referral hospitals, and district hospitals in SDCM. There are now more than 80 DTTUs functioning in the country. Many more large/referral hospitals have no DTTU, but, nonetheless, actively practice and promote SDCM. PMID:7499899

  20. Laparoscopic management of complicated foreign body ingestion: a case series.

    PubMed

    Chia, Daryl K A; Wijaya, Ramesh; Wong, Andrew; Tan, Su-Ming

    2015-05-01

    This study aims to demonstrate the safety and feasibility of laparoscopic management of complicated foreign body (FB) ingestion in a series of 5 patients. We present the merits of a minimally-invasive approach in this clinical setting from our series as well as published case reports. FB ingestion is occasionally complicated by abscess formation or perforation, requiring surgical intervention. Anecdotal reports of such cases managed by laparoscopic surgery have alluded to its merits over the conventional approach of open surgery. Over an 18-month period, 5 of 256 patients with FB ingestion at our unit were managed by laparoscopic surgery. Clinical and operative data were collected for this study. In all 5 cases, patients could not recall their FB ingestion and had normal plain radiographs. The diagnosis was made on a computed tomography (CT) scan. Laparoscopy was successfully employed to retrieve all FBs (fish bones), deroof abscesses, and primarily repair gastrointestinal perforations. The mean operative time was 69 minutes (55-85), utilizing 2 to 4 noncamera ports. There was no operative mortality and patients were discharged on average postoperative day (POD) 5 (2-8). Laparoscopic surgery is safe and feasible in small-diameter, complicated FB ingestion requiring surgical intervention and should be considered in similar patients. PMID:26011205

  1. An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians.

    PubMed

    Gagnon, Marie-Pierre; Godin, Gaston; Gagné, Camille; Fortin, Jean-Paul; Lamothe, Lise; Reinharz, Daniel; Cloutier, Alain

    2003-09-01

    Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (beta=1.08; P<0.001) and self identity (beta=-0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper. PMID:14519403

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

    Microsoft Academic Search

    Adriana Fodor; Eddy Karnieli

    \\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,

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

    PubMed

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

    2013-05-01

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

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

    PubMed

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

    2015-03-01

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

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

    E-print Network

    Tommelein, Iris D.

    Practical Knowledge Builds Projects: Case for Independent Construction Information Management Knowledge: How Organizations Manage What They Know", Thomas Davenport and Laurence Prusak explain process under independent management, we will create knowledge by making unprecedented amounts of reliable

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

    NASA Technical Reports Server (NTRS)

    1991-01-01

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

  7. Evaluating a Web-Based Interface for Internet Telemedicine

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  8. Telemedicine via satellite to support offshore oil platforms.

    PubMed

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

    2008-01-01

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

  9. Endovascular management of axillosubclavian artery injuries: report of three cases.

    PubMed

    Leong, Benjamin Dak Keung; Naresh, Govindarajanthran; Hanif, Hussein; Lee, Soon Khai; Zainal, Ariffin Azizi; Sara, Chelwan Muniandy

    2013-08-01

    Open surgical repair of axillosubclavian artery injuries is technically demanding and associated with significant morbidity and mortality. Endovascular intervention has emerged as a valuable alternative to open surgical repair. This report presents three cases with axillosubclavian artery injuries managed with endovascular intervention. All three cases had a pseudoaneurysm of the axillosubclavian artery with one case associated with an arteriovenous fistula. They were successfully treated with endovascular stenting and balloon angioplasty. There were no observed acute complications. No complications or recurrence have occurred, with a mean follow-up of 26 months. Endovascular intervention for axillosubclavian artery injuries is less invasive, safe and effective; however, data concerning the long-term effects and complications associated with this technique are lacking. PMID:22987278

  10. Chiropractic management of breast-feeding difficulties: a case report

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2010-05-01

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

  12. BCG-related renal granulomas managed conservatively: A case series

    PubMed Central

    Al-Qaoud, Talal; Brimo, Fadi; Aprikian, Armen G.; Andonian, Sero

    2015-01-01

    Introduction: The aim of this case series is to present two cases of renal granulomas discovered incidentally post-intravesical Bacillus Calmette-Guerin (BCG) installations and were managed conservatively. Case reports: The first case is a 68-year-old man with bladder and right ureteral orifice carcinoma in situ. After transurethral resection of the right ureteral orifice and bladder tumours, he received 6 + 3 weekly intravesical installations of BCG and then 6 + 3 weekly intravesical installations of BCG with interferon alpha (IFN) in the presence of an indwelling ureteral stent since he had refused cystoprostatectomy. At the 18-month follow-up, his computed tomography scan showed two right renal masses. Biopsy demonstrated non-necrotizing granulomatosis. Serial follow-up with imaging studies showed complete resolution of these masses without anti-tuberculous medications. The second case is a 74-year old man with left renal high-grade papillary urothelial carcinoma. After ureteral meatotomy and insertion of indwelling ureteral stents, he received 6 weekly intravesical installations of BCG followed by 3 weekly installations of BCG and IFN prior to the definitive management with laparoscopic left nephroureterectomy. Final pathology showed pT1 urothelial carcinoma and an incidental finding of BCG-related renal granulamotosis. The patient has been asymptomatic and did not require anti-tuberculous medications. Conclusions: While these two cases demonstrate the ability of intravesical BCG to reach the renal pelvis, patients with a history of intravesical BCG with incidental renal masses may benefit from renal biopsy. These renal granulomas may resolve without anti-tuberculous medications.

  13. Case Managers' Attitudes Toward the Use of Homework for People Diagnosed With a Severe Psychiatric Disability

    Microsoft Academic Search

    Peter J. Kelly; F. P. Deane; N. Kazantzis; T. P. Crowe

    2007-01-01

    The study examined mental health case managers' attitudes toward the use of homework and explored the relationship between clinician attitudes and systematic homework ad- ministration 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 attitudes reported better client responses to homework. Systematic home- work

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

    Microsoft Academic Search

    Nadine Nehls

    2001-01-01

    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

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

    E-print Network

    Sheridan, Scott

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

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

    E-print Network

    Sheridan, Scott

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

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

    E-print Network

    Sheridan, Scott

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

  18. Case Management in a Psychiatric Hospital: Review of Outcomes and Resource Utilisation

    Microsoft Academic Search

    R Mahendran; M Hendriks; V Thambyrajah; T Vellayan

    Objective: Case management is a heterogeneous concept used in psychiatry and other health, welfare, and service sectors. The several models of case management in psychiatry can be viewed as arising from task areas of psychiatric care, namely medical, rehabilitation, social control, growth, and development. This study investigated the development of the brokerage model of case management in acute psychiatric care

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

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

  20. Neurocysticercosis: Acute presentation and intensive care management of two cases

    PubMed Central

    Sharma, Aanchal; Mahajan, Charu; Rath, Girija P.; Mohapatra, Sarita; Padhy, Uma P.; Kumar, Lokesh

    2011-01-01

    Neurocysticercosis (NCC), a common helminthic infestation in developing countries, may cause acquired epilepsy and neurological morbidities. Acute symptomatic seizure is the most common manifestation. The other clinical conditions include headache, hydrocephalus, chronic meningitis, focal neurological deficits, and psychological disorders. Altered sensorium and raised intracranial pressure (ICP) may require ventilatory support in an intensive care unit (ICU). Definitive diagnosis is made by identification of parasites in tissues or by a radiological demonstration of the scolex in cystic lesions. Antiepileptic drugs are used to control seizures after NCC. Steroids are generally administered along with antihelminthics, in order to control the edema and intracranial hypertension that may occur as a result of antiparasitic medications. In patients with intracranial hypertension, the priority is to manage the ICP before considering other treatment options. Antiparasitic drug treatment is never the mainstay of treatment, especially in the setting of elevated ICP. Here, we present the ICU management of two such cases. PMID:22013314

  1. Management of familial hypercholesterolemia during pregnancy: case series and discussion.

    PubMed

    Eapen, Danny J; Valiani, Kiran; Reddy, Shilpa; Sperling, Laurence

    2012-01-01

    With an occurrence of approximately 1 in 500 individuals worldwide, the heterozygous form of familial hypercholesterolemia is not uncommon. With statins being contraindicated in pregnancy (Category X), the management of pregnant women who carry this diagnosis has not been clearly defined. This case series describes five pregnant women seen at the Emory Center for Heart Disease Prevention between 2004 and 2010 who carried this diagnosis, their treatment, and subsequent outcomes. The article concludes with treatment options for clinicians in dealing with such individuals. PMID:22264579

  2. Continuous Case Management of a German Statutory Health Insurance

    PubMed Central

    Hecke, Torsten L.; Erzberger, Melanie

    2005-01-01

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

  3. Case Management insider. The top ten mistakes you may be making in your case management department!: Part 1.

    PubMed

    Cesta, Toni

    2015-06-01

    This month we have begun reviewing the top mistakes hospitals make within their case management department's infrastructure. As discussed, the biggest mistake is to not clearly and prospectively define the roles of the RN case manager and the social worker to optimize each discipline's skill sets. Associated with this mistake is to have inadequate patient ratios assigned to each discipline. These mistakes are related and when roles are not clearly defined, it becomes almost impossible to understand or advocate for appropriate staffing ratios. If it appears that nurses and social workers can all do the same things equally well, then the organization will likely choose to go with the professional group that will cost the organization the least amount of money. In the end, this logic is penny-wise and pound foolish. We do both disciplines a disservice when we don't apply their skill sets adequately and don't have each group functioning at the "top of their license!" Next month, we will continue to discuss the top mistakes hospitals make in their acute care management departments' design. We will discuss the use of clerical support staff, assessments, and days of coverage. PMID:26031112

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

    PubMed Central

    2012-01-01

    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. PMID:22709349

  5. Telemedicine based screening of infants at risk for retinopathy of prematurity.

    PubMed

    Lorenz, B; Bock, M; Müller, H M; Massie, N A

    1999-01-01

    Retinopathy of Prematurity (ROP) is a major risk for permanent visual loss in extreme prematures. In stage 3+ (zone I and II), defined as threshold disease, the risk for retinal detachment with subsequent blindness is about 50% without treatment, compared to only a few percent with laser photoablation. Visualisation and interpretation of the critical retinal changes requires a high degree of expertise. Therefore, screening by general ophthalmologists will not identify all cases at threshold necessary to prevent blindness in as many infants as possible. The development of a new digital wide-field camera system (RetCam 120) allows documentation of nearly the entire retina within minutes. Recently, sensitivity, specificity, positive predictive power and negative predictive power have been evaluated to be high. Data collection is also possible by trained staff of the neonatal care units. Data can be transferred electronically, even though it could be transferred through physical transport. Analyzing the data in a central reading center specialized in the treatment of ROP will allow optimal timing of treatment and thus salvage vision in more infants. In addition, unnecessary referrals that are not only expensive but put also stress on the very vulnerable prematures can be avoided. At present, efforts are made to realize a pilot project in Eastern Bavaria that will test the potentials of telemedicine based screening for ROP. In addition, the potential of the system will be evaluated in other neuroophthalmological diseases. PMID:10747534

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

    SciTech Connect

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

    1996-12-31

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

  7. Conservative management of a case of tarsal tunnel syndrome

    PubMed Central

    Hudes, Karen

    2010-01-01

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

  8. The Business Case for Diabetes Disease Management for Managed Care Organizations

    Microsoft Academic Search

    Nancy Dean Beaulieu; David M. Cutler; Katherine E. Ho; George Isham; Tammie Lindquist; Andrew Nelson; Patrick OConnor

    2006-01-01

    Diabetes is a common and very costly chronic disease. There is broad-based agreement on how to manage diabetes, yet less than 40% of adults with diabetes achieve guideline-recommended levels of medical care. We investigate the reasons for this phenomenon by examining the business case for improved diabetes care from the perspective of a single health plan (HealthPartners of Minnesota). The

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

    Microsoft Academic Search

    Hauke Heier; Susanne Strahringer

    2006-01-01

    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

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

    PubMed Central

    Henry, Lucian

    2015-01-01

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

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

    PubMed

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

    2014-12-10

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

  12. A Taxonomy of Telemedicine Efforts with Respect to Applications, Infrastructure, Delivery Tools, Type of Setting and Purpose

    Microsoft Academic Search

    Bengisu Tulu; Samir Chatterjee; Swamy Laxminarayan

    2005-01-01

    In the history of telemedicine, various definitions have been published and numerous terminologies have been coined. The introduction of new technologies played an important role in the changing definitions. After three decades of experience in telemedicine and its variations, the need for a single taxonomy that is detailed enough to define all the terms introduced until today is evident. Taxonomy

  13. The effect of telemedicine on the duration of treatment in dementia patients.

    PubMed

    Cheong, Chae-Kyo; Lim, Kyu-Hyoung; Jang, Jae-Won; Jhoo, Jin Hyeong

    2015-06-01

    We studied 442 patients who met the DSM-IV-TR criteria for dementia and whose treatment was initiated at the Kangwon National University Hospital (KNUH) in Chuncheon. Over a five-year period, there were 259 patients who regularly visited the KNUH dementia clinic in person, and 168 patients who received medical services from the dementia clinic via telemedicine. The telemedicine patients attended a public health centre in Hongcheon, a facility located in a rural area about 50?km south east of the KNUH. The mean treatment duration was significantly longer for the telemedicine group than for the clinical visit group (P?telemedicine (hazard ratio?=?0.55, 95% confidence interval?=?0.42-0.72) were found to be independent predictive factors of increased treatment duration. These findings suggest that telemedicine may be useful in slowing disease progression in dementia patients in rural areas. PMID:25586813

  14. Telemedicine system for the care of patients with neuromuscular disease and chronic respiratory failure

    PubMed Central

    Morete, Emilio; González, Francisco

    2014-01-01

    Introduction Neuromuscular diseases cause a number of limitations which may be improved by using a telemedicine system. These include functional impairment and dependence associated with muscle weakness, the insidious development of respiratory failure and episodes of exacerbation. Material and methods The present study involved three patients with severe neuromuscular disease, chronic respiratory failure and long-term mechanical ventilation, who were followed up using a telemedicine platform. The telemedicine system is based on videoconferencing and telemonitoring of cardiorespiratory variables (oxygen saturation, heart rate, blood pressure and electrocardiogram). Two different protocols were followed depending on whether the patient condition was stable or unstable. Results Over a period of 5 years, we analyzed a series of variables including use of the system, patient satisfaction and clinical impact. Overall we performed 290 videoconference sessions, 269 short monitoring oximetry measurements and 110 blood pressure measurements. With respect to the clinical impact, after enrolment in the telemedicine program, the total number of hospital admissions fell from 18 to 3. Conclusions Our findings indicate that the system was user friendly for patients and care givers. Patient satisfaction scores were acceptable. The telemedicine system was effective for the home treatment of three patients with severe neuromuscular diseases and reduced the need for hospital admissions. PMID:25395959

  15. Positioning the performance of public service. When management tools are in conflict : the case of urban water management

    E-print Network

    Paris-Sud XI, Université de

    in the framework of the total quality management approach. We shall see how, beyond the apparently neutral-existing tool, the quality management approach, to examine how the actors involved question the contentPositioning the performance of public service. When management tools are in conflict : the case

  16. Telemedicine for patients with epilepsy: A pilot experience.

    PubMed

    Haddad, Naim; Grant, Irish; Eswaran, Hari

    2015-03-01

    We aimed to describe our preliminary experience with the telemedicine (TM) seizure clinic. A retrospective database analysis for the TM seizure visits between January 2009 and January 2012 was performed. Each subject's age, gender, epilepsy syndrome, seizure types, and outcome were identified. The antiepileptic drug (AED) regimen at each visit was noted, as well as instances where surgical therapies and admission for monitoring were discussed. We identified a total of 74 encounters with 24 patients. Fifteen subjects (62.5%) had focal epilepsy, whereas seven (29%) had generalized epilepsy. Seven patients (29%) experienced one seizure type, 14 (58.5%) had two seizure types, and five (12.5%) had three or more seizure types. Thirty-two out of the 74 encounters (43%) resulted in some change in the AED regimen. Surgical therapeutic options were discussed in 35% of the visits. Two-thirds of subjects were either seizure-free or improved by the last encounter. The no-show rate was only 11%. We were able to deliver follow-up care through a TM model to patients with epilepsy with a wide spectrum of syndromes and severity. We believe that TM improves access to specialized care for patients with epilepsy living in rural areas. PMID:25617692

  17. Transmission of olfactory information for tele-medicine

    SciTech Connect

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

    1995-01-01

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

  18. A Web Application to Support Telemedicine Services in Brazil

    PubMed Central

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

    2003-01-01

    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. PMID:14728133

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

    Microsoft Academic Search

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

    1999-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  1. Paradise nearly Gained. Volume 2: Case Studies of Impact and Diversity for Frontline Management Initiative Practice.

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    This document presents the case studies from a multi-phase study of the impact of Australia's Frontline Management Initiative (FMI), which provides a framework for competency-based development of frontline managers in Australian enterprises. Nineteen organizational case studies and one individual case study of the FMI's impacts are included. The…

  2. The STARPAHC collection: part of an archive of the history of telemedicine.

    PubMed

    Freiburger, Gary; Holcomb, Mary; Piper, Dave

    2007-01-01

    An early telemedicine project involving NASA, the Papago Tribe (now the Tohono O'odham Indian Nation), the Lockheed Missile and Space Company, the Indian Health Service and the Department of Health, Education and Welfare explored the possibilities of using technology to provide improved health care to a remote population in southern Arizona. The project, called STARPAHC (Space Technology Applied to Rural Papago Advanced Health Care), took place in the 1970s and demonstrated the feasibility of a consortium of public and private partners working together to provide medical care to remote populations via telecommunication. In 2001 the Arizona Health Sciences Library acquired important archival materials documenting the STARPAHC project and in collaboration with the Arizona Telemedicine Program established the Arizona Archive of Telemedicine. The material is likely to interest those studying early attempts to use technology to deliver health care at a distance, as well as those studying the sociological ramifications of technical and scientific projects among indigenous populations. PMID:17697507

  3. [How could telemedicine improve the quality of health care in Poland?].

    PubMed

    Ho?y?ska, Iga; Rybarczyk, Agata; Dawidowicz, Monika; Tyrakowski, Tomasz

    2005-05-01

    From the view-point of the health-care system there is possibility of application of modern communication and informatics technologies to optimize some important aspects of patient treatment. This new fields of medical interest are called: telemedicine and medical telecare. Telemedicine deals with distance diagnose (for example: during emergency transport) and specialist consultations based on videoconferencing programs. Medical telecare concerns with home monitoring of patients with chronic diseases by means of computer control of important diagnostic parameters and automatic signaling when the variables exceed the defined values. Both disciplines share problems of standards of electronic medical documentation, virtual medical care networks and tele-education of health-care professionals and patients. The preliminary trials of introduction of some telemedicine programs in the health service units of local and specialist levels should make possible to evaluate the applicability and advantages of using these technologies in the whole Polish health care system in the future. PMID:16161964

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

    PubMed Central

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

    2013-01-01

    Objectives Evaluate whether telemedicine can be used to perform dysmorphology and neurologic examinations in the neonatal intensive care unit (NICU) by determining the examination accuracy, limitations, and optimized procedures. Study design Prospective evaluation of NICU patients referred for subspecialty consultation for dysmorphic features (n=10) or encephalopathy (n=10). A physician at bedside (bedside clinician) performed an in-person examination which was viewed in real-time by a remote physician (remote consultant). Standardized examinations were recorded and compared. Subsequently, a qualitative approach established technique adjustments and optimization procedures necessary to improve visualization. Results Telemedicine examinations identified 81 of 87 (93%) dysmorphology examination abnormalities and 37 of 39 (92%) neurologic examination abnormalities. Optimization of remote consultant visualization required an active bedside clinician assisting in camera and patient adjustments. Conclusions Telemedicine can be used to accurately perform many components of the dysmorphology or neurologic examinations in NICU patients, but physicians must be mindful of specific limitations. PMID:24406740

  5. Anesthetic management of two cases of Beckwith-Wiedemann syndrome.

    PubMed

    Kimura, Yoshinobu; Kamada, Yasuhiro; Kimura, Saori

    2008-01-01

    Two cases of children with Beckwith-Wiedemann syndrome are presented. This syndrome consists of various abnormalities, including macroglossia, visceromegaly, omphalocele, and gigantism. These abnormalities frequently require operative correction during the neonatal period. We anesthesiologists should make plans for difficult airway managements in patients with this syndrome. Our two patients also showed larger sized tracheas than those estimated by their age and height. A cuffed tube, though still controversial, has recently been used in children. We recommend using a cuffed tube in patients with this syndrome, because the appropriate tracheal size may not be predictable, tracheal intubation might be difficult, and risks incurred during changing of a tracheal tube should be avoided. PMID:18306025

  6. Epidermolysis Bullosa, Dental and Anesthetic Management: A Case Report

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Porter, C J W; Armstrong, J R

    2004-01-01

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

  8. Can economic evaluation in telemedicine be trusted? A systematic review of the literature

    PubMed Central

    Bergmo, Trine S

    2009-01-01

    Background Telemedicine has been advocated as an effective means to provide health care services over a distance. Systematic information on costs and consequences has been called for to support decision-making in this field. This paper provides a review of the quality, validity and generalisability of economic evaluations in telemedicine. Methods A systematic literature search in all relevant databases was conducted and forms the basis for addressing these issues. Only articles published in peer-reviewed journals and written in English in the period from 1990 to 2007 were analysed. The literature search identified 33 economic evaluations where both costs (resource use) and outcomes (non-resource consequences) were measured. Results This review shows that economic evaluations in telemedicine are highly diverse in terms of both the study context and the methods applied. The articles covered several medical specialities ranging from cardiology and dermatology to psychiatry. The studies analysed telemedicine in home care, and in primary and secondary care settings using a variety of different technologies including videoconferencing, still-images and monitoring (store-and-forward telemedicine). Most studies used multiple outcome measures and analysed the effects using disaggregated cost-consequence frameworks. Objectives, study design, and choice of comparators were mostly well reported. The majority of the studies lacked information on perspective and costing method, few used general statistics and sensitivity analysis to assess validity, and even fewer used marginal analysis. Conclusion As this paper demonstrates, the majority of the economic evaluations reviewed were not in accordance with standard evaluation techniques. Further research is needed to explore the reasons for this and to address how economic evaluation in telemedicine best can take advantage of local constraints and at the same time produce valid and generalisable results. PMID:19852828

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

    PubMed Central

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

    2015-01-01

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

  10. Management of intracranial pathology during pregnancy: Case example and review of management strategies

    PubMed Central

    Ravindra, Vijay M.; Braca, John A.; Jensen, Randy L.; Duckworth, Edward A.M.

    2015-01-01

    Background: Intracranial tumors during pregnancy are uncommon, and they present an interesting challenge to both the neurosurgeon and the obstetrician. Special considerations must be made in every aspect of care. The authors use the rare case of a 27-year-old pregnant female with suspected pineal region tumor eventually diagnosed as a thalamic region ganglioglioma to review the current literature on management of pathology in this unique patient population. Case Description: A 27-year-old female who was 26 weeks pregnant presented to her obstetrician with complaints of headaches, blurriness of vision, and left-sided numbness and tingling. She was diagnosed with 1-cm mass in the pineal region and obstructive hydrocephalus. She initially underwent an endoscopic third ventriculostomy with biopsy of what appeared grossly to be a thalamic mass. The child was delivered via cesarean section at 39 weeks. Serial postpartum imaging demonstrated increasing tumor size and enhancement, which led the authors to proceed with subtotal resection via a supracerebellar infratentorial approach with stereotactic neuronavigation. Tissue specimens obtained for pathological analysis resulted in a revised diagnosis of World Health Organization (WHO) grade II ganglioglioma. Conclusions: Pregnancy presents a challenge for any patient requiring neurosurgical intervention. We present an interesting case example with a rare central nervous system neoplasm and discuss the management of intracranial pathology in pregnant patients. PMID:25883835

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

    NASA Astrophysics Data System (ADS)

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

    1999-07-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1994-03-01

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

  13. Cognitive Behavioral Case Management for Depressed Low-income Older Adults

    Microsoft Academic Search

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

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

  14. Clinically based risk management principles for recovered memory cases.

    PubMed

    Gutheil, T G; Simon, R I

    1997-11-01

    Controversy over cases involving so-called recovered memories of sexual abuse has threatened to divide the mental health field, just as lawsuits based on recovered memories have sometimes divided children from parents and others. The authors review issues in this controversy, including the role of misdirected advocacy for recovered memory by some practitioners, the distinction between the actual events and patient's narrative truth as a factor in the therapeutic alliance, and the contrast between therapeutic and legal remedies. They recommend nine clinically based risk management principles to guide clinicians in dealing with cases involving recovered memory. They include the need for documentation and consultation; the value of psychotherapeutic neutrality, maintaining a calm perspective, and understanding the difference between historical and narrative truth; the incompatibility of the roles of treater and forensic expert; the risks of special therapies such as hypnosis; awareness of the roles of other professionals and the significance of the patient's family; and the importance of knowing when to end treatment. PMID:9355166

  15. Knowledge Management in Image Processing by Means of Case-Based Reasoning

    E-print Network

    Paris-Sud XI, Université de

    Knowledge Management in Image Processing by Means of Case-Based Reasoning Valérie Ficet. The implementation of knowledge reuse is achieved by means of Case-Based Reasoning (CBR) techniques. Capitalising

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

    ERIC Educational Resources Information Center

    Lee, Jeongseok

    2009-01-01

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

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

    PubMed

    Stenis, Jan

    2005-02-01

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

  18. Cost benefit of providing comprehensive case management for lead-burdened children

    SciTech Connect

    Ballas, C.; Rusczek, F.A.; DiPentima, R. [City of Manchester Dept. of Health, NH (United States)

    1995-05-01

    It is sometimes difficult to illustrate the cost benefits of providing case management services on the local level. The City of Manchester Department of Health in New Hampshire has identified the cost benefits associated with providing comprehensive case management services to lead-burdened children. Comprehensive case management involves collaborating with primary care providers and health department staff to coordinate appropriate medical and lead-based paint abatement follow-up. Case management also involves making home visits for the purpose of conducting visual home inspections and medical assessments and of providing education and nutrition counselling. The city of Manchester believes that providing case management services can be one of the most beneficial services available for lead-burdened children, as it may help prevent a case of lead poisoning from occurring. Additionally, it is one of the least costly services provided.

  19. Working with families in Assertive Community Treatment (ACT): the case manager's perspective.

    PubMed

    Chen, Fang-pei

    2008-10-01

    In response to research findings of insufficient family involvement in mental health services for people with severe mental illness, this grounded theory study examines case managers' interactions with families of clients in Assertive Community Treatment (ACT). Findings suggest that case managers conceptualize families as sources of social connections, rather than sources of care, for clients. This conceptualization is influenced by case managers' goals, which also guide their assessments of families for involvement in treatment in terms of the extent to which families help attain treatment goals. In developing strategies to work with families, case managers engage in ongoing assessments and consider client permission for family involvement in treatment, family availability to clients, and family wishes for involvement in treatment. Three case examples illustrate the relationships among case managers' goals, assessments of families, and selections of work strategies. The potential role of the ACT model in shaping this particular view on families is also discussed. PMID:19123767

  20. Management of a rare case of arrhythmogenic right ventricular dysplasia in pregnancy: a case report

    PubMed Central

    Anouar, Jarraya; Mohamed, Smaoui; Kamel, Kolsi

    2014-01-01

    Arrhythmogenic right ventricular dysplasia is a rare but not exceptional inherited cardiomyopathy characterized by fibrofatty replacement of the myocardium of the right ventricular which could lead to serious arrhythmia and sudden death. Only a few cases of pregnancies with ARVD have been reported. The aim of this case presentation is to describe the clinical characteristics and anesthetics specificities in management of this disease in pregnancy and in delivery. We report the case of a young woman aged 28 years old with a past history of ARVD treated by medical treatment with radiofrequency ablation. This patient was pregnant and it was scheduled for cesarean section delivery. Preoperative evaluation showed a well tolerated pregnancy inspite of the severity of the ARVD. It was a severe form of ARVD because of RV dilation, the spread of the disease to LV and the history of ventricular tachycardia during an attempted of ablation by radio frequency. The treatment received by the patient was kept until the day of surgery. The act took place under general anesthesia. The postoperative period was uneventful and morphine titration was used for pain relief. The patient exits the hospital 3 days after delivery and breastfeeding was forbidden. We should pay attention on this disease witch is not yet well known and witch is highly risky in the peri-partum period. Even if pregnancy may be tolerated in moderate forms of ARVD, conception and delivery sould be discouraged especially in severe forms. PMID:25852789

  1. Management of a rare case of arrhythmogenic right ventricular dysplasia in pregnancy: a case report.

    PubMed

    Anouar, Jarraya; Mohamed, Smaoui; Kamel, Kolsi

    2014-01-01

    Arrhythmogenic right ventricular dysplasia is a rare but not exceptional inherited cardiomyopathy characterized by fibrofatty replacement of the myocardium of the right ventricular which could lead to serious arrhythmia and sudden death. Only a few cases of pregnancies with ARVD have been reported. The aim of this case presentation is to describe the clinical characteristics and anesthetics specificities in management of this disease in pregnancy and in delivery. We report the case of a young woman aged 28 years old with a past history of ARVD treated by medical treatment with radiofrequency ablation. This patient was pregnant and it was scheduled for cesarean section delivery. Preoperative evaluation showed a well tolerated pregnancy inspite of the severity of the ARVD. It was a severe form of ARVD because of RV dilation, the spread of the disease to LV and the history of ventricular tachycardia during an attempted of ablation by radio frequency. The treatment received by the patient was kept until the day of surgery. The act took place under general anesthesia. The postoperative period was uneventful and morphine titration was used for pain relief. The patient exits the hospital 3 days after delivery and breastfeeding was forbidden. We should pay attention on this disease witch is not yet well known and witch is highly risky in the peri-partum period. Even if pregnancy may be tolerated in moderate forms of ARVD, conception and delivery sould be discouraged especially in severe forms. PMID:25852789

  2. Baby CareLink: development and implementation of a WWW-based system for neonatal home telemedicine.

    PubMed Central

    Gray, J.; Pompilio-Weitzner, G.; Jones, P. C.; Wang, Q.; Coriat, M.; Safran, C.

    1998-01-01

    Baby CareLink is a multifaceted telemedicine application designed to provide individualized information and support to families of Very Low Birth Weight infants. We believe that this innovative use of WWW and telemedicine technologies will improve family satisfaction and clinical care. In conjunction with improvements in family involvement, discharge planning, education, and follow-up enabled by other CareLink components, this system may allow infants to transition home even earlier in their hospital stay and thereby provide a clear cost savings. This paper discusses the CareLink architecture and lessons learned in implementing a telemedicine link with families at home from an in-hospital clinical unit. PMID:9929240

  3. A platform to integrate climate information and rural telemedicine in Malawi

    NASA Astrophysics Data System (ADS)

    Lowe, R.; Chadza, T.; Chirombo, J.; Fonda, C.; Muyepa, A.; Nkoloma, M.; Pietrosemoli, E.; Radicella, S. M.; Tompkins, A. M.; Zennaro, M.

    2012-04-01

    It is commonly accepted that climate plays a role in the transmission of many infectious diseases, particularly those transmitted by mosquitoes such as malaria, which is one of the most important causes of mortality and morbidity in developing countries. Due to time lags involved in the climate-disease transmission system, lagged observed climate variables could provide some predictive lead for forecasting disease epidemics. This lead time could be extended by using forecasts of the climate in disease prediction models. This project aims to implement a platform for the dissemination of climate-driven disease risk forecasts, using a telemedicine approach. A pilot project has been established in Malawi, where a 162 km wireless link has been installed, spanning from Blantyre City to remote health facilities in the district of Mangochi in the Southern region, bordering Lake Malawi. This long Wi-Fi technology allows rural health facilities to upload real-time disease cases as they occur to an online health information system (DHIS2); a national medical database repository administered by the Ministry of Health. This technology provides a real-time data logging system for disease incidence monitoring and facilitates the flow of information between local and national levels. This platform allows statistical and dynamical disease prediction models to be rapidly updated with real-time climate and epidemiological information. This permits health authorities to target timely interventions ahead of an imminent increase in malaria incidence. By integrating meteorological and health information systems in a statistical-dynamical prediction model, we show that a long-distance Wi-Fi link is a practical and inexpensive means to enable the rapid analysis of real-time information in order to target disease prevention and control measures and mobilise resources at the local level.

  4. A web 2.0 telemedicine system integrating TV-centric services and Personal Health Records

    Microsoft Academic Search

    Alberto Faro; Daniela Giordano; Isaak Kavasidis; Concetto Spampinato

    2010-01-01

    In this paper we propose a novel telemedicine system capable of medical data acquisition, transmission, integration and analysis. In detail, the proposed system consists of: 1) a wearable acquisition system for ECG (electrocardiogram), EEG (electroencephalogram), body temperature and blood pressure, 2) a storage\\/analysis center where the acquired medical data are integrated into a Personal Health Record (PHR) system that also

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

    Microsoft Academic Search

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

    1995-01-01

    The United States military gained experience with a deployed telemedicine team and unit during the deployment of United States military troops to Haiti as part of `Operation Uphold Democracy.' Consults were conducted primarily between the 28th combat support hospital in Haiti and Walter Reed Army Medical Center in Washington, D.C. The Advanced Communications Technology Satellite and International Maritime Satellite services

  6. An 802.11 n wireless local area network transmission scheme for wireless telemedicine applications.

    PubMed

    Lin, C F; Hung, S I; Chiang, I H

    2010-10-01

    In this paper, an 802.11 n transmission scheme is proposed for wireless telemedicine applications. IEEE 802.11n standards, a power assignment strategy, space-time block coding (STBC), and an object composition Petri net (OCPN) model are adopted. With the proposed wireless system, G.729 audio bit streams, Joint Photographic Experts Group 2000 (JPEG 2000) clinical images, and Moving Picture Experts Group 4 (MPEG-4) video bit streams achieve a transmission bit error rate (BER) of 10-7, 10-4, and 103 simultaneously. The proposed system meets the requirements prescribed for wireless telemedicine applications. An essential feature of this proposed transmission scheme is that clinical information that requires a high quality of service (QoS) is transmitted at a high power transmission rate with significant error protection. For maximizing resource utilization and minimizing the total transmission power, STBC and adaptive modulation techniques are used in the proposed 802.11 n wireless telemedicine system. Further, low power, direct mapping (DM), low-error protection scheme, and high-level modulation are adopted for messages that can tolerate a high BER. With the proposed transmission scheme, the required reliability of communication can be achieved. Our simulation results have shown that the proposed 802.11 n transmission scheme can be used for developing effective wireless telemedicine systems. PMID:21138238

  7. A Preliminary Investigation on Computer Vision for Telemedicine Systems Using OpenCV

    Microsoft Academic Search

    Zenon Chaczko; LaReine A. Yeoh; Venkatesh Mahadevan

    2010-01-01

    OpenCV is typically, an open source vision library suitable for computer vision programs. In this paper, we present some of our preliminary investigation experiences of developing Computer Vision programs using OpenCV for robotic telemedicine cluster system, within the practice based ICTD subject within the undergraduate Software Engineering Program at the Faculty of Engineering, University of Technology Sydney (UTS). Firstly, it

  8. Building a wireless telemedicine network within a WiMax based networking infrastructure

    Microsoft Academic Search

    Ivan Chorbev; Martin Mihajlov

    2009-01-01

    In this paper we propose an implementation of a WiMAX-based integrated system for e-medicine in the Republic of Macedonia. We present developed telemedicine multimedia services and their related QoS. We also present the problems and challenges for using a public wireless IP network for setting up the system.

  9. Group Speech Therapy in Individuals With Parkinson Disease: Face-to-Face Versus Telemedicine

    E-print Network

    Wilson, Kristel Renee

    2008-07-31

    The purpose of this study was to evaluate the outcomes of group speech therapy for individuals with Parkinson Disease (IWPD) in general and to compare outcomes of group treatment delivered face-to-face (FtF) versus delivery via telemedicine (TM...

  10. Predicted utilization of emergency medical services telemedicine in decreasing ambulance transports

    Microsoft Academic Search

    Paul A. Haskins; David G. Ellis; James Mayrose

    2002-01-01

    Objective. To determine predicted utilization, decrease in ambulance transports, and target population for emergency medical services (EMS) if telemedicine capabilities were available to the medic units in the field. Methods. A retrospective chart review of 345 consecutive ambulance transports to four hospitals (Level I urban trauma center, urban tertiary care center, children's hospital, and suburban community hospital) was performed by

  11. Sun-Sentinel Home care, tele-medicine cut health costs

    E-print Network

    Fernandez, Eduardo

    -like insurance system. #12;"Reducing hospital readmissions will not only save the Medicare program billionsSun-Sentinel Home care, tele-medicine cut health costs Florida programs reduce unnecessary hospital of which are falsely positive, and is admitted unnecessarily to the hospital, where she gets acute

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

    PubMed

    Tishuk, Brian S

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

  13. Governance and management of a deepwater port: a case study

    SciTech Connect

    Olcott, E.S.

    1985-10-01

    A deepwater port is many things to many people. Clearly, the Port of Rotterdam, the largest port in the world, is a deepwater port with its 75 feet of water, more than $1.5 billion invested in facilities and its annual volume of more than 280 million metric tons of cargo in a broad commodity mix. Bantry Bay in Ireland, a major import petroleum and trans-shipment facility for Britain and the European continent, is a deepwater port. So also is the Louisiana Offshore Oil Port (LOOP), comprised of a single-point mooring buoy and sophisticated petroleum distribution system, located in deep water off the Gulf coast of the US. And so is the Port of Seattle a deepwater port, located in the natural deep water of Puget Sound. Deep drafts ports abound in Japan where as many as nine ports have been developed with water depths in excess of 55 feet. The multi-purpose port and industrial island located in Delaware Bay, the case study being scrutinized in this article would also be a deepwater port. The author takes no position in this article on the feasibility of the enterprise. A number of models or options are reviewed on how this project might be organized, managed, and governed if a decision were made to move forward with such an undertaking. 15 references, 2 figures.

  14. Applying case-based reasoning to aid fault management in supervisory control

    Microsoft Academic Search

    Andrew J. Weiner; David A. Thurman; Christine M. Mitchell

    1995-01-01

    This research explores the use of case-based reasoning as a technique for storing fault management experience and making it available to operators confronting similar anomalous situations. Specifically, this project investigates the use of case-based reasoning technology to construct a knowledge base of actual fault management experience. This knowledge base is organized so as to enable the retrieval of this fault

  15. HIV Risk Behavior among Delinquent and Mentally Ill Teens: Case Manager Perspectives

    ERIC Educational Resources Information Center

    Smith, Michael D.; Seal, David Wyatt; Hartley, Shannon

    2006-01-01

    An HIV knowledge survey and qualitative interview were administered to 20 case managers in community-based programs for troubled youth to assess HIV knowledge and their perception of client HIV risk behaviors. Participants had good HIV knowledge. Case managers perceived client youth to be at high risk for HIV infection due to unsafe sexual…

  16. Recognition and management of hungry bone syndrome--a case report.

    PubMed

    Hisham, A N; Aina, E N; Zanariah, H

    2000-03-01

    Hungry bone syndrome (HBS) following successful parathyroid surgery is a well described phenomenon. However, few studies have clearly addressed this syndrome or looked at the outcome of perioperative management. We report a case of HBS following successful parathyroid surgery. The perioperative management is discussed and literature pertaining to this interesting case is reviewed. PMID:11072498

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

    Levine, Joanne; Adams, Ruifang Hope

    2013-01-01

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

  19. AN INDUCTION MODEL OF INFORMATION TECHNOLOGY ENABLED KNOWLEDGE MANAGEMENT: A CASE STUDY

    Microsoft Academic Search

    SHOUHONG WANG; HAI WANG

    Knowledge management (KM) has become an important discipline in the field of management. Yet, few induction models of IT enabled KM are available for research and teaching in the literature. This paper presents the development of an induction model based on five real-life cases of successful KM. Based on a so-called Joint Qualitative Analysis, this case study has identified several

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

    ERIC Educational Resources Information Center

    McLean, Gary N., Ed.

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

  1. Parent Satisfaction with Case Managed Systems of Care for Children and Youth with Severe Emotional Disturbance

    Microsoft Academic Search

    Jeffrey R. Measelle; Rhona S. Weinstein; Miriam Martinez

    1998-01-01

    Case management has emerged as an integral component of current efforts to reform the delivery of mental health services to children and youth with Severe Emotional Disturbance (SED). We examined parental satisfaction with one program's case management system for SED children. In order to validly address parental satisfaction, the program first turned to a group of its parents to develop

  2. How Far Gender Role Is Successful in School Management? Cross Case Analysis from Pakistan

    ERIC Educational Resources Information Center

    Safdar, Qamar

    2007-01-01

    This article reports a case study research about the management of successful schools with special emphasis on female leadership, to prove that gender does matter in successful school management. A cross case analysis was conducted with three different school leaderships, especially with regard to their profiles, personal, academic and…

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

    ERIC Educational Resources Information Center

    Ronnau, John; And Others

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

  4. A Frame of Operational Risk Management System Based on Case-Based Reasoning

    Microsoft Academic Search

    Qian Chen; Jinlin Li; Lun Ran

    2009-01-01

    With more and more increasingly significant attention has paid to operational risk, it is urgent for the banks to find some suitable approaches to measure and manage their operational risk. An operational risk management system (ORMS) is set up, which based on case-based reasoning (CBR) methods. The frame of operational risk management system is presented. Some key techniques associated with

  5. Case Studies on the Support of Computer Managed Instruction Functionalities in e-Learning Systems

    Microsoft Academic Search

    Gennaro Costagliola; Filomena Ferrucci; Vittorio Fuccella

    2006-01-01

    The term computer managed instruction (CMI) often refers to a set of functionalities which allow learning objects to be launched in the learning management system and to exchange data with it. A framework for the support of CMI functionalities in learning management systems, named CMIFramework, has been developed at the University of Salerno. In this paper, we present two case

  6. Exploring quality management for business services from a buyer's perspective using multiple case study evidence

    Microsoft Academic Search

    Elmar Holschbach; Erik Hofmann

    2011-01-01

    Purpose – This paper aims to investigate how buying companies manage the quality for their externally sourced business services. It explores how quality management for business services influences the performance of the buying company and what the major determinants of quality management are. The paper presents case evidence on which a conceptual model with preliminary propositions is built upon. Design\\/methodology\\/approach

  7. Case management in an acute-care hospital: collaborating for quality, cost-effective patient care.

    PubMed

    Grootveld, Kim; Wen, Victoria; Bather, Michelle; Park, Joan

    2014-01-01

    Case management has recently been advanced as a valuable component in achieving quality patient care that is also cost-effective. At St. Michael's Hospital, in Toronto, Ontario, case managers from a variety of professional backgrounds are central to a new care initiative--Rapid Assessment and Planning to Inform Disposition (RAPID)--in the General Internal Medicine (GIM) Unit that is designed to improve patient care and reconcile high emergency department volumes through "smart bed spacing." Involved in both planning and RAPID, GIM's case managers are the link between patient care and utilization management. These stewards of finite resources strive to make the best use of dollars spent while maintaining a commitment to quality care. Collaborating closely with physicians and others across the hospital, GIM's case managers have been instrumental in bringing about significant improvements in care coordination, utilization management and process redesign. PMID:24844723

  8. The global integration of diversity management: a longitudinal case study

    Microsoft Academic Search

    Aulikki Sippola; Adam Smale

    2007-01-01

    Whilst the extant diversity management literature has provided a comprehensive array of theoretical frameworks and empirical studies on how organizations can and have approached the management of a diverse workforce, the same cannot be said about the literature on diversity in an international setting. Indeed, from a diversity management perspective we know surprisingly little about how multinational firms are responding

  9. MULTICHANNEL CUSTOMER MANAGEMENT: A CASE STUDY IN EGYPT

    Microsoft Academic Search

    Maged Ali; Laurence Brooks

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

  10. Web Services for Integrated Management: A Case Study

    Microsoft Academic Search

    Jean-philippe Martin-flatin; Pierre-alain Doffoel; Mario Jeckle

    2004-01-01

    As evidenced by discussions in standards organizations, vendors and the user community have recently showed a growing interest in using XML technologies for management purposes. To investigate the relevance of this approach, we have added support for Web Services to JAMAP (a Java-based research prototype of a management platform) and managed a gigabit transoceanic testbed. In this paper, we present

  11. Quality Management System development: Some implications from case studies

    Microsoft Academic Search

    C. L. Yeung; L. Y. Chan

    1998-01-01

    The literature in the field of Industrial Engineering suggests that the improvement of quality management practices is a continuous development process. According to this suggestion, a Quality Management System (QMS) is developed gradually step-by-step and not in sudden dramatic jumps. It has also been pointed out by many authors that the improvement of quality management progressively leads to more efficient

  12. Assessing the rigor of case study research in supply chain management

    Microsoft Academic Search

    Stefan A. Seuring

    2008-01-01

    Purpose – This paper aims to assess the current practice in research on supply chain management applying a case study method. Two particular research fields, namely sustainable supply chain management (SustSCM) and performance supply chain management (PerformSCM), are used as examples. Design\\/methodology\\/approach – The paper is based on a content analysis, where quality criteria for documenting case study research are

  13. Telemedicine: what framework, what levels of proof, implementation rules.

    PubMed

    Zannad, Faiez; Maugendre, Philippe; Audry, Antoine; Avril, Carole; Blaise, Lucile; Blin, Olivier; Burnel, Philippe; Falise-Mirat, Béatrice; Girault, Danièle; Giri, Isabelle; Goehrs, Jean-Marie; Lassale, Catherine; Le Meur, Roland; Leurent, Pierre; Ratignier-Carbonneil, Christelle; Rossignol, Patrick; Satonnet, Evelyne; Simon, Pierre; Treluyer, Laurent

    2014-01-01

    The concept of telemedicine was formalised in France in the 2009 "Hospital, patients, health territories" (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation. With this background, the round table wanted to produce recommendations on different areas of medical telemonitoring (the role of telemonitoring, the regulatory system, the principles for assessment, methods of use and conditions for sustained and seamless deployment). Whilst many studies carried out on new medical telemonitoring approaches have led to the postulate that it offers benefit, both clinically and in terms of patient quality of life, more information is needed to demonstrate its impact on the organisation of healthcare and the associated medico-economic benefit (criteria, methods, resources). Similarly, contractual frameworks for deployment of telemonitoring do exist, although they are complicated and involve many different stakeholders (Director General fo the Care Offering [Direction générale de l'offre de soins, DGOS], ARS, HAS, Agency for Shared Health Information Systems [Agence des systèmes d'information partagés de santé, ASIP], French National Data Protection Commission [Commission nationale informatique et libertés, CNIL], French National Medical Council [Conseil national de l'Ordre des médecins, CNOM], etc.) that would benefit from a shared approach and seamless exchange between the partners involved. The current challenge is also to define the conditions required to validate a stable economic model in order to promote organisational change. One topical issue is placing the emphasis on its evaluation and operation. Access to patient data, particularly data from the health insurance funds and the use of these data, may enable the process to be more effective. In addition, the budgetary non-fungibility of the various financial envelopes for the different areas of work, restricts the consolidation of financial impact. Funding methods will need to be adapted to this new distribution of roles, both at the centre of the healthcare system and in the industrial ecosystem. All of these changes will help the leaders of our healthcare system to bring this new ambition closer to all of the people working in the health economy. PMID:25230356

  14. Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co., Business…

  15. Comparing the Effectiveness of Telemedicine and Traditional Surveillance in Providing Diabetic Retinopathy Screening Examinations: A Randomized Controlled Trial

    PubMed Central

    Gleitsmann, Ken; Gardiner, Stuart; Sheppler, Christina; Demirel, Shaban; Wooten, Kathleen; Becker, Thomas M.

    2013-01-01

    Abstract Objective: To determine the effectiveness of telemedicine for providing diabetic retinopathy screening examinations compared with the effectiveness of traditional surveillance in community health clinics with a high proportion of minorities, including American Indian/Alaska Natives. Subjects and Methods: We conducted a multicenter, randomized controlled trial and assigned diabetic participants to one of two groups: (1) telemedicine with a nonmydriatic camera or (2) traditional surveillance with an eye care provider. For those receiving telemedicine, the criteria for requiring follow-up with an eye care provider were (1) moderate nonproliferative diabetic retinopathy or higher, (2) presence of clinically significant macular edema, or (3) “unable to grade” result for diabetic retinopathy or macular edema. Results: The telemedicine group (n=296) was more likely to receive a diabetic retinopathy screening examination within the first year of enrollment compared with the traditional surveillance group (n=271) (94% versus 56%, p<0.001). The overall prevalence of diabetic retinopathy at baseline was 21.4%, and macular edema was present in 1.4% of participants. In the telemedicine group, 20.5% would require further evaluation with an eye care provider, and 86% of these referrals were because of poor-quality digital images. Conclusions: Telemedicine using nonmydriatic cameras increased the proportion of participants who obtained diabetic retinopathy screening examinations, and most did not require follow-up with an eye care provider. Telemedicine may be a more effective way to screen patients for diabetic retinopathy and to triage further evaluation with an eye care provider. Methods to decrease poor quality imaging would improve the effectiveness of telemedicine for diabetic retinopathy screening examinations. PMID:24102102

  16. CM experts: hospitals need ED case managers now more than ever.

    PubMed

    2012-10-01

    It's no longer a luxury for hospitals to have case managers in their emergency departments, according to some case management experts--it's a necessity to make sure patients are admitted in the proper status and to ensure that those being discharged from the emergency department have what they need to manage their conditions. Hospitals need to ensure that patients meet medical necessity criteria to avoid losing reimbursement. Case managers can help provide a smooth transition from the emergency department back to the community and connect patients with post-discharge services. Case managers can work with patients who frequently utilize the emergency department and educate them about more appropriate venues of care. PMID:23091838

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

    PubMed Central

    Arora, Suraj; Saluja, Priyanka; Setia, Vikas

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  19. The business case for equal opportunities: implications for women in management

    Microsoft Academic Search

    Catherine Cassell

    1997-01-01

    Recently there has been an increased interest in the business case for equal opportunities. It has been argued that employers are attracted to such a case as it focuses on the business benefits which accrue from equal opportunities strategies. Presents a cautiously critical analysis of the attractiveness of the business case and its implications for women managers. States that the

  20. Additional management improvements are needed to speed case processing at the Federal Energy Regulatory Commission

    Microsoft Academic Search

    Staats

    1980-01-01

    Despite notable progress resulting from actions the Commission has taken and continues to take toward improving case management, the agency still faces a large volume of backlogged cases and lengthy processing delays. At the end of fiscal year 1979, over 15,000 cases were pending, many of which were backlogged - i.e., beyond what the Commission considers a reasonable processing time

  1. The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia

    PubMed Central

    Shiferaw, Fassil; Zolfo, Maria

    2012-01-01

    Background Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes. Objective This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources. Design Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites. Results Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect ‘one size fits all’ technology and the use of combined interoperable applications, according to the local context, is highly recommended. Conclusions Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts. PMID:22479235

  2. Change Management and Complexity: The Case for Narrative Action Research

    ERIC Educational Resources Information Center

    Boxelaar, Lucia; Paine, Mark; Beilin, Ruth

    2007-01-01

    Post-modern theorists have challenged the totalizing and unifying ambitions of change management practices. This paper explores how a narrative action research approach may be used to combine our modernist commitment to facilitate change and collaboration in the land management context with a post-modern sensitivity to complexity and difference.…

  3. Introducing a New Learning Management System: An Institutional Case Study

    ERIC Educational Resources Information Center

    Benson, Robyn; Palaskas, Tom

    2006-01-01

    The introduction of an online learning management system (LMS) raises a number of complex issues involving institutional responses at various levels to the adoption and diffusion of technological change. Issues include those related to governance, management and technical support, as well as to core learning and teaching matters associated with…

  4. Interdisciplinary Programs Focused Populations: The Case of Health Management Program

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Yavich, Roman

    2015-01-01

    The Ariel University has a unique interdisciplinary program in healthcare management that targets experienced healthcare professionals who wish to earn an academic degree. Only one academic study has been held so far on the integration of graduates of an academic university-level school in healthcare management in the field. In the current study,…

  5. Open Source Course Management Systems: A Case Study

    ERIC Educational Resources Information Center

    Remy, Eric

    2005-01-01

    In Fall 2003, Randolph-Macon Woman's College rolled out Claroline, an Open Source course management system for all the classes on campus. This document will cover some background on both Open Source in general and course management systems in specific, discuss technical challenges in the introduction and integration of the system and give some…

  6. Training evaluation: a case study of training Iranian health managers

    Microsoft Academic Search

    Maye Omar; Nancy Gerein; Ehsanullah Tarin; Christopher Butcher; Stephen Pearson; Gholamreza Heidari

    2009-01-01

    BACKGROUND: The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers

  7. Medical waste management in China: A case study of Nanjing

    Microsoft Academic Search

    Zhang Yong; Xiao Gang; Wang Guanxing; Zhou Tao; Jiang Dawei

    2009-01-01

    Medical waste management is of great importance due to its infectious and hazardous nature that can cause undesirable effects on humans and the environment. The objective of this study was to analyze and evaluate the present status of medical waste management in the light of medical waste control regulations in Nanjing. A comprehensive inspection survey was conducted for 15 hospitals,

  8. Case Management: Steadfast Resource for Addressing Linkage to Care and Prevention with Hospitalized HIV-Infected Crack Users

    PubMed Central

    Kenya, Sonjia; Chida, Natasha; Cardenas, Gabriel; Pereyra, Margaret; Del Rio, Carlos; Rodriguez, Allan; Metsch, Lisa

    2015-01-01

    Interviews were conducted among HIV-positive inpatients in Miami, Florida and Atlanta, Georgia to examine whether having a case manager was associated with improved outcomes. We explored whether current use of a case manager was associated with unprotected sex, HIV care, use of antiretroviral medications, and referral to case management at time of diagnosis. Outcomes among patients who received case management were compared to those without a case manager. Participants with a current case manager were significantly more likely to take HIV medications, have obtained HIV care within the past six months, and have been referred to case management when first diagnosed. They were also significantly less likely to engage in unprotected sex within the last six months. Interventions that link HIV positive patients with a case manager may improve HIV health-seeking behaviors and reduce sexual risk engagement which may lead to improved clinical results. PMID:25635176

  9. 77 FR 41986 - Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-17

    ...HUMAN SERVICES Indian Health Service Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services...OCPS), Community Based Model of Public Health Nursing Case Management Services. This program is...

  10. Case Study of Two Alternative Energy Management Systems

    E-print Network

    Wagner, J. R.

    1983-01-01

    Energy Management systems (EMS) have become increasingly popular for reducing energy consumption at commercial and industrial facilities. This paper documents the installation of his equipment in two buildings, one using dedicated wire and the other...

  11. WATERSHED NITROGEN MANAGEMENT "UPPER POTOMAC RIVER BASIN CASE STUDY"

    EPA Science Inventory

    Are watershed processes controlling the yield, transport, and transformation of carbon, nitrogen, and phosphorous scientifically understood and amenable to man's control in an ecological management framework? or many large estuarine ecosystems such as the Hudson, Chesapeake Bay, ...

  12. Telemedicine can improve the quality of oral anticoagulation using portable devices and self-testing at home.

    PubMed

    Barcellona, Doris; Fenu, Lara; Cornacchini, Simona; Marongiu, Francesco

    2013-09-01

    Point-of-care testing (POCT) devices can be used to monitor anticoagulant therapy. We compared patients being monitored at home by self-testing using a POCT device and telemedicine support with a previous period of conventional monitoring at a Thrombosis Centre. A total of 114 anticoagulated patients participated. The number of blood checks (INR) was significantly higher in the home monitoring group and the interval between checks was significantly shorter. The percentage of missed INR checks was significantly higher during the conventional monitoring period compared with home monitoring. Patients were divided into two groups on the basis of the time spent within the therapeutic range (TTR) during conventional monitoring: the unstable group had TTR<70% and the stable group had TTR ?70%. In the unstable group there was a significant increase in TTR with home monitoring: 63% to 68% (P < 0.001) while in the stable group there was no significant change (77% to 75%). The study showed that oral anticoagulation management by means of self-testing is suitable and safe. PMID:24163291

  13. Scaling up a Mobile Telemedicine Solution in Botswana: Keys to Sustainability.

    PubMed

    Ndlovu, Kagiso; Littman-Quinn, Ryan; Park, Elizabeth; Dikai, Zambo; Kovarik, Carrie L

    2014-01-01

    Effective health care delivery is significantly compromised in an environment where resources, both human and technical, are limited. Botswana's health care system is one of the many in the African continent with few specialized medical doctors, thereby posing a barrier to patients' access to health care services. In addition, the traditional landline and non-robust Information Technology (IT) network infrastructure characterized by slow bandwidth still dominates the health care system in Botswana. Upgrading of the landline IT infrastructure to meet today's health care demands is a tedious, long, and expensive process. Despite these challenges, there still lies hope in health care delivery utilizing wireless telecommunication services. Botswana has recently experienced tremendous growth in the mobile telecommunication industry coupled with an increase in the number of individually owned mobile devices. This growth inspired the Botswana-UPenn Partnership (BUP) to collaborate with local partners to explore using mobile devices as tools to improve access to specialized health care delivery. Pilot studies were conducted across four medical specialties, including radiology, oral medicine, dermatology, and cervical cancer screening. Findings from the studies became vital evidence in support of the first scale-up project of a mobile telemedicine solution in Botswana, also known as "Kgonafalo." Some technical and social challenges were encountered during the initial studies, such as malfunctioning of mobile devices, accidental damage of devices, and cultural misalignment between IT and healthcare providers. These challenges brought about lessons learnt, including a strong need for unwavering senior management support, establishment of solid local public-private partnerships, and efficient project sustainability plans. Sustainability milestones included the development and signing of a Memorandum of Understanding (MOU) between the Botswana government and a private telecommunications partner, the publication and awarding of the government tender to a local IT company, and the development and signing of a Memorandum of Agreement between the Ministry of Health Clinical Services department and the local tender winner. The initial system scale-up is scheduled to occur in 2014 and to ensure the project's sustainability, the system is aligned with the national eHealth strategy and local ownership of the project remains at the forefront (1). PMID:25566520

  14. Advanced information management tools for investigation and case management support in a networked heterogeneous computing environment

    NASA Astrophysics Data System (ADS)

    Clifton, T. E., III; Lehrer, Nancy; Klopfenstein, Mark; Hoshstrasser, Belinda; Campbell, Rachel

    1997-02-01

    The right information, at the right time and place, is key to successful law enforcement. The information exists; the challenge is in getting the information to the law enforcement professionals in a usable form, when they need it. Over the last year, the authors have applied advanced information management technologies towards addressing this challenge, in concert with a complementary research effort in secure wireless network technology by SRI International. The goal of the combined efforts is to provide law enforcement professionals the ability to access a wide range of heterogeneous and legacy data sources (structured, as well as free text); process information into digital multimedia case folders; and create World Wide Web-based multimedia products, accessible by selected field investigators via Fortezza-enhanced secure web browsers over encrypted wireless communications. We discuss the results of our knowledge acquisition activities at federal, regional, and local law enforcement organizations; our technical solution; results of the one year development and demonstration effort; and plans for future research.

  15. The role of the Department of Defense in PACS and telemedicine research and development.

    PubMed

    Mogel, Greg T

    2003-01-01

    The United States Department of Defense (DOD) has played a leading role in the movement of digital imaging, picture archiving and communications systems, and more recently telemedicine with its associated technologies into the mainstream of healthcare. Beginning in the 1980s with domestic implementations, and followed in the 1990s by both small and large-scale military deployments, these technologies have been put into action with varying degrees of success. These efforts however, have always served as a guidepost for similar civilian efforts and the establishment of a marketplace for the technologies. This paper examines the history of the DOD's role in these areas, the projects and programs established, assessing their current state of development and identifying the future direction of the DOD's research and implementation efforts in telemedicine and advanced medical technologies. PMID:12620303

  16. Towards Total Quality Management in higher education: A case study of the University of Wolverhampton

    Microsoft Academic Search

    Geoffery D. Doherty

    1993-01-01

    This case study describes why the University of Wolverhampton made the decision first to pursue Total Quality Management (TQM) and then to develop a Quality Assurance System to an international quality standard (ISO 9000).

  17. 63 FR 32015 - Medicare Program; Notice for the Solicitation for Proposals for a Case Management Demonstration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1998-06-11

    ...Demonstration Project Focused on Congestive Heart Failure or Diabetes Mellitus AGENCY: Health...life for beneficiaries with congestive heart failure or diabetes mellitus who are in...focusing on case management of congestive heart failure, diabetes mellitus, or...

  18. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for case management? Social services workers must document regular contact with...

  19. 25 CFR 20.515 - What is required for case management?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for case management? Social services workers must document regular contact with...

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

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.515 What is required for case management? Social services workers must document regular contact with...

  1. The Development and Implementation of Case Management for Substance Use Disorders in North America and Europe

    PubMed Central

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

    2007-01-01

    Because of the multifaceted, chronic, and relapsing nature of substance use disorders, case management has been adapted to work with persons who have these disorders. Deliberate implementation has been identified as a powerful determinant of successful case management. This article focuses on six key questions about implementation of case management services on the basis of a comparison of experiences from the United States, the Netherlands, and Belgium. It was found that case management has been applied in various populations with substance use disorders, and distinct models have been associated with positive effects, such as increased treatment participation and retention, greater use of services, and beneficial drug-related outcomes. Program fidelity, robust implementation, extensive training and supervision, administrative support, a team approach, integration in a comprehensive network of services, and minimal continuity have all been linked to successful implementation. PMID:15292541

  2. “Because Somebody Cared about Me. That's How It Changed Things”: Homeless, Chronically Ill Patients’ Perspectives on Case Management

    PubMed Central

    Davis, Elizabeth; Tamayo, Aracely; Fernandez, Alicia

    2012-01-01

    Background Case management programs for chronically ill, homeless people improve health and resource utilization by linking patients with case managers focused on improving management of medical and psychosocial problems. Little is known about participants’ perspectives on case management interventions. Methods This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective of participants. A standardized interview guide with open-ended questions explored experiences with the case management program and feelings about readiness to leave the program. Results Four recurrent themes emerged: (1) Participants described profound social isolation prior to case management program enrollment; (2) Participants perceived that caring personal relationships with case managers were key to the program; (3) Participants valued assistance with navigating medical and social systems; and (4) Participants perceived that their health improved through both the interpersonal and the practical aspects of case management. Conclusions Chronically ill, homeless people enrolled in a case management program perceived that social support from case managers resulted in improved health. Programs for this population should consider explicitly including comprehensive social support interventions. Further research on case management should explore the impact of different types of social support on outcomes for homeless chronically ill patients. PMID:23029350

  3. Malaria case-management under artemether-lumefantrine treatment policy in Uganda

    Microsoft Academic Search

    Dejan Zurovac; James K Tibenderana; Joan Nankabirwa; James Ssekitooleko; Julius N Njogu; John B Rwakimari; Sylvia Meek; Ambrose Talisuna; Robert W Snow

    2008-01-01

    BACKGROUND: Case-management with artemether-lumefantrine (AL) is one of the key strategies to control malaria in many African countries. Yet, the reports on translation of AL implementation activities into clinical practice are scarce. Here the quality of AL case-management is reported from Uganda; approximately one year after AL replaced combination of chloroquine and sulphadoxine-pyrimethamine (CQ+SP) as recommended first line treatment for

  4. Information needs of case managers caring for persons living with HIV

    Microsoft Academic Search

    Rebecca Schnall; James J Cimino; Leanne M Currie; Suzanne Bakken

    2011-01-01

    ObjectiveThe goals of this study were to explore the information needs of case managers who provide services to persons living with HIV (PLWH) and to assess the applicability of the Information Needs Event Taxonomy in a new population.DesignThe study design was observational with data collection via an online survey.MeasurementsResponses to open-ended survey questions about the information needs of case managers

  5. Surgical Management of Chiari Malformation: Analysis of 128 Cases

    Microsoft Academic Search

    Fuyou Guo; Meiyun Wang; Jiang Long; Huaili Wang; Hongwei Sun; Bo Yang; Laijun Song

    2007-01-01

    Objective: A variety of surgical interventions have been recommended for patients with Chiari malformations (CMs). In this study, we have evaluated the intraoperative findings and clinical outcome in different-aged patients with CMs undergoing posterior fossa decompression. Methods: Sixteen pediatric and 112 adult cases with CMs underwent suboccipital craniectomy and wide duraplasty as well as autogenous bone grafting in selected cases.

  6. Telemedicine as an ethics teaching tool for medical students within the nephrology curriculum.

    PubMed

    Bramstedt, Katrina A; Prang, Melissa; Dave, Sameer; Shin, Paul Ng Hung; Savy, Amani; Fatica, Richard A

    2014-09-01

    A novel patient-centered approach was used to deliver ethics curriculum to medical students. Two medical school clinicians designed a telemedicine session linking their facilities (across 2 continents). The session, Exploring the Patient Experience Through Telemedicine: Dialysis and End-Stage Renal Disease, allowed second-year medical students to explore various parameters of quality of life experienced by dialysis patients. A panel of 4 medical students interviewed a dialysis patient via Skype video connection between the medical school and the hospital's dialysis unit. Interview questions were adapted from the Kidney Disease Quality of Life instrument. During the live video-streamed interview, the remaining 23 second-year medical students observed the session. Afterward, the 23 were offered a voluntary anonymous online feedback survey (15 responded). The 4 panelists submitted narrative responses to 2 open-ended questions about their experience. All 15 responding students "Strongly agreed" or "Agreed" that the session was an aid to their professionalism skills and behaviors; 14 of 15 "Strongly agreed" or "Agreed" that telemedicine technology contributed to their understanding of the topic; 12 of 15 "Strongly agreed" that the session improved their understanding of the psychosocial burdens of dialysis, quality of life, and human suffering, and increased their empathy toward patients; and 12 of 15 "Strongly agreed" or "Agreed" that the session encouraged reflective thinking and was an aid to improving their communication skills. Telemedicine can be an effective and feasible method to deliver an ethics curriculum with a patient-centered approach. Additionally, the cross-cultural experience exposes students to additional contextual features of medicine. PMID:25193732

  7. Non-adherence to telemedicine interventions for drug users: systematic review.

    PubMed

    Moreira, Taís de Campos; Signor, Luciana; Figueiró, Luciana Rizzieri; Fernandes, Simone; Bortolon, Cassandra Borges; Benchaya, Mariana Canellas; Ferigolo, Maristela; Barros, Helena Mt

    2014-06-01

    OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence. PMID:25119947

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

    Microsoft Academic Search

    Fikreyohannes Lemma; Solomon Atnafu; Samuel Kinde Kassegne

    For a developing country such as Ethiopia with a difficult mountainous terrain and limited transportation infrastructure coupled with one of the lowest patient-doctor ratios anywhere in the world (almost 30,000 to 1), telemedicine offers a cost-effective health-care system. This awareness is slowly gaining traction in the country with a pilot program entering a trial and implementation stage. Looking forward, however,

  9. Non-adherence to telemedicine interventions for drug users: systematic review

    PubMed Central

    Moreira, Taís de Campos; Signor, Luciana; Figueiró, Luciana Rizzieri; Fernandes, Simone; Bortolon, Cassandra Borges; Benchaya, Mariana Canellas; Ferigolo, Maristela; Barros, Helena MT

    2014-01-01

    OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence. PMID:25119947

  10. Assessment of long-term outcomes for the STRokE DOC telemedicine trial.

    PubMed

    Meyer, Brett C; Raman, Rema; Ernstrom, Karin; Tafreshi, Gilda M; Huisa, Branko; Stemer, Andrew B; Hemmen, Thomas M

    2012-05-01

    Telemedicine can provide stroke evaluations in locations with limited available expertise. The reliability of telestroke has been established. Decision making efficacy has been shown in the National Institutes of Health's STRokE DOC trial. No prospective trial has assessed long-term telestroke outcomes, however. In an institutional review board-approved trial (NCT00936455), we contacted patients originally enrolled in the STRokE DOC trial. A telephone script was used to verify consent. Patients were asked standardized questions regarding disposition, modified Rankin Scale (mRS) score, mortality, and recurrent stroke for 2 retrospective time points (6 and 12 months postevent) and one current time point. Blind was maintained. Primary outcome measures of mortality and percent mRS score of 0-1 [%mRS(0-1)] at 6 months are reported. Wilcoxon's rank-sum test was used for continuous variables, and Fisher's exact was used for categorical variables. Of the original 222 participants, 75 patients or surrogates could be contacted. Mean time from enrollment was 3.96 ± 1.0 years (range, 2.33-5.45 years). Mean National Institutes of Health Stroke Scale (NIHSS) score was 8 ± 7 (5 ± 8 for telephone; 12 ± 8 for telemedicine; P = .002). The rate of intravenous recombinant tissue plasminogen activator (rt-PA) use was 31%. Six-month %mRS(0-1) outcome was not different, at 42%. Mortality after imputation to the entire study sample also was not different, at 18%. There was no difference in the rate of recurrent stroke (P = .61). Some 85% of patients were home at 6 months. This study reports a good 6-month outcome for stroke patients evaluated by telemedicine or telephone. This design is limited by the time since original enrollment and resultant inability to contact participants. Although these findings can add to the limited data on telemedicine outcomes, a prospective trial is needed. PMID:20851629

  11. Forest management strategies for reducing carbon emissions, the French case

    NASA Astrophysics Data System (ADS)

    Valade, Aude; Luyssaert, Sebastiaan; Bellassen, Valentin; Vallet, Patrick; Martin, Manuel

    2015-04-01

    International agreements now recognize the role of forest in the mitigation of climate change through the levers of in-situ sequestration, storage in products and energy and product substitution. These three strategies of carbon management are often antagonistic and it is still not clear which strategy would have the most significant impact on atmospheric carbon concentrations. With a focus on France, this study compares several scenarios of forest management in terms of their effect on the overall carbon budget from trees to wood-products. We elaborated four scenarios of forest management that target different wood production objectives. One scenario is 'Business as usual' and reproduces the current forest management and wood production levels. Two scenarios target an increase in bioenergy wood production, with either long-term or short-term goals. One scenario aims at increasing the production of timber for construction. For this, an empirical regression model was developed building on the rich French inventory database. The model can project the current forest resource at a time horizon of 20 years for characteristic variables diameter, standing volume, above-ground biomass, stand age. A simplified life-cycle analysis provides a full carbon budget for each scenario from forest management to wood use and allows the identification of the scenario that most reduces carbon emissions.

  12. Meeting the Need for Knowledge Management in Schools with Knowledge-Based Systems - A Case Study

    Microsoft Academic Search

    Anneli Edman

    2005-01-01

    \\u000a Usually the aim with knowledge management is to increase the profit, through capturing, storing, sharing, and utilising knowledge\\u000a in an innovative way. Can knowledge management be of use in organisations as schools, where profit is of no interest? This\\u000a article discusses the need for knowledge management from the perspectives of students, teachers and parents. In a case study\\u000a master students

  13. Management and Training across Cultures: Importance of Non-Verbal Communication Strategies--A Case Study.

    ERIC Educational Resources Information Center

    Potoker, Elaine

    Noting that cross-cultural and language barriers pose formidable challenges to managers, a case study examined the application of selective nonverbal communication strategies (nonverbal cues, learning by observation, and the organization of learning) for management and training development efforts within diverse cultural environments. Source…

  14. DISEASE EPIDEMIOLOGY -INFECTIOUS Open Access Rational case management of malaria with a

    E-print Network

    Paris-Sud XI, Université de

    DISEASE EPIDEMIOLOGY - INFECTIOUS Open Access Rational case management of malaria with a rapid and prevention strategies are recommended by the World Health Organization for the control of malaria during management of malaria in pregnancy in Bangui, Central African Republic. Methods: A cohort of 76 pregnant

  15. Table of Contents Traceability Management from `Business Processes' to `Use Cases' 15

    E-print Network

    Rumpe, Bernhard

    Table of Contents Preface 5 Traceability Management from `Business Processes' to `Use Cases' 15) An information management project: What to do when your business 95 specification is ready Haim Kilov (Merill Birol Berkem (CNAM, Cergy, Paris, France) Comparative Analysis of the OO Business System Specification

  16. Water accounting for conjunctive groundwater/surface water management: case of the SingkarakOmbilin

    E-print Network

    Walter, M.Todd

    groundwater levels. q 2004 Elsevier B.V. All rights reserved. Keywords: Water accounting; Water balanceWater accounting for conjunctive groundwater/surface water management: case of the Singkarak University, 216 Riley-Robb Hall, Ithaca, NY 14853-5701, USA b International Water Management Institute, P

  17. Case report: Non-invasive management of Madura foot with oral posaconazole and ciprofloxacin.

    PubMed

    Sharma, Amit M; Sharma, Namita; Nat, Amritpal; Rane, Meghan; Endy, Timothy P

    2014-12-01

    Madura foot is a chronic infection caused by fungus and/or bacteria. Traditionally, treatment has been surgical debridement or amputation. Non-invasive management with long-term antimicrobials alone has been reported as successful. We report a case of Madura foot in a Somali refugee successfully managed with oral posaconazole and ciprofloxacin. PMID:25349373

  18. Stakeholder Participation In Site Assessment And Management: A Real Case Of Vincennes, France B. Hazebrouck13

    E-print Network

    Boyer, Edmond

    assessment and thé management of a contaminated site. It is also acknowledged to be a difficult and sometimes cases of extensive stakeholders1 participation on contaminated sites in Europe. No guideline or support management of a contaminated site. It is also acknowledged to be a difficult and sometimes risky challenge

  19. Assessing the US watershed management movement: national trends and an Illinois case study

    Microsoft Academic Search

    Leslie A. Duram; Timothy Loftus; Jane Adams; Christopher L. Lant; Steven E. Kraft

    2008-01-01

    Local watershed planning is an increasingly important component of environmental management. This article provides an overview of local watershed management efforts occurring across the US and then focuses on one case study from southern Illinois. First, analysis of 1145 local watershed groups shows that government agencies, farmers, and rural residents are key stakeholders in local groups that primarily deal with

  20. Modeling Safety Case Evolution Examples from the Air Traffic Management Domain

    E-print Network

    Felici, Massimo

    Modeling Safety Case Evolution ­ Examples from the Air Traffic Management Domain Massimo Felici]. Enhancing safety levels affects the ability to accommodate increased traffic demand as well the ATM (Air Traffic Management) 2000+ Strategy, systems from different suppli- ers will be interconnected

  1. Virtual Organisation in the Small Business Sector: The Case of Cavendish Management Resources

    Microsoft Academic Search

    Christopher Barnatt

    1997-01-01

    MARGARIDA FONTES IS A RESEARCHER li\\/Eat the Instituto Nacional de LYL Enghenaria e Tecnologia Industrial in Lisbon, Portugal, and Rod Coombs is Professor of Technology Management at the Manchester School of Management, United Kingdom. This paper addresses the process of internationalisation of new technology based firms (NTBFs), focusing on the case of firms from small, less advanced economies. NTBFs operating

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

    E-print Network

    Paris-Sud XI, Université de

    in "Security and Privacy - Silver Linings in the Cloud Springer (Ed.) (2012) 31-42" DOI : 10Group Dynamics in a Security Risk Management Team Context: A Teaching Case Study Rostyslav-up of security risk management teams and their performance. Three different models were used to construct team

  3. Knowledge Management and the Practice of Knowledge Sharing and Learning at Work: A Case Study

    ERIC Educational Resources Information Center

    Elmholdt, Claus

    2004-01-01

    This article offers a critique of knowledge management. The critique is empirically based on the case study of a Danish software production company's (A-Soft) knowledge management strategy of implementing an information technology (IT) tool known as 'knowledge centre' (KC). The article argues: (1) the discourses on knowledge and learning informing…

  4. Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

    ERIC Educational Resources Information Center

    Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

    2014-01-01

    With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages,…

  5. Exploring the Dynamics behind Knowledge Management Challenges—An Enterprise Resource Planning Case Study

    Microsoft Academic Search

    Ulrich Remus

    2012-01-01

    The conductor of this case study uses causal mapping to show that external changes to an enterprise resource planning project can trigger a chain reaction, resulting in weak performance of key knowledge management activities such as knowledge capture, sharing, and integration. Management decisions responding to these changes may lead to knowledge dilemmas that can trigger unwanted dynamic behavior, finally causing

  6. Development and pilot of Case Manager: a virtual-patient experience for veterinary students.

    PubMed

    Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P

    2014-01-01

    There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format. PMID:24947678

  7. Management and control of clinical engineering productivity: a case study.

    PubMed

    Mahachek, A R

    1987-01-01

    This paper describes, in chronological order, the steps taken to install productivity measurements and controls within the Clinical Engineering Department of a large teaching hospital. Motivation for this project involved both preparation for going "for profit" and the need to resolve an over-budget condition of labor cost. The project steps included current hospital management reports, database adequacy, supervisors' time logs, computerized budget spread sheets, testing changes on a financial simulation model, developing labor task standards, and departmental labor performance reporting. The project yielded significant positive results for the department's performance versus budget and also led to growth in supervisory and management skills. PMID:10301536

  8. Managing Action Duration Uncertainty with Just-In-Case Scheduling

    NASA Technical Reports Server (NTRS)

    Bresina, John; Drummond, Mark; Swanson, Keith

    1994-01-01

    Some applications involve automatic generation and execution of schedules that contain actions with uncertain durations. Such uncertainty can cause schedules to break during execution. This paper presents a technique, called Just-In-Case scheduling or JIC, for building robust schedules that tend not to break. The technique implements the common sense idea of being prepared for likely errors, just in case they should occur. The JIC algorithm analyzes a given schedule, determines where it is likely to break, reinvokes the scheduler to generate a contingent schedule for each highly probable break case, and produces a "multiply contingent" schedule. The technique was developed for a real telescope scheduling problem, and the paper presents empirical results showing that Just-In-Case scheduling performs extremely well for this problem.

  9. Case Studies of State-Wide Special Education Management Systems.

    ERIC Educational Resources Information Center

    Education Turnkey Systems, Inc., Falls Church, VA.

    This report presents results of a study of five state and local computer-based special education management information systems (MISs). Descriptions are provided of the five MISs used for reporting and decision-making in special education, the planning and implementation processes used by the states and districts, and the general benefits that…

  10. Managing Learning Trajectories: The Case of 14-19 Mathematics

    ERIC Educational Resources Information Center

    Noyes, Andrew; Sealey, Paula

    2011-01-01

    In this paper we explore how mathematics department leaders manage curriculum (what is taught), teaching (how it is taught) and learner progression (what results) for 14-19 year olds. The background to the study is a range of national, and international, concerns about participation rates in university entrance level mathematics. Given the…

  11. Standardized food safety management: the case of industrial yoghurt

    Microsoft Academic Search

    Panagiotis Chountalas; Dimitrios Tsarouchas; Athanasios Lagodimos

    2009-01-01

    Purpose – The recently introduced ISO 22000:2005 modified the classical HACCP approach by embedding food safety into the wider context of a standardized management system and refining the required safety control measures. There is little guidance regarding ISO 22000 implementation as well as inconsistencies regarding definitions and control measures specifications. This paper aims to provide a structured approach for the

  12. Integrating System Modeling with Project Management - A Case Study

    Microsoft Academic Search

    Jonas Helming; Jörn David; Maximilian Koegel; Helmut Naughton

    2009-01-01

    In software engineering projects, there are two different types of modeling tools. On the one hand, there are tools to model the system under construction, i.e. tools for requirements or UML tools for design. On the other hand, there are tools to model the project itself such as project management tools, bug trackers, or tools to model the organizational structure.

  13. Integrated maintenance management of hospital buildings: a case study

    Microsoft Academic Search

    Sarel Lavy; Igal M. Shohet

    2004-01-01

    Over the course of the past three decades, facilities management has become the subject of an increasing number of research and development efforts. The main objective of the present research was to examine the efficiency of maintenance under alternative maintenance policies and different sources of human resources. The research focused on the maintenance of public hospital buildings in Israel, with

  14. Live Case Analysis: Pedagogical Problems and Prospects in Management Education

    ERIC Educational Resources Information Center

    Roth, Kevin J.; Smith, Chad

    2009-01-01

    The selection of an appropriate and effective pedagogy has been a central theme in management education for decades. There currently exists a wide range of pedagogical options designed to match course content with the most appropriate technique(s) for effective learning outcomes. Most recently, a variety of experiential learning methods have been…

  15. Managing water losses in Amman's renovated network: a case study

    Microsoft Academic Search

    Christian W. Decker

    2006-01-01

    Purpose – To provide water utilities operating under rationing conditions with some insight into issues related to managing non-revenue water (NRW). Design\\/methodology\\/approach – Reviews general theories associated with pressure, surges and water leakage, and compares them with real data in a rationed water distribution system. Findings – In water networks there is a strong relationship between rationing hours and rationing

  16. Case Studies for Management Development in Bangladesh. Third Book. Prepared for the World Bank/Bangladesh Management Education and Training Project.

    ERIC Educational Resources Information Center

    McLean, Gary N.

    This document contains 10 case studies of management situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. Two to four discussion questions follow each case study. Three case studies on the subject of pay and compensation were prepared by Abu Hossain Siddique; the…

  17. Human Resource Management Policies and Productivity: New Evidence from An Econometric Case Study

    Microsoft Academic Search

    Derek C. Jones; Panu Kalmi; Antti Kauhanen

    2006-01-01

    First we distinguish various approaches used by economists to assess the impact of human resource management practices on productivity and then we briefly review and illustrate studies that represent different approaches. In the main part of the paper we illustrate the econometric case study method, by using new data to analyse a case from retail trade and by emulating an

  18. Learning from Action Evaluation of the Use of Multimedia Case Studies in Management Information Systems Courses

    ERIC Educational Resources Information Center

    Kawulich, Barbara B.

    2011-01-01

    This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…

  19. No Teacher Left behind: Transition Management in Teacher Education--A Case Study

    ERIC Educational Resources Information Center

    DePeza, Hazel Ann Gibbs

    2010-01-01

    This qualitative case study examined the management of the transition and implementation of the process of change from in-service to pre-service teacher education in Trinidad and Tobago in 2006 and explored the perceptions of 21 participants of the transition process. This case study was both exploratory and descriptive. It explored the change…

  20. The action-oriented approach and case study method in management studies

    Microsoft Academic Search

    Pekka Pihlanto

    1994-01-01

    Although the case study method has become increasingly popular in management studies, it does not always seem to be properly understood: researchers have not fully clarified for themselves the scientific approach they are using, although it greatly controls the realization of a study. This article focuses on action-oriented or hermeneutic case studies. The subjectivist nature of this approach and its

  1. True and False Allegations of Child Sexual Abuse: Assessment and Case Management.

    ERIC Educational Resources Information Center

    Ney, Tara, Ed.

    This book addresses the clinical, legal, and ethical issues arising in child sexual abuse cases; the assessment and case management of allegations; research issues; and practice recommendations. Chapter titles are as follows: "Assessing Allegations in Child Sexual Abuse: An Overview" (Tara Ney); "The Nature of Allegations of Child Sexual Abuse"…

  2. Anesthetic management of caesarean section of a pregnant woman with cerebral arteriovenous malformation: a case report

    Microsoft Academic Search

    Demet Coskun; Ahmet Mahli; Zerrin Yilmaz; Pelin Cizmeci

    2008-01-01

    INTRODUCTION: The choice of anesthetic technique for Caesarean section of a pregnant woman with cerebral arteriovenous malformation (AVM) is made to maintain a stable cardiovascular system, but due to the rarity of this condition, no definitive guidelines exist. CASE PRESENTATION: We report the case of anesthetic management of Caesarean section of a pregnant woman with cerebral AVM (grade V). After

  3. An Innovative Approach for Reviewing Case Studies Conducted at a Taiwan University - Information Management Perspectives

    Microsoft Academic Search

    Pei-Hsuan Hsieh

    This research proposes an innovative approach for r eviewing 52 case studies conducted at a Taiwan univ ersity. The roles played by the cases are first clarified, followed by a discussion of the formation of the ca ses by the study methods. Then, by applying the perspectives from th e information management (IM) field, three study met hod types: algorithm

  4. Management Consulting Case Study. Research on Evaluation Program. Paper and Report Series. No. 74.

    ERIC Educational Resources Information Center

    Stanfield, Jonathan

    A set of studies done for the Washington State Superintendent of Public Instruction (WSPI) constituted a case study testing the conjecture that management consulting is potentially cost effective in some areas of educational evaluation. The case study involved first interviewing 22 respondents from four WSPI constituencies (educators, employers,…

  5. A technology management perspective on collaborations in the Indian automobile industry: a case study

    Microsoft Academic Search

    Zafar Husain; Sushil; R. D Pathak

    2002-01-01

    A study was conducted to analyze technology management practices of firms in the automobile industry in India. The case studies of three firms which collaborated in post Indian independence (i.e. after 1947) period and after the economic reforms began (i.e. after 1985) have been presented. The cases were prepared using interviewing and observation techniques. Profitability, liquidity, and turnover ratio analyses

  6. Technology management: case study of an integrated health system.

    PubMed

    Dahl, D H; McFarlan, T K

    1994-12-01

    Technology management has assumed a role of vital importance in today's health care environment. Capital reserves and operating income have been stretched by pervasive and expensive technologies, while overall reimbursement has been reduced. It is imperative for hospitals to develop and consistently use technology management processes that begin prior to a technology's introduction in the hospital and continue throughout its life cycle. At Samaritan Health System (SHS), an integrated health care delivery system based in Phoenix, technology management provides tools to improve decision making and assist in the system's integration strategy as well as control expenses. SHS uses a systemwide technology-specific plan to guide acquisition and/or funding decisions. This plan describes how particular technologies can help achieve SHS' organizational goals such as promoting system integration and/or improving patient outcomes while providing good economic value. After technologies are targeted in this systemwide plan they are prioritized using a two-stage capital prioritization process. The first stage of the capital prioritization process considers the quantitative and qualitative factors critical for equitable capital distribution across the system. The second stage develops a sense of ownership among the parties that affect and are affected by the allocation at a facility level. This process promotes an efficient, effective, equitable, and defensible approach to resource allocation and technology decision making. Minimizing equipment maintenance expenditures is also an integral part of technology management at SHS. The keys to reducing maintenance expenditures are having a process in place that supports a routine fiscal evaluation of maintenance coverage options and ensuring that manufacturers are obligated to provide critical maintenance resources at the time of equipment purchase. Maintenance service options under consideration in this report include full-service contracts with the manufacturer, insurance coverage, time and materials, and independent service vendors/in-house support. Careful consideration of all the ramifications of each option is warranted because there are substantial cost differences among these methods. At SHS, technology management efforts resulted in equipment purchases and maintenance negotiations representing savings of more than $1.5 million in a single year. SHS undertakes an intensive review of purchases and maintenance expenditures, using the techniques described in this report, with the objective of reducing expenses by 10% per year. This report describes the technology management methods that SHS uses to achieve these results. PMID:10139509

  7. Medical Management of Thyroid Ectopia: Report of Three Cases

    PubMed Central

    Dutta, Deep; Kumar, Manoj; Thukral, Anubhav; Biswas, Dibakar; Jain, Rajesh; Ghosh, Sujoy; Mukhopadhyay, Satinath; Chowdhury, Subhankar

    2013-01-01

    Thyroid ectopia (TE) is an embryological aberration of the thyroid gland migration most commonly observed in the lingual region followed by the sublingual, hyoid, and mediastinal regions. TE is often complicated by local compressive symptoms resulting in dysphagia, dysphonia, and dyspnea. Surgical removal of TE is frequently complicated by difficulties in intubation, increased perioperative bleeding, and severe primary hypothyroidism; on the other hand, I131 ablation is limited by high doses needed and the concern for long-term effects especially in children. We report three children with TE who all presented with compressive symptoms and were managed conservatively with levothyroxine resulting in resolution of compressive symptoms and favorable outcomes. Levothyroxine supplementation is effective and has an important role in managing TE, not only in correcting the associated hypothyroidism but also in resolving the associated compressive symptoms by reducing the size of the ectopic thyroid tissue. Conflict of interest:None declared. PMID:24072094

  8. Training evaluation: a case study of training Iranian health managers

    PubMed Central

    Omar, Maye; Gerein, Nancy; Tarin, Ehsanullah; Butcher, Christopher; Pearson, Stephen; Heidari, Gholamreza

    2009-01-01

    Background The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes. Methods The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact. Results Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and leadership. Participants reported little difficulty in applying learning deemed "useful", and had applied it often. In general, a learning area was used less when it was found difficult to apply, with a few exceptions, such as problem-solving. Four fifths of respondents claimed they could perform their jobs better because of new skills and more in-depth understanding of health systems, and one third had been asked to train their colleagues, indicating a potential for impact on their organization. Interviews with key informants indicated that job performance of trainees had improved. Conclusion The health management training programmes in Iran, and the external university involved in capacity building, benefited from following basic principles of good training practice, which incorporated needs assessment, selection of participants and definition of appropriate learning outcomes, course content and methods, along with focused evaluation. Contracts for external assistance should include specific mention of capacity building, and allow for the collaborative development of courses and of evaluation plans, in order to build capacity of local partners throughout the training cycle. This would also help to develop training content that uses material from local health management situations to demonstrate key theories and develop locally required skills. Training evaluations should as a minimum assess participants' reactions and learning for every course. Communication of evaluation results should be designed to ensure that data informs training activities, as well as the health and human resources managers who are investing in the development of their staff. PMID:19265528

  9. Community-based case management for the prevention of suicide reattempts in Kaohsiung, Taiwan.

    PubMed

    Chen, Wei-Jen; Chen, Cheng-Chung; Ho, Chi-Kung; Lee, Ming-Been; Lin, Guei-Ging; Chou, Frank Huang-Chih

    2012-12-01

    Although a previous suicide attempt constitutes a major risk factor for an eventual completed suicide, few interventions specifically designed to prevent suicide reattempt shave been evaluated. The aim of this study was to determine the effectiveness of case management for the prevention of suicide reattempts. A total of 4,765 subjects with a recent suicide attempt referred from medical and non-medical organizations were consecutively recruited from July 2006 to June 2008. The suicide prevention program of Kaohsiung Suicide Prevention Center (KSPC)provided case management and followed up suicide attempt cases for 6 months. Survival analysis showed that the risk of suicide reattempt was significantly lower in the case management group than in the non-contact group throughout a six-month follow-up period (hazard ratio =2.93; 95% CI = 2.47–3.47). The hazard ratio (HR) of the Cox proportional hazard model for sex was 0.77 (95%CI = 0.65–0.91). Case management appears to be effective in preventing suicide reattempts in patients with a recent prior attempt. In addition, case management appeared to be more beneficial in preventing suicide reattempts in male subjects. PMID:22302211

  10. Managing benzodiazepine withdrawal during pregnancy: case-based guidelines.

    PubMed

    Gopalan, Priya; Glance, Jody B; Azzam, Pierre N

    2014-04-01

    Substance use disorders during pregnancy pose serious risks for both the mother and the fetus, demanding careful monitoring by the patient's medical providers. Sedative-hypnotic use, in particular, is common but remains poorly studied. Management of withdrawal from chronic benzodiazepine use during pregnancy presents unique challenges to the treating physician. We present two pregnant patients with dependence on sedative-hypnotic agents, outline principles of benzodiazepine withdrawal, and suggest guidelines for detoxification during pregnancy. PMID:24271083

  11. Hospital waste management and toxicity evaluation: A case study

    SciTech Connect

    Tsakona, M.; Anagnostopoulou, E. [Laboratory of Toxic and Hazardous Waste Management, Department of Environmental Engineers, Technical University of Crete, GR-73100 Polytechnioupolis, Chania, Crete (Greece); Gidarakos, E. [Laboratory of Toxic and Hazardous Waste Management, Department of Environmental Engineers, Technical University of Crete, GR-73100 Polytechnioupolis, Chania, Crete (Greece)], E-mail: gidarako@mred.tuc.gr

    2007-07-01

    Hospital waste management is an imperative environmental and public safety issue, due to the waste's infectious and hazardous character. This paper examines the existing waste strategy of a typical hospital in Greece with a bed capacity of 400-600. The segregation, collection, packaging, storage, transportation and disposal of waste were monitored and the observed problematic areas documented. The concentrations of BOD, COD and heavy metals were measured in the wastewater the hospital generated. The wastewater's toxicity was also investigated. During the study, omissions and negligence were observed at every stage of the waste management system, particularly with regard to the treatment of infectious waste. Inappropriate collection and transportation procedures for infectious waste, which jeopardized the safety of staff and patients, were recorded. However, inappropriate segregation practices were the dominant problem, which led to increased quantities of generated infectious waste and hence higher costs for their disposal. Infectious waste production was estimated using two different methods: one by weighing the incinerated waste (880 kg day{sup -1}) and the other by estimating the number of waste bags produced each day (650 kg day{sup -1}). Furthermore, measurements of the EC{sub 50} parameter in wastewater samples revealed an increased toxicity in all samples. In addition, hazardous organic compounds were detected in wastewater samples using a gas chromatograph/mass spectrograph. Proposals recommending the application of a comprehensive hospital waste management system are presented that will ensure that any potential risks hospital wastes pose to public health and to the environment are minimized.

  12. A comparison of telemedicine teaching to in-person teaching for the acquisition of an ultrasound skill?-?a pilot project.

    PubMed

    Brisson, Anne-Marie; Steinmetz, Peter; Oleskevich, Sharon; Lewis, John; Reid, Andrew

    2015-06-01

    Telemedicine is widely used for medical education but few studies directly investigate how telemedicine teaching compares to conventional in-person teaching. Here we determine whether telemedicine teaching is as effective as in-person teaching for the acquisition of an ultrasound skill important in trauma care. Nurses with no prior ultrasound experience (n?=?10) received study material and a teaching session on how to locate and image the hepatorenal space (Morison's pouch). One group of nurses was taught in-person (In-person Group) and the other group was taught via telemedicine (Telemedicine Group). Telemedicine allowed two-way audio and visual communication between the instructor and the nurses. A comparison of the teaching techniques showed that telemedicine teaching was equivalent to in-person teaching for the acquisition of practical and theoretical skills required to locate Morison's pouch. The average time required to locate Morison's pouch after teaching was similar between both groups. The results demonstrate that telemedicine teaching is as effective as in-person teaching for the acquisition of bedside ultrasound skills necessary to identify Morison's pouch. Remote teaching of these bedside ultrasound skills may help in the diagnosis of intra-abdominal bleeding in rural healthcare centers. PMID:25766853

  13. Designing a complex intervention for dementia case management in primary care

    PubMed Central

    2013-01-01

    Background Community-based support will become increasingly important for people with dementia, but currently services are fragmented and the quality of care is variable. Case management is a popular approach to care co-ordination, but evidence to date on its effectiveness in dementia has been equivocal. Case management interventions need to be designed to overcome obstacles to care co-ordination and maximise benefit. A successful case management methodology was adapted from the United States (US) version for use in English primary care, with a view to a definitive trial. Medical Research Council guidance on the development of complex interventions was implemented in the adaptation process, to capture the skill sets, person characteristics and learning needs of primary care based case managers. Methods Co-design of the case manager role in a single NHS provider organisation, with external peer review by professionals and carers, in an iterative technology development process. Results The generic skills and personal attributes were described for practice nurses taking up the case manager role in their workplaces, and for social workers seconded to general practice teams, together with a method of assessing their learning needs. A manual of information material for people with dementia and their family carers was also created using the US intervention as its source. Conclusions Co-design produces rich products that have face validity and map onto the complexities of dementia and of health and care services. The feasibility of the case manager role, as described and defined by this process, needs evaluation in ‘real life’ settings. PMID:23865537

  14. Effect of a behavioural health and specialty care telemedicine programme on goal attainment for youths in juvenile detention.

    PubMed

    Fox, Karen C; Connor, Pamela; McCullers, Elizabeth; Waters, Teresa

    2008-01-01

    We conducted a pre-post study of the effect of a telepsychiatry counselling service on youths housed in three juvenile detention facilities. In the first year of the telemedicine programme, 321 psychiatry consultations were conducted via telemedicine; in the second year of the programme, 573 psychiatry consultations were conducted. Records for 190 students were then examined by two raters. The total number of behavioural goals for each adolescent increased from 8.2 in the pre-telemedicine year to 8.7 in the first year of telemedicine and then to 10.0 in the second year (P < 0.05). In Year 2 of the study, subjects also had a significantly higher number of goals in four of the five categories: education, family, health and social skills (P < 0.05). Although other changes at the youth detention facilities or in the juvenile justice system may have been partly responsible for the effects observed, the study suggests that telemedicine may be useful for improving the rate of attainment of goals associated with family relations and personality/behaviour. PMID:18632995

  15. Using off-the-shelf medical devices for biomedical signal monitoring in a telemedicine system for emergency medical services.

    PubMed

    Thelen, Sebastian; Czaplik, Michael; Meisen, Philipp; Schilberg, Daniel; Jeschke, Sabina

    2015-01-01

    In order to study new methods of telemedicine usage in the context of emergency medical services, researchers need to prototype integrated telemedicine systems. To conduct a one-year trial phase-intended to study a new application of telemedicine in German emergency medical services-we used off-the-shelf medical devices and software to realize real-time patient monitoring within an integrated telemedicine system prototype. We demonstrate its feasibility by presenting the integrated real-time patient monitoring solution, by studying signal delay and transmission robustness regarding changing communication channel characteristics, and by evaluating issues reported by the physicians during the trial phase. Where standards like HL7 and the IEEE 11073 family are intended to enable interoperability of product grade medical devices, we show that research prototypes benefit from the use of web technologies and simple device interfaces, as they simplify product development for a manufacturer and ease integration efforts for research teams. Embracing this approach for the development of new medical devices eases the constraint to use off-the-shelf products for research trials investigating innovative use of telemedicine. PMID:25312967

  16. Ontology Management: a Case Study and Research Plans

    Microsoft Academic Search

    Jeroen Hoppenbrouwers; Manfred A. Jeusfeld; Hans Weigand; Willem-jan Van Den Heuvel

    2005-01-01

    We foresee that ontologies for interoperability are likely organized by a loosely linked network. In the case of digital libraries, the network is realized by a federation of ontologies where cross-links are made on demand. For the future, we plan to work on two extensions. The first one is to develop a new paradigm for synchronization of ontologies, called imitation.

  17. Managing Communication during a School Crisis: A Case Study

    ERIC Educational Resources Information Center

    Gentilucci, James L.

    2007-01-01

    Crisis communication training of school principals is problematic because it overemphasizes media relations and underemphasizes the critical importance of immediate and personal communication with students, staff, and parents--those most affected by school crises. A case study involving the death of a student in a small rural school explains why…

  18. Multidisciplinary management of hypohydrotic ectodermal dysplasia – a case report

    PubMed Central

    Joseph, Suja; Cherackal, George J; Jacob, Jose; Varghese, Alex K

    2015-01-01

    Key Clinical Message Hypohydrotic ectodermal dysplasia is a hereditary disorder, which affects ectodermal derivatives. It manifests several abnormalities of the teeth, and is commonly inherited through female carriers. This case report presents a patient with compromised esthetics and function. A multidisciplinary approach was planned involving an oral pathologist, endodontist, orthodontist and a prosthodontist. PMID:25984305

  19. Secondary School Art: A Case for Increased Senior Management Support

    ERIC Educational Resources Information Center

    Etherington, Margaret

    2015-01-01

    This case study explores the way that school art in England remains a marginalised subject at secondary level, despite the expansion of art-based career opportunities. A recent government document evaluating art, craft and design education highlights the potential role of head teachers in raising an art department's profile. The current study…

  20. Harlequin syndrome: two new cases and a management proposal.

    PubMed

    Willaert, W I M; Scheltinga, M R M; Steenhuisen, S F; Hiel, J A P

    2009-09-01

    The Harlequin syndrome is a rare autonomic disorder, characterized by unilateral diminished sweating and flushing of the face in response to heat or exercise. We present two new cases and evaluate the data of 83 patients described in the literature. We provide diagnostic and therapeutic guidelines. PMID:19902816

  1. Coastal erosion through integrated management: A case of Southern Thailand

    Microsoft Academic Search

    Cherdvong Saengsupavanich; Somchai Chonwattana; Thitima Naimsampao

    2009-01-01

    This study presents how Thailand applied an integrated approach to tackle erosion problems by using a case study in Nakorn Si Thammarat province. Communities along 36km of coastline suffered from continual erosion. Community members believed the erosion was a natural phenomenon that was intensified by human actions. Historical erosion rate estimated by overlaying aerial photographs was about 5m per year,

  2. A Case of Diprosopus: Perinatal Counseling and Management

    PubMed Central

    Thornton, Kimberly M.; Bennett, Timothy; Singh, Vivekanand; Mardis, Neil; Linebarger, Jennifer; Kilbride, Howard; Voos, Kristin

    2014-01-01

    Diprosopus is a rare congenital malformation associated with high mortality. Here, we describe a patient with diprosopus, multiple life-threatening anomalies, and genetic mutations. Prenatal diagnosis and counseling made a beneficial impact on the family and medical providers in the care of this case. PMID:25254133

  3. The sony corporation: A case study in transnational media management

    Microsoft Academic Search

    Richard A. Gershon; Tsutomu Kanayama

    2002-01-01

    The following paper is a case study analysis of the Sony Corporation; a leading transnational media corporation in the production and sale of consumer electronics, music and film entertainment and videogame technology. There are two main parts to this study. Part I, examines the history and development of the Sony Corporation. This paper argues that the business strategies and corporate

  4. Teaching and Learning about Managing People: Human Resource Management for Education Settings--A Queensland Case.

    ERIC Educational Resources Information Center

    McCrea, Nadine L.; Ehrich, Lisa C.

    1996-01-01

    Describes the development of a human resource management (HRM) elective for educators aspiring to management positions in various educational settings. The unit is part of a graduate diploma offered within the Faculty of Education at one Australian university. The paper argues the necessity of HRM studies in postgraduate education courses. (SM)

  5. Managing and Financing Urban Community Colleges in the '80s: The Case for Strategic Management.

    ERIC Educational Resources Information Center

    Ellison, Nolen M.

    New approaches to planning and management will be required in the 1980s if community colleges are to deal with the challenges posed by declining enrollments and funds and changing public attitudes toward financing higher education. In the past two decades, management development and college planning have emphasized the creation and expansion of…

  6. A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

    PubMed Central

    León, Agathe; Cáceres, César; Fernández, Emma; Chausa, Paloma; Martin, Maite; Codina, Carles; Rousaud, Araceli; Blanch, Jordi; Mallolas, Josep; Martinez, Esteban; Blanco, Jose L.; Laguno, Montserrat; Larrousse, Maria; Milinkovic, Ana; Zamora, Laura; Canal, Neus; Miró, Josep M.; Gatell, Josep M.; Gómez, Enrique J.; García, Felipe

    2011-01-01

    Background Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. Methodology We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. Findings Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p?=?0.21) and compliance levels >90% (p?=?0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. Conclusions Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. Trial Registration Clinical-Trials.gov: NCT01117675. PMID:21283736

  7. Case managers play important part in employers' culture of health.

    PubMed

    Owen, Mindy

    2006-01-01

    At Duncan Aviation, an aircraft support company based in Lincoln, Nebraska, meetings with the wellness staff are a job requirement. At least quarterly and often monthly, all managers and team leaders are required to schedule a presentation by the company's wellness staff as part of regular department or team meetings. "That way exposure to the wellness team and program is 100%, not just the 10% to 20% that we might have at a 'learn at lunch' program," explained wellness director Craig Johnson. "This is happening on company time. People are being paid to attend the presentation. It's part of the culture here." PMID:16720260

  8. Frontoethmoidal encephalocele: Case report and review on management

    PubMed Central

    Dhirawani, Rajesh B.; Gupta, Richa; Pathak, Sanyog; Lalwani, Gaurav

    2014-01-01

    Encephaloceles, especially in the frontoethmoidal region, are a form of neural tube defect affecting patients in Southeast Asia more commonly than those in western countries, where they are more common in the occipital regions. All patients with classical frontoethmoidal encephalocele had swelling over the bridge of nose or inner canthus of eye since birth, with varying degrees of hypertelorism. This paper emphasizes on the clinical features of this pathology and its surgical management, along with, reviewing the evolution of single-stage correction and fine refinements. PMID:25593873

  9. [Rehabilitation management categories. A new approach to case mix in medical rehabilitation].

    PubMed

    Spyra, K; Müller-Fahrnow, W

    1998-06-01

    Creating typical treatment case groups in medical rehabilitation, in short: Rehabilitee Management Categories (RMKs, Rehabilitanden-Management-Kategorien), is a key issue for quality assurance within the frame of modern concepts of Total Quality Management (TQM), not least utilizing current organization and management concepts (Managed Care). So far, the problem of creating highly homogeneous case groups has remained unsolved on the basis of the present methodological framework. Critical prerequisites for any further scientific work on this problem are being established in the field of medical rehabilitation with the help of the Classification of Therapeutic Services (CTS) as well as development of instruments documenting therapy plans for typical rehabilitation case groups, process-relevant quality features and definitions of therapy goals as a basis for quality screening under the Pension Insurance quality assurance programme in medical rehabilitation. These developments have clearly contributed to expanding the theoretical foundations as well as the prerequisites for empirical grounding of Rehabilitee Management Categories in medical rehabilitation under the Pension Insurance scheme. A project for determination of rehabilitation case groups which is based on these developments, is due to start at the Humboldt University and Technical University, Berlin in the near future within a rehab promotion initiative of the German Pension Insurance system in cooperation with the Federal Ministry of Research and Technology. Conceptually, the determination of Rehabilitee Management Categories by far exceeds all previous approaches as (1) it will be generated by an iterative process of empirical service descriptions and theoretical consensus building among experts, (2) not only static parameters but also process-related details will be recorded, and (3) quality requirements will be defined for the rehabilitation process and outcome. As a result, rehabilitation-relevant case groups are to be created, which will include a definition of process- and outcome-oriented quality standards. Unlike previous case group concepts, the new approach encompasses quality management issues as an integral part of its development. Since this concept for determination of Rehabilitee Management Categories incorporates the definition of quality standards, i.e., guidelines, prerequisites will be created for integrating these standards into quality management concepts, as well as service management across the interfaces of the German service delivery system (Managed Care). PMID:9706114

  10. Developing open geographic data model and analysis tools for disaster management: landslide case

    NASA Astrophysics Data System (ADS)

    Aydinoglu, A. C.; Bilgin, M. S.

    2014-10-01

    Disaster Management aims to reduce catastrophic losses of disasters as landslide. Geographic information technologies support disaster management activities for effective and collaborative data management considering complex nature of disasters. Thus, this study aims to develop interoperable geographic data model and analysis tools to manage geographic data coming from different sources. For landslide disaster, 39 scenario-based activities were analyzed with required data according to user needs in a cycle of activities at mitigation, preparedness, response, and recovery phases. Interoperable geographic data model for disaster management (ADYS), enabling up-to-date exchange of geographic data, was designed compliant with standards of ISO/TC211 Geographic Information/Geomatics, Open Geospatial Consortium (OGC), and Turkey National GIS (TUCBS). Open source and free analysis toolbox was developed and tested in case study of the activities such as landslide hazard analysis and disaster warning system to support Provincial Disaster Management Centers of Turkey.

  11. The use of telemedicine in burn care: development of a mobile system for TBSA documentation and remote assessment

    PubMed Central

    Parvizi, D.; Giretzlehner, M.; Dirnberger, J.; Owen, R.; Haller, H.L..; Schintler, M.V.; Wurzer, P.; Lumenta, D.B.; Kamolz, L.P.

    2014-01-01

    Summary The requirements for accurate documentation within the process of burn assessment have increased dramatically over the years. TBSA (total body surface area) and burn depth are commonly determined by visual inspection, especially in the emergency or acute care setting. However, inexperience often results in incorrect estimation of these factors. In 2001, BurnCase 3D was initiated in order to develop a tool for objective burn assessment and documentation on mobile devices (Apple iPhoneTM). The centerpiece is a 3D model representing the actual patient. At two international burn meetings, a survey containing three pictures of patients was conducted and this data was collected. A patient-specific 3D model adapted to the height and weight of the real patient was created and the digital picture was superimposed in the computer system. The burns were transferred to the model and the TBSA in % was calculated by the software BurnCase 3D. The preferred methods of the 80 respondents for burn extent estimation were: the Rule of Nines (38%), the Rule of Palm (37%) and the Lund-Browder chart (18%). Analysis showed very high deviations of TBSA within the participants, even among the group of experts. In comparison to a computer-aided method we found massive overestimation of up to 230%. The use of BurnCase 3D could have a true impact on the quality of treatment in burns. In the acute care setting for burn injuries, telemedicine has great potential to help guide decisions regarding triage and transfer based on TBSA, burn depth, patient age and injury mechanism.

  12. Client satisfaction with a new group-based model of case management for supported housing services.

    PubMed

    Tsai, Jack; Reddy, Navin; Rosenheck, Robert A

    2014-04-01

    Supportive housing typically offers rental subsidies and individual intensive community-based case management and has become a predominant service model for homeless adults. Alternative case management models have not been adequately explored. This study evaluates satisfaction with a novel group-intensive peer support (GIPS) model of case management for the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program. A total of 95 HUD-VASH clients rated their satisfaction with services and responded to open-ended questions about what they liked best and least about the program. Quantitative and qualitative analyses compared clients who attended groups as part of the GIPS model and those who did not. No significant difference in satisfaction between group and non-group attenders were found. Clients reported what they liked best about the program was the staff; those who attended groups reported what they liked best was the social interaction and peer support. These findings suggest clients who attend groups for their primary source of case management may be as satisfied as those who receive only individual case management. GIPS offers a feasible and acceptable service model and should be further explored along with other alternative models of care in supportive housing services. PMID:24413143

  13. Giant inguinoscrotal hernia: case report and management principles.

    PubMed

    Tahir, Mohammad; Ahmed, Faiz U; Seenu, V

    2008-12-01

    We present a case of a giant inguinoscrotal hernia reaching up to the patient's knees. It was only partially reducible but was not associated with any other complications. It was treated by an inguinal incision and the reduction of contents aided by a small midline infra-umbilical incision. The hernial sac contained loops of small bowel along with its mesentery, appendix, cecum and ascending colon. The defect was repaired using prolene mesh. PMID:19059158

  14. Case management for frail older people – a qualitative study of receivers’ and providers’ experiences of a complex intervention

    PubMed Central

    2014-01-01

    Background Case management interventions have been widely used in the care of frail older people. Such interventions often contain components that may act both independently of each other and interdependently, which makes them complex and challenging to evaluate. Qualitative research is needed for complex interventions to explore barriers and facilitators, and to understand the intervention’s components. The objective of this study was to explore frail older people's and case managers’ experiences of a complex case management intervention. Methods The study had a qualitative explorative design and interviews with participants (age 75-95 years), who had received the case management intervention and six case managers who had performed the intervention were conducted. The data were subjected to content analysis. Results The analysis gave two content areas: providing/receiving case management as a model and working as, or interacting with, a case manager as a professional. The results constituted four categories: (1 and 2) case management as entering a new professional role and the case manager as a coaching guard, as seen from the provider’s perspective; and (3 and 4) case management as a possible additional resource and the case manager as a helping hand, as seen from the receiver’s perspective. Conclusions The new professional role could be experienced as both challenging and as a barrier. Continuous professional support is seemingly needed for implementation. Mutual confidence and the participants experiencing trust, continuity and security were important elements and an important prerequisite for the case manager to perform the intervention. It was obvious that some older persons had unfulfilled needs that the ordinary health system was unable to meet. The case manager was seemingly able to fulfil some of these needs and was experienced as a valuable complement to the existing health system. PMID:24410755

  15. Endonasal Endoscopic Approach in Management of Paediatric CSF Rhinorrhoea Cases.

    PubMed

    Chappity, Preetam; Alok, Thakar; Rohit, Verma

    2015-03-01

    Though endoscopic repair has been the proven to be the gold standard for the repair of cerebrospinal fluid rhinorrhoea in adult patients, the type of approach to be used in paediatric patients especially those below 5 years is still a challenge with no clear cut guidelines. The objective of this study was to evaluate the efficacy of using endonasal endoscopic approach for treating paediatric patients aged less than 5 years diagnosed with cerebrospinal fluid rhinorrhoea. This was a retrospective analysis of five cases of paediatric CSF rhinorrhoea operated in a tertiary health care centre with an age of less than 5 years from October 2002 to September 2010. All the five cases treated by endoscopic approach have no further complaints of CSF leak or meningitis with a follow up period of a minimum period of 6 months. Two cases were further detected to have meningocele and meningoencephalocele which was detected preoperatively and treated by reduction and excision respectively. The good results obtained by endoscopic closure with lack of major complications and the decreased morbidity for the patient suggests that the endoscopic approach should be considered the first line of approach in pediatric population. But we would warrant a careful selection procedure and availability of adequate expertise for this approach to avoid complications. PMID:25621241

  16. Surgical management of Giant Lumbar Extradural Schwannoma: Report of 3 cases

    PubMed Central

    Srikantha, Umesh

    2015-01-01

    Standard surgical approach for extradural paraspinal tumours has been through a unilateral facetectomy, inter-transverse or retroperitoneal approach. Some of these approaches destabilise the spine and consequently require a fusion procedure. Access to these tumours through a minimal access route can decrease tissue damage, fasten post-operative recovery and obviate the need for a concomitant fusion procedure. However, proper case selection and adequate pre-operative planning are important in choosing cases for a minimally invasive approach. We discuss three cases of giant extradural, paraspinal schwannomas. One case that was associated with listhesis along with the tumour situated more anteriorly and embedded in the psoas muscle was managed by lateral retroperitoneal route with simultaneous interbody graft followed by posterior interspinous stabilising device. The other two cases were managed by minimal access route using a 22mm fixed tubular retractor, one by a paramedian approach and one by far lateral approach. The technique and merits of the procedure are discussed.

  17. How Widely Applicable is River Basin Management? An Analysis of Wastewater Management in an Arid Transboundary Case

    NASA Astrophysics Data System (ADS)

    Dombrowsky, Ines; Almog, Ram; Becker, Nir; Feitelson, Eran; Klawitter, Simone; Lindemann, Stefan; Mutlak, Natalie

    2010-05-01

    The basin scale has been promoted universally as the optimal management unit that allows for the internalization of all external effects caused by multiple water uses. However, the basin scale has been put forward largely on the basis of experience in temperate zones. Hence whether the basin scale is the best scale for management in other settings remains questionable. To address these questions this paper analyzes the economic viability and the political feasibility of alternative management options in the Kidron/Wadi Nar region. The Kidron/Wadi Nar is a small basin in which wastewater from eastern Jerusalem flows through the desert to the Dead Sea. Various options for managing these wastewater flows were analyzed ex ante on the basis of both a cost benefit and a multi-criteria analysis. The paper finds that due to economies of scale, a pure basin approach is not desirable from a physical and economic perspective. Furthermore, in terms of political feasibility, it seems that the option which prompts the fewest objections from influential stakeholder groups in the two entities under the current asymmetrical political setting is not a basin solution either, but a two plant solution based on an outsourcing arrangement. These findings imply that the river basin management approach can not be considered the best management approach for the arid transboundary case at hand, and hence is not unequivocally universally applicable.

  18. The case for clean metal analysis in management

    SciTech Connect

    Pederson, J. [Massachusetts Coastal Zone Management, Boston, MA (United States)

    1994-12-31

    The Commonwealth of Massachusetts through its regulatory agencies is responsible for implementing the Clean Water Act and ensuring that the waters are fishable and swimmable. Recently, the state adopted marine water quality standards and criteria for permitting point source discharges. The standards are frequently lower than the detection limits of federal methodologies and have not provided appropriate data for developing total maximum daily loads and mass loading estimates for watershed and ecosystems. The necessity for ``clean lab`` data are evident in developing loading estimates for watersheds and using these data to determine impacts on coastal regions. Metal loading estimates are compared using clean metal analyses and the US Environmental Protection Agency methodologies. As the states and federal agencies move towards management on a watershed basis where polluters can barter levels of contamination, the level of accuracy for metal concentrations is necessary for protection of the ecosystem.

  19. Diagnosis and management of occlusal wear: a case report.

    PubMed

    Thirumurthy, V R; Bindhoo, Y A; Jacob, Sunil Joseph; Kurien, Anjana; Limson, K S; Vidhiyasagar, P

    2013-09-01

    The rationale for doing full mouth rehabilitation are, when occlusal forces become traumatic hampering the health of periodontal tissues, extensive occlusal diseases, trauma, temporomandibular joint disease and congenital disorders with malformed dentition. Literature exposes that full mouth fixed rehabilitation is one of the taxing procedures in the field of Prosthodontics. A critical aspect for successful occlusal rehabilitation is to determine the aetiology, correct sequence of treatment and most importantly the occlusal vertical dimension and centric relation in which to plan the treatment. A systematic approach in managing these patients can lead to a predictable and favourable prognosis. This article presents the stages of prosthodontic rehabilitation, from diagnosis to final treatment and follow-up, of a bruxer patient with severely worn dentition. PMID:24431762

  20. Business continuity management in emerging markets: the case of Jordan.

    PubMed

    Sawalha, Ihab H; Anchor, John R

    2012-01-01

    Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan. PMID:22576137

  1. Managing discovery risks--A Tevatron case study

    SciTech Connect

    Bakul Banerjee

    2004-07-28

    To meet the increasing need for higher performance, Management of Fermi National Accelerator Laboratory has undertaken various projects to improve systems associated with the Tevatron high-energy particle collider located at Batavia, Illinois. One of the larger projects is the Tevatron Beam Position Monitor (BPM) system. The objective of this project is to replace the existing BPM electronics and software system that was originally installed during early 1980s, along with the original construction of the Tevatron.The original system consists of 236 beam position monitors located around the underground tunnel of the accelerator. Above ground control systems are attached to these monitors using pickup cables. When the Tevatron collider is operational, signals received from the BPMs are used to perform a number of control and diagnostic tasks. The original system can only capture the proton signals from the collider. The new system, when fully operational, will be able to capture combined proton and antiproton signals and will be able to separate the antiproton signal from the combined signal at high resolution. This significant enhancement was beyond the range of technical capabilities when the Tevatron was constructed about two decades ago. To take advantage of exceptional progress made in the hardware and software area in past two decades, Department of Energy approved funding of the BPM electronics and software replacement project. The approximate length of the project is sixteen months with a budget of four million dollars not including overhead, escalation, and contingencies. Apart from cost and schedule risks, there are two major risks associated with this research and development project. The primary risk is the risk of discovery. Since the Tevatron beam path is highly complex, BPMs have to acquire and process a large amount of data. In this environment, analysis of data to separate antiproton signals is even more complex. Finding an optimum algorithm that can be implemented with current state of the art hardware and software technology is even more complex. The second most important risk is the risk of unavailability of the premiere high energy physics scientific facility to worldwide users. This paper presents a model of minimizing these risks using a phased model of project management. To complete the project successfully, it is essential to keep track of the constraints imposed by uncertainties in the discovery phase while maintaining the highest possible availability of the Tevatron. In this paper, a methodology based on earned value management system is explained to measure and manage discovery risks. Metrics based on the initial basis of estimate and familiar earned value measures are used to monitor risks of discovery. Subsequently, these metrics are used to refine the project and adjust tasks and resource assignments to minimize the unavailability of the user facility. One of the measures is the variance at phase completion. From the phased model of the WBS, variance at completion is examined for various project baselines at the end of project phases. This allowed for understanding the risk of not only cost and schedule, but also the discovery risks. Since similar risk measurement data is not available within the organization, these metrics will also allow us to define risk baselines for future scientific projects that involve discovery along with state of the art system development.

  2. Evolution of Radio Resource Management: A Case for Cognitive Resource Manager with VPI

    Microsoft Academic Search

    Marina Petrova; Petri Mähönen; Janne Riihijärvi

    2007-01-01

    The cognitive radio and cognitive wireless networks paradigms are interesting candidates for the next generation self-organizing and self-reconfigurable wireless networks. In this paper we argue that the concept of cognitive resource manager as an evolution of the classical radio resource manager in the cellular networks is a promising concept to enable dynamic and distributed cross-layer in the future cognitive wireless

  3. Managing Projects in an Embedded System Development Context: An In-Depth Case Study from an Improvisational Perspective

    Microsoft Academic Search

    Wolfgang Molnar; Joe Nandhakumar

    2009-01-01

    This paper reports the findings of an empirical investigation into developing and managing an embedded system project in the context of structured process management. This research adopts an interpretive case study approach and explores project managers' and developers' experiences in embedded system development within a turbulent environment. The study describes the complex undertaking of managing embedded system development, which, in

  4. Application of cased-hole logs to reservoir management

    SciTech Connect

    Olarunsola, A.O.; Ekpo, E.U.

    1984-04-01

    Cased-hole electric wireline logs can be useful for diagnosing well problems as well as assuring optimum application of clearly defined remedial work. These logs are carefully run directly opposite points of fluid entry into the borehole. When used appropriately, interpretation is facilitated, and their subsequent application to well problems often yield positive results. The data obtained offer more definitive and more complete understanding of the production trends and the reservoir behavior. This work illustrates the interpretation and the appropriate use of various logs for identifying gas and water production problems in oil reservoirs. Examples as encountered in the Niger Delta are discussed.

  5. The Case of the Crying Baby Surgical vs. Medical Management

    NSDL National Science Digital Library

    Kari A. Mergenhagen

    2003-01-01

    The parents of a six-week-old baby girl know there is something seriously wrong with their child, but it takes a number of frustrating visits to the pediatrician before they finally get a correct diagnosis. Once they do, the parents must decide whether they want to seek a surgical solution or rely on a course of medical treatment for their daughter. Best suited for classes in pharmacology, nursing, or medicine, this case could also be used in a basic biology or anatomy course.

  6. Two different management modalities in a two sibling case report of Adams Oliver syndrome

    PubMed Central

    Al-Hadithy, Nada; Mennie, Joanna; Stewart, Ken

    2011-01-01

    The authors report two-sibling case of Adams Oliver syndrome. One was managed with early surgical intervention after a period of failed conservative management and the other conservatively managed until reconstruction and surgical correction of alopecia. The goal of treatment is to achieve a complete closure of the defect without encountering any fatal complications such as haemorrhage and infection or causing any long-term neurological morbidity. Various papers have been published related to ACC, yet there is no consensus on the therapeutic approach. The management decision hinges upon balancing the risks of complications including spontaneous sagittal sinus haemorrhage and the risk of surgical intervention. Both treatment modalities proved successful in these cases. PMID:22670005

  7. Case studies of occupational health management in the engineering construction industry.

    PubMed

    Gyi, D E; Haslam, R A; Gibb, A G

    1998-05-01

    Construction workers are exposed to considerable hazards carrying a health risk, e.g., dusts, fumes, noise and manual handling, yet there is often poor occupational health service provision particularly for subcontracted labourers. This paper presents seven case studies from large, engineering construction organizations, concerning current practice in occupational health management. The results supported the fact that data and records regarding health-related absence were limited and inconsistent, and that little existed in terms of medicals and health surveillance, particularly in the case of subcontracted workers. The main difficulties envisaged were reported to be the sizeable costs involved; the temporary and mobile work force; demonstrating cost-benefits to top management and a lack of interest amongst workers, perhaps exacerbated by the threat of lost livelihood. Managers also admitted limited health expertise and knowledge of the wider role health professionals could play in health management. Training and further research in this area are indicated. PMID:9800426

  8. A Data Management System for Multi-Phase Case-Control Studies

    PubMed Central

    Gibeau, Joanne M.; Steinfeldt, Lois C.; Stine, Mark J.; Tullis, Katherine V.; Lynch, H. Keith

    1983-01-01

    The design of a computerized system for the management of data in multi-phase epidemiologic case-control studies is described. Typical study phases include case-control selection, abstracting of data from medical records, and interview of study subjects or next of kin. In consultation with project personnel, requirements for the system were established: integration of data from all study phases into one data base, accurate follow-up of subjects through the study, sophisticated data editing capabilities, ready accessibility of specified programs to project personnel, and generation of current status and exception reports for project managment. SIR (Scientific Information Retrieval), a commercially available data base management system, was selected as the foundation of this system. The system forms a comprehensive data management system applicable to many types of public health research studies.

  9. Do-it-yourself managed care. Case study I: Randall's Medical Network. Case study II: Hershey's Managed Care Plan.

    PubMed

    1993-01-01

    Employers, who pay for much of the healthcare in this country, are not waiting for government to restructure the healthcare system. In this cover story, PROFILES examines how two firms formed their own managed care networks to control healthcare cost and quality, and what hospitals did to become players. By understanding the employer' point of view, hospital marketers can better anticipate their needs and develop a marketing strategy to form closer relationships with employers, provide quality care at a lower cost, and increase their market share. PMID:10125016

  10. Management of infections complicating the orbitocranial approaches: Report of two cases and review of literature

    PubMed Central

    Patel, Akash J.; Duckworth, Edward A. M.

    2015-01-01

    Background: The orbitocranial approaches are now indispensible for treating lesions of the skull base, providing access to lesions in the anterior and middle cranial fossae, as well as the upper clivus and anterior brainstem. The management of infectious complications of the orbitocranial approaches, however, has evaded the literature. Case Description: We present two cases of patients who underwent orbitocranial approach whose clinical course was complicated by wound infection and osteomyelitis. One patient was treated with antibiotics and then had a custom implant placed for cranioplasty. The other case was managed with removal of bone and wire-mesh cranioplasty. Conclusion: Management of orbitocraniotomy infections can be difficult due to the complex geometry of the flap and to cosmetic considerations. Once the infection involves the bone, the bone can be replaced after cleaning or discarded and a cranioplasty performed. Cranioplasty can be performed with wire-mesh or a custom implant made by computer-assisted modeling.

  11. Crisis Management Systems: A Case Study for Aspect-Oriented Modeling

    NASA Astrophysics Data System (ADS)

    Kienzle, Jörg; Guelfi, Nicolas; Mustafiz, Sadaf

    The intent of this document is to define a common case study for the aspect-oriented modeling research community. The domain of the case study is crisis management systems, i.e., systems that help in identifying, assessing, and handling a crisis situation by orchestrating the communication between all parties involved in handling the crisis, by allocating and managing resources, and by providing access to relevant crisis-related information to authorized users. This document contains informal requirements of crisis management systems (CMSs) in general, a feature model for a CMS product line, use case models for a car crash CMS (CCCMS), a domain model for the CCCMS, an informal physical architecture description of the CCCMS, as well as some design models of a possible object-oriented implementation of parts of the CCCMS backend. AOM researchers who want to demonstrate the power of their AOM approach or technique can hence apply the approach at the most appropriate level of abstraction.

  12. Noninvasive management of an odontoid process fracture in a toddler: case report.

    PubMed

    Kim, Woosung; O'Malley, Mike; Kieser, David Christopher

    2015-02-01

    Study Design?Case report. Objective?Odontoid process fractures represent an uncommon injury in small children, with their optimal management remaining unclear. We present a case of conservatively managed displaced type 2 odontoid process fracture in a small child. Methods?We analyzed clinical and radiographic outcomes of a restrained 2-year-old girl involved in a motor vehicle accident who sustained a displaced type 2 odontoid process fracture and was treated conservatively in a semirigid Aspen collar. Results?The fracture progressively healed with callus formation evident at 6 weeks. By 12 weeks, the patient was asymptomatic and had regained head control and a full range of movement. Radiographic remodeling of the fracture was seen to improve over the 6-month follow-up. Conclusion?This case illustrates that displaced type 2 odontoid process fractures can be successfully managed conservatively in small children. PMID:25649544

  13. Development of a mobile phone based ophthalmoscope for telemedicine

    Microsoft Academic Search

    Mike Blanckenberg; Christo Worst; Cornie Scheffer

    2011-01-01

    Regular retinal examinations can contribute to the management of both hypertensive and diabetic retinopathy. One of the most successful means of evaluating these retinopathies is by means of a fundus camera generating a fundus photograph. Patients in rural clinics unfortunately often lack the financial means to undergo regular examinations. This study produced a handheld ophthalmoscope that combines with a digital

  14. Status of States' Policies that Affect Families: Case Management P.L. 99-457, Part H. The Infants and Toddlers with Handicaps Program.

    ERIC Educational Resources Information Center

    Anderson, Kathy; And Others

    This report is one of three resulting from a 50-state survey on the development of family policies through the implementation of Public Law 99-457 (Part H) and focuses on the selection of case managers, qualifications and training of case managers, vehicles to monitor and supervise case managers, and financing the case management system. Among…

  15. Nonoperative management of a giant omphalocele using a silver impregnated hydrofiber dressing: a case report.

    PubMed

    Almond, Stephen; Reyna, Roxana; Barganski, Natalie; Emran, Mohammad A

    2010-07-01

    The surgical management of a giant omphalocele is challenging. Many cannot be closed at birth and must initially be managed nonoperatively with a topical agent to facilitate epithelialization. We report the case of a term, 1-day-old female neonate with a giant omphalocele treated initially with a hydrofiber dressing containing silver (Aquacel Ag; ConvaTec Inc, Skillman, NJ) and then with delayed primary closure. PMID:20638542

  16. Sustaining Participatory Forest Management: Case Study Analyses of Forestry Assistance from Tanzania, Mozambique, Laos and Vietnam

    Microsoft Academic Search

    Irmeli Mustalahti; Steve Harrison; John Herbohn

    2009-01-01

    This paper introduces case study analysis against an illustrative model, the ‘house model’, which contains a number of key\\u000a elements for sustaining participatory forest management (PFM). In theory, the elements in the model are basic requirements\\u000a for ensuring that the participation of local people in forest management will continue after external donor support ceases.\\u000a In practice, the study shows that

  17. Measuring the performance of quality assurance processes: pharmaceutical industry deviation management case study

    Microsoft Academic Search

    Zorana Boltic; Nenad Ruzic; Mica Jovanovic; Slobodan Petrovic

    2010-01-01

    This article presents experience from the practice of a successful pharmaceutical company related to design and implementation\\u000a of performance measures (PMs) for deviation management linked to the analysis of impact on the production cost for the selected product. Case study focuses\\u000a on PMs within good manufacturing practice (GMP) processes related to quality assurance (QA) and quality management, with the aim

  18. Risk Management and Expert Opinion Assessment at Non-Profit Organizations: the case of UNESCO

    Microsoft Academic Search

    F. M. Cavalcanti; Leonardo P. Santiago

    2006-01-01

    Non-profit organizations play an increasingly important role in contemporary society. The fact that they are not profit-oriented, however, does not guard them against the need to manage resources efficiently. Still, due to their specific goals and organizational environment, non-profit organizations require appropriate tools to manage their projects' risk. With this in mind, we chose to study the case of Monumenta

  19. Case management of arthritis patients in primary care: a cluster-randomized controlled trial

    Microsoft Academic Search

    Thomas Rosemann; Stefanie Joos; Gunter Laux; Jochen Gensichen; Joachim Szecsenyi

    2007-01-01

    OBJECTIVE: To assess whether providing information on arthritis self-management through general practitioners (GPs) increases the quality of life in patients with osteoarthritis and whether additional case management provided by practice nurses shows better results. METHODS: We conducted a pragmatic, cluster-randomized, controlled, 3-arm trial that included 1,021 patients from 75 primary care practices in Germany. GPs were randomized to intervention group

  20. Managing hyperglycaemic emergencies: an illustrative case and review of recent British guidelines.

    PubMed

    Gouveia, Catherine F; Chowdhury, Tahseen A

    2013-04-01

    Diabetic ketoacidosis and hyperosmolar hyperglycaemic syndrome are important hyperglycaemic emergencies seen in patients with diabetes. Occasionally, differentiation between the two conditions can be difficult. We present the case of a patient whose hyperglycaemic emergency was managed in a way that could have adversely influenced the outcome. We also discuss important aspects of the new Joint British Diabetes Societies Guidelines on the management of hyperglycaemic emergencies. PMID:23681864