Concept Of Telemedicine Research Articles

\u2018Do-It-Yourself\u2019 Healthcare? Quality of Health and Healthcare Through Wearable Sensors

Wearable sensors are an integral part of the new telemedicine concept supporting the idea that Information Technologies will improve the quality and efficiency of healthcare. The use of sensors in diagnosis, treatment and monitoring of patients not only potentially changes medical practice but also one’s relationship with one’s body and mind, as well as the role and responsibilities of patients and healthcare professionals. In this paper, we focus on knowledge assessment of the online communities of Fitbit (a commercial wearable device) and the Quantified Self movement. Through their online forums, we investigate how users’ knowledge claims, shared experiences and imaginations about wearable sensors interrogate or confirm the narratives through which they are introduced to the publics. Citizen initiatives like the Quantified Self movement claim the right to ‘own’ the sensor generated data. But how these data can be used through traditional healthcare systems is an open question. More importantly, wearable sensors trigger a social function that is transformative of the current idea of care and healthcare, focused on sharing, socialising and collectively reflecting about individual problems. Whether this is aligned with current policy making about healthcare, whose central narrative is focused on efficiency and productivity, is to be seen.

A Review Paper on Knowledge Based System on Telemedicine

As we are very much aware about the healthcare and medical system going traditionally from years. In this way, our country has failed to provide good healthcare, medicines, therapies, diagnosis and all other health related services. Due to lack of services, over population, illiteracy, dream of underdeveloped to developed nation has become a fear, like whether it will be fulfilled someday or not. Besides all these serious problems, India is majorly populated with under-developed remote areas, having improper health care system and lack of medicinal advantages. Also with the advancement in technology, these are areas and people residing in these areas are not in reach with the services. Keeping all these issues in mind, we came to the point, that these are inter-related with some factors like economic condition, awareness of various fields globally, healthcare , reach of technology to each and every part of country and citizens respectively. Therefore, we introduced with the concept of telemedicine in the scenario of India. Keywords- autism , medicine, multi-agent..

A Telephone- and Text Message-Based Telemedicine Concept for Patients with Mental Health Disorders: Results of a Randomized Controlled Trial

Background: A telemedicine care concept based on telephone contacts and individualized text messages was developed for patients with mental disorders to continue treatment after therapy in a psychiatric day hospital. The primary objective of this study was to evaluate the effectiveness of the telemedicine interventions. Methods: The study had a 3-armed, randomized design with 2 intervention arms (intervention 1: telephone contacts; intervention 2: telephone contacts and short text messages; both took place over a period of 6 months and in addition to usual care), and a control group with usual care. Primary outcomes were 18-item Brief Symptom Inventory (BSI-18) scores for anxiety, depression and somatization. All participants were recruited from psychiatric day hospitals. The study was registered in the German Clinical Trials Register (DRKS00000662). Results: 113 participants were analyzed 6 months after starting the intervention. The average BSI-18 anxiety score after 6 months was -2.04 points lower in intervention group 2 than in the control group (p value: 0.042). The difference in BSI depression score between these two groups was marginally significant (p value: 0.1), with an average treatment effect of -1.73. In an exploratory sensitivity analysis restricted to the 75% of patients with the highest symptom scores at baseline, intervention group 1 yielded a significant effect for anxiety and depression compared to the control group (p = 0.036 and 0.046, respectively). Conclusions: Telemedicine provides a novel option in psychiatric ambulatory care with statistically significant effects on anxiety. A positive tendency was observed for depression, especially in cases with higher symptom load at baseline.

Impact of telemedicine in hospital culture and its consequences on quality of care and safety.

ABSTRACTObjective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice.Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein.Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis.Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.

22. Telemedicine a new frontier of neurophysioly: The “Add-On Role” of neurophysiological technologist

The computer technologies advancement with the spread of hospital wireless networks has introduced the new concept of Telemedicine. This has increased the responsibility of Neurophysiological Technologist(NT), called in the “front line” to interact with the Neurophysiologist in another forum. Provide our management experience in Neonatal-ICU that connects quickly the work of the neonatologist’s ICU with the neurophysiologist in his clinic, using the wireless system. Standardised collection, agreed with the neurophysiologist, medical history and the Video Capture(VC) of locomotor repertoire of the neonate, prior to the neurophysiological examination. Improving of the skills of the NT in early recognition of pathological movements to enhanced their monitoring and VideoEEG enforcement. For each newborne “tailored”, anamnestic, somatic and clinical data on-board-computerized were collected.; before the 1 h-VideoEEG-recording, we performed Short-VC(5′-10′) viewable both off and on-line, to evaluating neonates’ spontaneous movements and subsequent neurological assessment simplified by Mercuri’s table (2005) sharing of two parts for the anamnestic collection and for a first clinical approach of neurological newborn, useful for improving the interpretation of neurophysiological data. The competence and reliability of the NT can implement the synergy of different professional figures in the diagnosis and treatment in Neonatal ICU using “WI-FI”.

Telemedicine: What Framework, What Levels of Proof, Implementation Rules

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 medicoeconomic 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.

Enhancing trauma education worldwide through telemedicine

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

Principle‐based analysis of the concept of telecare

To report a concept analysis of telecare. Lately telecare has become a worldwide, modern way of giving care over distance by means of technology. Other concepts, like telemedicine, e-health, and telehealth, focus on the same topic though the boundaries between them seem to be blurred. Sources comprise 44 English language research articles retrieved from the database of Medline and Cinahl (1995-October 2011). Literature Review. A principle-based analysis was undertaken through content analysis of the definitions, attributes, preconditions, and outcomes of the concept. The attributes are well described according to the use of technology, caring activity, persons involved, and accessibility. Preconditions and outcomes are well described concerning individual and health political needs and benefits. The concept did not hold its boundaries through theoretical integration with the concept of telemedicine and telehealth. The definition of telecare competes with concepts like home-based e-health, telehomecare, telephonecare, telephone-based psychosocial services, telehealth, and telemedicine. Assessment of the definitions resulted in a suggestion of a new definition: Telecare is the use of information, communication, and monitoring technologies which allow healthcare providers to remotely evaluate health status, give educational intervention, or deliver health and social care to patients in their homes. The logical principle was assessed to be partly immature, whereas the pragmatical and linguistical principles were found to be mature. A new definition is suggested and this has moved the epistemological principle forward to maturity.

System of telesonography with synchronous teleconsultations and asynchronous telediagnoses (Togo)

Objectif. Concevoir un systeme de tele-expertise echographique, en temps reel et a bas prix, et de telediagnostic echographique en differe, entre un centre expert (CHU) et un site isole (hopitaux peripheriques et dispensaires). Materiels et methodes. Un systeme de communication via Internet transferant des videos echographiques et d’ambiance entre les deux sites permet une tele-expertise en temps reel, en presence d’un echographiste peu experimente sur le site isole. Si le site isole ne dispose pas d’echographiste, un operateur non initie realise une capture volumique par mouvements de tilt de ± 40 par rapport a la verticale avec une sonde echographique en deux dimensions (2D) en se servant d’une cartographie de localisation des fenetres acoustiques. Un programme de reconstruction tridimensionnelle (3D) original permet a l’expert de naviguer dans le volume d’image envoye par le centre isole pour un telediagnostic en differe. Resultats. Le systeme a ete teste entre le CHR Tsevie (Togo) et les CHU experts de Campus (Lome, Togo) et de Trousseau (Tours, France) avec une connexion Internet moyenne de 2 Mbps. Une tele-expertise en temps reel etait realisee a partir des videos echographiques de qualite tres satisfaisante acheminees avec un delai maximal de 1,5 s. Un telediagnostic echographique en differe etait aussi realise avec des resultats satisfaisants. Conclusion. Ce systeme de tele-echographie necessitant une infrastructure peu onereuse, et presentant des resultats preliminaires satisfaisants, constitue une methode de telemedecine, utilisable tant dans les pays developpes que dans les pays en developpement.

Telemedicine and Primary Health: The Virtual Doctor Project Zambia

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

Telemedicine in Primary Health: The Virtual Doctor Project Zambia

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

Device-based impedance measurement is a useful and accurate tool for direct assessment of intrathoracic fluid accumulation in heart failure

Heart failure patients are often equipped with implanted devices and are frequently hospitalized due to volume overload. Reliable prediction of imminent fluid congestion has the potential to provide early detection of cardiac decompensation and therefore might be capable of enhancing therapy management. We investigated whether implant-based impedance (Z) measurement is closely correlated with directly assessed extravascular lung water and might thus be useful for patient monitoring. In sheep, pulmonary fluid congestion was induced. Continuous haemodynamic monitoring was performed and extravascular lung water index (EVLWI) assessed. An implanted device with a right ventricular lead measured Z using different electrode configurations. All animals developed gradual pulmonary fluid accumulation leading to inclining lung oedema: EVLWI did increase from 9.5 +/- 1 to 21.1 +/- 5.1 mL/kg (+127%). A concomitant decrease of Z by up to 23%, depending on the electrode configuration, was observed and regression analysis between Z and EVLWI yielded a significant inverse correlation. Changes of Z show a strong inverse correlation with changes of directly measured EVLWI. This allows the application of Z as a measure of intrathoracic fluid status and has the potential to optimize patient care, especially in the context of evolving telemedicine concepts.

Telehealth in the Developing World

tion via high-tech telecommunications technologies. While saving time, energy and money to visit a medical specialist, patients will be given more opportunities to get high-quality healthcare services. From a healthcare provider’s perspective, telehealth has the benefits of improving the continuity of care, offering an opportunity of continuing education and increasing cooperation in diagnosis and research activities. Above all, telehealth is a means of improving the limited and imbalanced medical resource supply structure that the service can be directly provided to those in poor areas or prisoners. In fact, telehealth is a concept in which the interest and care for those who want the minimum services at least to stay healthy should be considered along with the technology itself. Many people from the developing world have suffered from limited medical resources and poor and inappropriate healthcare services. In particular, the problem was far more serious in rural and remote communities. Therefore, telehealth could be more meaningful in the developing world than advanced countries where medical resources are already abundant, and the access to high-quality healthcare services and excellent healthcare professionals is much easier. Wootton, one of the editors of this book, pointed out that even though a lot of articles have been published on the concept of telemedicine in the developing world, a success story has been barely told. He has attempted to collect and suggest a representative cross-section of the very wide range of work that has been carried out in this book. He also mentioned that the related policies and clinical and educational matters that are covered in this book insisted that this book includes a state-of-the art review of telemedicine in the developing world and provides the base for a high-level operation manual. In fact, various telemedicine projects and related case studies which have been performed in poor areas in the developTelehealth in the Developing World

Development of a Portable Device for Telemonitoring of Snoring and Obstructive Sleep Apnea Syndrome Symptoms

The First Intensive Balkan Telemedicine and e-Health Seminar was held in the war-ravaged capital of Kosova, Prishtina, in 2002. This event was created under the auspices of the International Virtual e Hospital (IVeH). This organization, the brain child of Rifat Latifi, M.D., was established with the intent to establish a medical capability using telemedicine in an environment where the health infrastructure had been totally destroyed by war. Recently, the IVeH opened six regional telemedicine centers in Kosova. These centers are in the cities of Gjilan, Prizren, Gjakove, Peja, Skenderaj, and Mitrovica. These centers cover the entire country through a telemedicine network. Recently, the Second Intensive Seminar was organized and held October 2123, 2007, in Tirana, Albania. It was organized to broaden the concept of telemedicine and e-health in the Balkans region, and to introduce telemedicine in Albania, which was an ideal choice for holding the seminar. The seminar represented a significant step for Albania as it embraces the concept of telemedicine. These important events have shaped telemedicine development in the Balkans and are serving as a model for the rest of the South Eastern European countries to embrace telemedicine and e-health. This paper summarizes the events of this second seminar and addresses the importance telemedicine has for the region.

Teaching Histology to First-Year Veterinary Science Students Using Virtual Microscopy and Traditional Microscopy: A Comparison of Student Responses

Virtual microscopy (VM) is a comparatively recent innovation that is revolutionizing both the teaching of microscopic structure in human medicine and the concept of online diagnosis and telemedicine. The interactivity of the various commercially available browsers attempts to simulate the experience of looking down a microscope while offering advantages over traditional microscopy that include clarity of image, reduced infrastructure, and high flexibility, as the images are accessible online. We developed our own VM system, including customized software and a browser that was simple and intuitive to use, with the added advantage of further modifications possible to assist student learning. In this article, we report on a preliminary study wherein VM was introduced to veterinary science students in one course and directly compared to traditional microscopy to determine whether students would readily accept this new technology and which aspects of VM were advantageous. Responses from a survey form showed that students rated VM significantly higher than traditional microscopy as a tool to learn histology because it offers clearer images, the ability to learn collaboratively, more effective use of time, and the flexibility of online learning. Students also indicated a strong preference for the use of VM in future courses. These results suggest that VM is a flexible and enjoyable resource that could be useful to enhance the learning of microscopic structure in veterinary science courses.

Knowledge and perception of health workers towards tele-medicine application in a new teaching hospital in Lagos

To determine the perception of health workers in the health-care towards tele-medicine application in a new tertiary teaching hospital, a modified structured questionnaire using a prospective postal survey was administered to a cross-section of health workers in Lagos State University Teaching Hospital (LASUTH)/Lagos State University College of Medicine (LASUCOM). Only 60.9% of respondents were familiar with this new emerging concept of tele-medicine / tele-health in the health care system. Although, 50% of health workers had expressed concern about the ethical and medico-legal consideration of tele medicine practice, this was irrespective of their socio-religious background. The principal factors weighing in favour of willingness to use tele-health services were knowledge of tele-health applications (28.1%); perception of tele-health benefits (14.1%), reduced barriers to tele-health care among others. Most of the respondents believed that tele-health would enhance direct access to health care services (23.4%), improve quality of care (14.1%) among others. It is desirable to offer tele-medicine to patients especially for emergency and chronic medical conditions. Key words: Tele-medicine / tele-health, health workers, perception, knowledge, Lagos.

Telemedicine: the next healthcare delivery medium: fad or future?

During the past two decades, advances in Information Technology (IT) particularly in database technologies, internet technologies and telecommunications have brought about a revolution in healthcare. These IT advances have enabled medical personnel to have round-the-clock access to clinical data irrespective of the geographic location of both medical personnel and clinical data. This in turn has led to the coming of age of a new medium of healthcare delivery telemedicine. This paper explores the viability (in organisational, technological and financial terms) of the telemedicine concept. The main findings are as follows: (1) an analysis of the uptake of information and communication technologies within the healthcare sector indicates that, in the next 1015 years, telemedicine is likely to emerge as an alternative medium for healthcare; (2) telemedicine will allow patients to carry out routine medical tests, reducing the number of visits to the physician and thereby reducing costs for routine consultations.

Interface areas complexity characterization of echographic images

The telemedicine concept integrates images, video acquisition and video transfer which are usually managed by using a standard videoconference system. Very often, the initial blur of echography pictures makes it difficult to use standard segmentation techniques such as snakes or Sobel filters which aid the doctor in making his decision. In medical echography practice, contour properties of an organ are often more relevant to decipher the presence of pathologies than the exact lineout of the contour itself. The processing, via the fuzzy approach, enables us to subdivide an image in different classes: one gathering the homogeneous zones (pixels belonging to a medium) and the other gathering more heterogeneous zones (e.g. transition between two media). Complexity measurement of each region can be approximated by the calculation of a fractal dimension. Thus, we can obtain interface complexity without having to extract the interfaces themselves. Finally, the link between fractal dimension and fuzzy rate is carried out.

Novas tecnologias da informação em pneumologia

The authors make a brief introduction on the evolution of the use of the new technologies of information in the Medicine, particularly in the area of the respiratory diseases. Some concepts of Telemedicine are mentioned, as Telehealth and Telecare, its advantages, disadvantages and limitations. They refer some of its practical applications as well, in the area of the respiratory illnesses, namely in the monitorizing of chronic respiratory diseases, as asthma, Chronic Obstructive Pulmonary Disease and Cystic Fibrosis and in the diagnosis of Sleep Apnoea. Syndrome Finally, we present our experience in a program of telephone attendance of chronic insufficient respiratory patients and in a program still going on of home monitorizing patients with chronic respiratory failure, by means of a Doc@Home device via a website. This device makes possible the monitorizing of the ECG, heart rate, arterial blood oxygen saturation, as well as clinical parameters, quality of life and compliance with treatment.

A Virtual Educational Strategy on Telemedicine and Medical Simulation

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