Existing Telemedicine System Research Articles

Accuracy of virtual assessment in hand trauma

SummaryA virtual clinic was developed from an existing telemedicine system to manage hand trauma in the Queen Victoria Hospital, East Grinstead, UK, during the first wave of the COVID-19 pandemic. This study evaluates the accuracy of the assessments made and makes comparisons to the traditional face-to-face clinic.The accuracy of assessment was analysed by comparing diagnosis with findings at surgery. One hundred and eighty-nine virtual assessments conducted by telephone with photographic data or by video were compared to 129 face-to-face assessments conducted prior to the pandemic.There was no difference in the accuracy of virtual and face-to-face clinics for patients treated surgically (p=0.27); treatment was correctly predicted for 87% of the virtual group and 78% of the face-to-face group. However, fewer virtual assessments led to a surgical outcome (p=0.0064); 68% of the virtual group had surgical outcomes compared to 82% of the face-to-face group. Most face-to-face assessments were done by a specialty trainee compared to a range of clinicians in the virtual clinic. Accuracy of assessment among trainees was significantly associated with experience for the virtual (p=0.045) but not face-to-face clinics (p=0.94). Virtual assessment by video versus telephone plus photographs were similarly accurate.We conclude that virtual triage serves as a successful alternative to face-to-face appointments. It is robust and succeeds in reducing footfall to the hospital site in line with recent social distancing measures against COVID-19. We have shown that video conferencing triage is no better than telemedicine triage with telephone and photographs.

Scalability of Telemedicine Services in a Large Integrated Multispecialty Health Care System During COVID-19

Immediately before the pandemic, 300 enterprise Mayo Clinic physicians and advanced practice providers had performed a minimum of one video telemedicine consult in the preceding year. By July 15, 2020, the number of Mayo Clinic providers performing video telemedicine consults had risen to >6,500, reflecting a 2,000% increase. Through this pandemic, we have witnessed unprecedented growth in telemedicine utilization. The existing telemedicine system has proven to be scalable.

Telemedicine During the COVID-19 Pandemic: Experiences From Western China.

Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.

A 5G Cognitive System for Healthcare

Developments and new advances in medical technology and the improvement of people’s living standards have helped to make many people healthier. However, there are still large design deficiencies due to the imbalanced distribution of medical resources, especially in developing countries. To address this issue, a video conference-based telemedicine system is deployed to break the limitations of medical resources in terms of time and space. By outsourcing medical resources from big hospitals to rural and remote ones, centralized and high quality medical resources can be shared to achieve a higher salvage rate while improving the utilization of medical resources. Though effective, existing telemedicine systems only treat patients’ physiological diseases, leaving another challenging problem unsolved: How to remotely detect patients’ emotional state to diagnose psychological diseases. In this paper, we propose a novel healthcare system based on a 5G Cognitive System (5G-Csys). The 5G-Csys consists of a resource cognitive engine and a data cognitive engine. Resource cognitive intelligence, based on the learning of network contexts, aims at ultra-low latency and ultra-high reliability for cognitive applications. Data cognitive intelligence, based on the analysis of healthcare big data, is used to handle a patient’s health status physiologically and psychologically. In this paper, the architecture of 5G-Csys is first presented, and then the key technologies and application scenarios are discussed. To verify our proposal, we develop a prototype platform of 5G-Csys, incorporating speech emotion recognition. We present our experimental results to demonstrate the effectiveness of the proposed system. We hope this paper will attract further research in the field of healthcare based on 5G cognitive systems.

ENutrition: An extension of teleintensive care

The aim of this brief report was to introduce the term eNutrition and to describe our new initiatives expanding the traditional role of existing telemedicine systems to provide nutrition support services. This is especially useful at institutions that still do not have a physician or dietitian with specialized knowledge and clinical expertise in nutrition-related issues. We also describe details of the various components of our eNutrition program, including early assessments and optimal provision of enteral and parenteral nutrition, many of which can be used with minimal investment in computer software and hardware.

Telementoring: using the Kinect and Microsoft Azure to save lives

This paper outlines a study and technology that teleports the knowledge and skills of doctors when and where they are needed resulting in a reduction of costs by reducing the number of patients who must be transported from remote areas to cities where specialists are located. Rapid access to specialists' expertise results in lowered risk of death or permanent damage which requires lifelong treatment and monitoring. The technology presented in this paper has the potential to replace and/or supplement existing telemedicine systems costing in excess of $25,000 with a laptop, a $150 Kinect, an Azure connection, and an Office 365 account. The Kinect allows doctors to control the system without breaking the sterile field via hand gestures and voice commands with a goal of reducing the direct cost of healthcare associated infections to hospitals and patients in the USA currently ranging from $28.4 to $33.8 billion annually.

실버타운을 위한 CPS 기반 고령친화적 원격진료 시스템 설계 및 구현

Recently, the need for telemedicine services and user`s service requirements are increasing, the research for more convenient telemed service is underway in various fields. In this paper, we propose that Integrated telemedicine system possible to regular health care. unlike the existing telemedicine system, we combine the voice communications systems and biometric information based on CPS (Cyber Physical System) using wireless communication sensor and elderly people who disabilities are transmit the information comfortably, Also doctors in correspondent site are able to improves the accuracy of the medical treatment by received information about biometric and audio communication. In addition Health status information is stored selectively and then doctor can check the elders status everytime and everywhere. In this paper, we designed the telemedicine system suitable for korea aging society situation, therefore we could offer the Elderly-friendly medical service for seniors who live in silver town.

The Feasibility of Using Ultrasound and Video Laryngoscopy in a Mobile Telemedicine Consult

Emergency healthcare systems in rural communities often have limited access to experienced trauma and emergency physicians. Advanced telecommunication technologies may offer an opportunity to help meet this need. We evaluated healthcare providers' satisfaction with the audio and visual components of an existing telemedicine system, and asked them whether emergency medical services (EMS) personnel could be supported via telemedicine guidance, using video laryngoscopy and ultrasonography, during vulnerable transport periods. Physicians and technologists at a central workstation were linked to a telemedicine-equipped ambulance providing real-time audio and visual communications during patient transport. A scoring system was created for system evaluation using a scale of 1-9. Seven evaluators observed ultrasonography of the carotid vessels and abdominal aorta. Nine evaluators observed an intubation with video laryngoscopy. These observers rated the quality of the images transmitted from the ambulance. Evaluators were asked if this telemedicine system would be suitable for telementoring advanced technical procedures. Mean rating for technical satisfaction with ultrasound was 5.1, the majority of evaluators estimated that they could telementor an abdominal ultrasound examination. The mean rating for technical satisfaction with laryngoscopy was 7.2 with 100% of evaluators estimating they could use the system to telementor intubation. The rating for laryngoscopy was significantly higher than for ultrasound (p = 0.01). Results of this study suggest that telemedicine may provide an advanced support mechanism for rural EMS personnel and patients. Procedures for advanced airway management and ultrasound diagnosis may someday be managed using a remote telepresence.

Systematic Human Factors Evaluation of a Teledermatology System within the U.S. Military

The benefits of telemedicine systems within the U.S. military have been widely recognized. However, a number of telemedicine systems have encountered resistance and have failed to be adopted and widely used. The purpose of the present project was to use a human factors analysis to characterize the facilitators and impediments to the use of a teledermatology system. More specifically, the goal was to investigate areas such as training, workload distribution, and communication between team members because these topics can be broadly classified as human factors issues. Across different sites, structured interviews were administered to three user groups within the system (i.e., consult managers, primary care managers who are comparable to civilian primary care physicians, and dermatologists). All three user groups reported that system support, speed, personal benefits, and increased education and experience were facilitators to system use; impediments were usability problems and insufficient training. However, each user group also identified unique facilitators and impediments. For example, users at the referring site (consult managers and primary care managers) focused on workload distribution among team members and the importance of onsite support as facilitators. In contrast, key facilitators for physicians (primary care and dermatologists) were effective communication, professional benefits, and increased quality of patient care. Human factors issues are critical for successful telemedicine systems and user issues may vary across user groups. The method reported herein provides guidance for development of new telemedicine systems and evaluation of existing telemedicine systems to increase adoption and usage.

A Telemedicine System for Remote Health and Activity Monitoring for the Elderly

The aging population is placing increasing pressure on healthcare services around the world. Telemedicine, which provides medical information or healthcare services at a distance using telecommunication technologies, is of growing interest to governments and healthcare providers. Existing telemedicine systems are primarily for medical information sharing and consultation with no teleoperation capabilities for activity monitoring. Moreover, the equipment of most systems available to support older patients to stay in their living environment must be tied to a fixed location, which severely limits their feasibility and applicability. In this paper, a new telemedicine structure is introduced for regular and ad hoc health monitoring services. In particular, it aims at scenarios where frequent interactive contacts between patients and professionals are required. This system incorporates several different networking technologies that work harmoniously to facilitate data communication, which potentially have a profound impact on the method of delivering medical service remotely. Another unique characteristic of the developed system is its capabilities of adaptation to network conditions, such as network congestion and availability of bandwidth. The concept of the proposed structure is validated using a laboratory-based test platform with some pilot experiments. Preliminary results demonstrate its feasibility for remote health monitoring services of the elderly. The potential benefits of the system are also presented.

Design of Hybrid Multimedia Telemedicine System over Heterogeneous Networks

The advancement of computing capabilities and increase of available network bandwidths have resulted in an emergency telemedicine services which can provide high quality medical services. However, existing telemedicine systems mainly have offered a one to one communication configuration instead of a multi-connection configuration. Therefore, we suggested a hybrid multimedia telemedicine system to support the multi-patients services in wired and wireless (heterogeneous) network environments. Methods: We designed the hybrid multimedia telemedicine system consisting of 4 sub-systems, a patient system, a doctor system, a emergency monitoring system, and a multi-control server system. The patient system could deliver multimedia data of a patient to the emergency monitoring system or to the doctor system according to link configuration. The link configuration was decided as 'Flowing', or 'By-passing' in accordance the connection type of patient systems or doctor systems. At this time, as the multi-control server system considers the hybrid network, it monitored the patient's multimedia data and the state of emergency telemedicine services. Results: The hybrid multimedia telemedicine system including the multi-control server system performed the best communication configuration over heterogeneous networks. This system achieved high quality emergency telemedicine services through dynamic wired and wireless networks at real-time. Conclusion: This study represented a hybrid multimedia telemedicine system over heterogeneous networks in emergency cases. We expected that the designed system could provide not only the high quality services, tele-diagnosis and tele-consultation, but also the effective emergency telemedicine services to multi-patients in the heterogeneous network environments.239