Implementation Of Telemedicine Program Research Articles

Telemedicine Screening for Diabetic Retinopathy Using Digital Technology: Foreign Experience

Background. Timely detection and treatment of diabetic retinopathy (DR) could prevent the development of blindness. However, large number of patients are diagnosed at late stages when effective treatment becomes impossible. In this context, active screening for DR plays an important role. Various screening programs have been developed, including programs using digital technologies.Objective. To analyze and summarize the literature data on digitalization of DR screening.Materials and methods. The study was carried out based on the results of a search in the PubMed / Medline bibliographic database and the Google system. The used keywords were “diabetes”, “retinopathy”, “telemedi-cine”, “digital technologies”, “artificial intelligence” and others. Relevant publications were selected by exam-ining the titles and abstracts of articles.Results. The study addressed the approaches to organizing the telemedicine programs of DR screening. The examples of innovative digital technologies for performing diagnostic studies as well as the characteristics of various electronic systems and devices are presented. It was noted that the DR screening could be performed in a local center with data transfer to a regional specialized diagnostic (analytical) center where telemedicine analysis is done. All diagnostic information is available to the diabetologist who prescribes and adjusts ther-apy. This operating principle facilitates the interaction between various specialists and thus increases the efficiency of screening.Discussion. Although the telemedicine screening for diabetic retinopathy has already been introduced in a number of countries, it is still at its early stages of development. Many modern technologies such as portable mobile devices could be adapted and used in the implementation of telemedicine programs. Deep machine learning algorithms and other artificial intelligence-based approaches demonstrate excellent results. Some systems have already received regulatory approval. Conclusions. The early diagnostics of diabetic retinopathy could be improved by integrating innovative screening technologies in a unified digital platform implemented in routine clinical practice.

The response of the mental health network of the Salamanca area to the COVID-19 pandemic: The role of the telemedicine.

The COVID-19 pandemic reached world-wide causing a great impact on healthcare services. The aim of this work is to describe the response of the Mental Health Network of the Salamanca´ Area (Spain) to this crisis and the reorganization of its resources within the first 8 weeks after the state of alarm was declared. The Psychiatry Service applied a contingency plan which included the reorganization of the human resources, the closure of some of the units and the implementation of telemedicine programs along with two specific programs, namely a mental health assistance program in the context of the infection by coronavirus, and another program for homeless people. 9.038 phone interviews were carried out in the outpatients and community mental health programs. The activity in subacute and acute wards, as well as that of the day hospital programs was decreased to 50%.Based on that this real-world response provided we concluded that the usage of telemedicine is promising in patients with any kind of disorder. Its implementation in daily practice will be considered in the future. Research must continue on COVID-19′s impact on patients with mental disorders and Psychiatry's necessary adaptations and new approaches to them.

Diabetic retinopathy screening and the use of telemedicine.

Evidence-based practice guidelines and treatments are highly effective in reducing vision loss from diabetic retinopathy. However, less than half of the total number of patients with diabetes mellitus receive recommended annual retinal evaluations, and vision loss due to diabetic retinopathy remains the leading cause of blindness in adults. Poor adherence to screening recommendations stems from a number of challenges which telemedicine technology may address to increase the evaluation rates and ultimately reduce vision loss. The aim of this review was to provide an update on the recent advances in tele-ophthalmology and how it may expand our current concept of eye care delivery for diabetic eye disease. The benefits of telemedicine diabetic retinopathy are proven for large population-based systems. Outcomes information from community-based programs is now also beginning to emerge. Improved screening rates and less vision loss from diabetic retinopathy are being reported after implementation of telemedicine programs. New imaging platforms for telemedicine programs may enhance the ability to detect and grade diabetic retinopathy. However, financial factors remain a barrier to widespread implementation. Telemedicine diabetic retinopathy screening programs may have a significant impact on reducing the vision complications and healthcare burden from the growing diabetes epidemic.

The Costs of Critical Care Telemedicine Programs: A Systematic Review and Analysis

Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.