Telemedicine Applications Research Articles

Body Mass Index Classification based on Facial Features Using Machine Learning Algorithms for Utilizing in Telemedicine

Objectives: Given the benefits of controlling Body mass index (BMI) on the quality of life, BMI classification based on facial features can be used for developing telemedicine systems and eliminate the limitations of existing measuring tools especially for paralyzed people, that enable physicians to help people online when faced with situations like the COVID-19 pandemic.
 Methods: In this study, new features and some previous-work features were extracted from face photos of white, black and Asian people, ages 18 to 81, with normal and overweight BMI. Faces were evaluated in three different steps. First, all faces were considered as one group. Second, they were divided into elliptical, round and square shape groups and third, they were separated based on gender. Then for each step, the performances of Random Forest (RF) and Support Vector Machine (SVM) were evaluated with all of the facial features and with selected features based on Pearson correlation coefficient. Matlab R2015b was used for implementation.
 Results: The results revealed that features with higher correlation improved the accuracy of both algorithms. RF best performance using highly correlated features for 97 women and 92 men was in women and square-face groups (91.75% and 87.30% respectively), and SVM best performance was in women group (94.84%), square-face and round-face groups (84.12% and 84% respectively).
 Conclusion: Accuracy of BMI classification based on facial features can be improved by categorizing faces into shapes and gender, and selecting appropriate features. The findings can be used for performance enhancement of telemedicine applications, especially for helping the differently-abled.

Artificial intelligence-based spatio-temporal vision sensors: applications and prospects

Introduction: Advances in machine vision and mobile electronics will be accelerated by the creation of sophisticated optoelectronic vision sensors that allow for sophisticated picture recognition of visual information and data pre-processing. Several new types of vision sensors have been devised in the last decade to solve these drawbacks, one of which is neuromorphic vision sensors, which have exciting qualities such as high temporal resolution, broad dynamic range, and low energy consumption. Neuromorphic sensors are inspired by the working principles of biological sensory neurons and would be useful in telemedicine, health surveillance, security monitoring, automatic driving, intelligent robots, and other applications of the Internet of Things.Methods: This paper provides a comprehensive review of various state-of-the-art AI vision sensors and frameworks.Results: The fundamental signal processing techniques deployed and the associated challenges were discussed.Discussion: Finally, the role of vision sensors in computer vision is also discussed.

Dynamic Evaluation Approaches to Telehealth Technologies and Artificial Intelligence (AI) Telemedicine Applications in Healthcare and Biotechnology Organizations

The COVID-19 pandemic has ushered in an unprecedented adoption and integration of telehealth and artificial intelligence (AI) driven by telemedicine technologies into healthcare systems worldwide. These innovations promise to revolutionize healthcare delivery by offering greater accessibility, efficiency, and responsiveness to patient needs. However, the rapid deployment of these technologies in response to the crisis has illuminated the imperative need for systematic evaluation processes that comprehensively assess their operations and outcomes. This article underscores the critical importance of developing rigorous evaluation frameworks tailored to the evolving landscape of telehealth and AI-driven telemedicine technologies. The absence of standardized evaluation processes presents multifaceted challenges including uncertainties regarding long-term efficacy, patient safety, data security, and ethical considerations. Ensuring the responsible and effective integration of telehealth and AI into healthcare systems requires adaptable, multidimensional evaluation mechanisms that align with clinical objectives and regulatory standards. Through an examination of documents, procedures, policies, and best practices by regional hospitals, this article advocates for developing evaluation processes that enable stakeholders to optimize the deployment of telehealth and AI technologies fostering patient-centered care while addressing emerging challenges. In an era marked by healthcare transformation, establishing robust evaluation frameworks emerges as a paramount endeavor essential for realizing the full potential of telehealth and AI-driven telemedicine in the post-COVID-19 healthcare ecosystem.

The e-DENT teledentistry project: Achievements, lessons learned, and perspectives

In October 2010, the decree n°2010–1229 relating to telemedicine, published in the “Journal officiel de la république française” (JORF) n°0245 of October 21, 2010, specified the terms of the application of telemedicine in France. The practice of remote oral medicine is now becoming more widespread in the country. Since 2010, the dental public health team of the University Hospital (CHU) of Montpellier and the University of Montpellier has been working on the subject, with nearly ten thousand telemedicine acts performed as part of the work of the “First consultation and telemedicine” Medical Activity Unit of the Center for Dental Care, Teaching and Research (CSERD) of the CHU of Montpellier. Various studies have been conducted with multiple target populations to evaluate the value of teledentistry in different settings. The practice of teledentistry should help fight against inequalities of access to care and prevention in France. It has shown to be beneficial for patients, health professionals, dentists and health institutions, but improvements are needed to structure and perpetuate this practice. The profession must make major decisions and relaunch discussions so that France remains one of the leaders in this field.

Telemedicine with special focus on allergic diseases and asthma-Status 2022: An EAACI position paper.

Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID-19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face-to-face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described.

Perception of the Health-care Providers toward Telemedicine Practice: A Cross-sectional Study from Karnataka, India

Introduction: The major advantages of telemedicine can be saving time, cost, and effort, especially for rural patients, during challenging times such as COVID for obtaining consultation and treatment. Telemedicine, if properly implemented, can reduce gaps and strengthen the health-care delivery system in India. Objective: The objective of the study was to assess the perception and practice of health-care providers toward telemedicine. Methodology: We conducted a cross-sectional study among 141 health-care providers who ever practiced telemedicine consultation. Utilizing online Google Forms, we used snowball sampling. Four sections made up the pretested study questionnaire: demographic information, perceptions, and practices. Statistical Package for the Social Sciences (SPSS) version 21 was used for data analysis. Results: Among them, majority were aged between 35 and 44 years (49.6%), males (56%), had M.D./M.S. degree (57.4%), postgraduates (33.3%), worked in private sector (56.7%), and were from clinical specialty (80.8%) We had majority health-care workers who used telemedicine application for the first time after COVID (80.1%), used only mobile (82.2%), used only one application (83.6%), and gave 5–10 consultations per day (57.4%). Most of our study participants feel teleconsultation takes less time (61.7%), reduces waiting list at medical center (92.9%), has better communication (83.6%), gives better aid during emergency (53.9%), and saves money on transportation (97.1%). Conclusion: In this study, we could conclude that most participants started practicing telemedicine post-COVID. Health-care professionals still feel challenging to provide effective patient counseling through telemedicine; moreover, they are benefitted from telemedicine practice.

Legal Aspects of Therapeutic Agreements in Online-Based Health Services (Telemedicine)

The purpose of this study is to determine the legal aspects of therapeutic agreements using online-based health services in the relationship between doctors and patients. At the beginning of the pandemic, the spread of Coronavirus Disease-2019 (COVID-19) developed very quickly, one of the government's steps in preventing the spread of COVID-19 was to limit face-to-face health services through the use of telemedicine or online-based health services. Telemedicine is the use of information and communication technology combined with medical expertise to provide health services without being limited in space or carried out remotely. Currently, although it is still in progress, the implementation of telemedicine application services continues to be used and has experienced a rapid increase in use. The research method used is normative law. The results of the research method concluded that: in online-based health services therapeutic agreements between doctors and patients still occur even though they do not face each other directly, electronic agreements that are binding for the parties are agreements that have fulfilled the requirements of a valid agreement as in Article 1320 of the Civil Code. And there is still no specific legal certainty in the use of online-based health services.

Patent and Bibliometric Analysis of the Scientific Landscape of the Use of Pulse Oximeters and Their Prospects in the Field of Digital Medicine.

This study conducted a comprehensive patent and bibliometric analysis to elucidate the evolving scientific landscape surrounding the development and application of pulse oximeters, including in the field of digital medicine. Utilizing data from the Lens database for the period of 2000-2023, we identified the United States, China, the Republic of Korea, Japan, Canada, Australia, Taiwan, and the United Kingdom as the predominant countries in patent issuance for pulse oximeter technology. Our bibliometric analysis revealed a consistent temporal trend in both the volume of publications and citations, underscoring the growing importance of pulse oximeters in digitally-enabled medical practice. Using the VOSviewer software(version 1.6.18), we discerned six primary research clusters: (1) measurement accuracy; (2) integration with the Internet of Things; (3) applicability across diverse pathologies; (4) telemedicine and mobile applications; (5) artificial intelligence and deep learning; and (6) utilization in anesthesiology, resuscitation, and intensive care departments. The findings of this study indicate the prospects for leveraging digital technologies in the use of pulse oximetry in various fields of medicine, with implications for advancing the understanding, diagnosis, prevention, and treatment of cardio-respiratory pathologies. The conducted patent and bibliometric analysis allowed the identification of technical solutions to reduce the risks associated with pulse oximetry: improving precision and validity, technically improved clinical diagnostic use, and the use of machine learning.

). Lessons Learned from the Pandemic in Indonesia: Enhancing Doctor-Patient Medical Communication to Improve Diagnostic Certainty in Telemedicine

Objective: The COVID-19 pandemic in Indonesia has transformed various aspects of life, particularly in healthcare, where communication between doctors and patients has shifted toward increased utilization of telemedicine. This research aims to achieve several objectives. Firstly, it investigates the deployment process of telemedicine as a remote medical service solution during pandemic circumstances, involving physical distancing and constraints. Secondly, it explores how telemedicine is adapted within clinic settings, considering the unique challenges and necessary adjustments for effective integration.
 
 Method: This research utilizes a case study approach, specifically a multiple case study.
 
 Result: Telemedicine heavily relies on patients' knowledge, information, and their role in substituting a physician's sensory input in making comprehensive medical decisions. Effective communication skills emerge as a critical solution, often overlooked as a soft skill for medical practitioners. Telemedicine encounters difficulties in discerning nonverbal cues compared to in-person consultations. To address this challenge, information gathering should encompass various media, such as photos and videos, in addition to text or verbal exchanges. Furthermore, telemedicine faces barriers related to connectivity and network issues.
 
 Conclusion: Recognizing the equal standing of doctors and patients is imperative, with physicians fostering openness and trust as the foundation for mediated communication. Although specific criteria for information collection exist, doctors should proactively explore relevant patient aspects. To mitigate network issues, healthcare facilities should establish robust network infrastructure, provide healthcare professionals with suitable devices, and consider dedicated telemedicine applications for comprehensive technology mastery.

PHYSICIANS AND DISRUPTION ON TELEMEDICINE: A SYSTEMATIC LITERATURE REVIEW

Background: Telemedicine has developed rapidly since the COVID-19 pandemic. Telemedicine applications have marked significant transformations in healthcare. Rapid changes in healthcare services inevitably affect health service providers, specifically physicians. Aims: This study examines physicians' responses to a disruptive era in the healthcare industry. Methods: This paper applies a systematic literature review approach to characterize physicians’ experiences, challenges, and obstacles in managing disruption in the health service delivery context. A comprehensive literature review was conducted using the Scopus database and borrowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. There were 78 articles included in the analysis. Results: This study found that doctors who use telemedicine experience several types of disruption. The studies that examine physicians’ experience in health service disruption tend to be dominant in 4 (four) out of 5 (five) disruption types. First, disruption to the current delivery mode. Second, disruption to clinical practice role and responsibility. Third, disruption to clinical practice role and responsibility. Fourth, disruption to the work environment. Meanwhile, the disruption in personal life becomes less elaborated in the telemedicine studies debate. Conclusion: It is essential to pay close attention to the disruptions that have an effect on physicians' personal lives. Personal life is essential because it benefits physicians and directly supports the quality and sustainability of telemedicine services. Keywords: Disruption, Physician, and Telemedicine.

DroidChamber: Multilevel Security for Mobile Devices to Support Telemedicine on the Battlefield.

Apps that support telemedicine on the battlefield typically run on classified devices and transmit information over classified networks, whereas the medical data the apps create and transmit are unclassified. Current systems treat these data as classified, so a cross-domain solution is required to transfer the data back to an unclassified domain, which adds delays and costs to the process of transmitting critical data needed to treat injured warfighters. To address this gap, ATC-NY developed DroidChamber, which is a software-based Android system that enables multilevel security and which runs on smartphones and tablets. DroidChamber enables warfighters to execute apps in multiple security domains without risking information leakage. DroidChamber v6 is a collection of mobile device management and security containerization technologies targeting Android 6, and it applies these technologies by leveraging Linux kernel operating-system-level virtualization technologies. DroidChamber v10 takes advantage of Android Work Profiles and Samsung's Knox technology in Android 10, which provides the ability to provision separate "work" and "personal" profiles that securely isolate applications; apps within each profile can further be isolated through the built-in Android controls and the Knox Application Policy. DroidChamber is a software-based Android system, so it requires no added hardware to be attached or integrated with an end-user device. DroidChamber's innovation is isolation of specific Android app resources (e.g., networking) enforced with fine-grained security policies. With DroidChamber, a medic can connect their device to different security domains, giving a wider range of access to medical information in a tactical environment. DroidChamber improves telemedicine applications by enabling the warfighter to share information without requiring a cross-domain guard that may erroneously block some data. Using DroidChamber, a warfighter can use a single mobile device to manage/transmit data at different security levels, thereby reducing the cost and complexity of a mission.

Investigation of Health Professionals' Intention to Use Telemedicine in Turkey.

Introduction: The aim of this study is to determine the usage intention levels by health professionals of telemedicine applications whose legal infrastructure is recently completed by the Ministry of Health in Turkey and whose use is desired to be expanded. Methods: In addition to the questions posed to determine the demographic characteristics of the health professional, their relationship with technology, and their level of knowledge about the word telemedicine; survey data, which included statements to determine factors such as telemedicine use intentions, perceived usefulness, perceived ease, and attitude, were analyzed. Results: Survey questions were answered by 337 health professionals. It has been determined that 83.4% of health professionals have a medium and high level of relationship with technology, 26.4% have never heard of telemedicine, and the rest have various interactions with medicine. According to the results of the research, it is clearly stated that the intention of health professionals to use telemedicine applications is shaped by factors such as perceived usefulness, perceived ease, and attitude. Conclusion: It has been clearly determined that the intention of health professionals to use telemedicine applications is shaped by factors such as perceived usefulness, perceived ease, and attitude. In parallel with this information, it is seen that the possibility of affecting the intentions of using telemedicine by managing the perceptions of health professionals is possible within the obtained results.

Remote, Touchless Interaction with Medical Images and Telementoring in the Operating Room Using a Kinect-Based Application—A Usability Study

Innovative technologies can improve user usability and satisfaction in computer-based activities in the work environment, including surgeons working in the operating room (OR). A scrubbed surgeon must ask unscrubbed staff to retrieve medical images from a surgical PACS system on a monitor in a hybrid operating room. The study aimed to check users’ usability and satisfaction with the designed and developed Ortho_Kinect_OR application, which enables contactless control of access to medical images during surgery. The application also facilitates access to telemedicine applications such as intraoperative telementoring during orthopedic procedures or tele-education. The application’s usability was tested by assigning standardized tasks to surgeons for PACS and teleconferencing in the operating room. Hand gestures were recognized and translated to function like mouse buttons. Field tests conducted among orthopedic surgeons showed high usability and user satisfaction. PACS access in the operating room did not distract the orthopedic surgeon during orthopedic surgery procedures. All surgeons completed the tests and tasks without any problems. OR field test results showed high agreement among users and were very satisfactory. Junior surgeons and residents pointed out that people with average computer knowledge could use the application. It has been shown that the contactless system designed and built based on the Kinect sensor available on the shelves meets the requirements of the operating room environment and is easy to use. Touchless controller technology provides the opportunity to increase the use of intraoperative imaging previews and improve the safety of surgical patients by improving sterility and reducing unnecessary staff in the operating room. Using the Ortho_Kinect_OR application and the Kinect sensor, it is possible to provide contactless access to videoconference telementoring and PACS in the operating room without an orthopedic surgeon’s unnecessary distraction in the operating room environment.

Applications and Challenges of Telemedicine: Privacy-Preservation as a Case Study.

Today, technology has an important impact on the development of medical services, especially during the outbreak of COVID-19. Telemedicine, known by terms such as telehealth and digital health, refers to the utilization of technology to provide health care services at a distance that leads to improved monitoring, detecting and treatment of disease, and provision of individual care. It has been considered in various fields such as radiology, cardiology, pulmonology, psychiatry, emergency care and surgery. The most important advantages of using telemedicine are saving time for the doctor and the patient, reducing the cost of multiple visits to the doctor, reducing the spread of contagious diseases and caring for patients who cannot see a doctor, such as the elderly. In this paper, we review the research in the field of applying telemedicine, as well as its advantages and disadvantages. Next, we discuss the challenges in the field of using telemedicine which are privacy preserving, data security, cost of infrastructures, lack of physical examination and responsibility for patients' compensation. One of the most important challenges is privacy preserving of patients' information during transmission and process. We categorize and compare the various methods that have been proposed to protect peoples' privacy.

The application of telemedicine technologies under medical care provision to crew members on shipboard

The impact of development of technique and technology as result of scientific and technological progress in modern society tremendously affected population life of people in its various areas. One of these technologies is telemedicine. The telemedicine technologies permit to ensure accessibility of highly qualified medical care to travelers, ship crew members and persons located at remote objects. The actuality of application of telemedicine technologies is excessively high in conditions of providing medical care to ship crew members working hundreds miles away from nearest medical care station. The article considers application of telemedicine technologies in world-wide practice. The legal norms of applying telemedicine in the Russian Federation were analyzed. The results of scientific research of telemedicine application on shipboard are analyzed and both advantages and disadvantages of technology under study are determined. The ways of resolving existing problems are proposed to minimize risks associated with application of telemedicine technologies on shipboard.

Application of telemedicine in global surgery partnerships between high-income and low- and middle-income countries: a scoping review

Application of telemedicine in global surgery partnerships between high-income and low- and middle-income countries: a scoping review

A Study of Factors that Influence Intention to Use Telemedicine Applications in the Era of Post Covid-19 Pandemic in Indonesia

This study was conducted to get some insights into what factors influence individual behavior to use telemedicine applications post-COVID-19 pandemic in Indonesia. Some studies were done previously during the COVID-19 pandemic era; however, as we moved to the new era post covid-19 pandemic, it would be interesting to find the answers. The research method was the quantitative approach. Survey to total 746 respondents spread throughout Indonesia were conducted, but 620 valid responses were collected to analyse user behavior towards the of telemedicine applications. Findings – The findings indicated that intention to use telemedicine application post COVID-19 pandemic in Indonesia was jointly predicted and explained 64.8% by performance expectancy, effort expectancy, social influence, facilitating condition, hedonic motivation, price values, habit, perceived security and reliability. The result also revealed that three variables which are performance expectancy, habit, perceived security and reliability have strong positive correlations and significant influence on individual behavior towards the use of telemedicine. Respondents were collected randomly from some areas, meanwhile Indonesia is a large country, consists of more than 10,000 islands. The result may be applicable only in some places. Based on the findings, it is important for healthcare professionals or those who have interest in the telemedicine industry to carefully look at three key factors related to improve performance expectancy, build users habit, and ensuring security and reliability in order to drive individuals' behavior to use telemedicine application in Indonesia. This study is using modified UTAUT2 model to assess individual behavior towards use of telemedicine application post covid-19 pandemic in Indonesia.

Semi-Blind watermarking using convolutional attention-based turtle shell matrix for tamper detection and recovery of medical images

“Telemedicine or e-medicine” refers to an electronic communication system that shares medical information from one location to another through the transmission channel. The increase in multimedia data sharing/transmission across the communication channel has raised to an uncontrollable stage. Thus, the transmission of medical reports across the network has increased higher, which has a chance of tampering either intentional or unintentional attacks. In the case of deliberate attacks, tamper detection and localization are the highly required criteria to verify the originality. In such cases, medical image authentication, security, and integrity verification are also essential criteria in telemedicine applications to verify whether the report belongs to the right person or not. To achieve these criteria and to satisfy these requirements Digital watermarking techniques are highly suggested. Much research has been carried out to address this issue, but some drawbacks and limitations still need to be addressed. The objective is to accomplish a Tamper detection, localization, and recovery (TDLR) system with minimal source information at the receiver end with a better payload or embedding capacity. This paper presents a novel Conventional Attention network (CoAtNet) based invariant watermark generation. A two-level embedding is proposed to enhance watermark security, where image tamper localization and recovery information is generated. The primary level of embedding is carried out by the Turtle Shell Data Hiding Algorithm (TSDH), and the secondary level of embedding is carried out by the DWT-SVD transform. The result shows that the proposed model achieves high imperceptibility and tamper detection accuracy of 60.24 and 99.51% respectively. Furthermore, the suggested system performed well in evaluations of tamper detection and image restoration for various malicious attacks against state-of-the-art systems.

Leveraging telemedicine in gastroenterology and hepatology: a narrative review.

Over the years, telemedicine has played a prominent role in delivering healthcare to patients. Due to its flexibility and many benefits, telemedicine confers physicians the ability to guide and promote medical care remotely. The advent of the coronavirus disease 2019 (COVID-19) pandemic has changed the landscape of medicine and has accelerated the usage of digital and remote healthcare systems for clinical care. Herein, we provide an overview of telemedicine, its applications in managing inflammatory bowel disease (IBD), celiac disease (CD), and liver diseases, its advantages and limitations, and its use in educating the next generation of gastroenterologists. We conducted a review of scientific articles published in PubMed and Google Scholar. Articles were selected based on the search terms included in the search strategy summary. The language of the articles was restricted to English only. We report that telemedicine has the potential to streamline and improve patient care in gastroenterology (GI) and hepatology while also limiting health care expenses. Additionally, we noted the importance of tele-education for training the next generation of physicians who intend on practicing in rural settings. Furthermore, we identified barriers to telemedicine care that exacerbate health inequities and potential solutions to achieving digital health equity. Lastly, we briefly discuss the role of artificial intelligence (AI) in remote patient monitoring. Although telemedicine has existed for many decades, over the past decade there have been many advancements in telemedicine applications in GI and hepatology. Despite its broad benefits, further research needs to be done to alleviate barriers to telemedicine care.

Tele-rehabilitation to improvement of the quality of nursing care

In recent years, the progress of new computer science technologies and more advanced telemedical devices has led to a significant increase in the use of telemedicine applications [1-3]. Various methods, such as videoconferencing, email, and texting, have made long-distance communication convenient [4, 5]. Additionally, remote control of robots, robotic arms, or drones has become feasible [6]. The impact of these advancements on human activities has been noteworthy [7]