[Remote histopathological diagnosis using artificial telecommunications satellites].
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We describe here a two-way teleconferencing system which links the sterile and pediatric units of the Center for Cancer Treatment in Lyon to a secondary school and the pediatric unit of the University Hospital Edouard-Herriot where primary teaching is given. Léon-Bérard Center and Edouard-Herriot Hospital are 300 m apart. Elie-Vignal secondary school is 6 km from the first site; all three institutes are connected through hyperfrequency aerials. With the help of this system, communication (voice and image) between children in hospital and pupils or teachers in school is instantaneous. Children in bed can listen to the lesson, break in on the conversation in school, ask questions or answer those of teachers. After school time, the system can also be used to organize games between children, or friendly contacts between children in each institute, children in the college, brothers, sisters or friends who may have access to one of those institutes. The system aims are: 1) to improve the education delivered to children and teenagers who spend long periods in hospital; 2) to establish a relationship between both worlds of healthy or sick children through teaching and playing in common; 3) finally, to facilitate the social insertion of sick children at leaving hospital.
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The Los Angeles Free-Net, an interactive community information resource, was established in part to help community members become more effective consumers of health care services. By providing timely, expert answers to anonymously asked medical questions at no charge, we hope to decrease unnecessary physician-patient encounters, encourage effective preventive-health measures, and improve the overall results of health care in our community. Although it is too early to assess health care benefits from this system, the following observations may help guide the development of similar systems around the nation: (1) A small annual registration fee generates both moral and financial public support. (2) Demographic information from registered users can help direct attempts at enfranchising all members of the community. (3) Toll-free access, free public-instruction sessions, moderated forums, extensive volunteer help, and encryption security are encouraged, while Internet censorship is difficult and counterproductive. (4) Access to Internet resources is important, but the strength of a community system lies primarily in the sharing of expertise and resources among members of the community. (5) A critical mass of available physicians to answer questions must be matched with a critical level of question input for this type of interactive medical information resource to function in a time-sensitive fashion.
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OBJECTIVE: To compare thoracic radiographs of clinically normal dogs and dogs with mild clinical heartworm disease with images transmitted by a desk-top, two-way audiovisual teleconferencing system. DESIGN: Prospective, matched-set study. STUDY POPULATION: 50 thoracic radiographs from clinically normal and heartworm-infected dogs and the digitally transmitted images of those radiographs. PROCEDURE: Thoracic radiographs from 25 clinically normal dogs and 25 dogs infected with 1 to 24 heartworms were evaluated by 3 clinicians. Using classic criteria for heartworm disease, evaluations of radiographs and images transmitted digitally over 2 high-speed data-transfer telephone lines (56 kilobits/s/line) were performed. Clinicians were asked to determine whether dogs had radiographic signs of heartworm disease. RESULTS: Clinicians' ability to detect heartworm disease did not differ between interpretations of radiographs and those of transmitted images. CLINICAL IMPLICATIONS: Radiographic images transmitted via a teleconference system can be used to provide reliable diagnostic information. Thoracic radiographs can be interpreted at a remote site permitting rapid consultation and immediate advice on clinical management.
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The future of critical care nursing will be dependent upon the subspecialty's ability to prepare the high-tech homecare nurse for practice in the next millennium. Client self-management of highly complex interventional therapies will be enabled by the high-tech homecare nurse, who will facilitate the transitioning of critical care nursing to the home setting. Rapidly evolving technologic capabilities will be managed by the high-tech homecare nurse, who will assist in the development of a seamless health care delivery system, where quality of care is maintained in settings beyond the traditional boundaries of the intensive care unit.