Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Telecommunications”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed2000

Telephone management in substance abuse treatment.

The purpose of this article is to describe the results of a clinical trial in which telephonic case management was evaluated as a supplement to substance abuse treatment. An interactive voice response system (IVR) was developed by the research team for use in the case management of randomly assigned participants in a clinical trial research project. The features of the software program facilitated a double caseload for the case manager as well as real-time data capture. At intake, no significant differences were found between participants in the telecommunication condition and the general project. Thus, the effectiveness of random assignment was supported. An IVR was useful for case management services, was less costly, and showed acceptability to clients. A reduction in time expenditure by using telecommunication occurred within three activity areas. Telecommunication facilitated client interaction and the use of case management, and it reduced provider time expenditure. As an alternative strategy, telecommunication case management can enhance cost effectiveness improvements.

Adult↗
PubMed2002

Internet infrastructures and health care systems: a qualitative comparative analysis on networks and markets in the British National Health Service and Kaiser Permanente.

BACKGROUND: The Internet and emergent telecommunications infrastructures are transforming the future of health care management. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources. OBJECTIVE: to identify the effects of ideological differences on health care market infrastructures including the Internet and telecommunications technologies by a comparative case analysis of two large health care organizations: the British National Health Service and the California-based Kaiser Permanente health maintenance organization. METHODS: A qualitative comparative analysis focusing on the British National Health Service and the Kaiser Permanente health maintenance organization to show how system infrastructures vary according to market dynamics dominated by health care institutions ("push") or by consumer demand ("pull"). System control mechanisms may be technologically embedded, institutional, or behavioral. RESULTS: The analysis suggests that telecommunications technologies and the Internet may contribute significantly to health care system performance in a context of ideological diversity. CONCLUSIONS: The study offers evidence to validate alternative models of health care governance: the national constitution model, and the enterprise business contract model. This evidence also suggests important questions for health care policy makers as well as researchers in telecommunications, organizational theory, and health care management.

Computer Communication Networks↗
PubMed1999

[Telemedical support in emergency medicine].

In July 1997 we began support of paramedics who would respond to emergency scenes using a telecommunications system based in the hospital emergency unit. However, since no telecommunications system that could be employed on the actual clinical site was available, we had to develop a new system. Our telecommunications system (TMS-6101, NIHON KOHDEN WELLNES Co., Tokyo, Japan) can transmit vital signs in real time and interactively transmit several types of moving images. Because the current infrastructure for radio communications cannot provide adequate telemedical support for paramedics, we are using the new system for clinical support between our unit and associated hospitals. Based on 57 cases of clinical telemedical intervention, the system has enabled high-quality decision making by specialists without the need for them to travel to the scene or transport X-rays films, ultrasonographic reports, or endoscopic results. If this newly developed telecommunications system is employed for telemedical interventions in medical facilities in remote areas or on remote islands, medical consultations for Japanese individuals overseas, night-time first aid in urban areas, and in disaster situations, the physicians on both side of the line will be able to obtain a wealth of timely information, greatly influencing outcome in both emergency and nonemergency cases.

Emergency Medical Services↗
PubMed2000

Technological requirements of teleneuropathological systems.

Teleneuropathology is the practice of conducting remote neuropathological examinations with the use of telecommunication links. Because of a limited number of expert neuropathologists, some, especially smaller departments have the equipment to conduct the examination but do not have a specialist who would be able to evaluate material from the central nervous system. In case of teleneuropathology, a neuropathologist examines tissue fragments taken during an operation by means of a telemicroscope connected with the computer through a telecommunications network. It enables the neuropathologist to operate the microscope and camera remotely. Two basic systems exist for performing remote neuropathological examination: static and dynamic. Both have different needs in medical, computing and telecommunication aspect. Depending on the type of service the public telephone network, the integrated services digital network, or optical fibre should be used. Conditionally Internet can be used as a link for teleneuropathological system. However, for the newest developments in teleneuropathology such as teleconference and remote operation on robotized microscope only transmission over the integrated service digital network, which guarantees high speed of transmission gives a possibility to communicate. Because images are basic information element in teleneuropathological systems the high capacity of acquisition, processing, storing, transmission, and visualization equipment is necessary. The farther development of telecommunication as well as standardization of recording and transmission procedures of pictorial data is necessary.

Computer Communication Networks↗
PubMedDate not supplied

Redefining continuing education delivery.

Just as technology is transforming the delivery of education, the Internet and advanced telecommunication applications are changing the "face" of CE and the connotation of "lifelong learning." As late as the mid-1980s, a discussion of computer applications in nursing CE focused on the "timely" transition to microcomputers as tools for the enhancement of managerial tasks for increased productivity. Even as recently as 1990, there seemed to be "time" for those providers who were "slower to adopt innovation" to "catch up." Now, the CE provider who does not integrate the microcomputer and advanced telecommunications as an integral component of their delivery modalities may be outsourced rapidly by an educational or commercial competitive unit that is able to utilize the communication medium, mergers and partnerships, enterprise, and individual lifestyle and learning patterns that will epitomize the CE unit of the 21st century. As with the "re-engineering" of nursing education, the "re-engineered" delivery modalities of evolving CE entity might now best be conceptualized on a continuum from the traditional mode that time and place dependent to a mode of synchronous and asynchronous data and advanced telecommunication. Delivery methods will need to be selected according to the target populations, content, and situation. The health-care educational provider may discover, as in other industries, that a combination of distance and residential offerings will be the most successful medium for the delivery of CE to the progressively more "information and technologically savvy" lifelong learner of the 21st century. In addressing the dramatic effects of the information technology era on the refocused multimedia/interactive delivery method for student education, educators amply quoted Bob Dylan's phrase of the 1960s, "The times, they are a-changing." And so, we see that the times are also changing at an astronomical rate for the health-care educational provider as well as the individual health-care worker consumer. A number of national and world-wide trends are propelling rapid changes in the delivery modalities and types of emerging providers for health-care CE. Examples of these advanced telecommunications applications of CE opportunities for health-care personnel are becoming more prevalent in the literature and the pattern of CE marketing, and delivery evolution can be seen readily on the Internet. Continued program success and viability will belong to the individuals and organizations who are able to conceptualize and envision the positive transformations and opportunities that can occur from the evolving paradigm of education for the lifelong learner of the 21st century.

Computer Communication Networks↗
PubMed1998

Telemedicine in practice.

Telemedicine is defined as the "delivery of health care and sharing of medical knowledge over a distance using telecommunication systems." The concept of telemedicine is not new. Beyond the use of the telephone, there were numerous attempts to develop telemedicine programs in the 1960s mostly based on interactive television. The early experience was conceptionally encouraging but suffered inadequate technology. With a few notable exceptions such as the telemetry of medical data in the space program, there was very little advancement of telemedicine in the 1970s and 1980s. Interest in telemedicine has exploded in the 1990s with the development of medical devices suited to capturing images and other data in digital electronic form and the development and installation of high speed, high bandwidth telecommunication systems around the world. Clinical applications of telemedicine are now found in virtually every specialty. Teleradiology is the most common application followed by cardiology, dermatology, psychiatry, emergency medicine, home health care, pathology, and oncology. The technological basis and the practical issues are highly variable from one clinical application to another. Teleradiology, including telenuclear medicine, is one of the more well-defined telemedicine services. Techniques have been developed for the acquisition and digitization of images, image compression, image transmission, and image interpretation. The American College of Radiology has promulgated standards for teleradiology, including the requirement for the use of high resolution 2000 x 2000 pixel workstations for the interpretation of plain films. Other elements of the standard address image annotation, patient confidentiality, workstation functionality, cathode ray tube brightness, and image compression. Teleradiology systems are now widely deployed in clinical practice. Applications include providing service from larger to smaller institutions, coverage of outpatient clinics, imaging centers, and nursing homes. Teleradiology is also being used in international applications. Unresolved issues in telemedicine include licensure, the development of standards, reimbursement for services, patient confidentiality, and telecommunications infrastructure and cost. A number of states and medical boards have instituted policies and regulations to prevent physicians who are not licensed in the respective state to provide telemedicine services. This is a major impediment to the delivery of telemedicine between states. Telemedicine, including teleradiology, is here to stay and is changing the practice of medicine dramatically. National and international communications networks are being created that enable the sharing of information and knowledge at a distance. Technological barriers are being overcome leaving organizational, legal, financial, and special interest issues as the major impediments to the further development of telemedicine and realization of its benefits.

Computer Communication Networks↗
PubMed2000

Telepsychiatry: addressing mental health needs in Georgia.

Creation of a comprehensive mental health telecommunications system to serve isolated persons in Georgia, resulting in a more equitable distribution of mental health resources, is the goal of the telepsychiatry program at the Medical College of Georgia. Although telepsychiatric consultation is not a new idea, the "distribution" of telepsychiatry through additional integrated telecommunications channels such as the World Wide Web is a distinctive approach. This report describes the history of the development of the MCG Telepsychiatry Program. Through the use of a multichanneled telecommunications system, a more equitable distribution of mental health resources is underway in Georgia.

Adolescent↗
PubMed2002

On-site investigation of the early phase of Bhutan Health Telematics Project.

Telemedicine is valuable to many developing countries. International use of telemedicine is widespread. Telemedicine can improve health care in the developing countries by removing time and distance barrier, and optimize the use of limited health services in developing countries. The purpose of this paper is to investigate the current situation of healthcare services and telecommunications infrastructure in Bhutan. It summarizes the experience gained from a previous telemedicine pilot project initiated and implemented by the Telecommunication Development Bureau, International Telecommunication Union (BDT/ITU). It also introduces the priorities of telemedicine development set out by the local health authorities as well as the international organizations. By analyzing the common and most urgent problems in the country, which could be alleviated by using telemedicine, it formulates several recommendations concerning the future development strategy of telemedicine in Bhutan.

Bhutan↗
PubMed2002

Theory and applications of telemedicine.

In this study, telemedicine and the use of advanced telemedicine technologies are explained. Telemedicine is the use of modern telecommunications and information technologies for the provision of clinical care to individuals at a distance, and transmission of information to provide that care. Telemedicine can be used for decision making, remote sensing, and collaborative arrangements for the real-time management of patients at a distance. The use of telecommunications and information technologies in providing health services is determined. Telemedicine is described as combination of topics from the fields of telecommunication, medicine, and informatics. The medical systems infrastructure consisting of the equipment and processes used to acquire and present clinical information and to store and retrieve data are explained in details. The challenges existing in telemedicine development in different countries are given. Technological, political, and professional barriers in applications of telemedicine are defined. An investigation of telemedicine applications in various fields is presented, and enormous impact of telemedicine systems on the future of medicine is determined.

Decision Support Systems, Clinical↗
PubMed2003

Relation of premorbid cognitive abilities to substance users' problems at treatment intake and improvements with substance abuse treatment and case management.

Substance users' premorbid cognitive skills and abilities, assessed by their scores on standardized achievement tests (Iowa Tests of Basic Skills) during the fourth grade of elementary school, were examined as predictors of their problems at treatment intake and improvements with substance abuse treatment and case management over a 12-month follow-up period. Clients were assigned to four groups differing in the type of case management provided. Among 213 clients meeting criteria for the study, problems in several areas at treatment intake (assessed by the Addiction Severity Index) were milder for those with higher, relative to lower, premorbid cognitive abilities. Relationships of premorbid cognitive abilities to improvements at follow-ups were more prominent for clients who worked with case managers primarily via telecommunications than for clients who generally met with case managers at the substance abuse treatment or an independent agency, or who received only limited case management services from primary drug counselors. Thorough utilization of an interactive voice response system available to the telecommunications group might have placed demands on cognitive abilities that were less emphasized in the other groups. Alcohol differed markedly from other drugs in how improvements in problems were related to premorbid cognitive abilities among clients in the telecommunications group, and, to a lesser extent, among clients who generally met with case managers in person. Premorbid cognitive abilities should be considered when examining how outcomes are related to clients' characteristics and how maximally effective treatments can be selected based on clients' characteristics.

Adult↗
PubMed1991

National survey on telephone services and products. The views of deaf and hard-of-hearing people.

A national study of 128 deaf and hard-of-hearing adults aged 18 to 70 years found that they are willing to pay as much as $15 per month for new telephone-based information services, in part because they are frustrated with what they regard as inadequate access to the nation's telecommunications network. The services they most want are "enhanced 911," fire, police, and other life and safety services. A majority wants the telecommunications network equipped with speech recognition capabilities as soon as the state-of-the-art permits, so that they can gain full access to network-based services. These findings suggest that changes in the national telecommunications policy might enhance the lives of deaf and hard-of-hearing adults. Policy changes might also permit them, as well as younger deaf Americans, to benefit more from the recently enacted Americans with Disabilities Act and to benefit more from other rights and services promoting access to work, education, and independent living.

Adolescent↗
PubMed1994

Special report. PBX and voice mail fraud: what it is and how to protect against it.

As automation technology advances, so does the savvy of the criminal mind. And because the human factor is becoming more and more removed from costly operations such as telecommunications, scammers are even more difficult to track--in most cases leaving nothing but anonymous dial tones for clues. In this report, we will examine two types of telecommunications theft--PBX and voice mail fraud--as well as other scams capable of bilking thousands of dollars from hospital telecommunications budgets.

Fraud↗
PubMed1999

Technology and the future of medical equipment maintenance.

Maintenance of medical equipment has been changing rapidly in the past few years. It is changing more rapidly in developed countries, but changes are also occurring in developing countries. Some of the changes may permit improved maintenance on the higher technology equipment in developing countries, since they do not require onsite expertise. Technology has had an increasing impact on the development of medical equipment with the increased use of microprocessors and computers. With miniaturization from space technology and electronic chip design, powerful microprocessors and computers have been built into medical equipment. The improvement in manufacturing technology has increased the quality of parts and therefore the medical equipment. This has resulted in increased mean time between failures and reduced maintenance needs. This has made equipment more reliable in remote areas and developing countries. The built-in computers and advances in software design have brought about self-diagnostics in medical equipment. The technicians now have a strong tool to be used in maintenance. One problem in this area is getting access to the self-diagnostics. Some manufacturers will not readily provide this access to the owner of the equipment. Advances in telecommunications in conjunction with self-diagnostics make available remote diagnosis and repair. Since components can no longer be repaired, a remote repair technician can instruct an operator or an on-site repairman on board replacement. In case of software problems, the remote repair technician may perform the repairs over the telephone. It is possible for the equipment to be monitored remotely by modern without interfering with the operation of the equipment. These changes in technology require the training of biomedical engineering technicians (BMETs) to change. They must have training in computers and telecommunications. Some of this training can be done with telecommunications and computers.

Equipment Failure↗
PubMed1998

[Occupational exposure to lead in production units in Maracaibo, Venezuela].

A medical occupational study was performed in 40 workers belonging to productive units in telecommunication works, 22 to car radiator mechanics and 11 to battery repairs. A practical medical and occupational study was applied to the group and also were determined their blood lead and air lead exposure levels. Seventy-three individuals, without risk of laboral exposure to lead, without familiar, pathological and occupational antecedents, and healthy at the time of the test, to whom the blood lead levels were determined served as control group. The mean values of plumbemia in exposure workers to inorganic lead exceed the level threshold of the COVENIN 2277-85 norm (30 micrograms/dl) (Telecommunication work, 40.10 micrograms/dl, radiators mechanics, 37.40 micrograms/dl and battery repairs, 45.77 micrograms/dl), values that were significantly higher (p < 0.0001) compared with the ones obtained in the non-exposed population. The factors that can influence the variability of the results were analyzed and it was established a correlation between the plumbemia of the radiator mechanics and battery repairmen and the length of occupational period and air lead levels (p < 0.0001). The inherent factors to the climatic, occupational and personal conditions of technicians in telecommunications, are presented as elements able to explain the lack of correlation between blood lead levels and length of occupational period and air lead. The clinical findings in exposed workers were unspecific. The workers do not practice or follow the basic sanitary regulations, personal protection and industrial security. This work will contribute to establish a basic description, to further and more complex observational prospective studies in order to determine the occurrence of alterations that are derived from occupational lead exposure.

Adolescent↗
PubMed1999

Telemedicine: the new must for surgery.

The vision of telesurgery comprises a multitude of new communicative elements influencing the way surgeons will treat their patients in the future. The first prerequisite for effective telecommunication is to digitize surgical data. Many medical imaging modalities provide primarily digital data sets, and digital image communication is already entering clinical practice under the labels of teleradiology and telepathology. However, for any surgical purpose, images must refer to tissues. Three-dimensional image reconstruction is warranted, and if such data shall be useful during surgery, different image sources must be combined into some virtual, multiparametric body model and matched to an intraoperatively distorted organ contour. A multitude of detail problems arise, beginning with image standards, data interfaces, data transport, image fusion, registering, contour matching, and, once the data are integrated, all the aspects of surgery-suitable data display and interaction. We refer here to several demonstration projects illustrating such a complex surgical data set and its interactive telecommunication. In all instances, telecommunication was to enable a concentration of distributed medical intelligence at the site where the patient was treated. With further technological development, such telesurgical applications will have a growing influence on patient management and surgical decision making. In the very near future, computer-aided navigation and robotic assistance, based on the same surgical data sets, will be available to all fields of surgery. How decisive the role these methods will play for specific procedures or diseases needs to be determined.

Computer Simulation↗
PubMed2001

Medical e-commerce for regional Australia.

The residents of rural and regional Australia have less access to health care services than in capital cities. There is a reluctance of General Practitioners to practice in the country. New information technology and government initiatives are now addressing this problem. High bandwidth videoconferencing is now being routinely used to provide psychiatric consultations to areas without this service. But this (like many other implementations of telecommunication technologies to health) has resulted in loss of revenue to regional Australia while benefiting capital cities. Thus, the current implementation of telecommunication technology to health has resulted in loss of revenue of the regions while increasing the bias towards the cities. Further, the system is not economically viable and requires the Government to inject funds for the smooth operation of the system. This paper proposes the use of telecommunication technology for enabling the communities of regional Australia to access health facilities via physical and virtual clinics. The proposed technique is self supporting and is based in the country with the intent to prevent the drain of resources from regional Australia. The technique attempts to eradicate the problem at the root level by providing a business opportunity that is based in and to cater for the needs of the remote communities. The proposed system would provide health services by physical and virtual clinics and while serving the communities would be profit centres- and thus attracting doctors and other resources to the remote communities.

Australia↗
PubMed2005

Seven years of clinical experience with teleconsultation in craniomaxillofacial surgery.

PURPOSE: In this work the experiences from 50 telemedically supported treatments in craniomaxillofacial surgery are summarized and different setups for their technical realization are described. Furthermore, for the first time the innovative UMTS (universal mobile telecommunication system) is applied for the transmission of arthroscopic videos of the temporomandibular joint and other craniomaxillofacial structures. MATERIALS AND METHODS: The combination of computer-assisted navigation technology in augmented reality environments with telecommunication is used for execution of interactive stereotaxic teleconsultation. Furthermore, treatments without navigation are telemedically supported. This study is composed of 4 technical system configurations: 1) integrated services digital network (ISDN)-based videoconferencing without remote control of the navigation computer; 2) transmission control protocol/internet protocol (TCP/IP)-based interactive teleconsultation via bundled ISDN lines (including remote control of the navigation computer); 3) TCP/IP-based interactive teleconsultation via network; 4) combination of TCP/IP-connection and ISDN-based videoconferencing. The telemedically supported treatments are: orbitozygomatic osteotomies, positioning of the mandibular condyle in orthognathic surgery, insertion of implants, positioning of the maxilla in orthognathic surgery, distraction osteogenesis, arthroscopies of the temporomandibular joint, and operation simulations on stereolithographic models. The surgical interventions are evaluated on a 5-level system performance scale from the technical point of view. In a separate trial 20 videosequences of arthroscopies of the temporomandibular joint are transmitted via UMTS cellular phones and independently evaluated by 3 experts (ie, a total of 60 streamings) to investigate feasibility of this technology in the field of craniomaxillofacial surgery. RESULTS: In the years from 1996 to 2002 a total of 50 treatments were telemedically supported. All intraoperative applications were successfully finished; 48 of 60 UMTS transmissions were finished without any interruptions in constant quality, slight interruptions were observed in 8 tests, and a complete breakdown was observed during 4 streamings that required a restart of the transmission. Resolution was sufficient to diagnose even tiny anatomic structures inside the temporomandibular joint, but orientation was hardly recognizable. CONCLUSION: In many applications telecommunication technology can contribute to a quality improvement in cranio- and maxillofacial surgery because of the global availability of specialized knowledge. The required technical expenditure for teleconsultation crucially depends on the infrastructure that is already available at the clinic and the remote site. UMTS is a promising technology with the potential to be valuable in numerous craniomaxillofacial applications.

Arthroscopy↗