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At least 469 records · Page 26Linked to original sources
PubMed2003

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support.

The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC) or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile) unit. This integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3-12 lead ECG, SPO2, NIBP, IBP, Temp) and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available) or through Plain Old Telephony Systems (POTS) where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunication means; in addition the system has been clinically validated in three different countries using a standardized medical protocol.

Data Compression↗
PubMed2004

Case report of remote anesthetic monitoring using telemedicine.

UNLABELLED: We report a case supporting the use of telecommunications technology from a remote location to monitor anesthetic events. Vital signs, data, and video were transmitted from surgery conducted in the remote Amazonian rainforests of Ecuador to Richmond, VA. This application of telemedicine technologies makes available expert advice from remote locations during surgical procedures. IMPLICATIONS: This study validates the use of telecommunications technology from a remote location to monitor an anesthetic event. This type of work makes expert advice available during surgical procedures.

Adult↗
PubMedDate not supplied

Workload and availability of technology in metropolitan community pharmacies.

OBJECTIVE: To assess workload characteristics and the presence of prescription processing technologies within metropolitan community pharmacies in the United States. DESIGN: Cross-sectional postal survey. SETTING: 18 metropolitan statistical areas (MSAs) in the United States. PARTICIPANTS: 3000 managers located in community pharmacies processing at least 500 third-party claims per month for four major pharmacy benefits managers. INTERVENTIONS: 34-item survey instrument designed to collect data about the pharmacy including demographics, workload issues, handling of drug-drug interactions (DDIs), and pharmacists' attitudes toward computerized DDI alerts. MAIN OUTCOME MEASURES: Workload (hours of operation, prescription volume, staffing hours, prescription processing intensity) and prescription processing technologies (telecommunication systems, automated counting/filling or verification devices, number of computer terminals, and computer software vendors). RESULTS: Overall, 736 usable surveys were returned (response rate, 25.3%). On average, respondents reported a volume of approximately 1340 prescriptions per week processed at a rate of almost 17 prescriptions per hour. Independent pharmacies processed approximately 3 prescriptions per hour more than chain pharmacies even though a statistically equal or slightly lower proportion of those pharmacies had automated technologies. The presence of technology was generally high for all pharmacies, particularly countertop tablet/capsule-counting devices and telefacsimile machines. The most common software vendors differed considerably between chain and independent pharmacies. CONCLUSION: The number of prescriptions processed per hour and number of technologies available increased with the total weekly volume of prescriptions processed in this national survey. A majority of pharmacies had at least one type of automated prescription processing technology and an automated telecommunication system for accepting new or refill prescriptions. Independent pharmacies processed more prescriptions per hour than did chains but did so with fewer categories of technologies.

Automation↗
PubMed2004

Alaska telemedicine: growth through collaboration.

The last thirty years have brought the introduction and expansion of telecommunications to rural and remote Alaska. The intellectual and financial investment of earlier projects, the more recent AFHCAN Project and the Universal Service Administrative Company Rural Health Care Division (RHCD) has sparked a new era in telemedicine and telecommunication across Alaska. This spark has been flamed by the dedication and collaboration of leaders at he highest levels of organizations such as: AFHCAN member organizations, AFHCAN Office, Alaska Clinical Engineering Services, Alaska Federal Health Care Partnership, Alaska Federal Health Care Partnership Office, Alaska Native health Board, Alaska Native Tribal health Consortium, Alaska Telehealth Advisory Council, AT&T Alascom, GCI Inc., Health care providers throughout the state of Alaska, Indian Health Service, U.S. Department of Health and Human Services, Office of U.S. Senator Ted Steens, State of Alaska, U.S. Department of Homeland Security--United States Coast Guard, United States Department of Agriculture, United States Department of Defense--Air Force and Army, United States Department of Veterans Affairs, University of Alaska, and University of Alaska Anchorage. Alaska now has one of the largest telemedicine programs in the world. As Alaska moves system now in place become self-sustaining, and 2) collaborating with all stakeholders in promoting the growth of an integrated, state-wide telemedicine network.

Alaska↗
PubMedDate not supplied

Distance education programs: defining issues of assessment, accessibility, and accommodation.

Identification and resolution of a variety of issues is imperative to establishing effective distance education via telecommunications. In this first-hand experience, the authors describe selected issues and possible responses inherent in the development and implementation of a new teaching modality. The decision to pursue distance education by telecommunications should be made only after a thorough examination of the needs, the required resources, and the changes to be expected. Advance planning is essential for problem solving.

Education, Nursing, Baccalaureate↗
PubMed2002

Logistical aspects of large telemedicine networks. 2: Measurement of network activity.

We carried out a retrospective review of the videoconference activity records in a university-run hospital telemedicine studio. Usage records describing videoconferencing activity in the telemedicine studio were compared with the billing records provided by the telecommunications company. During a seven-month period there were 211 entries in the studio log: 108 calls made from the studio and 103 calls made from a far-end location. We found that 103 calls from a total of 195 calls reported by the telecommunications company were recorded in the usage log. The remaining 92 calls were not recorded, probably for one of several reasons, including: failed calls--a large number of unrecorded calls (57%) lasted for less than 2 min (median 1.6 min); origin of videoconference calls--calls may have been recorded incorrectly in the usage diary (i.e. as being initiated from the far end, when actually initiated from the studio); and human error. Our study showed that manual recording of videoconference activity may not accurately reflect the actual activity taking place. Those responsible for recording and analysing videoconference activity, particularly in large telemedicine networks, should do so with care.

Australia↗
PubMed2004

Changing the medical world order with technological advances: the future has only begun.

It is a great honor to contribute in a small way to this book which in a way celebrates the continued evolution of telemedicine in Kosova. I was privileged to visit this brave land on several occasions in the last years. Severe circumstances were repeatedly resolved through great personal and professional sacrifice. Revolutionary solutions have been applied where evolutionary development was simply too slow in the realization of a new land in a complex world. In some ways telemedicine is emblematic of such struggle and success. We aspire to world health when world peace is elusive and hunger haunts us in the midst of plenty. Telecommunications have made it easy to report the failings of medicine, the injustice of health care and the unmet promise of political endeavor. It is the promise of telemedicine to use those same channels of information to empower, unify and advance the cause of health rather than only report the failings. Telemedicine entails the use of telecommunications and information technology to support the delivery of health care at a distance. There are critics who believe telemedicine is a waste of precious resources, which are needed urgently for higher health priorities. Telemedicine is dismissed as an expensive irrelevance, another distraction from the real needs of medicine in a chaotic world. That is patently ridiculous. Telemedicine is a part of the wider phenomenon of information and information is arguably the strongest change agent in play for medicine and other societal elements as well. A well-informed public armed with the tools for self-determination and the evidence for efficient action cannot be corrupted. Telemedicine is a part of the great change information brings to the world order, a drastic change toward a better world of health and justice.

Delivery of Health Care↗
PubMed1986

[Evolution and current uses of telematics in medicine. Future prospectives of telemedicine].

The medical use of data transmission has become a basic element in the application of telecommunications to medical practice. Hence the development of medical telematics i.e. the application of socalled "telematics" derived from the combined use of information science and telecommunications in medicine. In historical terms the foundations for medical telematics were laid in Italy in 1935 with the creation of the International Radiomedical Centre in Rome and more recently with the direct and indirect application of telematics to the flight and medical staff of the Air Rescue Service planes as well as the use--in space medicine--of special sensors computer-recorders, telecameras, etc., for the collection and long-distance transmission of data on the behaviour of men and animals during long space missions over the past 20 years. Other recent techniques enabling the long-distance transmission of data required for the long-distance treatment of the sick are also reviewed with the emphasis on cardiology, neurology, radiology, radiodiagnosis, nuclear medicine, oncology, nephrology, ophthalmology, haematology, laboratory diagnosis, etc. There are many other objectives of supreme human and social value that efficiently organised medical telematics can attain to solve the many difficult problems involved in the gradual development of a truly effective health service for all.

Computers↗
PubMed1985

Introduction to computer communications.

Telecommunications is the process of transmitting and receiving information, over the phone lines, by computer. This article will describe the hardware and software required to permit an office computer to participate in telecommunications. The article also describes various benefits to the practicing optometrist available through this new technology.

Computers↗
PubMedDate not supplied

Progress in telepathology.

The basic principles, technical objectives and future aspects of telecommunication in pathology (telepathology) are discussed. Visual information, which is the usually the basic source of medical disease classification, and its transfer have to be distinguished from acoustic information, which is commonly of secondary, i.e. abstract nature. Visual telecommunication in pathology can be applied in five different aspects, namely: a) to create visual data bases, b) to be used in expert consultation, c) to combine morphological and clinical data, d) to quantitate morphological findings (DNA- measurements, etc.), and e) to install remote control microscopes. Depending upon the application, different technical prerequisites and constraints have to be taken into account: queries of visual data bases and expert consultations can be performed by use of "normal" telephone lines; combination of morphological and clinical data and quantitation of morphological data may need a digitized telephone network (ISDN), and the transfer of live images needed for application of remote control microscopes can only be performed by use of ISDN or broadband networks (optical fiber transmission systems, satellite communication, etc.). The experiences of various groups working in different aspects of telepathology are described.

Forecasting↗
PubMedDate not supplied

Endoscopic surgery teleconferencing.

Modern telecommunication allowing the transmission of digitalized voice and images through telephone lines has expanded to medicine. The Integrated Digital Network System (ISDN) can be used to transmit 128 kbit/sec (ISDN-2) to 2 Mbit/sec (ISDN-30). Together with smart compression techniques a teleconferencing system can be implemented to transmit images of an endoscopic operation. In this paper 2 such experiments are described. In the first experiment a laparoscopic cholecystectomy performed in the Netherlands is followed at the same time by surgeons in Hawaii through ISDN-2 lines. In the second experiment a laparoscopic hernia repair was followed in Orlando during a congress using ISDN-6 lines. The images sent over the ISDN-2 lines are rather blurry with rapid movement. The images over the ISDN-6 lines were more acceptable. Data compression and decompression results in a time delay of approximately 1 second, which seems not disturbing during the connection. The cost of communication is comparable to telephone communication, which makes this form of telecommunication feasible in surgical practice.

Algorithms↗
PubMed2000

Telemedicine versus face to face patient care: effects on professional practice and health care outcomes.

BACKGROUND: Telemedicine is the use of telecommunications technology for medical diagnosis and patient care. From its beginnings telemedicine has been used in a variety of health care fields, although widespread interest among healthcare providers has only now become apparent with the development of more sophisticated technology. OBJECTIVES: To assess the effects of telemedicine as an alternative to face-to-face patient care. SEARCH STRATEGY: We searched the Effective Practice and Organisation of Care Group's specialised register, The Cochrane Library, MEDLINE (1966-August 1999), EMBASE (to 1996), Cinahl (to August 1999), Inspec (to August 1996), Healthstar (1983-1996), OCLC, Sigle (to 1999), Assia, SCI (1981-1997), SSCI (1981-1997), DHSS-Data. We hand searched the Journal of Telemedicine and Telecare (1995-1999), Telemedicine Journal (1995-1999) and reference lists of articles. We also hand searched conference proceedings and contacted experts in countries identified as having an interest in telemedicine. SELECTION CRITERIA: Randomised trials, controlled before and after studies and interrupted time series comparing telemedicine with face-to-face patient care. The participants were qualified health professionals and patients receiving care through telemedicine. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. MAIN RESULTS: Seven trials involving more than 800 people were included. One trial was concerned with telemedicine in the emergency department, one with video-consultations between primary health care and the hospital outpatients department, and the remainder were concerned with the provision of home care or patient self-monitoring of chronic disease. The studies appeared to be well conducted, although patient numbers were small in all but one. Although none of the studies showed any detrimental effects from the interventions, neither did they show unequivocal benefits and the findings did not constitute evidence of the safety of telemedicine. None of the studies included formal economic analysis. All the technological aspects of the interventions appear to have been reliable, and to have been well accepted by patients. REVIEWER'S CONCLUSIONS: Establishing systems for patient care using telecommunications technologies is feasible, but there is little evidence of clinical benefits. The studies provided variable and inconclusive results for other outcomes such as psychological measures, and no analysable data about the cost effectiveness of telemedicine systems. The review demonstrates the need for further research and the fact that it is feasible to carry out randomised trials of telemedicine applications. Policy makers should be cautious about recommending increased use and investment in unevaluated technologies.

Communication↗
PubMed1992

A computer-based, automated, telephonic system to monitor patient progress in the home setting.

In this report we describe an automated, telephonic system to monitor the progress of patients convalescing at home. The system includes a computerized central station that is capable of automated voice communication over the telephone, using voice reproduction, and touch-tone recognition. Peripheral hardware in multiple monitored homes need include only a touch-tone telephone, but may also be augmented by inexpensive, rudimentary diagnostic aids, such as a scale for body weight, a thermometer, or a blood pressure cuff and manometer. Current central hardware includes a NeXT computer, a fax modem, and a specialized telecommunications modem developed specifically for voice telecommunication using the NeXT. The central station acts like a robotic nurse in that it asks patients a series of questions and records the responses. The subjective questions to be asked are patient individualized and pre-selected by the physician from a question menu including items targeted specifically for the patient's disease or condition. In addition, clinical data such as body weight, blood pressure, and body temperature obtained from in-home diagnostic aids may be transmitted to the central station over the telephone using touch tones. The time-of-day and frequency of calling are pre-selectable, according to the patient's preference and clinical status. Data obtained by the central station can be easily accessed by the duty nurse via menu driven software. Reports depicting significant responses as a function of time are generated in graphical format to facilitate rapid identification of adverse trends. Hard copy reports can be dispersed directly by fax. Results from a pilot study show patients with cardiac disease readily use the system without difficulty or complaints. In one patient a five pound increase in body weight was detected, which prompted the patient's cardiologist to adjust his medication. In this way automated telephone follow-up can provide early detection of complications before they become severe, making the home environment safer and more secure for convalescence and contributing to reduced health-care costs.

Computer Systems↗
PubMed2004

A hierarchical architecture of centralized monitoring and controlling system and its high-performance and interoperability protocol.

This paper describes a hierarchical architecture and a high-performance and interoperability protocol for centralized monitoring and controlling systems (CMCS). The protocol we proposed can interoperate different monitoring and controlling systems constructed by different companies, each with different functions and communication protocols. The protocol reduces the amount of traffic and has real-time and high-performance advantages. The protocol was implemented in CMCS for telecommunication power supply and air-conditioner used by the Telecommunication Bureau of Zhejiang Province. This paper deals with the hierarchical architecture and function of CMCS and packet format, command ID, and SDL description of its protocol. We also discuss the properties of the interoperability and performance of the protocol in this paper.

Algorithms↗
PubMed1997

Video networking of cardiac catheterization laboratories.

UNLABELLED: A video telecommunication network was established to transmit coronary images between a cardiac catheterization laboratory and a remote core laboratory. In 40 patients during interventional procedures, cine angiograms, live fluoroscopy, intravascular ultrasound studies, and images of the cath lab were transmitted in real time over a T1 line at 768 kbits/second at 15 frames/second. RESULTS: Measurements of angiographic and intravascular ultrasound parameters were very close between the original studies and the transmitted images. The telecommunication link up during the interventional procedures had a significant affect in 58% of cases.

Cardiac Catheterization↗
PubMed1999

Application of the advanced communications technology satellite to teleradiology and real-time compressed ultrasound video telemedicine.

The authors have investigated the application of the NASA Advanced Communications Technology Satellite (ACTS) to teleradiology and telemedicine using the Jet Propulsion Laboratory (JPL)-developed ACTS Mobile Terminal (AMT) uplink. In this experiment, bidirectional 128, 256, and 384 kbps satellite links were established between the ACTS/AMT, the ACTS in geosynchronous orbit, and the downlink terrestrial terminal at JPL. A terrestrial Integrated Digital Services Network (ISDN) link was established from JPL to the University of Washington Department of Radiology to complete the bidirectional connection. Ultrasound video imagery was compressed in real-time using video codecs adhering to the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T) Recommendation H.261. A 16 kbps in-band audio channel was used throughout. A five-point Likert scale was used to evaluate the quality of the compressed ultrasound imagery at the three transmission bandwidths (128, 256, and 384 kbps). The central question involved determination of the bandwidth requirements to provide sufficient spatial and contrast resolution for the remote visualization of fine- and low-contrast objects. The 384 kbps bandwidth resulted in only slight tiling artifact and fuzziness owing to the quantizer step size; however, these motion artifacts were rapidly resolved in time at this bandwidth. These experiments have demonstrated that real-time compressed ultrasound video imagery can be transmitted over multiple ISDN line bandwidth links with sufficient temporal, contrast, and spatial resolution for clinical diagnosis of multiple disease and pathology states to provide subspecialty consultation and educational at a distance.

Humans↗
PubMed2004

Public perception of risk concerning celltowers and mobile phones.

OBJECTIVE: The controversy about health risks of electromagnetic fields (EMF) has contributed in raising fears concerning emissions from celltowers. The study was to examine whether or not neighbours of celltowers are particularly concerned about adverse health effects of mobile phones and their base stations. METHODS: Prior to information delivered by medical doctors of the Institute of Environmental Health at public hearings a questionnaire was handed out to participants asking for their personal rating of several environmental health risks including those of mobile telecommunication (n = 123, response rate approx. 48%). Medical students (n = 366) served as a contrast group. RESULTS: Participants rated health risk for both, mobile phones and celltowers higher as students. A trend for higher ratings was also seen with older subjects and female sex. The risk ratings of both exposures correlated well with each other. The magnitude of the perceived risks, however, resembled that of other ubiquitous exposures like traffic noise and air pollution. CONCLUSION: Contrary to the claims of the telecommunication industry, opponents of celltowers generally do not express unusual fears concerning electromagnetic field exposure. The outcome of our study indicates that the risk rating is comparable with other perceived common hazards of the civilised world. It is hypothesised that offering information and participation to the concerned population will be efficient in reducing exaggerated fears.

Adult↗
PubMed2000

[Telemedicine in otorhinolaryngology. Basic principles and possible applications].

Telemedicine includes all medical activities involved in diagnosis, therapeutics or social medicine undertaken by an electronic transfer medium. This technique requires the transmission of visual and acoustic information over long distances and does not require the specialist to be personally present at the requested consultation. In the last few years, the digital data transmission, e.g., ISDN (ISDN (Integrated Service Digital Network), has become available and has facilitated the use of telecommunication. Recently, the real-time transmission of acoustic and visual signals will be improved by use of asynchronous transfer mode (ATM). Advanced telecommunication applications in minimally invasive ENT surgery are experimental in most cases. We can distinguish three different telesurgical developments: surgical teleconsultation, surgical teleassistance, and surgical telemanipulation. The different applications and transmission media are explained and discussed.

Forecasting↗