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Results for “Telepathology”

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.

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At least 523 records · Page 29Linked to original sources
PubMed2000

The optimum time to employ telephotoscreening to detect retinopathy of prematurity.

PURPOSE: Labor-intensive screening of infants in the neonatal intensive care units is the only way to detect retinopathy of prematurity (ROP). Our purpose is to determine if RetCam 120 photos, acquired by a neonatal nurse, can be used to screen for ROP by performing 2 screening examinations, at 32 to 34 weeks (exam 1) and at 38 to 40 weeks (exam 2) post-conceptional age. METHODS: RetCam examinations are performed by a nurse on infants at exam 1 and exam 2 intervals. At the same time, an examination is performed by an experienced ophthalmologist. Masked readers evaluate the photos for ROP and determine if each eye will progress to prethreshold or threshold disease. The data are compared to the clinical course of the eyes. RESULTS: Forty-six eyes were photographed at exam 1 and 50 eyes at exam 2 from July 1, 1999, to December 15, 1999. Sensitivity and specificity of detecting ROP were 76% and 100% for exam 2 and 46% and 100% for exam 1. Sensitivity and specificity of predicting prethreshold disease were 64% and 97% for exam 2 and 33% and 100% for exam 1. Sensitivity and specificity of predicting threshold were both 100% at exam 2 and 0% (one photo in category) and 95% at exam 1. CONCLUSION: A potential reason for low sensitivity is technical limitations of the Retcam, such as the difficulty in capturing peripheral retina in small eyes and the need for a better lid speculum.

Disease Progression↗
PubMed2001

Teledermatopathology.

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Analog-Digital Conversion↗
PubMed2001

Putting retinal exams for diabetics in the primary care arena.

Only about half of all diabetics get their recommended annual eye exams. Until now, little progress has been made in boosting the number of diabetics who are compliant in getting this annual exam done. However, a new device that enables the exams to be completed in the PCP's office is getting rave reviews from early users.

Cost-Benefit Analysis↗
PubMedDate not supplied

Management of point-of-care testing in home health care.

There have been many strategic changes made in health care to address decreasing revenue. One successful strategy is the reduction of the patient's length of hospital stay. An outcome of early release from a hospital for some patients is that they still require medical assistance. Because of this requirement and the increasing aging population, the home health-care industry has been growing. In the past 20 years, the home health-care market has seen many changes. The latest has been a prospective payment system. This article will describe the past and present home health-care markets and future demands. New technologies in home health care, such as vital sign technology (telemedicine) and increased numbers of waived point-of-care tests, should decrease costs because of fewer visits to the home. A pilot study conducted at a home health-care agency in New York revealed that 7.3% of home visits offered laboratory testing. The study also revealed a 10% return visit to the home to recollect another sample because of specimen problems. Costs associated with these return visits are high for home health-care agencies, but can be altered via telemedicine technology. Telemedicine technology affords the homebound patient to send point-of-care testing results to any laboratory for review and storage, allowing the laboratory to take control of such testing.

Aged↗
PubMed2002

Test value.

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Computer Communication Networks↗
PubMed2002

[The future of pathology--from the viewpoint of clinical pathology].

Pathology is one of the fundamental diagnostic fields of medicine, its position has changed and will undergo transformation in the 21st century due to the introduction of new methods. Theoretically, pathology was based upon 3 pillars: 1. the autopsies, 2. the surgical pathology, i.e. the processing and evaluation of different biopsies and surgically resected specimens and 3. the cytological investigations. The autopsy was the dominant field till the end of the seventies of the 20th century but about the turn of the 20th and 21st century the cytology, first of all the fine needle aspiration cytology took over the leading role in the pathologic diagnostic activity. This displacement resulted in such a high decrease in the number of autopsies that it is impossible to conclude appreciable epidemiological statements. Meanwhile the role and position of the pathologist has changed also substantially. Previously he was regarded often as a prosecuting attorney. At present time this opinion is transformed into clinical pathologist. Errors in the histopathological diagnosis and reporting can occur in the surgical pathology but its number is not high. To detect and to avoid them is attainable by composition of an adequate audit-system. The number of the new investigatory methods is increasing nowadays wide-spreadingly in the medicine and so in the pathology too. The immunocytochemistry is regarded already as a conventional method but the PCR and FISH-technique are applied also on a large scale. At the same time, new tools such as the cDNA microarray technology, the micro-chip based analytical chemistry, the laser capture microdissection and the wireless medical information appear also in the pathology. The modern information technology is impacted more intensively into the day-to-day pathological work. This method enables to develop worldwide communicating systems which can make perfect the diagnostic work. The pathologist has traditionally functioned as a medical consultant to the clinician. The predominant function of the pathologist has to be evolved from that of medical consultant to that of information specialist.

Autopsy↗
PubMed2003

Legal pitfalls in teleneuropathology.

OBJECTIVES: This study aims to emphasize legal pitfalls, especially the often underestimated liability issues for both clients of telemedicine and "tele-doctors". The main relevance of telemedicine lies in its capability to link medical practitioners and remote hospitals to larger or specialized facilities in a very fast electronic manner. This may become even more important due to current increases in subspecialization and the demand for more precise diagnosis and consultation in difficult cases. However, every potential user or client of telemedicine should keep in mind that several questions of law are involved. METHODS: In this paper, two case studies representative of practical teleneuropathology scenarios are described. The assessment of the legal implications is focused on the personal liability of the teleneuropathologist. RESULTS: The far-reaching personal liability of the teleneuropathologist can lead to situations in which neither the insurance of the hospital nor the private professional liability insurance could be called on to refund possible damages for health impairments of a patient. CONCLUSIONS: In Germany, a contractual exclusion of liability in health matters is not admissible. With regard to the European situation, international agreements such as a European telemedicine law could be conducive to the future border-crossing development of telemedicine though, to date, the legal competencies remain with the single member countries of the European Community.

Brain Neoplasms↗
PubMed2003

A collaborative platform for consensus sessions in pathology over Internet.

The design of valid databases in pathology faces the problem of diagnostic disagreement between pathologists. Organizing consensus sessions between experts to reduce the variability is a difficult task. The TRIDEM platform addresses the issue to organize consensus sessions in pathology over the Internet. In this paper, we present the basis to achieve such collaborative platform. On the one hand, the platform integrates the functionalities of the IDEM consensus module that alleviates the consensus task by presenting to pathologists preliminary computed consensus through ergonomic interfaces (automatic step). On the other hand, a set of lightweight interaction tools such as vocal annotations are implemented to ease the communication between experts as they discuss a case (interactive step). The architecture of the TRIDEM platform is based on a Java-Server-Page web server that communicate with the ObjectStore PSE/PRO database used for the object storage. The HTML pages generated by the web server run Java applets to perform the different steps (automatic and interactive) of the consensus. The current limitations of the platform is to only handle a synchronous process. Moreover, improvements like re-writing the consensus workflow with a protocol such as BPML are already forecast.

Computer Systems↗
PubMed2003

Telemedical management system of structured clinical documentation--application for quality assurance and multicenter clinical trials.

The paper presents telematic system designed for providing secure medical data communication through the Internet. Security is achieved by strong enctription. The data transmission between remote hospitals and center can be done in both directions. Transmitted data may be of different type especially HTML forms. The HTML forms filled in hospitals are automatically loaded to tables of relational database in the center. Generated in the system HTML forms meet structured clinical documentation needs. The telematic system was applied in project financed by government based on WHO standards for quality assurance system in obstetrics and neonatology. The system covers 40 hospitals and 13 regional health authorities for mother and child. 40 000 records concerning maternal, fetal and infant health status during pregnancy, delivery and pospartum period were stored. Collected data are used for developing indications for monitoring and evaluating perinatal health in Poland.

Adult↗
PubMed2003

Medical video server construction.

The paper discusses two implementation options for a Digital Video Library, a repository used for archiving, accessing, and browsing of video medical records. Two crucial issues to be decided on are a video compression format and a video streaming platform. The paper presents numerous decision factors that have to be taken into account. The compression formats being compared are DICOM as a format representative for medical applications, both MPEGs, and several new formats targeted for an IP networking. The comparison includes transmission rates supported, compression rates, and at least options for controlling a compression process. The second part of the paper presents the ISDN technique as a solution for provisioning of tele-consultation services between medical parties that are accessing resources uploaded to a digital video library. There are several backbone techniques (like corporate LANs/WANs, leased lines or even radio/satellite links) available, however, the availability of network resources for hospitals was the prevailing choice criterion pointing to ISDN solutions. Another way to provide access to the Digital Video Library is based on radio frequency domain solutions. The paper describes possibilities of both, wireless and cellular network's data transmission service to be used as a medical video server transport layer. For the cellular net-work based solution two communication techniques are used: Circuit Switched Data and Packet Switched Data.

Hospital Communication Systems↗
PubMedDate not supplied

Digital photography in anatomical pathology.

Digital imaging has made major inroads into the routine practice of anatomical pathology and replaces photographic prints and Kodachromes for reporting and conference purposes. More advanced systems coupled to computers allow greater versatility and speed of turnaround as well as lower costs of incorporating macroscopic and microscopic pictures into pathology reports and publications. Digital images allow transmission to remote sites via the Internet for consultation, quality assurance and educational purposes, and can be stored on and disseminated by CD-ROM. Total slide digitisation is now a reality and will replace glass slides to a large extent. Three-dimensional images of gross specimens can be assembled and posted on websites for interactive educational programmes. There are also applications in research, allowing more objective and automated quantitation of a variety of morphological and immunohistological parameters. Early reports indicate that medical vision systems are a reality and can provide for automated computer-generated histopathological diagnosis and quality assurance.

Humans↗