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At least 541 records · Page 30Linked to original sources
PubMed2001

Home monitoring service improves mean arterial pressure in patients with essential hypertension. A randomized, controlled trial.

BACKGROUND: Technological advances in the distribution of information have opened new avenues for patient care. Few trials, however, have used telemedicine to improve blood pressure in patients with essential hypertension. OBJECTIVE: To determine the efficacy of a telecommunication service in reducing blood pressure. DESIGN: Randomized, controlled trial. SETTING: University-affiliated primary care outpatient clinics. PATIENTS: 121 adults with essential hypertension who were under evaluation for a change in antihypertensive therapy. INTERVENTION: A home service consisting of automatic transmission of blood pressure data over telephone lines, computerized conversion of the information into report forms, and weekly electronic transmission of the report forms to physicians and patients. MEASUREMENTS: 24-hour ambulatory blood pressure monitoring at baseline and exit. The primary end point was change in mean arterial pressure from baseline to exit. RESULTS: Mean arterial pressure decreased by 2.8 mm Hg in patients receiving the home service and increased by 1.3 mm Hg in patients receiving usual care (P = 0.013 for the difference). Mean diastolic blood pressure decreased by 2.0 mm Hg for home service but increased by 2.1 mm Hg for usual care (P = 0.012 for the difference). Mean systolic blood pressure decreased by 4.9 mm Hg for home service and 0.1 mm Hg for patients receiving usual care (P = 0.047 for the difference). Among African-American patients, mean arterial pressure decreased by 9.6 mm Hg in those receiving home service and increased by 5.25 mm Hg in those receiving usual care (P = 0.047). Part of the decrease in blood pressure for home service was due to more frequent changes in the type or dose of antihypertensive medications. CONCLUSION: This telecommunication service was efficacious in reducing the mean arterial pressure of patients with established essential hypertension.

Aged↗
PubMed1993

Developing Georgia's telemedicine network.

Passage of Georgia's Distance Learning and Telemedicine Act of 1992 resulted in a windfall of $50 million from telephone company over-earnings. Rather than refund the money to consumers, legislators created a fund to finance telecommunications projects in medicine and education. When Governor Zell Miller signed the Act into law more than a year ago, he said, "[It] will immediately catapult Georgia to the forefront of this nation in the use of advanced telecommunications to improve the quality of life of its people." The law also set the state's cable television and telephone companies at odds. Nancy Horne, executive director of the Cable Television Association of Georgia, said that her industry's broadband fiber and coaxial infrastructure is in place to provide the state with telemedicine capabilities, and that transmission of full motion video or high resolution diagnostic images could take hours over standard telephone lines. Representatives of telephone companies argue that new high-speed cell relay switching technology provides instantaneous communications. An appointed Board of Governors holds tightly to the strings that secure a purse containing the $50 million. No grants have yet been awarded. In the middle of the debate stands Georgia's Department of Administrative Services, which moderates the competition between the two industries. And, the Medical College of Georgia created a demonstration project based on telephone technology. Representatives of both institutions gave Healthcare Informatics their views on developments of telemedicine in Georgia.

Computer Communication Networks↗
PubMed1993

Telemedicine: a new paradigm.

Technological innovations sometimes compel paradigm shifts. Two decades ago the CT scanner was one such phenomenon: It quickly and absolutely transformed medical practice. A marriage of medicine and telecommunications could engender a similar transformation. The timing surely is favorable, as pressing requirements of healthcare reform coincide with the flowering of telecommunications technologies.

Diffusion of Innovation↗
PubMed1995

Writing a PACS program statement.

Medical telecommunications is becoming a necessity for maintaining the quality of care and delivering services on a timely basis in the current environment of cutting services and specialists to reduce costs. (Vanden Brink 1994). Picture archiving and communications systems (PACS) and teleradiology are increasingly viable because there is easier connectivity among modalities and manufacturers. Agreement on the DICOM Standard is one step toward greater connectivity. Two-thirds of the 350 radiology administrators, radiologists, hospital administrators and MIS directors interviewed for the 1994 IMACS/PACS Tracking Study believe that the use of image telecommunication technology is growing. In 1993, Vanderbilt University Medical Center (VUMC) formed a committee to evaluate the need for PACS and to compile a program statement. The principal purpose of the program statement is to provide fundamental information that can be understood easily by individuals outside the radiology department. It outlines the benefits of PACS and includes a financial analysis of the purchase and installation of a system. Key elements of the program statement include a description and analysis of the existing film library system, advantages of PACS, implementation plan, financial proforma and integration with the hospital information system. These and other topics are covered in detail in the following article.

Computer Communication Networks↗
PubMed1997

EMC(electromagnetic compatibility): how to manage the challenge.

The significant changes in health care and telecommunications has produced an emergence of new and exciting technologies. Clinical engineers must continue to safeguard patient safety by adequately refurbishing their arsenal of technical knowledge of electromagnetic compatibility (EMC). This document examines the methodology and the tools for managing the technical changes in the telecommunications and biomedical equipment areas.

Data Collection↗
PubMed1997

The ComputerLink projects: a decade of experience.

Telecommunications technology provides a pathway for nurses to reach patients and their family caregivers. The ComputerLink, an experimental computer network, enabled home-bound persons to access information, communications, and decision support services from their homes. Persons naive to computers can and will use telecommunications to maintain contact with peers and professionals. While participants in experimental networks used communication services most often, the access to relevant health information in a timely and convenient fashion may contribute more to the positive health benefits. Nursing interventions need to be tailored to capitalize on the unique features of computer network. The timing, cadence and content of interpersonal interactions must be modified to account for lags in the transmission of messages. Strategies for interpreting written text, which lacks the aural cues found in spoken speech, must be developed.

Aged↗
PubMed1995

The Georgia Information Network for Public Health Officials (INPHO): a demonstration of the CDC INPHO concept.

The Georgia Division of Public Health is serving as the first demonstration model of a statewide implementation of the Centers for Disease Control and Prevention Information Network for Public Health Officials. The goals of the project are to make communication easy, to make information accessible, and to make data exchange as swift and as smooth as technology will allow. By having a state-of-the-art telecommunications network, public health officials will be able to rapidly collect health data and transform them into meaningful health status information that can be used to inform health policy decisions. The Georgia Information Network for Public Health Officials is a unique consortium of private and public sector partners funded with a grant from the Robert W. Woodruff Foundation. The project will install the telecommunications infrastructure and the supporting software to position Georgia public health as the health information leader of the state.

Centers for Disease Control and Prevention, U.S.↗
PubMed1999

[An Internet-based "distance" learning for health, environment and sustainable development "distance learning without a frontier"].

Quality of the environment is crucial for human health. Environmental hazards may lead to adverse health effects, while a sound environment can support of enable health. It has been clear that health and environment must be understood within the context of social and economic development, which was stressed especially in the Earth Summit held in Rio de Janeiro, Brazil, in 1992. Investing in improvement of people's health and their environment is a prerequisite for sustainable development. The telecommunication revolution enables distance learning without frontiers in a reansparent and interactive environment. Applying the Internet and other telecommunication into public health including environmental health holds the greatest promise for global health. A wide application and access would facilitate and expedite the reduction of inequity prevailing between the south and north in an unprecedented speed. This proposed course is thus designed to provide an overview on health and environment in sustainable development through the Internet.

Environmental Health↗
PubMed1998

Setting a national informatics agenda for nursing education and practice to prepare nurses to develop and use information technology.

Efforts to build a telecommunications infrastructure that will link people nationally and internationally includes a focus on health care. A telecommunications infrastructure will add value to providers and consumers of health care only if they are able to use it to access and share information. Nurses often have information technology available to them, but are inadequately prepared to use it. Under the direction of the National Advisory Council for Nursing Education and Practice (NACNEP), the Division of Nursing convened a panel of experts in nursing informatics to recommend an informatics agenda. Using a nominal group technique the informatics experts identified informatics needs and recommended initiatives that would better prepare nurses to use and develop information technology. Their recommendations were reviewed by NACNEP resulting in a national informatics agenda for nursing education and practice.

Computer User Training↗
PubMed1998

System approach for a multicenter, multilingual international telemedicine conference.

Chinese Telemed 96, a three way international telemedicine conference was successfully held in November 1996. Over 1,000 physicians, allied health professional and medical students participated in this conference in Beijing, Hong Kong and London. This program demonstrated that the quality of telecommunication technology was suitable for the Chinese University of Hong Kong, Faculty of Medicine to use it in facilitating medical consultations and sharing expertise among widely dispersed colleagues. The consensus of Hong Kong participants was that the audiovideo and telecommunication technology used in this conference were adequate. In order to improve overall quality, however, a better co-ordination of the technical support across sites is required. Other felt that the conference suffers from the shortage of highly trained technical staff required to support the communication system. However, following the total evaluation of this conference, it is concluded that while technical support, site and location are important factors in a good telemedicine conference, a well run telemedicine conference is more dependent on a sound planning process and its execution.

Congresses as Topic↗
PubMedDate not supplied

[The current neurosurgical resources on the Internet].

Progress of information and telecommunication technologies, rapid development of local computer networks and their incorporation into the global computer network Internet are of great importance for the development of modern civilization. Internet presents all spheres of human activities, including medicine, neurosurgery in particular. It is the most available resource that has an unlimited amount of information, expands and is supplemented in geometric progression. A great deal of specialized neurosurgical information has been accumulated in the network that may be available to any neurosurgeon irrespective of the geographical region. There has come a time when information can be obtained through progress in telecommunication technologies that accelerate this process by hundreds of times, there has come a time when colleagues can actively contact with each other by transmitting not only verbal and textual information, but also graphic and video information. The present paper presents a review of currently available Internet neurosurgical resources by showing the benefits of this information source and the possibilities of its use in neurosurgery for both educational and scientific purposes.

Databases as Topic↗
PubMed1999

[Data protection in medical networks for the point of view of a representative for data protection].

The processing of medical data makes great demands on the guarantee of confidentiality, integrity and authentity. This applies to all layers of telecommunication: networks (telecommunication law), services (law of new media) and contents (data protection law). The use of strong encryption, data economicalness, offer of anonymous and pseudonym services and suitable methods of authentication are prerequisites of data medical networks which comply with data protection demands on the side of the physicians. The patients' sensitivity regarding their privacy has to be strengthened too.

Computer Communication Networks↗
PubMed1999

Are dermatologists in private practice interested in teledermatological services?

Diagnosing dermatologic skin conditions can be difficult, especially in pigmented skin lesions. Therefore, the consultation of an expert via teledermatology could prove vital. For this purpose, a rapid transfer of medical data including high resolution images is essential. This transfer can be performed with a variety of modern telecommunication technologies, including ISDN, highspeed-ISDN, Internet, and Intranet. As the levels of both communication software and camera-systems can be quite different, our survey investigated the equipment of 84 dermatologists in private practice. A questionnaire was distributed on computer equipment, operating system software, and any image documentation systems used, as well as required telecommunications equipment and possible applications of tele-dermatology. This survey showed a response rate of 54% and proves that dermatologists in private practice are interested in telemedicine services. Most dermatologists surveyed use Windows 95 operating software and 74% have access to modern ISDN modems or PC-cards. Dermatologists currently prefer applications with low-tech communication hardware and software requirements. Consultation of dermatological centers was the favored application with 59%. Our survey clearly demonstrates that a high percentage of dermatologists in private practice would use tele-dermatology. In our experience, for the excellence of this service an image documentation system is essential to provide the tele-dermatological expert with standardized images with constant illumination.

Dermatology↗
PubMed2000

[Surgery using master-slave manipulators and telementoring].

Master-slave manipulators enhance surgeons' dexterity and improve the precision of surgical techniques by filtering out surgeons' tremors and scaling the movements of surgical instruments. Among clinically available master-slave manipulators, the epoch-making system called "da Vinci" developed by Intuitive Surgical Inc. (Mountain View, CA, USA), equipped with 2 articulated joints at the tip of the surgical instruments allowing 7 degrees of freedom, mimics the movements of surgeons' wrists and fingers in the abdominal or thoracic cavity. Today advanced telecommunications technology provides us excellent motion images using only 3-ISDN telephone lines. Experienced surgeons at primary surgical sites have been able to perform complex procedures successfully by consulting specialists at remote sites. Because telecommunications costs have become lower each year, telementoring will be come a routine surgical practice in the near future. The usefulness of surgical telementoring has been greatly enhanced by the development of a technique to illustrate on video images from two directions. Moreover, remote advisory surgeons will be able to provide the optimal operative field to operating surgeons using robotic camera holders with voice-recognition systems. In the near future, when master-slave manipulators will also be coupled with telementoring systems, remote experts could actually perform complex surgical procedures.

Humans↗
PubMedDate not supplied

An educational intervention for hypertension management in older African Americans.

OBJECTIVE: The purpose of this study was to assess the efficacy of a telecommunications approach to hypertension education. METHODS: Participants (N = 83) were randomly assigned to the experimental and control groups. Experimental group participants received spiritual and hypertension-related messages via programmed telephone calls, and the control group participants received spiritual messages only. Both the experimental and control group participants received the following: printed material on hypertension-related information and regular home visits from a health educator to conduct pre-test and post-test assessments of hypertension knowledge, pill counts, and blood pressure readings. RESULTS: There were no statistically significant improvements in hypertension knowledge. By week 4 of the intervention, there was a statistically significant decrease in systolic and diastolic blood pressure for both groups. However, there were no differences between the experimental and control groups. DISCUSSION: There was no evidence that the telecommunications approach improved older African Americans' understanding of hypertension or its management.

Black or African American↗
PubMed2000

TongaSat: its obligation to Tonga and the Pacific region.

TongaSat, otherwise known as the Friendly Islands Satellite Communications Ltd., reckons itself as a toddler in the world of telecommunications. But since TongaSat has taken Tonga, a small Pacific island nation to the galaxies, it has also made it its responsibility to include other Pacific countries in its share of the 'glitter'. This short paper is to put TongaSat within the context of the Pacific region with the challenges to the rest of the world powers on telecommunications.

Humans↗
PubMed2001

Survey and analysis of satellite-based telemedicine projects involving Japan and developing nations: investigation of transmission rates, channel numbers, and node numbers.

We surveyed interactive telemedicine projects via telecommunications satellite (AMINE-PARTNERS, Post-PARTNERS, and Shinshu University Project using Inmarsat satellites) offered by Japan as assistance to developing countries. The survey helped clarify channel occupation time and data transfer rates. Using our survey results, we proposed an optimized satellite model with VSATs simulating the number of required channels and bandwidth magnitude. For future implementation of VSATs for medical use in developing nations, design of telecommunication channels should take into consideration TCP/IP-based operations. We calculated that one hub station with 30-76 VSATs in developing nation can be operated on bandwidth 6 Mbps using with 128 Kbps videoconferencing system for teleconsultation and teleconference, and linking with Internet.

Asia↗
PubMed2001

Virtual healthcare delivery: defined, modeled, and predictive barriers to implementation identified.

Provider organizations lack: 1. a definition of "virtual" healthcare delivery relative to the products, services, and processes offered by dot.coms, web-compact disk healthcare content providers, telemedicine, and telecommunications companies, and 2. a model for integrating real and virtual healthcare delivery. This paper defines virtual healthcare delivery as asynchronous, outsourced, and anonymous, then proposes a 2x2 Real-Virtual Healthcare Delivery model focused on real and virtual patients and real and virtual provider organizations. Using this model, provider organizations can systematically deconstruct healthcare delivery in the real world and reconstruct appropriate pieces in the virtual world. Observed barriers to virtual healthcare delivery are: resistance to telecommunication integrated delivery networks and outsourcing; confusion over virtual infrastructure requirements for telemedicine and full-service web portals, and the impact of integrated delivery networks and outsourcing on extant cultural norms and revenue generating practices. To remain competitive provider organizations must integrate real and virtual healthcare delivery.

Delivery of Health Care↗