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PubMed1992

Telemedicine: military applications.

Communications technology has enjoyed enormous growth in recent years and should be fully exploited by the medical community. Its application as part of disaster response was well demonstrated in the aftermath of the tragic earthquake in Soviet Armenia in 1988. Besides disaster response, telemedicine also has application for patient care, diagnostic imaging, and training and education. This capability would be particularly beneficial to the armed forces of many nations. If the communications equipment were portable, it could be well employed during peacetime, yet easily deployed to the battlefield. Therefore, armed forces should fully exploit telecommunications technology for the practice of military medicine.

Armenia↗

PubMed2004

[The place of telemedicine in rhythmology and cardiac pacing].

Rapid advancement in telecommunication technology has made possible automatic periodic transmission of pacemaker and implantable defibrillator data to the attending physician (home monitoring). Furthermore, technology using remote control software allows, through device programmers, interrogation of the device memory, permitting remote monitoring by physicians or technical support of the manufacturer. Potential applications of these two capabilities include a close watch over the functioning of the devices, ability to obtain an earlier diagnosis (and management) of arrhythmic events, and assistance at the time of implant procedure and routine follow up. Finally these new tools raise several questions concerning safety aspects (including reliability of transmission, encrypted transfer, restricted access of the central database), economic aspects, and physician and manufacturer's liability.

Arrhythmias, Cardiac↗

PubMed2004

Challenges and barriers to development of telemedicine programs.

The collection of data is a vital step in assuring that a system works, a method is correct and the process is adequate. As data is collected databases are created. These databases could be nothing more than a box or it could be in a computer-based, indexed database. Over the past 200 years, technology has played an increasingly larger role in health care delivery. With the advent of telecommunications capabilities and information systems, medicine has embraced these two disciplines, resulting in a new tool - telemedicine. This new tool is undergoing rigorous peer review and scientific challenge. This has lead to a plethora of data, which indicates telemedicine is an excellent tool for medicine.

Databases as Topic↗

PubMed2004

Creating telehealth networks from existing infrastructures.

Implementing a telehealth program can be a financial challenge due to associated costs such as hardware, software, networking, administration and clinical expertise. To maximize potential and minimize costs, it makes sense to leverage existing telecommunications infrastructures and tailor the program based on what is available.

Capital Financing↗

PubMed2004

Role of telemedicine in neurosciences.

That distribution of specialists in neurological sciences worldwide is lopsided is an accepted fact. That, increasing the number of specialists, providing them with the requisite infrastructure and maintaining high standards to provide neurological and neurosurgical surgical care worldwide is just not possible, is also accepted. Patients from suburban areas are sent to the limited number of tertiary neurosciences referral centers, incurring expense and time and resulting in overwork at these centers. It is easier to set up an excellent telecommunication infrastructure, to increase the reach of the limited number of urban specialists, than to put them in suburban areas.

Health Services Accessibility↗

PubMed2005

Technology. Rural discount.

The Federal Communications Commission recently changed its definition of rural community, which could mean more affordable telecommunications rates for certain providers. June 30 is the deadline for funding applications.

Fees and Charges↗

PubMed2005

Epidemiology of human ehrlichiosis and anaplasmosis in the United States, 2001-2002.

During 2001 through 2002, 1,176 cases of the tick-borne diseases human monocytic ehrlichiosis (HME) and human granulocytic anaplasmosis (HGA) were reported to the Centers for Disease Control and Prevention (CDC) by 32 states through the National Electronic Telecommunications System for Surveillance. The average reported annual incidences for HME and HGA during 2001-2002 were 0.6 and 1.4 cases per million population, respectively; incidence was highest among men > 60 years of age. During this same interval, a total of 883 cases of HME and HGA were reported to CDC through a passive surveillance system of tick-borne disease case report forms (CRFs). The surveillance information retrieved from CRFs has allowed for qualitative evaluation of ehrlichiosis and anaplasmosis risk factors, severity, and diagnostic accuracy. Although these surveillance systems likely substantially under-represent the true burden of ehrlichiosis and anaplasmosis in the United States due to poor recognition and reporting, they represent the first compilation of national data since these diseases were made nationally notifiable. Continued and improved surveillance activities will progressively reinforce our understanding and awareness of these newly recognized zoonotic infections.

Adolescent↗

PubMed2005

An assessment of telemedicine possibilities in massive casualties situations.

The use of existing possibilities of Telemedicine Center of Kaunas University of Medicine allows the live distant consultations from high-level medical specialised centers to rural areas. On July 2004 the Telemedicine Center took part in the RESCUER/MEDCEUR project exercise. A special objective was the use of telemedicine facilities for distant consultations and sorting of victims directly at the event place. Telemedicine Center used appropriate telecommunication devices for joint activities of civil and multinational military services in critical situations such as mass casualty events. There were used ISDN lines and IP radio-connection. On the final and most intensive day of the anti-terrorism drills, the multinational force of medics at the Kairiu Training Range in Lithuania reacted to a large mass casualty event--treating hundreds of victims from a simulated train crash. Using on-line telemedicine facilities from Kaunas Medical University Hospital there were corrected the tactics of giving the first help and sorting of casualties. The most complicated initiated cases of eye trauma, neurosurgical trauma, maxilloface trauma and traumatic amputation of limbs evaluated and selected for emergent evacuation to the third level hospitals. All those cases transported to Kaunas and Vilnius Universities Hospitals by helicopters (200 and 300 km from the event place). The common use of existing military and civil telemedicine infrastructure showed the possibilities of interaction in management, giving the first help and sorting of casualties between military and civil medical services during the rescue operations.

Disaster Planning↗

PubMedDate not supplied

National AIDS Hotline: HIV and AIDS information service through a toll-free telephone system.

The National AIDS Hotline (NAH), a service of the Centers for Disease Control (CDC), is an information resource for the population of the United States, its Territories, and Puerto Rico concerning the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Since its inception in 1983, NAH has grown to be the world's largest health-related hotline service. NAH has received an average of more than 1.4 million calls per year since October 1987. Services of NAH include responding to the public's questions about HIV and AIDS and providing referrals to State and local resources. All services, including HIV and AIDS publications, are provided free of charge. The public contacts NAH 24 hours a day, 7 days a week, through a toll-free telephone system. Services are available to English-speaking, Spanish-speaking, and deaf populations. Each service has its own telephone number--English-speaking, 1-800-342-2437; Spanish-speaking, 1-800-344-7432; TTY service for the deaf, 1-800-243-7889. NAH employs approximately 170 information specialists to answer calls. The facility uses modern telecommunications technology to effectively manage and direct calls to 43 work stations. Each work station is supported by a personal computer that allows access to CDC's National AIDS Clearinghouse data bases for referrals and publication ordering. NAH ensures that information provided to the public is current, accurate, and consistent with approved government policy. Quality assurance reviews address call management, delivery of information, and content of calls.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Addressing a community's cancer cluster concerns.

The felling of a telecommunications mast highlighted a community's concern regarding an alleged cancer cluster of eleven cases in a small rural area of Northern Ireland. At the request of the Local District Council, the Northern Ireland Cancer Registry (NICR) undertook an investigation. After extensive searching and contact with the community, only 6 of the alleged cases could be identified. Of these six, two did not have cancer and one had a non-malignant tumour. In addition to the three confirmed cancer cases, a search of the NICR database identified a further 17 cancers of mixed types in keeping with the population pattern of cancers. Standardised incidence and mortality rates were within, or lower than, the expected level. The results were presented to the local community at an open meeting. Despite extensive media interest when the issue of the alleged cluster was first raised, the negative findings received only local media attention. This study illustrates the value of an accurate population cancer registry in addressing cancer cluster concerns.

Attitude to Health↗

PubMed2006

Intelligent mobile voice information centre system: Taking the emergency triage support system as an example.

According to research by the International Telecommunications Union (ITU), Taiwan has the highest percentage of people holding mobile (cell) phones, and every one has one or two cell phones. We usually use mobile phones to make contact with hospitals or dial 119 in an emergency. We have developed a new call flow style and combine traditional passive call flow. The system is designed with a voice menu and users can command services actively. The telephone connects to a computer server to enter the call flow module with ASR and TTS. The recognition term comes from a voice term database. The voice management center is an ER triage decision system. We have tested three scenarios which are DOA, a large number of patients and critical trauma. We measured the completion time and recognition rate for all the scenarios. The recognition rate in all three cases was above 90%. The average completion time for DOA is 38.6 seconds, for the large number of patients is 20 seconds and for the critical trauma case, the average is 252.7 seconds. It is too slow to input one patient's data but the communication transfer of the message is fast and convenient; the DOA notice only takes 38 seconds to inform medical staff, which is very efficient and medical staff believe that this can help their communication. We will continue to extend our system and further apply it to other domains. Future studies may combine the Internet platform with the WiFi phone and soft phone (Skype) and broaden the scope of the application in Taiwan.

Emergency Medical Services↗

PubMed1990

Continuing education needs of health care professionals.

Formal continuing education for health professionals continues to grow around the base of courses, conferences, and general reading. These formats serve the indispensable function of keeping health professionals abreast of the state of medicine. Since most formal continuing education activities are planned for groups, they cannot address the specific information needed in the care of individual patients. Furthermore, the knowledge gained is memory-based, and it is misguided to believe that facts learned in lectures will be remembered accurately enough for patient-care applications. A recent study has demonstrated that physicians often want additional knowledge when they are caring for patients and that access to knowledge is often difficult and time consuming. Advances in computer and telecommunications technology may ultimately permit immediate short answers to specific questions that arise during medical practice. It is time to expand the activities of the National Library of Medicine and the libraries within the Regional Medical Library (RML) network that provide valuable information for health professionals by developing methods to answer specific questions on the spot while health professionals are caring for patients.

Education, Medical, Continuing↗

PubMed1986

[Speech input for handicapped patients].

Depending on the remaining functions of the limbs, head, or articulation organs, various types of aids are available to motor impaired persons for controlling technical devices. For those with their speech organs and speaking ability unimpaired, an innovative approach has recently become available through voice input which uses speech recognition to automatically identify spoken input. This mode permits the largest possible information input per time unit, may however involve faulty recognition. Practical applications of speech recognition systems for motor impaired persons lie in the private and occupational settings, with purposes ranging from telecommunication, environmental control, to locomotion or computer control. Examples are the speech-controlled use of a television set or a wheelchair. Apart from controlling technical devices, voice input may, in other disabling conditions, also be employed to aid human communication. An overview of commercial speech recognition devices is given.

Computers↗

PubMed1987

Telepathology and the networking of pathology diagnostic services.

Telepathology is the practice of pathology over a long distance. Components of a telepathology system include the following: a remote-controlled light microscope attached to a high-resolution video camera; a pathologist workstation incorporating controls for manipulating the microscope and a high-resolution video monitor; and a telecommunications linkage. An immediate challenge is to establish the specifications for a telepathology system. Breast tissue has served as a model. Receiver operator characteristic curve studies show that the pathologist's ability to discriminate benign from malignant breast tumors is similar using either a conventional light microscope or a video monitor with approximately 1000 lines of resolution. The percentage of cases for which pathologists render an "equivocal" diagnosis is the same for the two modalities. Telepathology may be an effective way to provide on-line consultations in difficult cases and to provide hospitals in remote areas with immediate access to anatomic pathology services.

Computer Communication Networks↗

PubMed1987

Changing technologies in the reference laboratory.

Changes in technology will have a profound impact on specialized reference laboratories. In their research and development efforts, reference laboratories will have to pursue the incorporation of the technologies of molecular and cell biology into clinical practice. Computers can be applied to the management of clinical laboratory data bases and to the organization of scientific and clinical knowledge for medical consultation. Because of the distance between the site of acquisition of referred specimens and the laboratory, research on analyte stability is needed. Computer networking will help to solve problems of inadequacy of clinical information, and bar code technology will address the problems of specimen identification. Finally, improved telecommunication will permit reference laboratories of the future to be true medical consultation centers rather than just technical analysis operations.

Clinical Laboratory Information Systems↗

PubMed1985

Outpatient computer-based 32-hour esophageal pH studies teletransmitted to a central esophageal laboratory.

Using a computer-based 32-hour esophageal pH system with a small patient-worn digital recording computer, outpatient studies are performed in the physiologic environment of the patient's workplace and home. Samples are taken at 15-s intervals, and the pH data stored in this computer are then fed into the main computer in the Central Esophageal Laboratory for analysis, scoring, printing out, and storage. Satellite esophageal laboratories located in regional hospitals, clinics, and physicians' offices conduct pH studies by telecommunication, using antimony electrodes, a recording computer, and a modem to transmit data to the main computer for high-quality computer analysis. One main computer and associated personnel serve multiple satellite stations. This maintains patient-physician relationships and is highly cost-effective.

Computers↗

PubMed1979

Center provides emergency care without unneeded inpatient units.

When a study showed that a hospital had enough beds for its service area but that one growing segment of this area needed faster access to emergency care, the Ambulatory Care Center/Emergency Services System (ACCESS) was established. Through its program and facility, ACCESS provides immediate ambulatory and emergency care in its community and, through referrals to the hospital's ED, ensures the provision of more extensive emergency or inpatient care, as needed. Telecommunications, coordination with the county rescue services and the hospital's ED, and cooperation with local private practitioners are vital elements of the program.

Ambulances↗

PubMed1984

Emergency medical care in France.

Emergency Medical Aid (AMU) has existed on an organized basis in France for ten years. Considering that every call for medical assistance requires an answer the SAMU (Emergency Medical Aid Service) acts as a switchboard. Its implantation in a hospital and its powerful centralized telecommunications make it possible to adapt responses to the type of case: serious ones require sophisticated equipment, whereas non-serious ones come under a General Practitioner. Treatment is free. Minor cases are taken care of by "omnipractitioners" who can be contacted by the SAMU via portable radio transceivers. Serious cases are dealt with by the Mobile Emergency and Intensive Care Service (SMUR); they either drive or fly to the spot within an average time-limit of ten minutes. The SMUR teams are composed of a physician, a nurse, often a student and a driver or a pilot. The physician makes the diagnosis, radios a description of the case and gives first-aid treatment. The minimal SMUR equipment fits into two cases. The SAMU also have other missions such as: teaching, prevention, disasters. The French system is aimed at reducing inequality in emergency situations and guaranteeing the whole population permanent medical care. Its cost to the public, however, is only +1 per inhabitant per year.

Emergency Medical Service Communication Systems↗