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PubMed1984

Beyond the library walls: use of slow-scan television.

The Telecommunications Information Network (TIN) was an applied research project that evaluated the ability of slow-scan television to provide medical information on demand to health-care professionals at hospitals far from any urban area. This paper reviews the TIN project, describes its use, and discusses system advantages and disadvantages. System evaluation encompasses (1) project benefits; (2) technical barriers to implementation and utilization; (3) the replication of services and the technology utilized; and (4) cost factors.

Costs and Cost Analysis↗
PubMed1984

Provider acceptance of telemedicine systems in remote areas of Ontario.

Telemedicine, the use of telecommunications technology to assist in the delivery of health care, is an increasingly popular solution to some of the problems faced by rural residents in obtaining health care. Since September 1, 1977, the Sioux Lookout Zone in northwestern Ontario has been experimenting with slow-scan video equipment as part of its health care delivery system. The attitudes of the providers who use the system were surveyed. The nurses were positive about slow-scan video as an aid in the delivery of health care; however, the physicians were less enthusiastic. This difference can be explained by physicians' having had more extensive training than the nurses, and therefore not feeling the same need for medical backup and support. Both nurses and physicians had more positive attitudes toward the system after experience with it.

Attitude of Health Personnel↗
PubMed1982

[An economical microprocessor system for use with a Quantimet 720 image analyser ].

Development and amplification of a Quantimet 720 image analyser are reported in combination with a microprocessing unit. The system controlling the measuring procedure with telecommunication for evaluation in a large computer is presented in detail. The new cost-saving units supplementing the analyser render possible: i) reduction of measuring times, ii) reduction of possible errors of measurement, and iii) optimal rational evaluation of data in a large computer system.

Autoanalysis↗
PubMed1995

Compact Disc Interactive (CD-i) multimedia project.

In 1993, the National Library of Medicine (NLM), in collaboration with the National Cancer Institute (NCI), developed a Compact Disc Interactive (CD-i) program: "Cervical Cancer: Screening For Life." This was NLM's first experience in developing for an all-digital interactive medium, containing motion video, graphic images, and text. In 1994, the original CD-i was expanded to include a telecommunications capability that allowed the user to obtain the NCI's most recent screening and treatment information related to cervical cancer.

Compact Disks↗
PubMed1995

Rural primary care. American College of Physicians.

This overview of rural health care today shows the role that internal medicine can and should play in delivering primary care to rural populations. The American College of Physicians recommends changes to improve access to and delivery of primary care in rural areas. There are six specific recommendations. 1. Implementing universal health care coverage through a system that makes primary care equally affordable to rural populations. 2. Increasing the supply of primary care providers in rural areas by lessening specialty and geographic differentials in physician income. 3. Increasing the supply of primary care providers in rural areas by changing medical education to emphasize training enough rural physicians. 4. Decreasing professional isolation in rural areas through accessible continuing medical education and through telecommunications technology. 5. Identifying tertiary care needs at the community level and using state and federal funds to assist rural hospitals where access to care would be threatened by hospital closure. 6. Using innovative delivery systems that emphasize coordination and cooperation among providers, institutions, and communities.

Demography↗
PubMed1994

Simulation studies of a wide area health care network.

There is an increasing number of efforts to install wide area health care networks. Some of these networks are being built to support several applications over a wide user base consisting primarily of medical practices, hospitals, pharmacies, medical laboratories, payors, and suppliers. Although on-line, multi-media telecommunication is desirable for some purposes such as cardiac monitoring, store-and-forward messaging is adequate for many common, high-volume applications. Laboratory test results and payment claims, for example, can be distributed using electronic messaging networks. Several network prototypes have been constructed to determine the technical problems and to assess the effectiveness of electronic messaging in wide area health care networks. Our project, Health Link, developed prototype software that was able to use the public switched telephone network to exchange messages automatically, reliably and securely. The network could be configured to accommodate the many different traffic patterns and cost constraints of its users. Discrete event simulations were performed on several network models. Canonical star and mesh networks, that were composed of nodes operating at steady state under equal loads, were modeled. Both topologies were found to support the throughput of a generic wide area health care network. The mean message delivery time of the mesh network was found to be less than that of the star network. Further simulations were conducted for a realistic large-scale health care network consisting of 1,553 doctors, 26 hospitals, four medical labs, one provincial lab and one insurer. Two network topologies were investigated: one using predominantly peer-to-peer communication, the other using client-server communication.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1994

Evolution of mechanical fingerspelling hands for people who are deaf-blind.

People who are both deaf and blind can experience extreme social and informational isolation due to their inability to converse easily with others. To communicate, many of these individuals employ a tactile version of fingerspelling and/or sign language, gesture systems representing letters or words, respectively. These methods are far from ideal, however, as they permit interaction only with others who are in physical proximity, knowledgeable in sign language or fingerspelling, and willing to engage in one of these "hands-on-hands" communication techniques. The problem is further exacerbated by the fatigue of the fingers, hands, and arms during prolonged conversations. Mechanical hands that fingerspell may offer a solution to this communication situation. These devices can translate messages typed at a keyboard in person-to-person communication, receive TDD (Telecommunication Devices for the Deaf) telephone calls, and gain access to local and remote computers and the information they contain.

Adult↗
PubMed1994

[Communication in emergency health services].

When the new national radio and telecommunications system for acute medical services is established in 1995, 25 years will have passed since publication of the first White Paper on the issue. By following the process of this reform as it has evolved it is possible to point out how various government bodies and professional groups have stimulated or hindered the process to suit their individual motives and needs. In addition to active involvement by enthusiastic professionals and government agencies, the approval and implementation of such a reform requires the support of other institutions, other professional groups, the media and politicians.

Emergency Medical Services↗
PubMed1993

Cost escalation in health-care technology--possible solutions.

Solutions to cost escalation due to health-care technology are proposed. It is argued that proper systems analysis, technology assessment, and planning would result in net savings and improved cost-benefits. Identification of needs early in the technological life cycle can positively influence the final form of the chosen technology. A national centre for technology assessment is proposed. Arguments in favour of a local medical equipment manufacturing industry, emulating overseas examples, are advanced, appropriateness being the main criterion. Analysis of the cost breakdown of imported technology suggests ways of reducing costs considerably, while stimulating the local economy. Digital telecommunications technology and its application to rural health care is cited as an example of a potentially worthwhile investment in making overall coverage more equitable.

Computers↗
PubMed1993

Picture archiving and communication systems and videoconference for medical communication.

The following summarize the present capability and future potential for telecommunications in radiology: 1. When used as a central archiving, reporting, and directing unit PACS principally leads to an increased economy and centralization and allows a more rational and efficient use of experienced staff and a better education for the young physicians. 2. PACS also have the capability to produce composite imaging, whereby an overall report, consisting of different radiologic examinations can be obtained. The integration of image and text data and the digital link between specialized clinical departments also makes immediate transmission of images and reports possible. 3. Analog and digital videoconferences permit long distance communication and consultation between specialists, without physicians and radiologists having to change location. These television conferences also lead to an important enhancement of education, providing interaction with specialists who might not usually be available.

Radiology Information Systems↗
PubMedDate not supplied

Americans With Disabilities Act.

The Americans with Disabilities Act gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. This act prohibits discrimination on the basis of disabilities in employment, public services, privately operated public accommodations, services, and telecommunications. The Americans with Disabilities Act is divided into five titles. Title I of the act pertains to discrimination against the disabled in the workplace. Title II prevents discrimination against persons with a disability in state and local government services. Title III prohibits discrimination against persons with disabilities in places of public accommodations and commercial facilities. Title IV ensures that companies offering telephone services to the general public provide special services for individuals with hearing and speech impairments. Under the enforcement provisions of the Americans with Disabilities Act, stringent penalties will be implemented for failure to comply with its provisions.

Commerce↗
PubMedDate not supplied

Teleradiology: the practice of radiology enters Cyberspace.

Teleradiology refers to the use of computers and electronic communication networks to transmit diagnostic images acquired at one location to another location for review and interpretation. The use of teleradiology has grown tremendously during the past few years. Many of the early problems with teleradiology are being resolved by the rapid advances taking place in telecommunications and computer technologies, while changes in health care economics are driving the need to establish cost-effective and efficient communications links between rural and urban health care providers and tertiary care specialists. Effective arguments can be made both for and against the role of teleradiology in improving patient care. These arguments, as well as an overview of the impact of teleradiology on the the practice of radiology, are discussed in this article.

Computer Communication Networks↗
PubMed1995

Impediments to developing wide area networks in health care.

The availability and prominence of telecommunication technology has spurred research into generic wide area health care networks. Electronic exchange of patient data supposedly results in cost efficiencies, increased accessibility to health care resources, and improved delivery of health care services. Although a number of pilot networks have been built, none yet have a broad, heterogeneous base of users and applications. Properties of the health care process and delivery system delay the acceptance of generic wide area networks and end-user computer applications. As the technical problems seem well understood, it seems advisable to investigate these factors in telemedical research.

British Columbia↗
PubMed1995

[Imaging diagnosis in border-less age].

Several proposals were made under the title of imaging diagnosis of border-less age. One was the wide range of application of multimedia in medicine. The application is in the world wide scale, such as information super highway, and information technology vision 2000, and so forth. Second and third proposals were to promote clinical and basic research groups beyond specialities to make micro and micron imaging possible both in morphology and function. As an example, imaging of interstitium of the bone marrow by magnetic resonance microimaging was discussed. To convey these concepts, multidiscipline and inter- and intra-speciality work is mandatory. Finally, PACS and telecommunication were introduced as one of the tools of imaging diagnosis in border-less age with illustration of PACS system at Saitama medical school.

Diagnostic Imaging↗
PubMed1996

Evaluation of the Newton Pen-Pad as a tool for collecting clinical research data at the bed-side.

A protocol for the study of practice variation between Quebec Intensive Care Units in the treatment of myocardial infarction by thrombolysis was coded into the Newton Pen-Pad. This tool for the direct recording of clinical data was tested in the working environment by research nurses of 4 different teaching hospitals. Data was sent directly from the pen-pad by telecommunication to the information coordinating center. The results of this evaluation confirm the reliability and robustness of this approach which promises to be an important tool for applied clinical research.

Attitude to Computers↗
PubMed1996

Introduction to telehealth home care.

Technologic advances in telecommunications and computer design will provide new tools for home health nurses to improve patient care and nurse efficiency. Participating in interactive electronic home visits, capturing vital sign data without visiting the home, scheduling daily events, teaching patients, and remotely managing the care plan all can be accomplished by using telehealth in home care.

Aged↗
PubMedDate not supplied

Voice terminal may offer opportunities for employment to the disabled.

A rapidly growing information industry based on the combined technologies of the digital computer and telecommunications offers unique opportunities for employment of the physically handicapped. In the studies reported here, the use of voice control was investigated as an alternative to mechanical control for two quadriplegic clients too severely disabled to successfully operate a typewriter keyboard. Using a recently developed voice terminal, the clients were able to type finished copy and program a remotely located computer entirely by voice control. The voice terminal is presently in production. An evaluation of the vocational potential of the voice terminal is currently being conducted by the Rehabilitation Services Administration, DHEW.

Adult↗
PubMed1998

A process for developing a rural training track.

BACKGROUND AND OBJECTIVES: This article describes the process used by the University of Wisconsin-Madison Family Practice Residency Program to establish its first rural training track (RTT) in Baraboo, Wis. The process includes 1) establishing a core planning group to develop rural site selection criteria with specifications on distance traveled, faculty composition, teaching commitment, rural hospital capabilities, and availability of subspecialty teaching, 2) involvement of the state Area Health Education Center, 3) budget planning, 4) telecommunications plans, including e-mail, library search, and Internet connectivity, 5) creation of a residency curriculum in collaboration with the rural site's faculty and staff, 6) preparing an accreditation document to submit to the Residency Review Committee, and 7) faculty development programs for rural faculty. The program then participates in the National Residency Matching Program with an independent Match number.

Accreditation↗