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PubMed1999

Low-cost ISDN videoconferencing equipment for orthopaedic second opinions.

We validated the application of low-cost ISDN videoconferencing equipment for telemedicine. A telemedicine benchmark was designed and four different office videoconferencing systems were evaluated, all using basic-rate ISDN connections (128 kbit/s). All the low-cost systems showed generally good or acceptable performance for clinical use. We also investigated the feasibility of videoconferencing for an orthopaedic second-opinion service. Eight point-to-point conferences were conducted to discuss real clinical cases by use of interactive sharing of medical images. The average duration of each session was 35 min. Encouraging results were obtained.

Costs and Cost Analysis↗
PubMed2006

The utility of videoconferencing to provide innovative delivery of psychological treatment for rural cancer patients: results of a pilot study.

The unmet psychological needs of rural cancer patients are numerous. Telepsychology is a novel and feasible option that may provide cost-savings and help overcome inequalities in access to specialists. This is the first known study of psychological treatment for people with cancer delivered entirely via videoconferencing. We hypothesized that a telepsychology service would improve rural cancer patients' anxiety and depression levels and quality of life, and would be an acceptable, satisfactory, and practical mode of service delivery. Twenty-five cancer patients attended an average of three sessions with a clinical psychologist providing brief cognitive-behavioral therapy. Questionnaires were completed at pre-, post-, and 1-month follow-up. Patients benefited in terms of anxiety (P=0.01) and quality of life (P=0.04). The service was both practical and acceptable. These preliminary positive results provide a firm basis to conduct a randomized controlled trial of face-to-face interaction vs. videoconferencing.

Adult↗
PubMed2005

Twelve tips for teaching using videoconferencing.

Videoconferencing is a highly flexible teaching tool. It can assist in delivery of a rapidly changing curriculum and can solve some of the problems caused by trying to deliver teaching to an audience dispersed across campuses. When well planned and delivered effectively, videoconferenced teaching sessions can be stimulating and enjoyable. An enthusiastic approach, a well-planned session, interactive teaching, use of site facilitators and a good working relationship with technical support are keys to success.

Education, Medical↗
PubMed2005

Prospective evaluation of remote, interactive videoconferencing to enhance urology resident education: the genitourinary teleteaching initiative.

PURPOSE: Changes in referral patterns and resource allocation into Centers of Excellence affect the educational experience of urology trainees by altering resident exposure to patients and clinicians, especially at sites where subspecialty deficiencies exist. Access to educators at Centers of Excellence using interactive videoconferencing technology may facilitate residency training objectives and enhance trainees' overall educational experience. We prospectively evaluated the implementation of this technology at tertiary care teaching centers to enhance urology resident education. MATERIALS AND METHODS: Using videoconferencing technology, urology residents at the University of Western Ontario (London, Canada) participated in a series of didactic, interactive pediatric urology teleteaching seminars. These were presented by an expert pediatric urologist from the Hospital for Sick Children, Toronto, Canada. Using a 5-point Likert scale (1-strongly disagree, 5-strongly agree), participants responded to statements pertaining to seminar content, technology and ease of use at the completion of each session. The results were subsequently tabulated and evaluated to determine the effectiveness and accessibility of the program in providing expert pediatric urological education to residents at a remote urology training program. RESULTS: The entire urology resident staff from postgraduate year 1 to 5 participated in the seminar program. The overall acceptance of this medium was high (mean score 4.5). The quality of presentation, as well as picture and sound quality, all received mean scores greater than 4. Participants indicated that their ability to interact with the presenter was not inhibited by using this medium. All participants agreed that they would use this technology in the future (mean score 4.5) and that the presentation would not be improved if the presenter were on-site. Due to preexisting technology at both centers, no direct cost was incurred throughout the study. CONCLUSIONS: Our experience suggests that interactive teleteaching using readily available, existing technology, is a cost-effective and accepted method of providing trainees with an appropriate educational experience. In centers where subspecialty deficiencies exist, this medium may provide residents with the necessary education requirements of their respective programs without the need for costly teacher (or student) travel. Continual improvements in technology as well as the addition of multiple sites will increased this medium's impact in the future.

Adult↗
PubMed2004

Comparison of face-to-face and videoconferenced multidisciplinary clinical meetings.

A trial of videoconferencing of multidisciplinary breast cancer clinical meetings between three public hospitals was conducted in an attempt to increase attendance by medical staff at the meetings, and thus facilitate multidisciplinary care for breast cancer patients. The videoconferences were compared with the previously existing face-to-face clinical meetings through questionnaires, attendance, number of cases discussed and anthropological analysis. Although more people attended the videoconferences than the face-to-face meetings, most of the participants in the trial preferred the face-to-face meetings to the videoconferences. The mean number of cases discussed at the videoconferences was significantly less than the mean number of cases presented at the face-to-face clinical meetings. The face-to-face meetings were informal, spontaneous and conducive to open discussion. In contrast, the videoconferences were formal and regimented. Multidisciplinary case discussion can be facilitated by videoconferencing. Some of the negative experiences we encountered could be overcome with changes in meeting format. Our experience may help others in setting up a successful multidisciplinary team via videoconference.

Breast Neoplasms↗
PubMed2004

Asthma educational videoconferencing for parents: a case-control study.

We used a case-control, pre-post study to determine the effectiveness of educational videoconferencing in the delivery of an asthma education programme. The participants were immigrant parents attending scheduled classes on English as a second language. The cases participated in the educational videoconferences, while the controls attended a class on American civics. Knowledge in both groups was assessed with 10 true/false statements. Ninety subjects participated (47 cases and 43 controls). Controls showed no significant post-test improvement in knowledge scores (6.6 for pre-test, 6.4 for post-test). In contrast, cases demonstrated significant knowledge gain after the videoconference (7.3 vs 8.3). Educational videoconferencing was an effective tool for the delivery of health education in asthma.

Adult↗
PubMed2005

Misconceptions surrounding videoconferencing.

We carried out a study to assess the level of training required by hospital staff to operate a videoconferencing system. Fifty members of hospital staff, who had no previous videoconferencing experience, were studied. When using simple pictorial instructions, they took on average just under 6 min to connect successfully to a remote site. Male subjects connected faster (average 309 s) than female subjects (385 s; P < 0.01). Subjects of 40 years or younger connected faster (average 311 s) than those over 40 years (average 398 s; P < 0.02). Only three individuals (6%) required supplementary help via the telephone. Dedicated training may not be necessary when simple pictorial instructions are available to the operator.

Adult↗
PubMed2005

A Brazilian model of distance education in physical medicine and rehabilitation based on videoconferencing and Internet learning.

We have developed an integrated educational model in rehabilitation mediated by technology. Three teams of professionals worked to implement the interactive model based on videoconferencing, use of the Internet and three-dimensional (3-D) animated models. Two courses were created: amputee rehabilitation and back pain. Each course was divided into four phases: (1) a first videoconference; (2) Internet-based learning; (3) a second videoconference (workshop); (4) an Internet discussion list. The Internet-based learning modules were divided into topics by multiple-choice questions. Multisite videoconferences were used to connect the remote sites. Eleven animated 3-D models were created to help the teaching process. Each course had 11 modules, and each module required up to 2 h to be completed. There were 136 participants on the two courses. None of the participants, including the teachers, had had any previous experience with Internet-based learning and videoconferencing. The integrated educational model has great potential in a country the size of Brazil, where there may be difficulties in travel for patients with disabilities and for health-care professionals.

Amputation, Surgical↗
PubMed2005

Supporting community carers via videoconferencing.

We provided support, practical advice and networking opportunities for carers in rural and remote areas of Western Australia through the use of videoconferencing. The first videoconference for carers occurred in June 2004. In the next 12 months there were 11 videoconferences with 11 rural towns. Some sessions were point-to-point and some were multipoint. Over 90 carers participated in the sessions. A facilitator with expertise on stress in carers delivered the sessions from Perth. The acceptance of videoconferencing as a support medium by the carers attending was positive and there were requests for the sessions to be continued. The skills of the facilitator to connect in a very personal way with each person were important to the success of the programme.

Aged↗
PubMed2006

A university oncology department and a remote palliative care unit linked together by email and videoconferencing.

We investigated the feasibility of using email and videoconferencing for clinical and educational support between oncologists at the University Hospital of North Norway and colleagues at the oncology and palliative care unit of the Nordland Hospital in Bodø. During a 12-month period, 23 cases (20 patients) and four general questions were sent by email and 32 videoconferences were planned. Breast and colorectal cancer were the most frequent diagnoses (59%) in the email messages. Most cases (15/23) were treated locally. Although five videoconferences failed due to telecommunication and/or user problems, videoconferencing was still a success in the education of the remote oncologists in Bodø. The study demonstrated that telemedicine can be used to incorporate a remote palliative care unit into a university department.

Adolescent↗
PubMed2001

Participating dentists' assessment of the pilot regional online videoconferencing in dentistry (PROVIDENT) project.

OBJECTIVE: To assess the educational effectiveness of delivering continuing professional education (CPE) from dental schools to small groups of dentists at distant sites via videoconferenced links using relatively inexpensive equipment and ISDN2 links. DESIGN: 41 videoconferences between the four campuses of London Dental Schools and postgraduate centres in South East England were assessed using a pre-piloted questionnaire which contained open and specific questions. The questionnaire was given to all participants at the end of each videoconference. Answers to the specific questions were graded using the Likert scale. RESULTS: 40 of the 41 videoconferences were completed satisfactorily and were attended by 257 participants, all of whom completed questionnaires. However, no individual question was answered by all the participants. Of the responses 90% were positive on the topics of appropriateness of the teaching material for delivery by videoconference and of its educational level. 90% of responses also indicated a wish to attend further videoconferences and satisfaction at avoiding the need to travel to London for similar educational activity. 87% rated the lecturers as good or excellent in their use of the medium. 85% of responses indicated that the question and answer sessions within the videoconferences were useful and 82% that the visual aids enhanced the sessions. The technical aspects of the videoconferences were rated positively but to a lesser extent than the educational aspects with 69% of positive responses for visibility of visual aids, 54% for sound quality and 76% for the lecturers use of the technology. The technical aspects of the videoconferences improved during the pilot study. In response to the open questions, participants stated that they found the most useful aspects of the videoconferences were not having to travel, access to first rate lecturers, the discussions and the opportunity to interact with experts. CONCLUSIONS: The participants in this pilot study were positive about the use of videoconferencing to deliver educational material from dental schools to small groups. Once the technology has improved, this medium has the potential to provide CPE for dentists at work or at home in response to their specific needs.

Education, Dental, Continuing↗
PubMed2002

Using videoconferencing to deliver a health education program to women health consumers in rural and remote Queensland: an early attempt and future plans.

Women's Health Queensland Wide, a non-government education and information organisation funded by Queensland Health, used videoconferencing to present a public education seminar on menopausal health to women health consumers across south-west Queensland. A panel of speakers addressed a live audience in a provincial city, with a further 10 sites participating remotely via videoconferencing, each with a local health worker supporting the seminar. Both local and remote audience members were given opportunities to ask questions of the speakers. Audience members were asked to complete feedback forms and their responses are presented. Overall, audience members were very positive about both the content of the event and its method of delivery. They also provided comments relating to the structure of the program, the difficulties of running a live and distant seminar and the needs of remote audiences. Based on this information, Women's Health Queensland Wide has adapted future videoconference seminars to better meet the needs of rural and remote women.

Data Collection↗
PubMed2004

Videoconferencing in a hospital school: removing barriers.

Videoconferencing has enhanced the learning experiences of children who, as a result of medical difficulties, have attended James Brindley School. The School is based in thirteen hospitals and specialist units across Birmingham, and provides educational opportunities for children from 3 to 19 years of age. At one of these sites, the Diana, Princess of Wales, Children's Hospital, the use of videoconferencing has been extremely effective in practice, and experiences suggest that it should be adopted as a fundamental tool by those who wish to develop and enhance the educational process in similar environments.

Adolescent↗
PubMed2000

Improved rural provider access to continuing medical education through interactive videoconferencing.

We sought to describe use patterns and user evaluation of remotely-attended continuing medical education (CME) programs in Vermont and upstate New York. Remote attendees were required to return an evaluation form to receive CME credit. The form included name and date of the program; name, location, and specialty of the respondent; and questions regarding program quality, value, effectiveness, and attendee plans if the program had not been available via telemedicine. From April, 1996, through December, 1998, health care providers from 14 remote sites used the network 927 times to attend 394 CME programs at Fletcher Allen Health Care in Burlington, Vermont. After the start-up period, an average of over three programs per week was attended, with an average of 2.4 remote attendees per program. Seventy-seven percent of remote attendees stated that they would not have attended the program if it had not been available over telemedicine, while the remaining 23% said that they avoided traveling due to videoconferencing. When asked the effectiveness of telemedicine technology for attending, 73% said it was as effective as having the presenter in the room, 23% said it was less effective, and 4% said it was more effective. Major technical problems, such as having the call disconnect during the presentation, decreased over time. There were continuing minor logistical problems common to large group videoconferencing. The telemedicine system has increased availability of CME programs for rural providers in Vermont and upstate New York. Most attendees have found the programs to be worthwhile, and technological advancements have improved the quality of the system.

Attitude of Health Personnel↗
PubMed1995

MDTV Telemedicine Project: technical considerations in videoconferencing for medical applications.

In spite of the many advances in technology, complex problems must be addressed in establishing and maintaining a telemedicine system. Although most such systems are built around interactive videoconferencing (IAVC) equipment, clinical requirements dictate that these systems offer more than traditional IAVC systems. Input from system users should be obtained early in the design process to ensure the functionality necessary to achieve maximum utilization. Surprisingly, audio, rather than video, signals may present the greatest challenge to achieving consistent, high-quality videoconferencing encounters. Audio technical problems can be frustrating for patients and providers alike and can undermine user confidence in IAVC as a vehicle for healthcare delivery. A capability for remote access and control of components at distant sites seems essential to providing cost-effective and technically reliable service.

Humans↗
PubMed2004

Interactive videoconferencing system for rural health education: a preliminary report.

OBJECT: To establish a videoconferencing network in a new Rural Clinical School. DESIGN: A report on choosing hardware and connecting multiple sites simultaneously. SETTING: Rural South Australia. SUBJECTS: Undergraduate medical, nursing and allied health students. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Establishment of an effective multisite, dual mode videoconferencing system. RESULTS: The choice of hardware was simple, but acquiring adequate broadband connection between sites proved difficult. CONCLUSIONS: Multi-site meetings for academic and administrative purposes are now routine. Evaluation of the effectiveness of medical education delivery will occur throughout 2004.

Computer Communication Networks↗
PubMed2007

Law & psychiatry: Telecourt: the use of videoconferencing for involuntary commitment hearings in academic health centers.

The use of videoconferencing for psychiatric involuntary commitment hearings is not a recent development. The courts ruled on the constitutionality of these proceedings as long ago as 1993. In 2004 University of Michigan Hospital began videoconferencing involuntary commitment hearings with Washtenaw County Probate Court. The experience of the University of Michigan Health System and the Washtenaw Probate Court with telecourt hearings for involuntary commitment has proven to benefit the safety and dignity of patients as well as the financial health of the medical center.

Academic Medical Centers↗
PubMed2002

The use of videoconferencing to enhance tertiary mental health service provision to the island of Jersey.

A six-month trial of videoconferencing was undertaken between the States of Jersey Health and Social Services in the Channel Islands and the South London and Maudsley NHS Trust in England. The purpose of the project was to evaluate the effectiveness and benefits of obtaining specialist tertiary mental health services not normally available on the island of Jersey. During the six-month pilot project in 2001, five teleconsultations were conducted: two acute psychiatric assessments and three case reviews. In addition, six presentations using videoconferencing were held on forensic psychiatry (24 participants), affective disorders (12), psychosis (8), eating disorders (3), crisis disorders (12) and community specialist teams (12). Results using the Guy s Communication Questionnaire indicated high satisfaction levels from all participants. The project successfully raised the awareness of telemedicine and its potential in the delivery of mental health services in Jersey.

Attitude of Health Personnel↗