[Internet: its significance in the prevention, delivery of health care and evidence-based medicine. Work Group Cybermedicine].
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Delivery of Health Care↗
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Results for “Remote Consultation”
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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[Teleconsultation network for ophthalmology--experiences and results].
MOTIVATION: Telemedical services for ophthalmology are developed within the OPHTEL project, which has been funded by the European Union and by the Bavarian government in the Bavaria-online initiative. METHODS: Seven private ophthalmologists, one university eye clinic, one clinical Diabetes center and an informatics research institute are connected within a teleconsultation network. Asynchronous (based on Internet E-Mail) and synchronous (based on ISDN-mediated videoconferencing tools) types of teleconsultations are realized. RESULTS: 86 teleconsultations (62 asynchronous, 23 synchronous) took place within the first 10 months. Complex and rare eye diseases as well as interdisciplinary questions (ophthalmology--diabetology) are the main area of medical communication interest. Legal and security problems are discussed. CONCLUSIONS: Telemedical services must be understood as a complete process of medical care on the basis of modern communication technologies, which influences also the management of this process.
Computer Communication Networks↗
Cybermedicine.
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Computer Communication Networks↗
Telephone-assisted Heimlich maneuver.
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Airway Obstruction↗
Teledermatology as a new tool in sub-saharan Africa: an experience from Tanzania.
Large areas of sub-Saharan Africa suffer a substantial lack of skin care. Hence teledermatology, meaning the online visual exchange of clinical and histologic data, could develop into a powerful medical resource. We report the first established teledermatologic connection in this area: between the Regional Dermatology Training Centre (RDTC) in Moshi, Northern Tanzania, and the Department of Dermatology, University Hospital of Zürich, Switzerland. This report illustrates local difficulties as well as the considerable potential of teledermatology in such a setting.
Dermatology↗
The fetal tele-ultrasound project in Queensland.
The need for access to tertiary centre experts for those living in rural and remote areas of Queensland is well recognised. With an estimated population of 3.3 million people of whom 55% live outside the capital city, Queensland is ideally suited to telemedicine, as it provides a potential opportunity to improve access to specialist care. Congenital fetal abnormalities are the major causes of perinatal morbidity and mortality. With only two Maternal Fetal Medicine Specialists in Queensland located in a major teaching hospital in Brisbane, the opportunity to use videoconferencing technology to develop a tertiary level tele-ultrasound service presented a challenge--that is, to find a technical and clinical solution to enable such a service. We report on some of our practical experiences and difficulties in establishing such a service.
Congenital Abnormalities↗
Funding arrangements for telehealth: encouraging efficiency rather than proliferation.
The use of telehealth as a basis for delivering health services is growing across Australia, and there is clear potential for these technologies to address some of the enduring issues of access and costs of service delivery. However, appropriate incentives must be created to encourage clinicians and managers to evaluate the true opportunity costs and benefits of delivering services in this way against the relevant alternative. This paper examines how different funding arrangements might encourage or discourage efficient use of telehealth.
Australia↗
Internet based counseling to remote orthopedic patients.
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Adolescent↗
Better health well in hand. Cell phones have the capacity to more frequently and efficiently connect chronically ill patients with caregivers.
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Cell Phone↗
The Institute of Medical Illustrators' 36th annual conference, Dunblane, 17-19 September 2003.
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Biomedical Technology↗
Ultrastructural telepathology--remote EM-diagnostic via Internet.
New collaboratory opportunities in ultrastructural research and diagnostics are now available on the Internet through the combination of digital image acquisition, remote operation of modern digitally controlled and automated electron microscopes, and the development of software specifically tailored for collaboratory needs. Remote experts can examine samples directly, and unique instruments can be utilized from anywhere. In the case of diagnostic dilemmas, the second-opinion expert is no longer constrained by problems inherent in the interpretation of preselected images. The remote examiner can independently choose the area of interest on the sample as well as select the appropriate magnification for an accurate diagnosis. With these capabilities and together with teleconferencing tools and securely accessible databases on-line, telepathology can provide increased effectiveness and support for diagnostics, research, and teaching in many areas. The authors report their experience with remote electron microscope diagnoses of pathological samples using two different dynamic imaging systems and discuss the main technical issues encountered. It appears that only minor technical issues need to be resolved before ultrastructural telepathology can be promoted for routine use in areas with high-speed Internet access.
Dementia, Multi-Infarct↗
The medicolegal dangers of telephone triage in mental health care.
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Emergency Services, Psychiatric↗
Effective diagnosis of spinal cord compression using telemedicine.
We report the case of a man with an acute cervical cord lesion which was diagnosed after a teleconsultation with a neurologist at a distant neurological centre. We show that the ability to assess patients clinically using real-time videolinks is also of use in detecting those patients who would benefit from specialist neurosurgical intervention, but who might otherwise be denied it because of their location.
Acute Disease↗
Email-facilitated qualitative interviews with traumatic brain injury survivors: a new and accessible method.
PRIMARY OBJECTIVE: To trial the method of email-facilitated qualitative interviewing with people with traumatic brain injury (TBI). RESEARCH DESIGN: Qualitative semi-structured email-facilitated interviews. PROCEDURES: Nineteen people (17 severe diagnosis) with a TBI participated in email interviews. MAIN OUTCOMES AND RESULTS: Findings indicate that this method facilitates the participation of people with TBI in qualitative interviews. Advantages include increased time for reflection, composing answers and greater control of the interview setting. In addition, the data indicates that people with a TBI are capable of greater insight, reflection and humour than indicated by previous research. CONCLUSION: Findings indicate that new technologies may advance data collection methods for people with cognitive-linguistic impairments who face participation barriers in face-to-face interviews.
Adult↗
"Distributed proton radiation therapy"--a new concept for advanced competence support.
The increased interest in high precision radiation therapy is to a large extent driven by the potential of modern imaging technology. The aim of this project was to analyse how an expensive proton facility best could support a multi-centre health care system. We have developed a model for distributed expert collaboration where all clinical experts will work close to their patients in regional centres. Patients who are candidates for proton therapy will be examined and dose-planned at their regional clinic, discussed in a fully information supported video conference and digitally made available at the proton treatment facility. The proton facility itself will be placed near a communication centre easily reached by all patients where they will be treated under full responsibility of their own physician at the home clinic. This concept has been analysed in detail both with respect to the overall functionality and with respect to possible weaknesses. It was found that the concept of distributed radiation therapy, as proposed here, will offer a stable clinical solution for advanced radiation therapy. It will support the spread of knowledge, serve as a fully developed backup system and the concept will further serve as an efficient base for clinical research.
Ambulatory Care Facilities↗
Using NetMeeting for remote configuration of the Otto Bock C-Leg: technical considerations.
Telehealth has the potential to be a valuable tool for technical and clinical support of computer controlled prosthetic devices. This pilot study examined the use of Internet-based, desktop video conferencing for remote configuration of the Otto Bock C-Leg. Laboratory tests involved connecting two computers running Microsoft NetMeeting over a local area network (IP protocol). Over 56 Kbs(-1), DSL/Cable, and 10 Mbs(-1) LAN speeds, a prosthetist remotely configured a user's C-Leg by using Application Sharing, Live Video, and Live Audio. A similar test between sites in Ottawa and Toronto, Canada was limited by the notebook computer's 28 Kbs(-1) modem. At the 28 Kbs(-1) Internet-connection speed, NetMeeting's application sharing feature was not able to update the remote Sliders window fast enough to display peak toe loads and peak knee angles. These results support the use of NetMeeting as an accessible and cost-effective tool for remote C-Leg configuration, provided that sufficient Internet data transfer speed is available.
Artificial Limbs↗
Comparing mind-body wellness interventions for older adults with chronic illness: classroom versus home instruction.
Two versions of a multicomponent mind-body wellness intervention were tested. One hundred seventy-eight physician-referred HMO patients (mean age = 64.5) were randomly assigned to a classroom intervention, a home study intervention, or a wait-list control group. Both interventions provided instruction on mind-body relationships, relaxation training, cognitive restructuring, problem solving, communication, behavioral treatment for insomnia, nutrition, and exercise. The home version was delivered by class videotapes and readings. Compared with the control condition, both interventions led to significant decreases in self-reports of pain, sleep difficulties, and symptoms of depression and anxiety. The home course also led to a significant decrease in self-reported frequency of medical symptoms, and the classroom program resulted in a significant decrease in "chance" health locus of control beliefs. No effects were obtained for health behaviors, life satisfaction, HMO satisfaction, and other health locus of control beliefs. A lower cost, more accessible home study version of a mind-body wellness program can be an effective alternative to classroom instruction.
Adaptation, Psychological↗
Using telerehabilitation to identify home modification needs.
Teleconferencing technology has great potential for providing cost-effective in-home assessment for home modification services from anywhere to anyone in need. Despite its enormous potential, the use of this technology as a means to deliver these specific services had not been investigated. This project investigated the use of televideo technology to provide remote home assessment services to patients prior to discharge so that they could function as independently as possible in their own homes after being discharged from a specialty clinic. Specifically, an assessment protocol that could be implemented using video-conferencing technology was developed and feasibility of the remote assessment process was determined by validating it against the standard of practice, an in-home assessment by a home modifications specialist. Independent in-home and remote home assessments were completed by two occupational therapists who specialize in home modifications. The results were compared for agreement in identification of specific accessibility problems in and quantitative measurements of the home. The remote assessment correctly identified a total of 51 of the 59 problems (86.4%) identified by the in-home assessment and only identified five problems (8.9%) that were not identified by the on-site assessment. In addition, 54 of 60 (90%) of the quantitative measurements from the remote assessment matched those from the in-home assessment. Findings suggest that remote telerehabilitation assessments have the potential to enable specialists to diagnose potential accessibility problems in home environments and prescribe appropriate modifications regardless of the location of the client, home, or specialist.
Architectural Accessibility↗