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At least 109 records · Page 6Linked to original sources
PubMed2007

Cost-effective dynamic telepathology in the Mohs surgery laboratory utilizing iChat AV videoconferencing software.

BACKGROUND: Dynamic telepathology is the real-time transmission of histologic images from one pathologist to another by means of telecommunications technology. OBJECTIVE: The objective was to determine whether dynamic telepathology can be accomplished accurately and inexpensively by use of readily available off-the-shelf consumer products and software. METHODS: We attached a standard, consumer-grade, digital video camera to a microscope in the Mohs surgery laboratory and then transmitted via the Internet real-time histologic video images and audio to a consultant dermatopathologist by means of iChat AV videoconferencing software (Apple Computer Inc., Cupertino, CA). In the first part of the study, 20 unknown formalin-fixed, paraffin-embedded slides from tumors typically seen in a Mohs practice were evaluated by the consultant dermatopathologist. In the second part of the study, the Mohs surgeon consulted the dermatopathologist on 20 Mohs frozen section slides in which the surgeon had a particular question (e.g., "Is this part of a pilosebaceous unit or is this basal cell carcinoma?"). RESULTS: The video images were adequate for pathologic interpretation. There was agreement between conventional light microscopy and dynamic telepathology diagnosis in 19 of 20 tumors. There was complete agreement for all 20 Mohs frozen section consultations. CONCLUSION: Dynamic telepathology can be accomplished accurately and inexpensively by use of readily available consumer products and software.

Cost-Benefit Analysis↗
PubMed2004

A pilot study of physiotherapy education using videoconferencing.

We investigated the possibility of instructing people in how to assist patients with activities of daily living via videoconferencing. A videoconference system was installed in two rooms to simulate a connection between a home and an institution. The subjects were five first-year university students. First, they saw a video-tape on several general assistance procedures to help a patient with sitting up, standing up and walking with a cane. Then they assisted a simulated patient who reproduced the effects of right hemiplegia due to a stroke. They also received instructions from a physiotherapist in another room using the videoconference system. The students experienced most difficulty in assisting the patient to stand up from sitting with legs stretched in a tatami room. Their mean score in the first session for this was 34.5 points out of 45, and this increased to 38.5 in a second session, after a question and answer period. The present study shows that the delivery of rehabilitation services is feasible in remote places.

Activities of Daily Living↗
PubMed2005

A comparison of teledermatology using store-and-forward methodology alone, and in combination with Web camera videoconferencing.

We compared the diagnostic accuracy of conventional asynchronous teledermatology ('store-and-forward' [SAF]) with a combined technique, in which SAF methodology was used first, followed by a videoconference using low-cost Web cameras. The study involved 228 patients with 242 lesions. For each case, two independent teledermatologists (A and B) evaluated digital images and clinical information by the conventional SAF method and gave a single diagnosis. Then, each communicated with the patient via Web cameras and gave a single diagnosis (combined method). Finally, teledermatologist A performed a face-to-face examination of each patient and established the gold standard diagnosis. With the conventional SAF method, the diagnostic accuracy of teledermatologist A was 81%, while that for teledermatologist B was 75%. With the combined method, the corresponding values were 90% and 82% (P<0.001 for both). There was no significant difference in the interobserver agreement between the two methods. Use of Web camera videoconferencing improved patient satisfaction with teledermatology. This method of teledermatology may be a useful alternative to the SAF method alone.

Adolescent↗
PubMed2005

Delivery of child development services by videoconferencing: a review of four years' experience in Queensland.

In 2001 the Child Development Unit (CDU) in Brisbane piloted a series of monthly multidisciplinary case discussions via videoconference in the area of child development. During 2001 two sessions were provided; during 2004 there were 40. The substantial growth in 2004 was due to the expansion of child development services to include special interest group meetings and multipoint case conference meetings. In 2004, a total of 49 h of videoconferencing was conducted. The average session length was 75 min. Education and training sessions were delivered to 32 hospitals and health centres in Queensland and northern New South Wales. The maximum number of sites involved during a single videoconference was 25. The average number of attendees for each videoconference was five per site, including allied health staff, nurses and paediatricians. The delivery of child development services via videoconference has been shown to be useful in Queensland, especially for allied health staff working in regional and remote areas. The growth of the programme indicates its acceptance as a mainstream child development service in Queensland.

Child↗
PubMed2006

A pilot study of videoconferencing for an Internet-based weight loss programme for obese adults in Taiwan.

We conducted a pilot study of the feasibility of an Internet-based weight loss programme using videoconferencing to emulate face-to-face situations and a Web service to support self-monitoring. A pre-post test design was used to compare changes in bodyweight, metabolic variables and attendance rate. Nine subjects lost on average 5.9 kg (6.0% of body weight, P<0.001) over the course of the 12-week programme. Waist circumference was reduced significantly (10.2 cm, P=0.03). Total cholesterol, aspartate transferase (AST) and alanine transferase (ALT) significantly decreased. Eight participants completed a questionnaire after the intervention. Overall, responders were satisfied with the protocol and considered the Internet weight loss programme to be helpful to them. One technical problem was that Internet congestion could reduce the quality of audio and video. The Internet appears to hold promise as a medium to facilitate communication in weight loss programmes.

Adolescent↗
PubMed2006

Management of urinary incontinence in older women using videoconferencing versus conventional management: a randomized controlled trial.

We compared telemedicine with a conventional outpatient continence service (CS) in community-dwelling older women with urge or stress incontinence. After an initial biofeedback-assisted pelvic floor muscle training session, subjects were randomized to behavioural training for eight weeks via the CS (n = 27) or a telemedicine continence programme (TCP) (n = 31). Participants in both treatment groups experienced significant improvement in their symptoms, namely, a reduction in the number of daily incontinence episodes (P<0.001) and voiding frequency (P<0.001), while the volume of urine at each micturition increased (P<0.005). Pelvic floor muscle strength as measured by the Oxford Score also improved (P<0.005). There were no significant differences in outcomes between the two groups. Thus our findings suggest that videoconferencing is as effective as conventional methods in the management of urinary incontinence.

Aged↗
PubMedDate not supplied

[Implantation of a videoconferencing system applied to nursing research and teaching environments].

Describes the trajectory followed by a research group at the Ribeirão Preto College of Nursing-USP to implant a research/teaching/continuous education project based on videoconferencing technology. The technical characteristics of the available systems are discussed, as well as the technological solution that was adopted in this project to attend to the needs of the academic and research environment as well as in the hospital context.

Education, Nursing↗
PubMed2004

Managing suicides via videoconferencing in a remote northern community in Canada.

INTRODUCTION: Telehealth in remote communities has been reported to be cost-effective for emergency medicine and possibly for psychiatry. METHODS: The cost of sending a patient out of a remote community for suicide assessment was compared with the cost of maintenance and on-line charges of videoconference. The cost comparison was used to determine the potential savings to the provincial government. User satisfaction was assessed through qualitative questionnaires. RESULTS: The use of videoconferencing for mental health assessment for 71 patients in a remote northern community saved the Government of Newfoundland and Labrador dollar 140,088 in 2003. Patients and health professionals were satisfied with mental health assessment via videoconference. CONCLUSION: The provision of mental health assessments for patients in a remote community in Labrador, Canada by videoconference was effective and saved money.

Health Care Costs↗
PubMed2004

An international landmine telehealth symposium between Hawaii and Thailand using an Internet2 and multi-protocol videoconferencing bridge.

An international telehealth symposium was conducted between healthcare institutions in Hawaii and Thailand using a combination of Asynchronous Transfer Mode, and Internet2 connectivity. Military and civilian experts exchanged information on the acute and rehabilitative care of landmine victims in Southeast Asia. Videoconferencing can promote civil-military cooperation in healthcare fields that have multiple international stakeholders.

Blast Injuries↗
PubMed2005

A pilot study of regional participation in a videoconferenced multidisciplinary genitourinary tumor board.

A successful pilot study of a videoconferenced multidisciplinary genitourinary tumor board involving 21 physicians over six geographic sites for a 6-month period is reported. The majority of cases presented at the tumor board were of prostate or bladder origin. Specific recommendations around management, patient referral or clinical trial eligibility were made in the majority of cases presented. Physician satisfaction with the rounds was high and participation beyond the pilot has continued. Scheduling in order to provide maximum access/participation has been the main logistical challenge with the rounds.

Humans↗
PubMed2005

Overcoming diverse security protocols across institutions to enable convenient file-sharing and videoconferencing among collaborators.

The use of videoconferencing and file sharing tools among colleagues at large institutions has traditionally been confounded by differing security policies in place at each location. Building an electronic collaboration infrastructure based upon the lowest-common-denominator security configuration expected to be encountered will yield an accessible collaboration environment previously unavailable to geographically diverse researchers and clinicians.

Computer Security↗
PubMed2004

A review of three years experience using email and videoconferencing for the delivery of post-acute burns care to children in Queensland.

A virtual outpatient service has been established in Queensland for the delivery of post-acute burns care to children living in rural and remote areas of the state. The integration of telepaediatrics as a routine service has reduced the need for patient travel to the specialist burns unit situated in Brisbane. We have conducted 293 patient consultations over a period of 3 years. A retrospective review of our experience has shown that post-acute burns care can be delivered using videoconferencing, email and the telephone. Telepaediatric burns services have been valuable in two key areas. The first area involves a programme of routine specialist clinics via videoconference. The second area relates to ad-hoc patient consultations for collaborative management during acute presentations and at times of urgent clinical need. The families of patients have expressed a high degree of satisfaction with the service. Telepaediatric services have helped improve access to specialist services for people living in rural and remote communities throughout Queensland.

Ambulatory Care↗
PubMed2003

Treating childhood depression over videoconferencing.

Effective cognitive-behavioral treatments for childhood depression have developed over the last decade, but many families face barriers to such care. Telemedicine increases access to psychological interventions by linking the child and the clinician using videoconferencing (VC). The current study evaluated an 8-week, cognitive-behavioral therapy (CBT) intervention for childhood depression either face-to-face (F2F) or over VC. The telemedicine setup included two PC-based PictureTel systems at 128 kilibits per second (kbps). Success was defined by (1) decreasing depressive symptoms at similar rates in both the VC group and the F2F group and (2) demonstrating the feasibility of a randomized controlled trial in telemental health. Children were assessed for childhood depression using the mood section of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present Episode (K-SADS-P). Twenty-eight children were randomized to either F2F or VC treatment. The participants completed the K-SADS-P and the Children's Depression Inventory (CDI) at pre- and post-treatment. The CBT treatment across the two conditions was effective. The overall response rate based on post-evaluation with the K-SADS-P was 82%. For the CDI total score, both the Time and the Group by Time effects were significant (p < 0.05). The interaction effect reflected a faster rate of decline in the CDI total score for the VC group. The study serves as a model for building on past research to implement a randomized controlled trial. This information provides persuasive research data concerning treatment effectiveness for clinicians, families, and funders.

Child↗
PubMed2003

Provision of pharmacy services to underserved populations via remote dispensing and two-way videoconferencing.

A telepharmacy program aimed to resolve the dual problem of access to prescription drugs and pharmacists for low-income populations is described. The program was conducted at the Community Health Association of Spokane (CHAS), a federally qualified community health center, and initiated in January 2001. The program, known as Telepharmacy at CHAS, allows for the dispensing of low-cost medications through participation in the federal government's 340B program and use of remote dispensing and counseling via a two-way interactive videoconferencing system to patients at six urban and rural clinics. The regulatory and practical steps necessary to implement and maintain the program are also presented. Consecutive patients whose prescriptions were filled at the base site or remote-sites were invited to complete a pharmacy satisfaction questionnaire during a two-week period in March 2003. Over the two-week period, 93 patients seen at remote sites and 106 seen at the base site completed the questionnaire. Over 75% of patients seen at the remote sites were satisfied with their videoconference interactions with the pharmacist. Of the patients seen at the base site, 66% agreed or strongly agreed that they were satisfied with the time required to obtain medications and counseling. A high percentage of patients at both the base site (94%) and remote sites (63%) strongly agreed or agreed that they would have difficulty affording their medications without this program. Telepharmacy at CHAS has been well received by most of the patients and improved their access to medications and pharmacy services.

Adolescent↗
PubMed1993

Preliminary evaluation of a Low-Cost VideoConferencing (LCVC) system for remote cognitive testing of adult psychiatric patients.

Mini-Mental State Examination scores were compared in an adult psychiatric population when the test was performed face to face and over a Low-Cost VideoConferencing System (LCVC). The minor changes to the instrument that are required to make it compatible with the LCVC are described. The high correlations achieved between the test scores in the two conditions suggests that this cognitive screening test may be reliably performed in this group of patients over the LCVC.

Adult↗
PubMed2000

Development of a telemedicine program: a review of 1,000 videoconferencing consultations.

OBJECTIVE: To examine the financial and organizational characteristics, demand for services, and satisfaction outcomes of a growing telemedicine program serving both urban or suburban and rural populations. DESIGN: Retrospective review of 1,000 consecutive telemedicine consultations in the University of California (UC) Davis Telemedicine Program. SETTING: Telemedicine videoconferencing units, used to integrate care in the UC Davis Health System among the UC Davis Medical Center and several urban or suburban primary care clinics, rural hospitals, and clinic affiliates. SUBJECTS: A total of 657 consecutive patients who consented to a telemedicine consultation. Main outcome measures Demographic information about the patient population, the rural and urban or suburban clinics, the types of specialty consultations, and telemedicine equipment used in the UC Davis Health System. Patient and physician satisfaction were measured on a 5-point Likert scale. RESULTS: Patients and primary care physicians reported high levels of satisfaction. Rural clinics requested more and a greater variety of specialist consultations than urban or suburban clinics. CONCLUSION: Although referring physicians and patients indicate a high level of satisfaction with telemedicine services and insurers are negotiating reimbursement policies, additional research must investigate the reasons why some payers, patients, and providers resist participation in these services.

Attitude of Health Personnel↗
PubMed2000

A feasibility study of realtime telemedicine in Croatia using Internet videoconferencing.

We explored the feasibility of realtime telemedicine in Croatia using Internet videoconferencing. A 33 kbit/s link was established between a team of specialists in the General Hospital 'Sveti Duh' in Zagreb and a general practitioner's clinic in Selca, on the island of Brac. During a two-week study, 16 patients (median age 51 years) were studied. Twenty-one teleconsultations (seven initial and 14 follow-up visits) were conducted, 13 with a specialist in internal medicine, six with a surgeon and two with a neurologist. In 18 cases (86%) telemedicine successfully replaced hands-on examination. The mean duration of the teleconsultations was 7.2 min (initial visits 7.4 min, follow-up visits 7.1 min). Each computer system cost about US$700. The total connection cost for the study was US$4.95. The teleconsultations saved the patients US$272 in travel costs. We suggest forming a permanent on-line specialist service connected to networked clinics via the Internet to improve access to health-care in Croatia.

Adolescent↗
PubMed2000

The potential of a nursing education support system using videoconferencing.

Japan currently employs a total of 400,000 practical nurses, accounting for approximately 40% of the total number of nurses in the country. An education system for improving the skills of practical nurses and encouraging them to obtain certification as registered nurses is due to begin in 2001. In Hokkaido, 90 nursing schools are scheduled to be used as transitional education facilities. These, however, tend to be concentrated in large cities. We have examined the possibilities for an education support system for nurses using videoconferencing. The system will include theoretical lectures using television broadcasts and technical lectures conducted at training facilities. Given Hokkaido's geographical conditions, a support system using telecommunication is considered to be essential for the success of transitional education.

Communication↗