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At least 19 recordsLinked to original sources
PubMed2005

Impact of modem-transferred blood glucose data on clinician work efficiency and patient glycemic control.

BACKGROUND: Communication of blood glucose (BG) results between patients and health care providers (HCPs) is of established benefit and remains a critical part of the diabetes management process. Currently, HCPs typically receive BG data from patients at the time of clinic visits or by telephone. The Accu-Chek Acculink modem (Roche Diagnostics Corp., Indianapolis, IN) provides an additional and attractive option that can potentially facilitate this communication. METHODS: To assess the impact of modem transfer of BG, we studied 47 participants with diabetes enrolled in a diabetes education program. Subjects were randomized to weekly communication of BG data to their HCP by either telephone (n = 23) or modem (n = 24) for 4 weeks. Mean age (+/- SD) was 44 +/- 15 years, 62% were female, 74% used insulin, 53% had type 1 diabetes, and mean baseline glycosylated hemoglobin (A1C) was 8.8% (range 5.2-13.2%). RESULTS: There were no differences between groups in the amount of time the HCP spent analyzing BG data and communicating with patients (12.6 +/- 6.1 min/week in the telephone group and 11.5 +/- 5.1 min/week in the modem group) or in the number of patient and HCP attempts needed to make contact. There were similar improvements in A1C between groups (change of -0.4 +/- 0.7% in the telephone group and -0.9 +/- 1.4% in the modem group, P = 0.18). BG data provided by telephone had a 6% error rate, in contrast to modem-sent data, which were transmitted without error. CONCLUSIONS: Modem transfer of BG data can provide an accurate and clinically useful option for communication between patients and their HCP and has comparable effects on A1C.

Adult↗
PubMed2003

Effect of modem transmission of blood glucose data on telephone consultation time, clinic work flow, and patient satisfaction for patients with gestational diabetes mellitus.

PURPOSE: To determine if modem transmission of blood glucose data by patients with gestational diabetes could provide faster communication of results, increased clinic work-flow efficiency, and equivalent accuracy. Participant and health care provider satisfaction with the technique was also assessed. DATA SOURCES: Participants were randomized to the modem group, which used the Acculink Modem to report blood glucose data, or to the control group, which used the telephone to report the data. Telephone consultation time, clinic visit time, and accuracy of data were measured. Participants and health care providers completed satisfaction questionnaires. CONCLUSIONS: No significant differences in telephone consultation time, clinic work-flow efficiency, or accuracy were found between the groups. However, both the modem group and clinic staff were highly satisfied with telemedicine transmission of blood glucose data. IMPLICATIONS FOR PRACTICE: Telemedicine is a convenient method for monitoring patients with gestational diabetes mellitus. As a result of this study, modem transmission was instituted in our clinic for insulin pump patients interested in using modem technology.

Adult↗
PubMed2003

Modem transmission of glucose values reduces the costs and need for clinic visits.

OBJECTIVE: To determine whether modem technology allows for effective management of type 1 diabetes when used in lieu of a clinic visit. RESEARCH DESIGN AND METHODS: A total of 70 adolescent patients with diabetes were prospectively randomized to either a control group or a modem group. Control group patients continued the standard of care of quarterly clinic visits, and modem group patients were instructed to transmit blood glucose data every 2 weeks for 6 months instead of a usual quarterly clinic visit. Health care providers analyzed the data received by modem and contacted patients to discuss diabetes treatment changes. GHbA(1c) levels were determined at 0 and 6 months, and the number of high and low blood glucose levels and adverse events were tracked. Clinic visit costs, patient expenses, and health care provider times were tracked for cost analysis for both groups. RESULTS: A total of 63 patients (33 control, 30 modem) completed the 6-month study. The GHbA(1c) values significantly decreased in both groups, with no statistically significant difference between groups (P = 0.96). The occurrence of mild-to-moderate hypoglycemic events were similar in the two groups, and there were no severe hypoglycemic events. The average cost of care for a clinic visit was $305.00, whereas the cost for 6 months of modem transmission was $163.00. CONCLUSIONS: This study shows that electronic transmission of blood glucose levels and other diabetes data every 2 weeks-in lieu of a clinic visit-results in a similar level of glucose control and incidence of acute diabetes complications when compared with current standard care.

Adolescent↗
PubMed1992

Telephone modem access improves diabetes control in those with insulin-requiring diabetes.

OBJECTIVE: To assess whether modem access improves diabetes control in IDDM patients. RESEARCH DESIGN AND METHODS: Forty-two patients participated in the study and were followed for 12 wk. The patients were randomly divided into two groups at baseline, a modem group and a control group. There were no significant differences between HbA1c, random blood glucose, and weight between the groups at the beginning of the study. Patients were asked to perform five blood glucose determinations/day (before breakfast, before lunch, afternoon [1500], before dinner, and at bedtime) twice/week. The modem group transferred their data over the phone once/week. The control group would bring in their results on their regular visits every 6 wk. Patients in the modem group were counseled every week over the telephone after transferring results to adjust insulin and food intake if necessary. RESULTS: In the modem group, HbA1c improved from 0.106 to 0.092 (13.20%). The control group improved from 0.112 to 0.102 (8.9%). There was no significant change in weight, random blood glucose, or insulin. CONCLUSIONS: The use of telephone modem-based patient-monitoring systems in diabetes clinical research seems to stimulate the patient to keep closer control of blood glucose levels. It might be especially useful in rural settings, for which this study was designed.

Adolescent↗
PubMed2000

Cable modem access to picture archiving and communication system images using a web browser over the Internet.

This presentation describes our experiences using a web-based viewing software and a browser to view our picture archiving and communication system (PACS) images at a remote site with cable modem-internet communications. Our testing shows that using a cable modem to access our radiology webserver produces acceptable transmission speeds to remote sites. The average time-to-display (TTD) for 16 computed tomography (CT) images on the web-based intranet system in our hospital was 7 to 8 seconds. Using a cable modem and comparable equipment at a remote site, the average TTD is 16 seconds over the internet. The TTD does not significantly change during various hours of the day. Security for our hospital-based PACS is provided by a firewall. Access through the firewall is accomplished using virtual private network (VPN) software, a secure ID, and encryption. We have found that this is a viable method for after-hours subspecialty radiology consultation.

Academic Medical Centers↗
PubMed2003

Is a condition-specific instrument for patients with low back pain/leg symptoms really necessary? The responsiveness of the Oswestry Disability Index, MODEMS, and the SF-36.

STUDY DESIGN: Analysis of longitudinal data collected prospectively from patients seen in 27 National Spine Network member centers across the United States. OBJECTIVE: To evaluate the responsiveness of the Oswestry Disability Index, MODEMS scales, and all scales and summary scales of the MOS Short-Form 36 (SF-36) for patients with low back pain/leg symptoms. SUMMARY OF BACKGROUND DATA: The responsiveness of general and condition-specific health status instruments is a key concept for clinicians and scientists. Various authors have explored responsiveness in common surveys used to assess spine patients. Although it is generally believed that condition-specific measures are more responsive to change in the condition under study, in the case of low back pain, most authors agree that further exploration is necessary. METHODS: Patients with diagnoses of herniated disc, spinal stenosis, and spondylosis from the National Spine Network database who completed baseline and 3-month follow-up surveys were analyzed. Patient-provider consensus regarding improvement, worsening, or no change in the condition was selected as the external criterion. Responsiveness was evaluated using ROC curve analysis and effect size calculations. RESULTS: Nine hundred and seventy patients had complete data at baseline and 3 months. At follow-up, 68% of the patients had consensus improvement. Based on ROC analysis, scales assessing pain were significantly more responsive than scales assessing function. There were no significant differences between the condition-specific scales and their equivalent general-health counterpart. The scales with the highest probabilities of correctly identifying patient's improvement were: the condition-specific pain scale from MODEMS (PAIN, ROC = 0.758); the combined pain and function scale from MODEMS (MPDL, ROC = 0.755); the general pain scale from the SF-36 (BP, ROC = 0.753); the combined pain and function scale from the SF-36 (PCS, ROC = 0.745); the condition-specific function measure from the Oswestry (ODI, ROC = 0.723); and the physical function measure from the SF-36 (PF, ROC = 0.721). A similar rank order was typically maintained with effect size calculations. Results were nearly identical in patients with multiple non-spine-related comorbidities and in patients with high degrees of perceived disability. The BP scale was most responsive to worsening of symptoms. CONCLUSION: For studies of patients with low back problems, the general SF-36 may be a sufficient measure of health status and patient function, without the need for additional condition-specific instruments. Pain scales appear to be the most responsive measures in patients with low back pain.

Cohort Studies↗
PubMedDate not supplied

POTS to broadband ... cable modems.

There have been 3 columns talking about broadband communications and now at the very end when it's time to compare using a telco or cableco, I'm asking does it really matter? So what if I can actually get the whole 30 Mbps with a cable network when the website I'm connecting to is running on an ISDN line at 128 Kbps? Broadband offers a lot more bandwidth than the connections many Internet servers have today. Except for the biggest websites, many servers connect to the Internet with a switched 56-Kbps, ISDN, or fractional T1 line. Even with the big websites, my home network only runs a 10 Mbps Ethernet connection to my cable modem. Maybe it doesn't matter that the cable lines are shared or that I can only get 8 Mbps from an ADSL line. Maybe the ISP that I use has a T1 line connection to the Internet so my new ADSL modem has a fatter pipe than my provider! (See table 1). It all makes me wonder what's in store for us in the future. PC technology has increased exponentially in the last 10 years with super fast processor speeds, hard disks of hundreds of gigabytes, and amazing video and audio. Internet connection speeds have failed to keep the same pace. Instead of hundreds of times better or faster--modem speeds are barely 10 times faster. Broadband connections offer some additional speed but still not comparable growth as broadband connections are still in their infancy. Rather than trying to make use of existing communication paths, maybe we need a massive infrastructure makeover of something new. How about national wireless access points so we can connect anywhere, anytime? To use the latest and fastest wireless technology you will simply need to buy another $9.95 WLAN card or download the latest super slick WLAN compression/encryption software. Perhaps it is time for a massive infra-restructuring. Consider the past massive infrastructure efforts. The telcos needed to put in their wiring infrastructure starting in the 1870s before telephones were useful to the masses. CATV was a minor player in the TV broadcast business before they installed their cabling infrastructure and went national. Even automobiles were fairly useless until roads were paved and the highway infrastructure was built!

Computer Communication Networks↗
PubMed1994

Innovations in intra-aortic balloon pump management: computer modem technology.

The computer modem technology being developed by Datascope Corporation for the purpose of off-site intra-aortic balloon pump (IABP) monitoring was clinically evaluated in 30 patients requiring IABP support. The Datascope System 95 model IABP with built-in modem was used on all patients. Remote communications via a personal computer with modem were conducted under both routine and emergency settings. The Datascope PC IABP software was evaluated for its user compatibility, efficiency, diagnostic capability and overall usefulness as a clinical tool. During the eight month evaluation period, 87 remote communications were conducted for both routine and emergency IABP evaluation checks. Adjustments were recommended on 22 occasions relevant to balloon timing, trigger mode selection and augmentation volume settings. Eight communications were initiated in emergency settings due to a variety of patient conditions. Emergency intervention was successful in diagnosing and resolving critical situations including atrial arrhythmias, pacemaker timing, low cardiac output syndrome, loss of trigger source, catheter malpositioning and poor augmentation. The diagnostic capabilities and efficient means of data collection by the computer software provide the clinician with a valuable tool for routine IABP clinical monitoring, as well as emergency problem resolution.

Adult↗
PubMed2001

Modem remote support of pulmonary-function testing and quality control systems.

The data coordinating center (DCC) of the Asthma Clinical Research Network (ACRN) is responsible for the support of 11 pulmonary-function testing systems and two quality control systems. Pulmonary-function data from these systems are used as outcome indicators in studies conducted by the ACRN. Each of these systems is composed of a spirometer, a personal computer for data acquisition from the spirometer, a modem, and a printer. These systems are located at six clinical centers nationwide. An analysis conducted at the beginning of the first ACRN protocol identified the following requirements: (1) standard pulmonary-function testing, (2) standard methacholine-challenge testing, (3) the ability to handle simultaneous multiple protocols as well as have data from non-ACRN subjects, (4) the ability to separate data from different protocols as well as separate ACRN and non-ACRN data, (5) the ability to transmit data from the remote clinical centers to the DCC, (6) the ability to ensure quality data and to report on those results, and (7) the ability to provide remote support.

Asthma↗
PubMed1995

Faxes, modems, and fax/modems.

Although the use of computers for word processing and spreadsheet analysis is widespread, other less well-known uses can also increase efficiency and productivity. In this bimonthly column, Dr. Nicoll discusses a variety of computer applications to help the nurse executive catch up, keep up, and get ahead.

Communication↗
PubMed2005

Studies of complex reactions using modem hyphenated methods: alpha-pinene ozonolysis as a model reaction.

Modern analytical equipment, in this case the combinations of gas chromatography (GC) with mass spectrometry (MS) and infrared spectroscopy (IR) and liquid chromatography (LC) with mass spectrometry, nuclear magnetic resonance (NMR) spectroscopy and infrared spectroscopy, respectively, have been used to monitor complex reactions that do not only form one or two but a larger number of products. Additionally, side reactions of one primary product with a reactant form a second line of secondary products. To be able to propose formation pathways or even mechanistic interpretation of reactions like these, sophisticated analytical instrumentation is necessary to be able to observe all steps of such a reaction. In this case, the gas phase reaction of alpha-pinene with ozone has been used as a model reaction. A number of both volatile and low-volatile reaction products could be characterized and formation pathways for a reaction with ozone and OH radicals were proposed.

Bicyclic Monoterpenes↗