Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2008
The last challenges and barriers to the development of telemedicine programs.
Over the past several decades the concept of telemedicine has evolved to be more commonplace with many unique applications. These applications have been made possible by overcoming challenges and barriers that have been present for most of telemedicine's development. The application of telemedicine continues to undergo growth and scrutiny. ⋯ Future generations of telemedicine users will look back at this period as one of transition. The first 30 years or so of telemedicine implementation were fraught with barriers and challenges. The next 30 years will see and entirely different paradigm of practicing medicine, including consumerism and smart systems.
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Stud Health Technol Inform · Jan 2008
Intensive care telemedicine: evaluating a model for proactive remote monitoring and intervention in the critical care setting.
Historically, telemedicine has focused on the application of traditional physician-to-patient (and physician-to-physician) interactions enhanced by two-way video and audio capability. This "one-on-one" interaction via a telemedicine link can dramatically extend a physician's or other caregiver's geographic range and availability. However, this same telemedicine model is most often implemented "on-demand" for a specified time-limited encounter. ⋯ Multiple challenges remain before remote ICU systems become more broadly accepted and applied. These include cost of implementation of the system, resistance to the system by ICU physicians and nurses, and integration of data systems and clinical information into the remote electronic ICU model. In this chapter, we will provide background information on error reduction theory and the role of the remote ICU model, review current data supporting use of the remote ICU system, address the current obstacles to effective implementation, and look to the future of the field for solutions to these challenges.
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Stud Health Technol Inform · Jan 2008
An artificial neural network derived trauma outcome prediction score as an aid to triage for non-clinicians.
In mass casualty events Emergency Medical Service Providers (EMS) choose treatment at Scene or a "scoop and run" approach. The latter requires clinically trained personnel at the reception site to triage patients. Current methodology based on Revised Trauma Score (tRTS) requires use of Glasgow Coma Scale, a method reliant on experience and clinical knowledge. ⋯ Models performed well in predicting mortality compared to standard outcome predictors. Possible additional variables such as gender or ethnicity might improve the Neural Network predictive ability. Pulse appears an essential variable not recorded by the NTDB.
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Stud Health Technol Inform · Jan 2008
Telemedicine for home health and the new patient: when do we really need to go to the hospital?
This chapter will review the current state-of-the-art of home health services in the telemedicine environment. Two aspects in particular will be discussed that reflect where most of the efforts in home telehealth care are being directed. ⋯ In this application, the users may be patients with chronic conditions such as asthma or diabetes that require regular monitoring to achieve or maintain healthy functioning, but they are typically not in an acute phase. More and more often, however, the users of distance monitoring technologies are relatively healthy people looking to enhance their health awareness and healthy status by monitoring various vital signs to alert them of any potential changes in their health status that would require actual medical attention.
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Although wound care has been practiced for centuries, telewound care is a relatively new concept. Currently, only a few pilot programs are in existence. Telewound care has yet to achieve the popularity and recognition of its other telemedicine predecessors amongst members of the health care industry and public alike. ⋯ With the advances in the field of telecommunications in connecting people across distances at a fraction of the time and costs, improved outcomes reported in other fields of telemedicine and positive legislative changes, there is an enormous potential in this field. We now have the ability, knowledge and resources to develop telewound care programs, which can provide high quality patient care in a more concise and cost-effective way. It is certainly a welcoming relief to a field that has traditionally been known to pose an emotional, physical and financial drain to all those involved.