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Adoption of telemedicine: from pilot stage to routine delivery
Paolo Zanaboni, Richard Wootton
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-1
Abstract: We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur.The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and professional incentives for potential telemedicine users and understand their importance for widespread adoption.The sustainability of healthcare systems is a matter for continuing concern [1]. Telemedicine technologies have been proven to work, and are considered to be a viable option [2] in future healthcare delivery, allowing healthcare organisations to provide care in a more economic and comprehensive way. Thus telemedicine is said to be ready for wider adoption [2]. However, te
Telemedicine and anaesthesia  [cached]
Chatrath Veena,Attri Joginder,Chatrath Raman
Indian Journal of Anaesthesia , 2010,
Abstract: Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article.
Telemedicine in veterinary practice  [cached]
M. Mars,R.E.J. Auer
Journal of the South African Veterinary Association , 2012, DOI: 10.4102/jsava.v77i2.348
Abstract: Veterinary surgeons have a long tradition of consulting one another about problem cases and many have unwittingly practised telemedicine when discussing cases by telephone or by sending laboratory reports by telefax. Specific veterinary telemedicine applications have been in use since the early 1980s, but little research has been undertaken in this field. The Pubmed and CAB International databases were searched for the following Boolean logic-linked keywords; veterinary AND telemedicine, veterinary AND telecare, animal AND telemedicine, animal AND telecare and veterinary AND e-mail and an additional search was made of the worldwide web, using Google Scholar. This returned 25 papers which were reviewed. Of these only 2 report research. Sixteen papers had no references and 1 author was associated with 13 papers. Several themes emerge in the papers reviewed. These include remarks about the use of telemedicine, the benefits that can and are derived from the use of telemedicine, areas of practice in which telemedicine is being used, ethical and legal issues around the practice of telemedicine, image standards required for telemedicine, the equipment that is required for the practice of telemedicine, advice on ways in which digital images can be obtained and educational aspects of telemedicine. These are discussed. Veterinary practice has lagged behind its human counterpart in producing research on the validity and efficacy of telemedicine. This is an important field which requires further research.
Telemedicine and cardiology
Jelki? Nikola,?anji Tibor,Ivanovi? Vladimir,Srdanovi? Ilija
Medicinski Pregled , 2003, DOI: 10.2298/mpns0304187j
Abstract: Introduction Telecommunications and information technology provide clinical care at distance by means of telemedicine. Hospitals and other health care facilities use medical telemetry devices for monitoring patients' vital signs. These portable devices are used for measuring patient vital signs such as ECG, blood pressure, heart rate, respiration, capnography (CO2) and other important parameters and then transmit these information to a remote location using a nearby receiver. Application of telemetry Eliminating the need for wired connection with the patient, monitors allow, otherwise bedridden patients to be mobile, which shortens the recovery time. Wireless technology is also useful in the emergency care units, because emergency physicians need not leave their patients while consulting a handheld wireless device. This equipment also enables a paramedic to communicate with emergency physicians for early assessment, well before patients' arrive in hospital. Telemedicine Certain types of medical telemetry devices may be used in home conditions. Telemetry can provide monitoring and home health care services at distance, using advanced telecommunications and information technology in patients with reasonably stable, but a severe, chronic, difficult condition and caring home environment. This information can enable health-care providers to effectively manage treatment without need for acute emergency treatment and hospitalization. Conclusion Hospitals worldwide are under constant pressure to decrease healthcare cost and to improve treatment outcome. Telemedicine and home health care may be one of the solutions for the problem.
Telemedicine: Perspectives and expectations  [PDF]
Zdravkovi? Svetozar
Archive of Oncology , 2008, DOI: 10.2298/aoo0804069z
Abstract: A rapid growth of Internet industry, total digitalization in almost all business fields including medicine and popularization of telemedicine and e-health impose dilemma about perspectives and expectations of telemedicine. The article has tried to point out some crucial facts about telemedicine perspectives and expectations to patients and health professionals, as well as wide social review. These facts could help readers to make their own general picture of telemedicine in the future.
Arithmetic circuits: the chasm at depth four gets wider  [PDF]
Pascal Koiran
Computer Science , 2010,
Abstract: In their paper on the "chasm at depth four", Agrawal and Vinay have shown that polynomials in m variables of degree O(m) which admit arithmetic circuits of size 2^o(m) also admit arithmetic circuits of depth four and size 2^o(m). This theorem shows that for problems such as arithmetic circuit lower bounds or black-box derandomization of identity testing, the case of depth four circuits is in a certain sense the general case. In this paper we show that smaller depth four circuits can be obtained if we start from polynomial size arithmetic circuits. For instance, we show that if the permanent of n*n matrices has circuits of size polynomial in n, then it also has depth 4 circuits of size n^O(sqrt(n)*log(n)). Our depth four circuits use integer constants of polynomial size. These results have potential applications to lower bounds and deterministic identity testing, in particular for sums of products of sparse univariate polynomials. We also give an application to boolean circuit complexity, and a simple (but suboptimal) reduction to polylogarithmic depth for arithmetic circuits of polynomial size and polynomially bounded degree.
Crossing the quality chasm in resource-limited settings
Duncan Maru, Jason Andrews, Dan Schwarz, Ryan Schwarz, Bibhav Acharya, Astha Ramaiya, Gregory Karelas, Ruma Rajbhandari, Kedar Mate, Sona Shilpakar
Globalization and Health , 2012, DOI: 10.1186/1744-8603-8-41
Abstract: A young school-age boy with severe respiratory distress presented to the remote hospital. Previously, the boy had been seen by untrained private clinicians in the community three times over four days. At presentation to the hospital, the child was evaluated by a mid-level practitioner who provided an initial course of antibiotics. Despite the child's ill appearance, supportive treatment including intravenous fluids and supplemental oxygen were not provided until discussion with the Medical Director three hours later. Later that evening, the electric nebulizer and oxygen concentrator became unusable after the hospital lost power owing to a blackout of the public electric grid and malfunctioning of the hospital’s backup generator. The regulator for the backup oxygen canister could not be found. At this juncture, without the ability to provide oxygen, the medical team recommended transfer. The family did not agree to transfer due to the high costs of other regional health facilities (our facility provides free services). That evening, after not being examined for over two hours by on-call staff, the child was found unresponsive with a thready pulse. Cardiopulmonary resuscitation was not initiated for over ten minutes as the midwife managing the ward did not know the procedure and the bag valve mask was not at the bedside. Following fifteen minutes of unsuccessful resuscitation, the child was declared dead.Health care providers in resource-limited settings must do better [1]. Globally, resource-limited settings have received increasing funds over the last decade for the scaling up of health programs. These resources have generally been focused on the quantity of services provided. The quality of many of the resultant services, however, has often times been low or poorly understood. Since the 1980s, quality improvement (QI) research and implementation have taken steps towards reducing the “quality chasm” [2,3] that exists in developed-country settings [4-7]. If increased
Data protection in telemedicine  [cached]
Gusarova A.
SHS Web of Conferences , 2012, DOI: 10.1051/shsconf/20120200013
Abstract: Telemedicine – is the use of information and communication technologies in the situation when health care professional and the patient are not in the same location. That means that health care services are provided from the distance. The telemedicine services include transmission of information about patients’ health through text, sound, images and other data forms for the prevention, diagnosis treatment and follow-up of the patient. The use of telemedicine services contributes to health improvement and its application should be considered favourably. However, it is necessary to be aware that the use of different telemedicine solutions includes processing of patient’s data. Thus, this issue should be considered from the perspective of data protection. Despite the fact that the use of telemedicine services will positively makes changes in relationship between health care professional and patient that should not negatively affect persons’ rights to data protection. The person who receives health care services is entitled to expect that health care service will be provided with the respect to human rights.
Telemedicine Technology-An Overview
Sheshadri HS,Kandaswamy A
Calicut Medical Journal , 2005,
Abstract: .Technology has been used to deliver health care at a distance for many years. Early technologies included telephone, radio, television, and telemetry. More recently, microwave transmission, audio and visual teleconferencing, fax, and computer networks are being used. Telemedicine technologies may be synchronous simulations. Asynchronous methods include a popular "store-and-forward" computer technology that(real time, interactive) or asynchronous (off-line, batch). Examples of synchronous technologies are interactive full-motion video, robotics, and virtual reality uses high-resolution video and high-fidelity audio to transmit patient information. Telemedicine involves teleconsultation, telediagnosis, telemonitoring, and delivery of continuing medical education. Some examples of telemedicine applications include teleradiology, telecardiology, teledermatology, telepsychiatry, telepathology, telesurgery, and teleneurology. Telemedicine is used in a variety of locations including rural and urban areas, battlefields home care, prisons, and outerspace.In this paper we have made an attempt to discuss an overall view of the application of telemedicine and its major issues with respect to Indian context.
Telemedicine and rural health care applications  [cached]
Smith Anthony,Bensink M,Armfield N,Stillman J
Journal of Postgraduate Medicine , 2005,
Abstract: Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication.
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