International Journal of Telemedicine and Applications最新文献

In order to improve the efficiency of medical multimedia information sharing, this paper combines cloud computing technology and SOA (service-oriented architecture) technology to build a medical multimedia information sharing system. Building a medical information sharing platform requires integrating information resources stored in information systems of medical institutions and nonmedical information systems related to medical information and forming a huge resource pool. It is important to mine and analyze the information resources in the resource pool to realize the sharing and interaction of medical information. To this end, this paper proposes a gain-adaptive control algorithm with online adjustable parameters and investigates the extension of the mutual entropy optimization algorithm in the control domain and its integrated processing capability in the process of medical multimedia information processing. In addition, this paper constructs a medical multimedia information sharing and collaboration platform with medical multimedia information sharing and telemedicine as the core and verifies the effectiveness of the platform through experiments. The simulation results and comparison results with other systems prove that the system in this paper can realize fast data processing, retrieve and analyze massive data, and meet the demand of remote intelligent diagnosis under the premise of safety and stability. Meanwhile, the system in this paper can help hospitals achieve fast and accurate diagnosis, which has strong theoretical and practical values.

Background: Advances in information and communication technology have led to telemedicine applications that could support paramedics in the prehospital field. In an effort to optimise the available resources like prehospital emergency physicians (PHP), the State Health Services of a Swiss state decided to launch a pilot study on the feasibility of using telemedicine in the prehospital emergency setting.

Objective: The primary objective was to measure the number of missions completed without technical problems with remote PHP support through telemedicine (tele-PHP). The secondary objectives were to evaluate the safety of this protocol and to describe the actions and decisions that clinicians can make by using tele-PHP.

Methods: This was a prospective observational pilot study on all missions involving the dispatch of ground PHP or tele-PHP. The severity score, dispatch criteria, actions, and decisions made by ground PHP and tele-PHP were collected.

Results: PHP were dispatched simultaneously with an ambulance on 478 occasions, including 68 (14%) situations that started directly with tele-PHP. Among those situations, three had to be transformed into on-site PHP missions after the on-site evaluation by paramedics. Fifteen missions were cancelled by paramedics once they were on site, and six missions encountered a connection issue. Forty-four PHP missions that were dispatched simultaneously with paramedics were completed by tele-PHP only without any connection problems. Paramedics and PHP estimated that actions or decisions were provided by PHP in 66% of the on-site PHP missions and 34% of the tele-PHP missions.

Conclusions: This is the first experience of tele-PHP regarding PHP dispatch in Switzerland. Despite the small number of missions carried out, tele-PHP could be used for well-selected situations to reduce the need for a PHP on site.

Teledentistry is a new technology in the dentistry field, which has great benefits during pandemic such as the coronavirus disease 2019 (COVID-19). The overall purpose of the study was to assess the diagnostic sensitivity and specificity of virtual (mobile phone teledentistry) compared with clinical examinations during COVID-19. The basic design of the study was based on the comparison treatment plans by the students and the gold standard (clinical treatment plan of an expert pedodontist with 10 years of clinical experience). This double-blind clinical trial was conducted on 20 children (aged 6 to 12 years) with a chief complaint of dental caries with or without pain. An appropriate radiograph and five standard intraoral photographs (frontal view occlusion, maxillary occlusal view, mandibular occlusal view, right lateral view, and left lateral view) were prescribed for each patient according to the guidelines of the American Association of Pediatric Dentistry. Then, the treatment plan for the carious teeth was recorded for each patient. Each patient underwent a clinical examination at first and was followed randomly by a virtual examination by two dental students. Then, the clinical and virtual treatment plans were compared with each other, and also with the gold standard. The sensitivity and specificity values were calculated for each group. The accuracy of the diagnosis was measured by applying Cohen's kappa. Interexaminer reliability was measured using the intraclass correlation coefficient (ICC) and Cronbach's alpha. The mean kappa coefficient for the interexaminer agreement (for 24 teeth) was 0.62 in clinical and 0.69 in virtual examinations. The results showed no significant difference in the treatment plans of students and the gold standard (P > 0.05). The diagnostic sensitivity and specificity were 73.22% and 95.8% for clinical and 76.44% and 92.9% for virtual treatment plans showing no significant differences between virtual (mobile phone teledentistry) and clinical examinations (P > 0.05). The intraexaminer reliability of the examiners was found to be 0.92 by calculating the ICC. Then, teledentistry can be considered as a supplement to clinical examinations of pediatric dentistry, finally resulting in better patient management. However, more studies are necessary for teledentistry.

Methods: This was an observational cross-sectional study conducted among physicians working at the College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), and its affiliated academic tertiary hospital, King Fahad Hospital of the University (KFHU), Eastern province-KSA. Data were collected between August 2019 and March 2020 via a structured, pretested, self-administered questionnaire distributed to 220 eligible physicians at KFHU. A final sample of 101 physicians completed our survey. Collected data was coded and analysed using SPSS, and the results presented as frequencies, percentages, and summary statistics.

Results: Among our respondents, 62 (61.4%) were males, 46 (45.5%) were in the age group of 35 to 44 years, and 62 (61.3%) were Saudi. Two-thirds of physicians (58 (57.4%)) use smart devices in healthcare delivery, and 51 (50.5%) are satisfied with this use. A minority (21 (20.8%)) knew about telemedicine guidelines, 8 (7.9%) had encountered legal issues related to telemedicine use, and 52 (51.5%) were doubtful about patients' readiness for virtual care. Regarding physicians' awareness of the ethical aspects regulating the use of social media and medical apps in patient care, only 44 (45.3%) were aware of the proper reporting system if they found accounts sharing unreliable information. Nevertheless, the majority (91 (92.9%)) agreed it is essential for healthcare providers to report such accounts. Concerning physicians' awareness of the rules and regulations of online self-promotion, the majority of our respondents were unsure or unaware of such regulations (46 (45.6%) and 18 (17.8%)), respectively. Nonetheless, 67 (66.3%) of the physicians would not pay SM influencers to advertise for them.

Conclusion: Two-thirds of our physicians use smart devices in healthcare delivery, with 1 in 13 having encountered related legal issues. Nonetheless, only a minority was aware of telemedicine use regulating guidelines, including physicians' online self-promotion regulations. These results highlight the necessity of targeted physicians' training on telemedicine use related guidelines, thereby ensuring the safety of both patients and healthcare professionals and the optimum utilization of online health-related interactions.

Introduction: Technological advancements have transformed nursing care, quality, and education across the globe. In the Kingdom of Saudi Arabia (KSA), the inventions and adoption of mobile technologies such as an e-health application (app) called SEHA continue to revolutionize the healthcare system in the country.

Purpose: The present systematic review is aimed at examining the technological impact on nursing in Saudi Arabia. The study provides a comprehensive analysis of telehealth and its role in nursing quality, nursing practice, and education.

Methods: The present study adopted a literature review methodology by deriving data from journal articles from different databases, for example, Web Science, Google Scholar, CINAHL, MEDLINE, and PubMed databases. Inclusive years for the search ranged from 2016 to 2022. A total of eight articles were found dovetailing to meet the research objectives and answer research questions.

Result: After appraising and analyzing the research, the present review found that (Abolfotouh et al., 2019) telehealth in nursing is loosely researched; (Ahmed et al., 2021) telehealth impacts nursing practice and quality by fostering nurse-patient communication promoting positive outcomes, seamless nursing care, and positive experiences; and (Albahri et al., 2021) telehealth and telemedicine is a central tenet of contemporary nursing education and practice.

Conclusion: From these findings, this analysis informed three key recommendations: the need to integrate telehealth into the nursing curriculum, telehealth training, and reskilling among healthcare workers (HCWs) in KSA and further primary studies focusing predominantly on telenursing. Overall, telehealth remains a fundamental transformation of nursing practice that forms a central ideology in the contemporary nursing process.

Securing telehealth IoT infrastructure is essential to provide high-level medical care and prevent cyberattacks. A vulnerable stage in IoT telehealth is while the patient is being transported to a healthcare facility, the transporter could be an ambulance or an air ambulance. In this paper, we propose a multifactor authentication scheme to secure the system when the patient is in transit to the healthcare facility. We apply this scheme to an ambulance, using physical unclonable functions (PUFs) embedded in the ambulance to facilitate authentication and secure key exchange. We validated the security of the proposed scheme using formal and informal security analysis. The analysis supports our claim that the proposed scheme protects against many types of attacks.

Objective: To examine the factors associated with the first use of telehealth during the COVID-19 pandemic using Andersen's Model of Healthcare Utilization. Andersen's Model of Healthcare Utilization allowed the categorization of the independent variables into the following: (1) predisposing factors, including sociodemographic variables and health beliefs; (2) enabling factors, including socioeconomic status and access to care; and (3) need for care, including preexisting or newly diagnosed conditions and reasons to seek out care or to utilize a new mode of care.

Methods: Potential respondents (n = 4,077) were identified for recruitment from a volunteer registry in Arkansas. Recruitment emails provided a study description, the opportunity to verify meeting the study's inclusion criteria and to consent for participation, and a link to follow to complete the survey online. The online survey responses were collected between July and August of 2020 (n = 1,137).

Results: Telehealth utilization included two categories: (1) utilizers reported the first use of telehealth services during the pandemic, and (2) nonutilizers reported they had never used telehealth. Lower odds of reporting telehealth utilization during the pandemic were associated with race (Black; OR = 0.57, CI [0.33, 0.96]) and education (high School or less; OR = 0.45, CI [0.25, 0.83]). Higher odds of reporting telehealth utilization included having more than one provider (OR = 2.33, CI [1.30, 4.18]), more physical (OR = 1.12, CI [1.00, 1.25]) and mental (OR 1.53, CI [1.24, 1.88]) health conditions, and changes in healthcare delivery during the pandemic (OR = 3.49, CI [2.78, 4.38]).

Conclusions: The results illustrate that disparities exist in Arkansans' utilization of telehealth services during the pandemic. Future research should explore the disparities in telehealth utilization and how telehealth may be used to address disparities in care for Black Arkansans and those with low socioeconomic status.

Introduction: Synchronous telemedicine using teleconferencing may play a role in clinical care. In a tertiary care center, video conferencing-enhanced virtual clinics were established via a new application platform. They were introduced during COVID-19 pandemic to connect patients to trained health-care providers via a secured line. While maintaining patients' privacy, they were theorized to offer effective communications and continuous clinical care. In this cross-sectional cohort study, we ought to examine the impact of service and the assistance they may offer to cardiac patients in the outpatient setup.

Methods: A prospective cohort study looking at all video-conferencing virtual clinics' visits during the pandemic with primary focus on cardiac outpatient clinic, addressing primary endpoints of need for admission or emergency visits from cardiac demises during the pandemic and secondary endpoint of patient satisfaction based on patients' experiences.

Results: A total of 6000 live care video-based chats were made over 10 months period from March 10^th, 2020, to January 30^th, 2021, among which 277 patients were evaluated in the virtual cardiac clinic, of these 193 (69.7%) were males, with mean age of 48 ± 15.60 (22.3%), patients were requested to present to clinic for further evaluation and testing, 20 (7.2%) patients were asked to visit the emergency room, of whom 8 (2.8%) patients were hospitalized. All 8 were admitted for high-risk findings that require immediate medical attention, 4/8 underwent cardiac catheterization, mean duration of admission was 2 ± 1 days. When compared to regular walk-in care, there was a statistical difference in admission rate and emergency visits p = 0.001 and p = 0.0001, respectively, both were statistically higher in the virtual clinic. The satisfaction rate in a 5-scale grading system was 97% of 4 and above recommending the continuation of the service beyond pandemic time.

Conclusions: Video-enhanced virtual cardiology clinic works safely and efficiently during COVID-19 pandemic with a difference in admission rate and ER visits when compared to walk-in clinic. It can be used during nonpandemic time to reduce load on hospital and clinic crowdedness. It also decreases the chances of COVID-19 transmission indirectly by reenforcing physical distance.