{"title":"Additional Abstract from the American Telemedicine Association's Fifth Annual Meeting May 21-24, 2000, Phoenix, Arizona.","authors":"","doi":"10.1089/107830200415243","DOIUrl":"https://doi.org/10.1089/107830200415243","url":null,"abstract":"","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 2","pages":"295"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200415243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21793293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A new "Tele-Echo System" for real-time telediagnosis using medical ultrasound (US) image sequences on a public digital network has been implemented and evaluated. The Tele-Echo System compresses and transmits US image sequences in real-time using a network bandwidth up to 1.5 Mbps. This system compresses US image sequences with Motion Picture Experts Group (MPEG) compression algorithm and transmits with Internet protocol (IP) and user datagram protocol (UDP). Experiments were conducted on the Tele-Echo System for US image sequences of the heart. The transmitted US image sequences contained 9% root-mean-square-error (RMSE) and a 30-dB peak signal-to-noise ratio (PSNR) when the size of images was 352 X 240 pixels, and the speed was about 27 frames per second. The experiments confirmed the clinical effectiveness of the Tele-Echo System for remote diagnosis. The transmission of US image sequences was conducted in a few seconds, and some contained noise. The "Tele-Echo System" enables real-time ultrasound imag...
{"title":"Case Report: Tele-Echo System: A Real-Time Telemedicine System Using Medical Ultrasound Image Sequence","authors":"T. Umeda, A. Matani, O. Oshiro, K. Chihara","doi":"10.1089/107830200311860","DOIUrl":"https://doi.org/10.1089/107830200311860","url":null,"abstract":"A new \"Tele-Echo System\" for real-time telediagnosis using medical ultrasound (US) image sequences on a public digital network has been implemented and evaluated. The Tele-Echo System compresses and transmits US image sequences in real-time using a network bandwidth up to 1.5 Mbps. This system compresses US image sequences with Motion Picture Experts Group (MPEG) compression algorithm and transmits with Internet protocol (IP) and user datagram protocol (UDP). Experiments were conducted on the Tele-Echo System for US image sequences of the heart. The transmitted US image sequences contained 9% root-mean-square-error (RMSE) and a 30-dB peak signal-to-noise ratio (PSNR) when the size of images was 352 X 240 pixels, and the speed was about 27 frames per second. The experiments confirmed the clinical effectiveness of the Tele-Echo System for remote diagnosis. The transmission of US image sequences was conducted in a few seconds, and some contained noise. The \"Tele-Echo System\" enables real-time ultrasound imag...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"63-67"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60618228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. J. Bauer, Benjamin R. Lee, J. Bishoff, G. Janetschek, P. Bunyaratavej, Wichean Kamolpronwijit, Supoj Ratchanon, Shannon O'Kelley, J. Cadeddu, S. Micali, F. Micali, Man Kay Li, Peter Goh, D. Png, L. Kavoussi
To determine the clinical utility of delivering remote subspecialty surgical care using a novel telesurgical mentoring system with current telemedicine technology. A personal computer-based system ...
{"title":"International surgical telementoring using a robotic arm: Our experience","authors":"J. J. Bauer, Benjamin R. Lee, J. Bishoff, G. Janetschek, P. Bunyaratavej, Wichean Kamolpronwijit, Supoj Ratchanon, Shannon O'Kelley, J. Cadeddu, S. Micali, F. Micali, Man Kay Li, Peter Goh, D. Png, L. Kavoussi","doi":"10.1089/107830200311824","DOIUrl":"https://doi.org/10.1089/107830200311824","url":null,"abstract":"To determine the clinical utility of delivering remote subspecialty surgical care using a novel telesurgical mentoring system with current telemedicine technology. A personal computer-based system ...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60618112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is disproportionately prevalent among African Americans compared with other ethnic groups. Furthermore, research demonstrating effective management strategies for this group is limited. The objectives of this study were to determine: (1) compliance with home blood pressure monitoring among hypertensive African Americans, and (2) the effectiveness of telemanagement in blood pressure control within 1-3 months. Participants used a transtelephonic home monitor that transmitted their blood pressure daily via their existing telephone lines to a university server system. A one-group, pre-post design was used. The sample included 33 African Americans (age 51.5 ± 14.3, 70% female) with uncontrolled blood pressures despite pharmacological treatment for ≥ 1 year. Interventions were conducted over the phone, including patient education and medication titration congruent with JNC-VI guidelines. Daily data were transmitted by 88% of the sample; significant decreases (p ≤ 0.001) in mean systolic (154.1 ± 16...
{"title":"The Effect of Home Monitoring and Telemanagement on Blood Pressure Control Among African Americans","authors":"M. Bondmass, N. Bolger, Gerard Castro, B. Avitall","doi":"10.1089/107830200311815","DOIUrl":"https://doi.org/10.1089/107830200311815","url":null,"abstract":"Hypertension is disproportionately prevalent among African Americans compared with other ethnic groups. Furthermore, research demonstrating effective management strategies for this group is limited. The objectives of this study were to determine: (1) compliance with home blood pressure monitoring among hypertensive African Americans, and (2) the effectiveness of telemanagement in blood pressure control within 1-3 months. Participants used a transtelephonic home monitor that transmitted their blood pressure daily via their existing telephone lines to a university server system. A one-group, pre-post design was used. The sample included 33 African Americans (age 51.5 ± 14.3, 70% female) with uncontrolled blood pressures despite pharmacological treatment for ≥ 1 year. Interventions were conducted over the phone, including patient education and medication titration congruent with JNC-VI guidelines. Daily data were transmitted by 88% of the sample; significant decreases (p ≤ 0.001) in mean systolic (154.1 ± 16...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311815","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60618019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to evaluate patient satisfaction when telemedicine is used for clinical consultations. Patient satisfaction data from 495 real-time interactive telemedicine clinical consultations at the Telemedicine Center at East Carolina University School of Medicine in Greenville, NC were collected and evaluated. Patient satisfaction was examined in relation to patient age, gender, race, income, education, and insurance. Overall patient satisfaction was found to be 98.3%. Because so few patients were dissatisfied with their telemedicine consultation, correlation with the sociodemographic variables was limited. Patients are highly satisfied with consultations through telemedicine, and report that care was easier to obtain. The sample size in this study is larger than other reported telemedicine studies, but its findings are consistent with those of previous studies. In non-telemedicine settings where patient satisfaction has been studied, several significant factors have been correlated ...
{"title":"Patient Satisfaction with Telemedicine","authors":"S. Gustke, D. Balch, V. West, L. Rogers","doi":"10.1089/107830200311806","DOIUrl":"https://doi.org/10.1089/107830200311806","url":null,"abstract":"The objective of this study was to evaluate patient satisfaction when telemedicine is used for clinical consultations. Patient satisfaction data from 495 real-time interactive telemedicine clinical consultations at the Telemedicine Center at East Carolina University School of Medicine in Greenville, NC were collected and evaluated. Patient satisfaction was examined in relation to patient age, gender, race, income, education, and insurance. Overall patient satisfaction was found to be 98.3%. Because so few patients were dissatisfied with their telemedicine consultation, correlation with the sociodemographic variables was limited. Patients are highly satisfied with consultations through telemedicine, and report that care was easier to obtain. The sample size in this study is larger than other reported telemedicine studies, but its findings are consistent with those of previous studies. In non-telemedicine settings where patient satisfaction has been studied, several significant factors have been correlated ...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60617962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent strategies for evaluating telemedicine attempt to incorporate broad issues such as medical effectiveness, optimal strategies for blending face to face and telemedicine, the direct and indirect costs of telemedicine services, accessibility, and patient and provider satisfaction. To address these issues, a scheme of evaluating telemedicine for a series of medical conditions or diagnoses has been recommended. The primary problem with this evaluation scheme is the need to assess telemedicine for each condition in which its use is proposed. This paper suggests an alternative framework for evaluation based on the clinical tasks that a physician or other health care provider must do to assess, treat, and follow patients. These tasks, which are employed in the care of most conditions, include visual tasks, auditory tasks, and instrumentation and palpation tasks. For each clinical task, the technology requirements for tools and settings would first be established. The scope and limitation of the tools for t...
{"title":"Communication: Telemedicine: A New Framework for Evaluation","authors":"B. Yawn","doi":"10.1089/107830200311851","DOIUrl":"https://doi.org/10.1089/107830200311851","url":null,"abstract":"Recent strategies for evaluating telemedicine attempt to incorporate broad issues such as medical effectiveness, optimal strategies for blending face to face and telemedicine, the direct and indirect costs of telemedicine services, accessibility, and patient and provider satisfaction. To address these issues, a scheme of evaluating telemedicine for a series of medical conditions or diagnoses has been recommended. The primary problem with this evaluation scheme is the need to assess telemedicine for each condition in which its use is proposed. This paper suggests an alternative framework for evaluation based on the clinical tasks that a physician or other health care provider must do to assess, treat, and follow patients. These tasks, which are employed in the care of most conditions, include visual tasks, auditory tasks, and instrumentation and palpation tasks. For each clinical task, the technology requirements for tools and settings would first be established. The scope and limitation of the tools for t...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311851","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60618170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A fully automated, passively activated data-acquisition system was developed to allow routine, continuous, nonobtrusive monitoring of selected Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADLs) and the production of a behavioral record that could be subjected to trend analysis. The monitoring system uses "off-the-shelf" technology - standard heat, motion, vibration, and electric current sensors - to record the presence or absence of selected behavior and the time, date, duration and frequency of occurrence of sensor signals. Unlike other telemedicine and personal response system applications, this approach monitors strictly object-oriented behavioral indicators. Hence, the individual is not required to wear any special apparatus nor press buttons. The individual continues to undertake her/his normal activity as if the system were not in place. Objects in the environment, e.g., pill bottle, the refrigerator door, a kitchen cabinet, are electronically monitored, but not the indiv...
{"title":"Behavioral Telemedicine: A New Approach to the Continuous Nonintrusive Monitoring of Activities of Daily Living","authors":"A. Glascock, D. Kutzik","doi":"10.1089/107830200311833","DOIUrl":"https://doi.org/10.1089/107830200311833","url":null,"abstract":"A fully automated, passively activated data-acquisition system was developed to allow routine, continuous, nonobtrusive monitoring of selected Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADLs) and the production of a behavioral record that could be subjected to trend analysis. The monitoring system uses \"off-the-shelf\" technology - standard heat, motion, vibration, and electric current sensors - to record the presence or absence of selected behavior and the time, date, duration and frequency of occurrence of sensor signals. Unlike other telemedicine and personal response system applications, this approach monitors strictly object-oriented behavioral indicators. Hence, the individual is not required to wear any special apparatus nor press buttons. The individual continues to undertake her/his normal activity as if the system were not in place. Objects in the environment, e.g., pill bottle, the refrigerator door, a kitchen cabinet, are electronically monitored, but not the indiv...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"33-44"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60617684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of videoconferencing enables a primary care provider and patient at one location to confer with a specialist at a distant site. Although this encounter may benefit all parties, this arrange...
{"title":"Specialist–Primary Care Provider–Patient Communication in Telemedical Consultations","authors":"R. Street, E. Wheeler, W. McCaughan","doi":"10.1089/107830200311842","DOIUrl":"https://doi.org/10.1089/107830200311842","url":null,"abstract":"The use of videoconferencing enables a primary care provider and patient at one location to confer with a specialist at a distant site. Although this encounter may benefit all parties, this arrange...","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"45-54"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311842","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60617864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: Telemedicine Nomenclature: What Does It Mean?","authors":"R. Bashshur","doi":"10.1089/107830200311798","DOIUrl":"https://doi.org/10.1089/107830200311798","url":null,"abstract":"","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2000-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200311798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60617897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F Y Chan, B Soong, K Lessing, D Watson, R Cincotta, S Baker, M Smith, E Green, J Whitehall
Congenital fetal abnormalities are major causes of perinatal mortality and morbidity. The performance of ultrasound in the diagnosis and assessment of fetal anomalies varies enormously between tertiary referral centers and general units. Telemedicine offers a chance for tertiary realtime ultrasound consultations using standard telephone lines for remote sites. Preliminary investigations by our group have shown that real-time transmission of fetal ultrasound images over long distances via telephone (integrated systems digital network [ISDN]) lines is technically feasible. A live link of up to 2 Mb/s was established between Mater Mothers Hospital in Brisbane and Kirwan Hospital for Women in Townsville, which are 1,500 km apart. The objective of the current study was to evaluate the clinical value of a tertiary teleultrasound consultation service. Patients requiring tertiary ultrasound consultations were recruited from North Queensland. Clinicians from the referral site established an initial diagnosis and management plan. Using standard ISDN lines, the real-time ultrasound images were transmitted to the maternal fetal medicine subspecialists in Brisbane. The ultrasound examination was completed under the direction of the subspecialist. The subspecialist explained the findings to the patient at the end of the session, and discussed the diagnosis and management plans with the clinicians involved. Any diagnosis and management variations were classified into minor and major upon agreement by the two teams of clinicians involved. The clinicians and patients in Townsville rated the value of the consultation, and the subspecialists rated the confidence of their diagnoses on five-point scales. Pregnancy outcomes were obtained and the data analyzed. Over a 3-month period, 24 teleultrasound consultations were carried out. The indications for referral were: assessment of growth restriction/fetal wellbeing in the third trimester (6); detailed assessment for high-risk patients (5); evaluation of markers for anomalies (5); isolated fetal anomalies (1); and complex fetal problems such as twin/twin transfusion, multiple anomalies, etc. (7). Overall, the consultations resulted in some modifications to the clinical diagnosis in 45.8% of the cases, and modifications to the management plan in 33.3% of the cases (about half of which were minor variations). The clinicians rated the teleconsultations highly (mean rating 4.7, SD 0.44). The patients also rated the consultations highly, and were comfortable that their privacy and confidentiality were maintained during the consultation. The subspecialists were confident in making their diagnoses by telemedicine (mean score for confidence 4.2, SD 0.43). All the pregnancies have now been completed, with all antenatal diagnoses confirmed to be correct postnatally. Tertiary real-time ultrasound consultation by telemedicine is not only technically feasible, it is welcomed by the clinicians and patients involved. It also con
{"title":"Clinical value of real-time tertiary fetal ultrasound consultation by telemedicine: preliminary evaluation.","authors":"F Y Chan, B Soong, K Lessing, D Watson, R Cincotta, S Baker, M Smith, E Green, J Whitehall","doi":"10.1089/107830200415171","DOIUrl":"https://doi.org/10.1089/107830200415171","url":null,"abstract":"<p><p>Congenital fetal abnormalities are major causes of perinatal mortality and morbidity. The performance of ultrasound in the diagnosis and assessment of fetal anomalies varies enormously between tertiary referral centers and general units. Telemedicine offers a chance for tertiary realtime ultrasound consultations using standard telephone lines for remote sites. Preliminary investigations by our group have shown that real-time transmission of fetal ultrasound images over long distances via telephone (integrated systems digital network [ISDN]) lines is technically feasible. A live link of up to 2 Mb/s was established between Mater Mothers Hospital in Brisbane and Kirwan Hospital for Women in Townsville, which are 1,500 km apart. The objective of the current study was to evaluate the clinical value of a tertiary teleultrasound consultation service. Patients requiring tertiary ultrasound consultations were recruited from North Queensland. Clinicians from the referral site established an initial diagnosis and management plan. Using standard ISDN lines, the real-time ultrasound images were transmitted to the maternal fetal medicine subspecialists in Brisbane. The ultrasound examination was completed under the direction of the subspecialist. The subspecialist explained the findings to the patient at the end of the session, and discussed the diagnosis and management plans with the clinicians involved. Any diagnosis and management variations were classified into minor and major upon agreement by the two teams of clinicians involved. The clinicians and patients in Townsville rated the value of the consultation, and the subspecialists rated the confidence of their diagnoses on five-point scales. Pregnancy outcomes were obtained and the data analyzed. Over a 3-month period, 24 teleultrasound consultations were carried out. The indications for referral were: assessment of growth restriction/fetal wellbeing in the third trimester (6); detailed assessment for high-risk patients (5); evaluation of markers for anomalies (5); isolated fetal anomalies (1); and complex fetal problems such as twin/twin transfusion, multiple anomalies, etc. (7). Overall, the consultations resulted in some modifications to the clinical diagnosis in 45.8% of the cases, and modifications to the management plan in 33.3% of the cases (about half of which were minor variations). The clinicians rated the teleconsultations highly (mean rating 4.7, SD 0.44). The patients also rated the consultations highly, and were comfortable that their privacy and confidentiality were maintained during the consultation. The subspecialists were confident in making their diagnoses by telemedicine (mean score for confidence 4.2, SD 0.43). All the pregnancies have now been completed, with all antenatal diagnoses confirmed to be correct postnatally. Tertiary real-time ultrasound consultation by telemedicine is not only technically feasible, it is welcomed by the clinicians and patients involved. It also con","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"6 2","pages":"237-42"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/107830200415171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21793286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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