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A cost-effectiveness analysis of shipboard telemedicine. 船载远程医疗的成本效益分析。
P H Stoloff, F E Garcia, J E Thomason, D S Shia

Background: The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships. Besides improving the quality of care, benefits would arise from avoiding medical evacuations (MEDEVACs) and returning patients to work more quickly. Because telemedicine has not yet been fully implemented by the Navy, we relied on projections of anticipated savings and costs, rather than actual expenditures, to determine cost-effectiveness.

Objectives: To determine the demand for telemedicine and the cost-effectiveness of various technologies (telephone and fax, e-mail and Internet, video teleconferencing (VTC), teleradiology, and diagnostic instruments), as well as their bandwidth requirements.

Methods: A panel of Navy medical experts with telemedicine experience reviewed a representative sample of patient visits collected over a 1-year period and estimated the man-day savings and quality-of-care enhancements that might have occurred had telemedicine technologies been available. The savings from potentially avoiding MEDEVACs was estimated from a survey of ships' medical staff. These sample estimates were then projected to the medical workload of the entire fleet. Off-the-shelf telemedicine equipment prices were combined with installation, maintenance, training, and communication costs to obtain the lifecycle costs of the technology.

Results and conclusions: If telemedicine were available to the fleet, ship medical staffs would initiate nearly 19, 000 consults in a year-7% of all patient visits. Telemedicine would enhance quality of care in two-thirds of these consults. Seventeen percent of the MEDEVACs would be preventable with telemedicine (representing 155,000 travel miles), with a savings of $4400 per MEDEVAC. If the ship's communication capabilities were available, e-mail and Internet and telephone and fax would be cost-effective on all ships (including small ships and submarines). Video teleconferencing would be cost-effective on large ships (aircraft carriers and amphibious) only. Teleradiology would be cost-effective on carriers only. Telemedicine's bandwidth requirement is small-1% of a month's time. However, if the ships' medical departments need to resort to a commercial satellite, E-mail and Internet would be the only telemedicine modality generating enough monetary benefits to offset the costs.

背景:美国海军正在考虑在300多艘舰艇上安装远程医疗设备。除了提高护理质量外,避免医疗后送和更快地让病人重返工作岗位也会带来好处。由于远程医疗尚未在海军全面实施,我们依赖于预期节省和成本的预测,而不是实际支出,来确定成本效益。目的:确定远程医疗的需求和各种技术(电话和传真、电子邮件和互联网、视频电话会议(VTC)、远程放射学和诊断仪器)的成本效益,以及它们的带宽需求。方法:具有远程医疗经验的海军医学专家小组回顾了1年期间收集的有代表性的患者就诊样本,并估计了如果远程医疗技术可用,可能会节省人力和提高护理质量。通过对船舶医务人员的调查估计,可能避免使用医疗后送设备所节省的费用。然后将这些样本估计值预测到整个船队的医疗工作量。将现成的远程医疗设备价格与安装、维护、培训和通信成本相结合,以获得该技术的生命周期成本。结果和结论:如果远程医疗在船队中可用,船上医务人员每年将启动近19,000次咨询,占所有患者就诊的7%。远程医疗将提高三分之二的咨询服务质量。17%的医疗后送直升机可以通过远程医疗来预防(相当于155,000英里的行程),每架医疗后送直升机可以节省4400美元。如果舰艇的通信能力可用,电子邮件和因特网、电话和传真在所有舰艇(包括小型舰艇和潜艇)上将具有成本效益。视频电话会议只有在大型船只(航空母舰和两栖)上才具有成本效益。电视放射学只有在载体上才具有成本效益。远程医疗的带宽需求很小,仅占一个月时间的1%。然而,如果船上的医疗部门需要求助于商业卫星,电子邮件和互联网将是唯一的远程医疗模式,产生足够的金钱效益来抵消成本。
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引用次数: 25
Use of videophones and low-cost standard telephone lines to provide a social presence in telepsychiatry. 使用可视电话和低成本标准电话线在远程精神病学中提供社交存在。
P Cukor, L Baer, B S Willis, L Leahy, J O'Laughlen, M Murphy, M Withers, E Martin

Research findings suggest that the value added by the video channel of currently available video conferencing technology is limited to the creation of a social presence of the other party. Almost all clinical information exchange takes place on the audio channel, while the interpersonal interactions (nods, blinks, facial expressions, and body language), which are so important in a face-to-face meeting, may not be adequately captured by the video. Several of our case studies are presented which suggest that, consistent with the social presence role for video, low-cost videophones may be effectively substituted for expensive ISDN-based systems in many mental health applications.

研究结果表明,目前可用的视频会议技术的视频通道的附加值仅限于创造对方的社交存在。几乎所有的临床信息交流都是通过音频渠道进行的,而在面对面会议中非常重要的人际互动(点头、眨眼、面部表情和肢体语言)可能无法被视频充分捕捉到。我们提出的几个案例研究表明,与视频的社会存在作用相一致,在许多心理健康应用中,低成本的视频电话可以有效地取代昂贵的基于isdn的系统。
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引用次数: 91
Applications of telemedicine in the United States space program. 远程医疗在美国空间计划中的应用。
C R Doarn, A E Nicogossian, R C Merrell

Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth.

自人类太空飞行开始以来,美国宇航局一直将人类置于极端和偏远的环境中。在外层空间维持人类存在许多挑战,包括提供生命支持系统、辐射屏蔽和尽量减少微重力影响的对策。因为宇航员是根据他们的健康和其他因素来选择的,所以疾病和疾病被降到最低。然而,它仍然是非常重要的,有适当的医疗保健系统,以解决疾病和伤害,如果他们发生。除了阿波罗计划外,对太空的探索一直局限于距离地球表面几百英里以内的任务。在21世纪和新千年来临之际,人类的探索将集中在国际空间站(ISS)的运行和人类火星任务的准备上。这些特派团将给人类健康带来固有的风险,因此必须制定适当的计划来应对这些挑战和风险。执行长期任务的机组人员必须更加独立于地面控制人员。新的制度、协议和程序正在不断完善。信息系统和电信领域新兴技术的应用对飞行医疗至关重要。通过远程医疗应用这些技术将为机组人员提供信息访问、评估健康状况的非侵入性程序,并通过传感器、全息技术、决策支持系统和虚拟环境的集成进行指导。这些技术还将作为加强培训和医学教育的基础。空间飞行医疗保健的设计应导致重新设计地球上的医疗实践。
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引用次数: 76
Telemedicine should never be a substitute for training. 远程医疗永远不应该取代培训。
J Navein
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引用次数: 0
Effect of ISDN bandwidth on image quality for telemedicine transmission of obstetric ultrasonography. ISDN带宽对产科超声远程医疗传输图像质量的影响
F D Malone, A Athanassiou, J Nores, M E D'Alton

Objective: To evaluate objectively the effect of different bandwidths on the ability to interpret obstetric ultrasound scans transmitted live over a commercial telephone network.

Materials and methods: An integrated services digital network (ISDN) was established from three satellite offices to our central prenatal diagnostic center. In the first half of the study, the network was based on four ISDN channels transmitting at a bandwidth of 256 kbits per second (kbps), while in the second half of the study, this was increased to six ISDN channels transmitting at 384 kbps. A physician trained in obstetric ultrasonography provided an interpretation of fetal anatomy using a live, real-time telemedicine link. A scoring system consisting of 33 anatomic items was used to evaluate image quality objectively. The number of transmissions complicated by motion artifact was also recorded.

Results: One hundred patients had a fetal anatomy survey performed using the 256 kbps system, and these interpretations were compared with those from another group of 100 patients who were examined using the 384 kbps system. Although the visibility of the 33 anatomic items was similar using the two systems, significantly more examinations at 256 kbps were complicated by motion artifact (12% vs. 3%; P = 0.02).

Conclusions: Remote sonographic viewing of fetal anatomy was adequate using both 256 and 384 kbps systems, although motion artifact was significantly more likely to occur using the slower system. This problem may affect the ability of the lower-bandwidth system to allow optimal detection when fetal anomalies are present.

目的:客观评价不同带宽对商业电话网络产科超声扫描实时传输能力的影响。材料和方法:从三个卫星办公室到我们的中心产前诊断中心建立了综合服务数字网络(ISDN)。在研究的前半部分,网络基于4个ISDN通道,传输带宽为256 kb / s (kbps),而在研究的后半段,这一数字增加到6个ISDN通道,传输带宽为384 kb / s。一位接受过产科超声检查培训的医生通过实时远程医疗链接对胎儿解剖进行了解释。采用由33个解剖项目组成的评分系统对图像质量进行客观评价。同时记录了运动伪影导致的传输次数。结果:100名患者使用256 kbps系统进行了胎儿解剖调查,并将这些解释与另一组使用384 kbps系统检查的100名患者进行了比较。尽管两种系统对33个解剖项目的可见性是相似的,但在256 kbps下,明显更多的检查因运动伪影而复杂化(12% vs. 3%;P = 0.02)。结论:使用256和384 kbps系统时,胎儿解剖的远程超声观察是足够的,尽管使用较慢的系统时,运动伪影明显更容易发生。这个问题可能会影响低带宽系统的能力,以便在胎儿异常时进行最佳检测。
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引用次数: 29
Cost-minimization analysis: A follow-up study of a telemedicine program. 成本最小化分析:远程医疗项目的后续研究。
M J McCue, P E Mazmanian, C L Hampton, T K Marks, E J Fisher, F Parpart, W N Malloy, K J Fisk

Objective: To present the follow-up findings to a cost-benefit analysis of telemedicine subspecialty services provided between the Powhatan Correctional Center (PCC) of the Virginia Department of Corrections and the Medical College of Virginia Campus of Virginia Commonwealth University (MCV Campus).

Methods: Costs included those of operating the telemedicine system, transportation, litigation avoidance, and the medical care itself.

Results: Over a 12-month study period, the total number of consults completed through telemedicine was 290. The cost per visit of treating inmates at the MCV Campus clinics was $401. The cost per visit of treating inmates at PCC via telemedicine was $387, a net saving of $14 per visit with the use of telemedicine.

Conclusion: As a result of implementing telemedicine, the Department of Corrections for the State of Virginia was able to achieve a cost saving of $14 per visit. Nonmonetary cost savings, such as greater security and increased access to care, should be considered a net benefit as well.

目的:介绍弗吉尼亚惩教部波瓦坦惩教中心(PCC)与弗吉尼亚联邦大学弗吉尼亚校区医学院(MCV校区)之间提供远程医疗亚专科服务的成本效益分析的随访结果。方法:费用包括远程医疗系统的运行费用、交通费用、避免诉讼费用和医疗费用。结果:在12个月的研究期间,通过远程医疗完成的咨询总数为290。在MCV校园诊所治疗囚犯的每次就诊费用为401美元。通过远程医疗在PCC治疗囚犯的每次就诊费用为387美元,使用远程医疗每次就诊净节省14美元。结论:由于实施了远程医疗,弗吉尼亚州惩戒局每次就诊可节省14美元的费用。非货币性成本节约,如更高的安全性和更多的医疗服务,也应被视为一种净收益。
{"title":"Cost-minimization analysis: A follow-up study of a telemedicine program.","authors":"M J McCue,&nbsp;P E Mazmanian,&nbsp;C L Hampton,&nbsp;T K Marks,&nbsp;E J Fisher,&nbsp;F Parpart,&nbsp;W N Malloy,&nbsp;K J Fisk","doi":"10.1089/tmj.1.1998.4.323","DOIUrl":"https://doi.org/10.1089/tmj.1.1998.4.323","url":null,"abstract":"<p><strong>Objective: </strong>To present the follow-up findings to a cost-benefit analysis of telemedicine subspecialty services provided between the Powhatan Correctional Center (PCC) of the Virginia Department of Corrections and the Medical College of Virginia Campus of Virginia Commonwealth University (MCV Campus).</p><p><strong>Methods: </strong>Costs included those of operating the telemedicine system, transportation, litigation avoidance, and the medical care itself.</p><p><strong>Results: </strong>Over a 12-month study period, the total number of consults completed through telemedicine was 290. The cost per visit of treating inmates at the MCV Campus clinics was $401. The cost per visit of treating inmates at PCC via telemedicine was $387, a net saving of $14 per visit with the use of telemedicine.</p><p><strong>Conclusion: </strong>As a result of implementing telemedicine, the Department of Corrections for the State of Virginia was able to achieve a cost saving of $14 per visit. Nonmonetary cost savings, such as greater security and increased access to care, should be considered a net benefit as well.</p>","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"4 4","pages":"323-7"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/tmj.1.1998.4.323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21091204","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}
引用次数: 30
Effectiveness of telemedicine in the outpatient pulmonary clinic. 远程医疗在肺科门诊的应用效果。
E R Pacht, J W Turner, M Gailiun, L A Violi, D Ralston, H S Mekhjian, R C St John

Background: Over the past several years, there has been a resurgence of interest in telemedicine. Despite this renewed interest, some health care providers remain skeptical regarding the effectiveness of telemedicine for the delivery of health care.

Objective: The objective of this prospective, crossover study was to determine if there was any difference between care delivered using video conferencing-based telemedicine technology and that given by a traditional face-to-face encounter in a pulmonary medicine clinic.

Methods: Two pulmonologists sequentially examined 40 individuals via video conferencing-based telemedicine technology and by the traditional face-to-face method. Two additional pulmonologists, in a blinded fashion, compared the results for consistency in the history, examination with focus on auscultation of the lungs, diagnostic impression, and evaluation and treatment plans.

Results: Evaluation of patients by telemedicine was as effective as the traditional mode. The telemedicine physician and the physician examining the patient in the traditional manner were able to elicit the same key complaints and hear the same adventitious sounds on auscultation of the lungs.

Conclusion: Telemedicine can enable the provision of high-quality care in a pulmonary clinic setting.

背景:在过去的几年里,人们对远程医疗的兴趣重新燃起。尽管有这种新的兴趣,一些卫生保健提供者仍然对远程医疗提供卫生保健的有效性持怀疑态度。目的:这项前瞻性交叉研究的目的是确定使用基于视频会议的远程医疗技术提供的护理与在肺部医学诊所传统的面对面接触提供的护理之间是否存在差异。方法:两名肺科医生分别通过基于视频会议的远程医疗技术和传统的面对面方法对40名患者进行了检查。另外两名肺科医生采用盲法比较了病史、肺部听诊检查、诊断印象、评估和治疗方案的一致性。结果:远程医疗对患者的评价与传统模式一样有效。远程医疗医生和以传统方式检查患者的医生能够引出相同的主要主诉,并在肺部听诊中听到相同的外来声音。结论:远程医疗可以为肺部临床提供高质量的护理。
{"title":"Effectiveness of telemedicine in the outpatient pulmonary clinic.","authors":"E R Pacht,&nbsp;J W Turner,&nbsp;M Gailiun,&nbsp;L A Violi,&nbsp;D Ralston,&nbsp;H S Mekhjian,&nbsp;R C St John","doi":"10.1089/tmj.1.1998.4.287","DOIUrl":"https://doi.org/10.1089/tmj.1.1998.4.287","url":null,"abstract":"<p><strong>Background: </strong>Over the past several years, there has been a resurgence of interest in telemedicine. Despite this renewed interest, some health care providers remain skeptical regarding the effectiveness of telemedicine for the delivery of health care.</p><p><strong>Objective: </strong>The objective of this prospective, crossover study was to determine if there was any difference between care delivered using video conferencing-based telemedicine technology and that given by a traditional face-to-face encounter in a pulmonary medicine clinic.</p><p><strong>Methods: </strong>Two pulmonologists sequentially examined 40 individuals via video conferencing-based telemedicine technology and by the traditional face-to-face method. Two additional pulmonologists, in a blinded fashion, compared the results for consistency in the history, examination with focus on auscultation of the lungs, diagnostic impression, and evaluation and treatment plans.</p><p><strong>Results: </strong>Evaluation of patients by telemedicine was as effective as the traditional mode. The telemedicine physician and the physician examining the patient in the traditional manner were able to elicit the same key complaints and hear the same adventitious sounds on auscultation of the lungs.</p><p><strong>Conclusion: </strong>Telemedicine can enable the provision of high-quality care in a pulmonary clinic setting.</p>","PeriodicalId":79734,"journal":{"name":"Telemedicine journal : the official journal of the American Telemedicine Association","volume":"4 4","pages":"287-92"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/tmj.1.1998.4.287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21091200","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}
引用次数: 30
Telemedicine in Nova Scotia: report of a pilot study. 新斯科舍省的远程医疗:一项试点研究报告。
D S Reid, L E Weaver, J M Sargeant, M J Allen, W F Mason, P J Klotz, D B Langille

Objective: To provide and evaluate telemedicine services for rural physicians and patients in Nova Scotia.

Materials and methods: As a pilot project, three telemedicine services (videoconference continuing medical education [CME], teledermatology, and teleradiology) were provided to four hospitals in Nova Scotia communities. All four sites received CME (a total of 269 physicians, 53 other health care professionals); three sites received teledermatology (66 consultations), and two sites received teleradiology (808 radiologic examinations). At the consulting site, 12 faculty members presented 24 one-hour videoconferences, and there was one consulting radiologist and dermatologist. Each service was evaluated independently. Methods included participant questionnaires; focus groups; numbers and categories of participants or examinations; comparison of operational costs, capitol costs (teledermatology and teleradiology), and travel costs (CME); technical assessments of hardware, software, and telecommunications; assessment of clinical diagnostic procedures (teledermatology); and comparative study of original and digitized films (teleradiology).

Results: Despite growing pains, the technologies effectively provided the three services: the services were acceptable to referring and consulting physicians and patients. Improvements in patient care and outcomes comparable to those of traditional methods were demonstrated in teleradiology and teledermatology, especially for emergencies. Physician access to CME and patient access to dermatology consultation services were improved. Financial savings were demonstrated for CME, but further investigation is required to determine the savings attributable to teleradiology and teledermatology.

Conclusions: The telemedicine services supported rural physicians, their patients, and their communities. Although telemedicine is not a panacea for all concerns of rural physicians, the pilot project provided a strong foundation for further development and study.

目的:为新斯科舍省农村医生和患者提供远程医疗服务并进行评估。材料和方法:作为一个试点项目,向新斯科舍省社区的四家医院提供了三种远程医疗服务(视频会议继续医学教育[CME]、远程皮肤科和远程放射学)。所有四个地点都接受了CME(共有269名医生,53名其他卫生保健专业人员);3个站点接受了远程皮肤科(66次咨询),2个站点接受了远程放射学(808次放射检查)。在咨询现场,12名教师进行了24次一小时的视频会议,还有一名放射科医生和皮肤科医生。每个服务都是独立评估的。方法包括参与者问卷调查;焦点小组;参加或考试的人数和类别;比较运营成本、资本成本(远程皮肤科和远程放射学)和差旅成本(CME);硬件、软件和电信的技术评估;临床诊断程序评估(远程皮肤科);以及原始影像与数字化影像(远程放射学)的比较研究。结果:在成长的痛苦中,该技术有效地提供了三项服务:转诊医师和患者都能接受服务。与传统方法相比,远程放射学和远程皮肤病学的病人护理和结果得到了改善,特别是在急诊方面。医师获得CME的机会和患者获得皮肤科咨询服务的机会得到改善。财务上的节省已被证明用于CME,但需要进一步的调查来确定远程放射学和远程皮肤科的节省。结论:远程医疗服务支持农村医生、患者和社区。虽然远程医疗不是解决农村医生所有问题的灵丹妙药,但该试点项目为进一步发展和研究提供了坚实的基础。
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引用次数: 44
The Ottawa telehealth project. 渥太华远程保健项目。
S T Cheung, R F Davies, K Smith, R Marsh, H Sherrard, W J Keon

Objective: To examine the telehealth system as a means of improving access to cardiac consultations and specialized health services in remote areas of Ontario.

Methods: The University of Ottawa Heart Institute has set up a telehealth test program, Healthcare and Education Access for Remote Residents by Telecommunications (HEARRT), in collaboration with industry and the provincial and federal government, as well as several remote clinical test sites. The program makes off-site cardiology consultations possible. History taking and physical examinations are conducted by video and electronic stethoscope. Laboratory results and echocardiograms are transmitted by document camera and VCR. The technology is being tested in both stable outpatient and emergency situations. Various telecommunications bandwidths and encoding systems are being evaluated, including satellite and terrestrial-based asynchronous transfer-mode circuits. Patient satisfaction and cost-effectiveness are also being assessed.

Results: Bandwidths from as low as 384 kbps using H.320 encoders to 40 Mbps using digital transport of NTSC video signals have been evaluated. Although lower bandwidths are sufficient for sending echocardiographic and electrocardiogram data, bandwidths with transport speeds of 4 to 6 Mbps appear necessary to capture the nuances of the cardiac physical examination. A preliminary satisfaction survey of 19 patients noted that all felt that they could communicate effectively with the cardiologist by video, and each had confidence in the advice offered. None reported that he or she would rather have traveled to the doctor in person. Initial and projected examination of the costs suggested that telehealth will effectively reduce overall health care spending while decreasing travel expenses for rural patients.

Conclusion: Telehealth technology is sufficiently sophisticated to allow off-site cardiology assessments. Preliminary results suggest there is a sound business case for the implementation of telehealth technology to meet the needs of remote residents in northern Ontario. Working closely with government and industry, we will develop a marketing and commercialization plan to support the use of this technology throughout Ontario and expand application to patient education and continuing medical education.

目的:检查远程医疗系统作为一种手段,改善获得心脏咨询和专门的卫生服务在安大略省偏远地区。方法:渥太华大学心脏研究所与工业界、省和联邦政府以及几个远程临床试验点合作,建立了一个远程医疗测试项目,即通过电信为偏远居民提供医疗保健和教育服务(Heart)。该项目使异地心脏病咨询成为可能。录象和电子听诊器进行病史记录和体格检查。实验室结果和超声心动图由文件摄像机和录像机传送。这项技术正在稳定的门诊和紧急情况下进行测试。目前正在评估各种电信带宽和编码系统,包括卫星和地面异步传输模式电路。还在评估患者满意度和成本效益。结果:使用H.320编码器的带宽低至384kbps,使用NTSC视频信号的数字传输的带宽为40mbps。虽然较低的带宽足以发送超声心动图和心电图数据,但传输速度为4至6mbps的带宽对于捕捉心脏体检的细微差别似乎是必要的。对19名患者的初步满意度调查表明,所有患者都认为他们可以通过视频与心脏病专家进行有效沟通,并且每个人都对提供的建议充满信心。没有人报告说他或她宁愿亲自去看医生。对费用进行的初步和预计审查表明,远程保健将有效减少总体保健支出,同时减少农村病人的差旅费。结论:远程医疗技术足够成熟,可以进行非现场心脏病学评估。初步结果表明,实施远程保健技术以满足安大略省北部偏远地区居民的需求具有良好的商业案例。我们将与政府和工业界密切合作,制定一项营销和商业化计划,以支持在整个安大略省使用这项技术,并将其应用于患者教育和继续医学教育。
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引用次数: 23
Telekid Care: bringing health care into schools. 远程医疗:将医疗保健引入学校。
P Whitten, D J Cook, P Shaw, D Ermer, J Goodwin

Background: Telekid Care is a project that attempts to overcome the health and educational barriers faced by children in urban Kansas City, Kansas. Telemedicine units were placed in school nurses' offices and linked to physicians at the University of Kansas Medical Center (KUMC). This paper describes the development of this project, presents utilization data, and discuss the lessons learned from the application of telemedicine in a school setting.

Results: Project developers spent 11 months designing the protocol and procedures for a pilot test. Four elementary schools participated, and 187 consultations were conducted. The most common reason for consultation was ear, nose, and throat (ENT) problems, making up 28% of all consults. Mandatory school physical examinations and dermatology problems combined to make up an additional 40% of the consults. The average time that elapsed between the request for a consult and confirmation of an appointment was 23 minutes. When immediate service was requested, 85% of the consults occurred the day of the request. These results strongly demonstrate telemedicine's ability to offer immediate service to children in need.

Conclusion: Telemedicine enabled underserved inner-city children to gain access to health services. This service was most effective when it was integrated into the delivery system. Furthermore, community groups strongly favored the project, positively influencing its acceptance as an innovative health care delivery system.

背景:远程儿童护理是一个项目,旨在克服堪萨斯城儿童面临的健康和教育障碍。远程医疗单元被安置在学校护士办公室,并与堪萨斯大学医学中心(KUMC)的医生联系起来。本文描述了该项目的发展,提供了使用数据,并讨论了远程医疗在学校环境中的应用所获得的经验教训。结果:项目开发人员花了11个月的时间为试点测试设计协议和程序。有四所小学参与,进行了187次咨询。最常见的咨询原因是耳鼻喉科(ENT)的问题,占所有咨询的28%。强制性的学校体检和皮肤病问题加起来占咨询的另外40%。从请求咨询到确认预约之间的平均时间为23分钟。当要求立即提供服务时,85%的咨询在请求当天发生。这些结果有力地证明了远程医疗为有需要的儿童提供即时服务的能力。结论:远程医疗使得不到充分服务的市中心儿童能够获得保健服务。当这项服务被整合到递送系统中时,它是最有效的。此外,社区团体强烈支持该项目,积极影响其作为创新医疗保健提供系统的接受程度。
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引用次数: 28
期刊
Telemedicine journal : the official journal of the American Telemedicine Association
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