Loose Coupling and Healthcare Organizations: Deployment Strategies for Groupware

The impact of video consultation on interprofessional collaboration and professional roles: a simulation-based study in prehospital stroke chain of care

Healthcare is often conducted by interprofessional teams. Research has shown that diverse groups with their own terminology and culture greatly influence collaboration and patient safety. Previous studies have focused on interhospital teams, and very little attention has been paid to team collaboration between intrahospital and prehospital care. Addressing this gap, the current study simulated a common and time-critical event for ambulance nurses (AN) that also required contact with a stroke specialist in a hospital. Today such consultations are usually conducted over the phone, this simulation added a video stream from the ambulance to the neurologist on call. The aim of this study was to explore interprofessional collaboration between AN's and neurologists when introducing video-support in the prehospital stroke chain of care. The study took place in Western Sweden. The simulated sessions were video recorded, and the participants were interviewed after the simulation. The results indicate that video has a significant impact on collaboration and can help to facilitate better understanding among different professional groups. The participants found the video to be a valuable complement to verbal information. The result also showed challenges in the form of a loss of patient focused care. Both ANs and neurologists saw the video as benefiting patient safety.

VISYTER: versatile and integrated system for telerehabilitation

The versatile and integrated system for telerehabilitation (VISYTER) is a software platform for developing various telerehabilitation applications. VISYTER has been designed to take into account the environments and requirements of rehabilitation services. The requirements considered in the platform design include minimal equipment beyond what is available in many rehabilitation settings, minimal maintenance, and ease of setup and operation. In addition, the platform has been designed to be able to adjust to different bandwidths, ranging from the very fast new generation of Internet to residential broadband connections. VISYTER is a secure integrated system that combines high-quality videoconferencing with access to electronic health records and other key tools in telerehabilitation such as stimuli presentation, remote multiple camera control, remote control of the display screen, and an eye contact teleprompter. The software platform is suitable for supporting low-volume services to homes, yet scalable to support high-volume enterprise-wide telehealth services. The VISYTER system has been used to develop a number of telerehabilitation applications, including a remote wheelchair prescription, adult autistic assessments, and international physical therapy teleconsultations. An evaluation of VISYTER for delivering a remote wheelchair prescription was conducted on 48 participants. Results of the evaluation indicate a high level of satisfaction from patients with the use of VISYTER. The versatility and cost-effectiveness of the platform has the potential for a wide range of telerehabilitation applications and potentially may lower the technical and economic barriers of telemedicine adoption.