The telemedicine information exchange: an online resource

Perception towards the implementation of telemedicine during COVID-19 pandemic: a cross-sectional study

BACKGROUND

The COVID-19 pandemic has led to a surge in the use of telemedicine as a means of delivering healthcare services remotely. Healthcare providers play a key role in the adoption and implementation of telemedicine for its effectiveness. Despite its benefits, there have been unclear concerns about its effectiveness and acceptance in the process of implementing telemedicine. The objective of the study was to assess health professionals' perceptions towards the implementation of telemedicine during the COVID-19 pandemic.

METHODS

A cross-sectional study design was conducted among eight hundred forty-five study participants from December 2020 to February 2021. A pre-test was performed on 5% of the total sample size, and the quality of the data was ensured by checking its completeness and consistency. Descriptive statistics and bivariable and multivariable logistic regression were used. The Variables with a P-value equal to or less than 0.25 in bivariable logistic regression were entered into a multivariable logistic regression, and model fitness was assessed.

RESULT

The study revealed that 60.9% of professionals had a good perception toward telemedicine implementation, with an 87.2% response rate. Health professionals with IT support staff, ICT training, who use social media platforms regularly, and availability of computer or smartphone within/outside their health facility were 4.7, 3.3, 3.7, and 13.2 times more likely to have a positive association towards telemedicine implementation respectively.

CONCLUSION

More than half of the health professionals had a good perception of telemedicine. Social media use, ICT training, computer accessibility, and the presence of IT support staff were all found to have positive associations with the telemedicine perception. In the era of the COVID-19 pandemic, the government should take the initiative to strengthen opportunities for health professionals to learn and apply telemedicine in their medical practice by providing ICT training, IT infrastructure and support staff, improving computer access, and recommending health professionals' positive use of social media in the health facility.

Quality evaluation of signals collected by portable ECG devices using dimensionality reduction and flexible model integration

OBJECTIVE

Portable devices for collecting electrocardiograms (ECGs) and telemedicine systems for diagnosis are available to residents in deprived areas, but ECGs collected by non-professionals are not necessarily reliable and may impair the accuracy of diagnosis. We propose an algorithm for accurate ECG quality assessment, which can help improve the reliability of ECGs collected by portable devices.

APPROACH

Using challenge data from CinC (2019), signals were classified as 'acceptable' and 'unacceptable' by annotators. The training set contained 998 12-lead ECGs and the test set contained 500. A 998 × 84 feature matrix, S, was formed by feature extraction and three basic models were obtained through training SVM, DT and NBC on S. The feature subsets S1, S2 and S3 were obtained by dimensionality reduction on S using SVM, DT and NBC, respectively. Three other basic models were obtained through training SVM on S1, DT on S2 and NBC on S3. By combining these six basic models, several integrated models were formed. An iterative method was proposed to select the integrated model with the highest accuracy on the training set. Having compared differences between the output labels and the original data labels, evaluation criteria were calculated.

MAIN RESULTS

An accuracy of 98.70% and 98.60% was achieved on the training and test datasets, respectively. High F1 score and Kappa values were also obtained.

SIGNIFICANCE

The proposed algorithm has advantages over previously reported approaches during automatic assessment of ECG quality and can thus help to reduce reliance on highly trained professionals when assessing the quality of ECGs.

TeleHospice: A Community-Engaged Model for Utilizing Mobile Tablets to Enhance Rural Hospice Care

Background:

In rural communities, providing hospice care can be a challenge. Hospice personnel sometimes travel great distances to reach patients, resulting in difficulty maintaining access, quality, cost-effectiveness, and safety. In 1998, the University of Kansas Medical Center piloted the country’s first TeleHospice (TH) service. At that time, challenges with broad adoption due to cost and attitudes regarding technology were noted. A second TH project was launched in early 2017 using newer technology; this article updates that ongoing implementation.

Methods:

The Organizational Change Manager was followed for the guided selection of the hospice partner. The University of Kansas Medical Center partnered with Hospice Services, Inc. (HSI), a leader in rural hospice care, providing services to 16 Kansas counties. Along with mobile tablets, a secure cloud-based videoconferencing solution was chosen for ease of use.

Results:

From August 2017 through January 2018, 218 TH videoconferencing encounters including 917 attendees occurred. Calls were made for direct patient care, family support, and administrative purposes. These TH calls have been shown to save HSI money, and initial reports suggest they may strengthen the communication and relationships between staff, patients, and the patient’s family.

Conclusion:

Finding innovative, cost-effective, and community-driven approaches such as TH are needed to continually advance hospice care. TeleHospice’s potential to supplement and improve hospice services while reducing costs is significant, but continued research is needed to understand best fit within frontier hospices, to inform future urban applications, and to address reimbursement.

A novel indexing architecture for the provision of smart playback functions in collaborative telemedicine applications

This paper presents a novel indexing architecture to support a range of smart playback functions in collaborative telemedicine systems. These functions include replaying the session from a specified point in time, replaying all the session segments controlled by a particular physician, replaying all the session segments relating to a specific medical image, and playing a montage of the entire session. Since the contents of telemedicine sessions vary over time depending on the particular commands invoked by the physician(s) during the session, when executing the smart playback functions, it is necessary to restore the target image contents to the appropriate condition before commencing the playback routine. In this study, this is achieved by using an indexing scheme designated as three-level indexing hierarchy (TIH) to search for the appropriate cut-in point in the session and to identify the commands which should be applied to restore the current image contents to their original condition at the cut-in point. In the proposed indexing scheme, the performance of the cut-in point determination process and the content restoration procedure is enhanced by maintaining a link between all the changes which take place in the image contents over the duration of the session and the commands which induce these changes. The evaluation results confirm that TIH outperforms existing scene-based retrieval systems in terms of both an improved computational efficiency and a lower storage requirement.

Theory and applications of telemedicine

In this study, telemedicine and the use of advanced telemedicine technologies are explained. Telemedicine is the use of modern telecommunications and information technologies for the provision of clinical care to individuals at a distance, and transmission of information to provide that care. Telemedicine can be used for decision making, remote sensing, and collaborative arrangements for the real-time management of patients at a distance. The use of telecommunications and information technologies in providing health services is determined. Telemedicine is described as combination of topics from the fields of telecommunication, medicine, and informatics. The medical systems infrastructure consisting of the equipment and processes used to acquire and present clinical information and to store and retrieve data are explained in details. The challenges existing in telemedicine development in different countries are given. Technological, political, and professional barriers in applications of telemedicine are defined. An investigation of telemedicine applications in various fields is presented, and enormous impact of telemedicine systems on the future of medicine is determined.

An overview of telemedicine: the virtual gaze of health care in the next century

This article considers the role of telemedicine in the production of biomedical health care using three specific theoretical constructs as lenses through which to examine this phenomenon: (1) Foucault's medical "gaze"; (2) the political economy of health; and (3) deterritorialization and multisite ethnography. This examination focuses first on the changing corporate structure of health care and changing political attitudes toward telemedicine. Second, it documents the current use of telemedicine in prisons, the military, and in cross-cultural settings. Third, it discusses responses to telemedicine of individual physicians, health care staff, and patients, finding that these responses are broadly conditioned by an individual's mode of articulation with biomedical institutions and that they are mediated by personal experience.