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Dhunnoo P, Kemp B, McGuigan K, Meskó B, O'Rourke V, McCann M. Evaluation of Telemedicine Consultations Using Health Outcomes and User Attitudes and Experiences: Scoping Review. J Med Internet Res 2024; 26:e53266. [PMID: 38980704 PMCID: PMC11267102 DOI: 10.2196/53266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/27/2024] [Accepted: 03/19/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Despite a recent rise in adoption, telemedicine consultations retention remains challenging, and aspects around the associated experiences and outcomes remain unclear. The need to further investigate these aspects was a motivating factor for conducting this scoping review. OBJECTIVE With a focus on synchronous telemedicine consultations between patients with nonmalignant chronic illnesses and health care professionals (HCPs), this scoping review aimed to gain insights into (1) the available evidence on telemedicine consultations to improve health outcomes for patients, (2) the associated behaviors and attitudes of patients and HCPs, and (3) how supplemental technology can assist in remote consultations. METHODS PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guided the scoping review process. Inclusion criteria were (1) involving adults with nonmalignant, noncommunicable chronic conditions as the study population; (2) focusing on health outcomes and experiences of and attitudes toward synchronous telemedicine consultations between patients and HCPs; and (3) conducting empirical research. A search strategy was applied to PubMed (including MEDLINE), CINAHL Complete, APA PsycNet, Web of Science, IEEE, and ACM Digital. Screening of articles and data extraction from included articles were performed in parallel and independently by 2 researchers, who corroborated their findings and resolved any conflicts. RESULTS Overall, 4167 unique articles were identified from the databases searched. Following multilayer filtration, 19 (0.46%) studies fulfilled the inclusion criteria for data extraction. They investigated 6 nonmalignant chronic conditions, namely chronic obstructive pulmonary disease, diabetes, chronic kidney disease, ulcerative colitis, hypertension, and congestive heart failure, and the telemedicine consultation modality varied in each case. Most observed positive health outcomes for patients with chronic conditions using telemedicine consultations. Patients generally favored the modality's convenience, but concerns were highlighted around cost, practical logistics, and thoroughness of clinical examinations. The majority of HCPs were also in favor of the technology, but a minority experienced reduced job satisfaction. Supplemental technological assistance was identified in relation to technical considerations, improved remote workflow, and training in remote care use. CONCLUSIONS For patients with noncommunicable chronic conditions, telemedicine consultations are generally associated with positive health outcomes that are either directly or indirectly related to their ailment, but sustained improvements remain unclear. These modalities also indicate the potential to empower such patients to better manage their condition. HCPs and patients tend to be satisfied with remote care experience, and most are receptive to the modality as an option. Assistance from supplemental technologies mostly resides in addressing technical issues, and additional modules could be integrated to address challenges relevant to patients and HCPs. However, positive outcomes and attitudes toward the modality might not apply to all cases, indicating that telemedicine consultations are more appropriate as options rather than replacements of in-person visits.
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Affiliation(s)
- Pranavsingh Dhunnoo
- Department of Computing, Atlantic Technological University, Letterkenny, Ireland
- The Medical Futurist Institute, Budapest, Hungary
| | - Bridie Kemp
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Karen McGuigan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | | | - Vicky O'Rourke
- Faculty of Business, Atlantic Technological University, Letterkenny, Ireland
| | - Michael McCann
- Department of Computing, Atlantic Technological University, Letterkenny, Ireland
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Mínguez Clemente P, Pascual-Carrasco M, Mata Hernández C, Malo de Molina R, Arvelo LA, Cadavid B, López F, Sánchez-Madariaga R, Sam A, Trisan Alonso A, Valle Falcones M, Aguilar Pérez M, Muñoz A, Pérez de la Cámara S, Burgos A, López Viña A, Ussetti Gil P. Follow-up with Telemedicine in Early Discharge for COPD Exacerbations: Randomized Clinical Trial (TELEMEDCOPD-Trial). COPD 2020; 18:62-69. [PMID: 33307857 DOI: 10.1080/15412555.2020.1857717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The results reported by different studies on telemonitoring in patients with chronic obstructive pulmonary disease (COPD) have been contradictory, without showing clear benefits to date. The objective of this study was to ascertain whether an early discharge and home hospitalization telehealth program for patients with COPD exacerbation is as effective as and more efficient than a traditional early discharge and home hospitalization program. A prospective experimental non-inferiority study, randomized into two groups (telemedicine/control) was conducted. The telemedicine group underwent monitoring and was required to transmit data on vital constants and ECGs twice per day, with a subsequent telephone call and 2 home visits by healthcare staff (intermediate and at discharge). The control group received daily visits. The main variable was time until first exacerbation. The secondary variables were: number of exacerbations; use of healthcare resources; satisfaction; quality of life; anxiety-depression; and therapeutic adherence, measured at one and 6 months of hospital discharge. A total of 116 patients were randomized (58 to each group) without significant differences in baseline characteristics or time until first exacerbation, i.e. median 48 days (pp. 25-75:23-120) in the control group, and 47 days (pp. 25-75:19-102) in the intervention group; p = 0.52). A significant decrease in the number of visits was observed in the intervention versus the control group, 3.8 ± 1 vs 5.1 ± 2(p = 0.001), without significant differences in the number of exacerbations. In conclusion follow-up via a telemedicine program in early discharge after hospitalization is as effective as conventional home follow up, being the cost of either strategy not significantly different.
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Affiliation(s)
- P Mínguez Clemente
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - M Pascual-Carrasco
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - C Mata Hernández
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - R Malo de Molina
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - L A Arvelo
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - B Cadavid
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - F López
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - R Sánchez-Madariaga
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - A Sam
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - A Trisan Alonso
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - M Valle Falcones
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - M Aguilar Pérez
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - A Muñoz
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - S Pérez de la Cámara
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - A Burgos
- Telemedicine and e-Health Research Unit, Carlos III Institute of Health, Madrid, Spain
| | - A López Viña
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
| | - P Ussetti Gil
- Pneumology Department, Puerta de Hierro University Teaching Hospital, Majadahonda, Spain
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Emme C, Mortensen EL, Rydahl-Hansen S, Østergaard B, Svarre Jakobsen A, Schou L, Phanareth K. The impact of virtual admission on self-efficacy in patients with chronic obstructive pulmonary disease - a randomised clinical trial. J Clin Nurs 2014; 23:3124-37. [PMID: 24476457 DOI: 10.1111/jocn.12553] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To investigate how virtual admission during acute exacerbation influences self-efficacy in patients with chronic obstructive pulmonary disease, compared with conventional hospital admission. BACKGROUND Telemedicine solutions have been highlighted as a possible way to increase self-efficacy in patients with chronic diseases, such as chronic obstructive pulmonary disease. However, little is known about how telemedicine-based virtual admission as a replacement of hospital admission during acute exacerbation affects chronic obstructive pulmonary disease patients' self-efficacy. DESIGN This study was a nonblinded, randomised clinical multicentre trial. The study was a substudy to The Virtual Hospital, investigating the feasibility and safety of telemedicine-based treatment at home for patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS Participants were consecutively randomised to virtual admission or conventional hospital admission. Data from 50 patients were analysed. Self-efficacy was assessed at baseline, three days after discharge, and also six weeks and three months after discharge, using the Danish version of 'The chronic obstructive pulmonary disease self-efficacy scale'. RESULTS Intergroup comparison showed no significant differences between the two groups at baseline, three days after discharge, six weeks after discharge or three months after discharge. Furthermore, intragroup comparison did not reveal significant differences in the chronic obstructive pulmonary disease self-efficacy scale mean sum score within the two groups. CONCLUSIONS The results of the study suggest that there is no difference between self-efficacy in chronic obstructive pulmonary disease patients undergoing virtual admission, compared with conventional hospital admission. However, the anticipated sample size could not be reached, which prompts caution regarding interpretation of the findings. RELEVANCE TO CLINICAL PRACTICE This study provides new insight into how virtual admission affects chronic obstructive pulmonary disease patients' self-efficacy. Clinicians should consider the timing, duration and the content in the design of telemedical interventions directed at improving chronic obstructive pulmonary disease patients' self-efficacy, as telemedicine solutions alone may not be sufficient to enhance self-efficacy.
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Affiliation(s)
- Christina Emme
- Research Unit of Clinical Nursing, Bispebjerg and Frederiksberg University Hospitals, Copenhagen, Denmark
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Emme C, Rydahl-Hansen S, Ostergaard B, Schou L, Svarre Jakobsen A, Phanareth K. How virtual admission affects coping - telemedicine for patients with chronic obstructive pulmonary disease. J Clin Nurs 2013; 23:1445-58. [PMID: 24372676 DOI: 10.1111/jocn.12444] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe what characterises chronic obstructive pulmonary disease patients' coping of physical, emotional and social problems before, during and after virtual admission, in interaction with health professionals and relatives. BACKGROUND Telemedicine for patients with chronic obstructive pulmonary disease is gaining ground. However, virtual admission using telemedicine in the patients' home as a replacement of hospital admission has received little attention. Furthermore, little is known about how telemedicine affects chronic obstructive pulmonary disease patients' coping. DESIGN Grounded Theory study using semi-structured interviews. METHODS The study was a part of The Virtual Hospital study, exploring virtual admission for patients with acute exacerbation of chronic obstructive pulmonary disease. During virtual admission, patients had access to medical equipment consisting of monitoring devices, medication, nebuliser and a touch screen with built-in videoconference system. Nine participants were interviewed after virtual admission. Open coding, axial coding and selective coding, using constant comparative analysis, were conducted. RESULTS A substantive Grounded Theory was developed, containing the core category - struggling to be in control of life with chronic obstructive pulmonary disease - related to four categories: complete powerlessness, dependency, pursuit of regaining autonomy and efforts to remain in control of problems related to chronic obstructive pulmonary disease. Virtual admission supported participants' autonomy. The involvement of health professionals was reduced as participants used the medical equipment to cope with disease-related problems. Participants' coping was closely linked to the presence of the equipment, making it difficult for them to apply their experiences after discharge from virtual admission. CONCLUSIONS Virtual admission may support chronic obstructive pulmonary disease patients' coping of physical and emotional problems. However, coping experiences made during virtual admission may not be directly applicable outside a telemedical setting. RELEVANCE TO CLINICAL PRACTICE Telemedicine may result in different roles for patients, relatives and health professionals. Clinicians should consider how they can support chronic obstructive pulmonary disease patients' coping during telemedical interventions, focusing on how to ensure a sustained improvement that patients can benefit from outside the telemedical setting.
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Affiliation(s)
- Christina Emme
- Bispebjerg and Frederiksberg University Hospitals, Copenhagen, Denmark
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Abstract
AIM To report a concept analysis of telecare. BACKGROUND Lately telecare has become a worldwide, modern way of giving care over distance by means of technology. Other concepts, like telemedicine, e-health, and telehealth, focus on the same topic though the boundaries between them seem to be blurred. DATA SOURCES Sources comprise 44 English language research articles retrieved from the database of Medline and Cinahl (1995-October 2011). DESIGN Literature Review. METHOD A principle-based analysis was undertaken through content analysis of the definitions, attributes, preconditions, and outcomes of the concept. RESULTS The attributes are well described according to the use of technology, caring activity, persons involved, and accessibility. Preconditions and outcomes are well described concerning individual and health political needs and benefits. The concept did not hold its boundaries through theoretical integration with the concept of telemedicine and telehealth. The definition of telecare competes with concepts like home-based e-health, telehomecare, telephonecare, telephone-based psychosocial services, telehealth, and telemedicine. Assessment of the definitions resulted in a suggestion of a new definition: Telecare is the use of information, communication, and monitoring technologies which allow healthcare providers to remotely evaluate health status, give educational intervention, or deliver health and social care to patients in their homes. CONCLUSION The logical principle was assessed to be partly immature, whereas the pragmatical and linguistical principles were found to be mature. A new definition is suggested and this has moved the epistemological principle forward to maturity.
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Affiliation(s)
- Hilde Solli
- Faculty of Health and Social Studies, Telemark University College, Porsgrunn, Norway.
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Halpin DMG, Laing-Morton T, Spedding S, Levy ML, Coyle P, Lewis J, Newbold P, Marno P. A randomised controlled trial of the effect of automated interactive calling combined with a health risk forecast on frequency and severity of exacerbations of COPD assessed clinically and using EXACT PRO. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2012; 20:324-31, 2 p following 331. [PMID: 21687919 DOI: 10.4104/pcrj.2011.00057] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We have developed a winter forecasting service to predict when patients with COPD are at higher risk of an exacerbation and alert them via an automated telephone call. AIMS To assess the effect of the service and its ability to predict periods of increased risk. METHODS A 4-month prospective randomised controlled trial using clinical criteria and the EXACT PRO questionnaire to identify exacerbations. Patients were randomly allocated to receive alert calls. All patients completed a diary including the EXACT PRO questionnaire on a BlackBerry Smartphone each day. They were contacted and assessed if they appeared to be exacerbating. RESULTS 79 patients participated, 40 received alert calls. The exacerbation frequency per patient per week was significantly greater during periods of predicted high risk (0.086 ± 0.010 v 0.055 ± 0.010). The exacerbation frequency (± standard error of the mean, SEM) in patients receiving alert calls was lower (0.95 ± 0.27 v 1.17 ± 0.29) but this was not statistically significant. Fewer patients receiving alert calls had one or more EXACT event compared to the controls (34% v 53%, p=0.11), their duration was shorter (8.2 ± 2.0 v10.1 ± 1.9 days, p=0.481) and they were less severe (AUC 65 ± 21 v 115 ± 22, p=0.118). There were no significant differences in the mean change (± SEM) in SGRQ scores between the groups. CONCLUSIONS The ability of the forecast to predict high risk periods was confirmed unequivocally. Alert calls appeared to reduce the frequency and severity of exacerbations but these effects did not reach statistical significance, perhaps because of the number of participants, lower than expected exacerbation rates, and the fact that there was contact with patients in both groups whenever they appeared to be exacerbating.
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McLean S, Nurmatov U, Liu JLY, Pagliari C, Car J, Sheikh A. Telehealthcare for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2011; 2011:CD007718. [PMID: 21735417 PMCID: PMC8939044 DOI: 10.1002/14651858.cd007718.pub2] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a disease of irreversible airways obstruction in which patients often suffer exacerbations. Sometimes these exacerbations need hospital care: telehealthcare has the potential to reduce admission to hospital when used to administer care to the pateint from within their own home. OBJECTIVES To review the effectiveness of telehealthcare for COPD compared with usual face-to-face care. SEARCH STRATEGY We searched the Cochrane Airways Group Specialised Register, which is derived from systematic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; last searched January 2010. SELECTION CRITERIA We selected randomised controlled trials which assessed telehealthcare, defined as follows: healthcare at a distance, involving the communication of data from the patient to the health carer, usually a doctor or nurse, who then processes the information and responds with feedback regarding the management of the illness. The primary outcomes considered were: number of exacerbations, quality of life as recorded by the St George's Respiratory Questionnaire, hospitalisations, emergency department visits and deaths. DATA COLLECTION AND ANALYSIS Two authors independently selected trials for inclusion and extracted data. We combined data into forest plots using fixed-effects modelling as heterogeneity was low (I(2) < 40%). MAIN RESULTS Ten trials met the inclusion criteria. Telehealthcare was assessed as part of a complex intervention, including nurse case management and other interventions. Telehealthcare was associated with a clinically significant increase in quality of life in two trials with 253 participants (mean difference -6.57 (95% confidence interval (CI) -13.62 to 0.48); minimum clinically significant difference is a change of -4.0), but the confidence interval was wide. Telehealthcare showed a significant reduction in the number of patients with one or more emergency department attendances over 12 months; odds ratio (OR) 0.27 (95% CI 0.11 to 0.66) in three trials with 449 participants, and the OR of having one or more admissions to hospital over 12 months was 0.46 (95% CI 0.33 to 0.65) in six trials with 604 participants. There was no significant difference in the OR for deaths over 12 months for the telehealthcare group as compared to the usual care group in three trials with 503 participants; OR 1.05 (95% CI 0.63 to 1.75). AUTHORS' CONCLUSIONS Telehealthcare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital. However, further research is needed to clarify precisely its role since the trials included telehealthcare as part of more complex packages.
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Affiliation(s)
- Susannah McLean
- University of EdinburghAllergy & Respiratory Research Group, Centre for Population Health SciencesDoorway 1Teviot PlaceEdinburghScotlandUKEH8 9AG
| | - Ulugbek Nurmatov
- Centre for Population Health Sciences: GP Section, The University of EdinburghAllergy & Respiratory Research Group20 West Richmond StreetEdinburghUKEH8 9DX
| | - Joseph LY Liu
- Scottish Dental Clinical Effectiveness Programme, NHS Education for ScotlandThe University of Dundee, Dental Health Services & Research UnitFrankland Building, Small's WyndDundeeUKDD1 4HN
| | - Claudia Pagliari
- University of EdinburghCentre for Population Health Sciences20 West Richmond StEdinburghUKEH8 9DX
| | - Josip Car
- Imperial College LondonGlobal eHealth Unit, Department of Primary Care and Public Health, School of Public HealthReynolds BuildingSt Dunstans RoadLondonUKW6 8RP
- University of LjubljanaDepartment of Family Medicine, Faculty of MedicineLjubljanaSlovenia
| | - Aziz Sheikh
- The University of EdinburghCentre for Population Health SciencesMedical SchoolDoorway 3, Teviot PlaceEdinburghUKEH8 9AG
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Sorknaes AD, Madsen H, Hallas J, Jest P, Hansen-Nord M. Nurse tele-consultations with discharged COPD patients reduce early readmissions--an interventional study. CLINICAL RESPIRATORY JOURNAL 2011; 5:26-34. [PMID: 21159138 DOI: 10.1111/j.1752-699x.2010.00187.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Exacerbations of chronic obstructive pulmonary disease (ECOPD) are the most common cause for admissions and readmissions to medical wards worldwide. OBJECTIVES To investigate the effect on early readmissions of telemedicine video consultations (TVCs) between respiratory nurses placed at the hospital and COPD patients in their homes after a discharge from the hospital, which was caused by ECOPD. METHODS This study was an interventional study in which all ECOPD were consecutively allocated into two groups (TVC or control) depending on their home municipality. The patient received daily TVC at home with a nurse based at the hospital for approximately one week. Thereafter, the patient received at least one follow-up call and they could call the nurse for the rest of the study period of 28 days. The telemedicine equipment was composed of a computer with a web camera, a microphone and measurement equipment. RESULTS Within each of the two groups, TVC (n = 50) and control (n = 50), 12% and 22%, respectively, were readmitted [differences between rates -10% (95% confidence interval -25;5)] because of ECOPD. The multivariate Cox regression model showed the TVC assignment as a significant protective factor for early readmission [hazard ratio (HR) 0.25 (0.09-0.69)]. High age [HR 3.94 (1.46-10.6)] and male gender [HR 2.97 (0.99-8.97)] were associated with high hazard. Patient satisfaction was high. CONCLUSIONS In a hospitalised population with ECOPD, a nurse TVC assignment is protective against early readmission and reduces the days of readmission.
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Silva Junior EP, Esteves GP, Faria ACD, Melo PL. An internet-based system for home monitoring of respiratory muscle disorders. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2011; 2010:5492-5. [PMID: 21096291 DOI: 10.1109/iembs.2010.5626581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Home telemonitoring is of great interest in respiratory medicine where large numbers of people have long term conditions. We developed a telemedicine instrument for home monitoring of patients with disturbed respiratory muscles. The instrument measures the maximum inspiratory pressure (Pimax), the inspiratory time constant (τ(i)) and connects to the Internet through TCP/IP protocol. The instrument was evaluated by means of a comparative analysis in 18 normal individuals and 15 COPD patients. In close agreement with the pathophysiology, a reduction in Pimax (p < 0.0001) and an increase in τ(i) (p < 0.001) was observed in COPD patients. We concluded that the developed system could be a useful tool for the evaluation of inspiratory muscle and for the implementation of telemedicine services, contributing to reduce the costs of the assistance offered to patients with respiratory diseases.
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Affiliation(s)
- Evert P Silva Junior
- Biomedical Instrumentation Laboratory, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
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da Silva Junior EP, Esteves GP, Dames KK, Melo PLD. A telemedicine instrument for Internet-based home monitoring of thoracoabdominal motion in patients with respiratory diseases. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2011; 82:014301. [PMID: 21280845 DOI: 10.1063/1.3529443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol∕Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p < 0.0001) and the reduction in thoracic movement during abnormal abdominal breathing (p < 0.005). Simulated asynchrony in thoracoabdominal motion was also adequately detected by the system (p < 0.0001). The experimental results obtained for patients with respiratory diseases were in close agreement with the expected values, providing evidence that this instrument can be a useful tool for the evaluation of thoracoabdominal motion. The Internet transmission tests showed that the acquisition and analysis of the thoracoabdominal motion signals can be performed remotely. The user can also receive medical recommendations. The proposed system can be used in a spectrum of telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.
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Affiliation(s)
- Evert Pereira da Silva Junior
- Biomedical Instrumentation Laboratory, Institute of Biology, Faculty of Engineering, State University of Rio de Janeiro, Brazil
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de Almeida JPL, Pinto AC, Pereira J, Pinto S, de Carvalho M. Implementation of a Wireless Device for Real-Time Telemedical Assistance of Home-Ventilated Amyotrophic Lateral Sclerosis Patients: A Feasibility Study. Telemed J E Health 2010; 16:883-8. [DOI: 10.1089/tmj.2010.0042] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Jos Pedro Lopes de Almeida
- Department of Physical Medicine and Rehabilitation, University of Lisbon Medical School, Santa Maria Hospital, Lisbon, Portugal
- Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon Medical School, Lisbon, Portugal
| | - Anabela C. Pinto
- Department of Physical Medicine and Rehabilitation, University of Lisbon Medical School, Santa Maria Hospital, Lisbon, Portugal
- Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon Medical School, Lisbon, Portugal
| | - Joo Pereira
- Linde Sogás Co., The Linde Group, Lisbon, Portugal
| | - Susana Pinto
- Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon Medical School, Lisbon, Portugal
| | - Mamede de Carvalho
- Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon Medical School, Lisbon, Portugal
- Department of Neurology, University of Lisbon Medical School, Santa Maria Hospital, Lisbon, Portugal
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Domingo C, Blanch L, Murias G, Luján M. State-of-the-art sensor technology in Spain: invasive and non-invasive techniques for monitoring respiratory variables. SENSORS 2010; 10:4655-74. [PMID: 22399898 PMCID: PMC3292138 DOI: 10.3390/s100504655] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 03/29/2010] [Accepted: 04/15/2010] [Indexed: 11/16/2022]
Abstract
The interest in measuring physiological parameters (especially arterial blood gases) has grown progressively in parallel to the development of new technologies. Physiological parameters were first measured invasively and at discrete time points; however, it was clearly desirable to measure them continuously and non-invasively. The development of intensive care units promoted the use of ventilators via oral intubation ventilators via oral intubation and mechanical respiratory variables were progressively studied. Later, the knowledge gained in the hospital was applied to out-of-hospital management. In the present paper we review the invasive and non-invasive techniques for monitoring respiratory variables.
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Affiliation(s)
- Christian Domingo
- Pneumology Service, Hospital de Sabadell, Corporació Parc Taulí, 08208 Sabadell, Spain
- Department of Medicine, Autonomous University of Barcelona (UAB), 083208 Bellaterra, Barcelona, Spain
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: + 34- 93-723-10-10, ext. 29-142; Fax: + 34-93-716-06-46
| | - Lluis Blanch
- Critical Care Center; Hospital de Sabadell, Corporació Parc Taulí, 08208 Sabadell, Spain; E-Mail:
- Institut Universitari Fundació Parc Taulí, Corporació Parc Taulí Autonomous University of Barcelona (UAB). 08208 Sabadell, Spain
- CIBER Enfermedades Respiratorias CIBERes, Spain
| | - Gaston Murias
- Intensive Care Unit, Clínica Bazterrica and Clínica Santa Isabel. Buenos Aires, Argentina; E-Mail:
| | - Manel Luján
- Pneumology Service, Hospital de Sabadell, Corporació Parc Taulí, 08208 Sabadell, Spain
- Department of Medicine, Autonomous University of Barcelona (UAB), 083208 Bellaterra, Barcelona, Spain
- CIBER Enfermedades Respiratorias CIBERes, Spain
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Bartoli L, Zanaboni P, Masella C, Ursini N. Systematic Review of Telemedicine Services for Patients Affected by Chronic Obstructive Pulmonary Disease (COPD). Telemed J E Health 2009; 15:877-83. [DOI: 10.1089/tmj.2009.0044] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Laura Bartoli
- Department of Management, Economics, and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Paolo Zanaboni
- Department of Management, Economics, and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Cristina Masella
- Department of Management, Economics, and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Niccoló Ursini
- Department of Management, Economics, and Industrial Engineering, Politecnico di Milano, Milan, Italy
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14
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Zamith M, Cardoso T, Matias I, Gomes MJM. Telemonitorização domiciliária de insuficientes respiratórios crónicos graves e de doentes asmáticos. REVISTA PORTUGUESA DE PNEUMOLOGIA 2009. [DOI: 10.1016/s0873-2159(15)30142-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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15
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Botsis T, Hartvigsen G. Current status and future perspectives in telecare for elderly people suffering from chronic diseases. J Telemed Telecare 2008; 14:195-203. [DOI: 10.1258/jtt.2008.070905] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Summary We reviewed the literature on home telecare for elderly patients suffering from chronic diseases. Articles published between 1990 and 2007 were identified via the PubMed database. The literature search yielded 485 papers. After reviewing the title and abstract from each, 54 were selected for closer examination. They were published in 37 different journals. The number of papers increased from one in 1997 to 14 in 2006. The diseases in which home telecare had been used were diabetes (14 studies), heart failure (13 studies), cognitive impairment (dementia and/or Alzheimer's disease, 10 studies), chronic obstructive pulmonary disease (5 studies), chronic wounds (4 studies) and mobility disabilities (4 studies). Patients were generally satisfied with home telecare, but they preferred a combination of home telecare with conventional health-care delivery. Health-care professionals were positive about telecare. Users felt that on many occasions telecare led to a reduction in costs due to time savings and avoidance of travelling. Even though there were important benefits from home telecare, there are organizational, ethical, legal, design, usability and other matters that need to be resolved before widespread implementation can occur.
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Affiliation(s)
- Taxiarchis Botsis
- Medical Informatics and Telemedicine Group, Department of Computer Science, University of Tromsø
| | - Gunnar Hartvigsen
- Medical Informatics and Telemedicine Group, Department of Computer Science, University of Tromsø
- Norwegian Centre for Telemedicine, Tromsø, Norway
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16
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Trappenburg JC, Niesink A, de Weert-van Oene GH, van der Zeijden H, van Snippenburg R, Peters A, Lammers JWJ, Schrijvers AJ. Effects of Telemonitoring in Patients with Chronic Obstructive Pulmonary Disease. Telemed J E Health 2008; 14:138-46. [DOI: 10.1089/tmj.2007.0037] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jaap C.A. Trappenburg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anouk Niesink
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Hans van der Zeijden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Renée van Snippenburg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Albert Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan-Willem J. Lammers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Augustinus J.P. Schrijvers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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17
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Woodend AK, Sherrard H, Fraser M, Stuewe L, Cheung T, Struthers C. Telehome monitoring in patients with cardiac disease who are at high risk of readmission. Heart Lung 2008; 37:36-45. [PMID: 18206525 DOI: 10.1016/j.hrtlng.2007.04.004] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 04/09/2007] [Indexed: 12/19/2022]
Abstract
Patients with chronic conditions are heavy users of the health care system. There are opportunities for significant savings and improvements to patient care if patients can be maintained in their homes. A randomized control trial tested the impact of 3 months of telehome monitoring on hospital readmission, quality of life, and functional status in patients with heart failure or angina. The intervention consisted of video conferencing and phone line transmission of weight, blood pressure, and electrocardiograms. Telehome monitoring significantly reduced the number of hospital readmissions and days spent in the hospital for patients with angina and improved quality of life and functional status in patients with heart failure or angina. Patients found the technology easy to use and expressed high levels of satisfaction. Telehealth technologies are a viable means of providing home monitoring to patients with heart disease at high risk of hospital readmission to improve their self-care abilities.
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Affiliation(s)
- A Kirsten Woodend
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario
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18
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Saqui O, Chang A, McGonigle S, Purdy B, Fairholm L, Baun M, Yeung M, Rossos P, Allard J. Telehealth videoconferencing: improving home parenteral nutrition patient care to rural areas of Ontario, Canada. JPEN J Parenter Enteral Nutr 2007; 31:234-9. [PMID: 17463150 DOI: 10.1177/0148607107031003234] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Telehealth videoconferencing is a medium for health care professionals to communicate and care for patients living in remote areas. The aim of this study was to provide a survey to examine management outcome of home parenteral nutrition (HPN) patients when followed by telehealth as an alternative modality of care. METHODS Twenty-six individuals who were identified to benefit from tele-health were invited to participate in a satisfaction survey. The survey was sent to patients by postal mail. The survey also documented the incidence of line sepsis and other medical HPN complications. A cost analysis was also performed according to technology, human resources, and infrastructure. RESULTS Eighty-one telehealth videoconference sessions have been held since the inception of telehealth in 2002. Of the current telehealth patients, 13 were eligible for the survey. The satisfaction survey response rate was 11/13 (84.6%). The average line sepsis rate for the 13 patients was 0.89/1000 catheter-days. All patients were generally satisfied with videoconferencing as an alternative method of communication and care for new consultation, patient and family education, and follow-up. Travel time and costs to the patients, their families, and the health care system were significantly less. For example, a patient who resides 611 km from Toronto would cost CDN (Canadian) 724.00 dollars for flight and accommodation to meet with the team at the HPN clinic in Toronto. CONCLUSION Telehealth incorporated the cost-saving ability for HPN patients to maintain proper medical care, support, and collaboration of specialists inaccessible to their local community. Thus, its strongly positive role in HPN care deserves further consideration for a national application.
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Affiliation(s)
- Olivia Saqui
- Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
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19
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Whitten P, Buis L. Private payer reimbursement for telemedicine services in the United States. Telemed J E Health 2007; 13:15-23. [PMID: 17309350 DOI: 10.1089/tmj.2006.0028] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Telemedicine has garnered significant attention over the past decade as a solution to cost and access challenges facing healthcare. Yet, utilization rates have not reached their full potential. One major barrier to the adoption of telemedicine cited in the literature is the lack of universal reimbursement from private payers. The purpose of this investigation was to capture a current picture of private reimbursement for telemedicine services in the United States. This investigation was a follow-up to a 2003 survey conducted by the American Telemedicine Association (ATA) and AMD Telemedicine. Representatives from 116 telemedicine programs were contacted between September and November 2005 via telephone and/or e-mail to participate in this survey. Of those contacted, we received responses from 64 organizations, a 55% response rate. To provide answers to our research questions, descriptive statistics were used for data analysis. Data indicate that the United States is progressing toward expanded private reimbursement for telemedicine services with 58% of responding organizations who provide potentially billable telemedicine services receiving private reimbursement (up 5% from 2003). In addition, it was found that 81% of those who receive private pay reported no differences between reimbursement for telemedicine services as compared to traditional faceto-face consults. Finally, of those who receive private pay, data indicated that telemedicine programs are submitting on average approximately 40% of consults for private reimbursement. While this investigation does suggest that we are making small improvements in private payer reimbursement, the change appears to lag behind a pace needed to optimize telemedicine deployment.
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Affiliation(s)
- Pamela Whitten
- Department of Telecommunication, Michigan State University, East Lansing 48824-1212, USA.
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20
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Intermediate care--Hospital-at-Home in chronic obstructive pulmonary disease: British Thoracic Society guideline. Thorax 2007; 62:200-10. [PMID: 17090570 PMCID: PMC2117156 DOI: 10.1136/thx.2006.064931] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 08/23/2006] [Indexed: 01/16/2023]
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21
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May C, Rapley T, Moreira T, Finch T, Heaven B. Technogovernance: Evidence, subjectivity, and the clinical encounter in primary care medicine. Soc Sci Med 2006; 62:1022-30. [PMID: 16162385 DOI: 10.1016/j.socscimed.2005.07.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Indexed: 11/12/2022]
Abstract
Technological solutions to problems of knowledge and practice in health care are routinely advocated. This paper explores the ways that new systems of practice are being deployed as intermediaries in interactions between clinicians and their patients. Central to this analysis is the apparent conflict between two important ways of organizing ideas about practice in primary care. First, a shift away from the medical objectification of the patient, towards patient-centred clinical practice in which patients'heterogeneous experiences and narratives of ill-health are qualitatively engaged and enrolled in decisions about the management of illness trajectories. Second the mobilization of evidence about large populations of experimental subjects revealed through an impetus towards evidence-based medicine, in which quantitative knowledge is engaged and enrolled to guide the management of illness, and is mediated through clinical guidelines. The tension between these two ways of organizing ideas about clinical practice is a strong one, but both impulses are embodied in new 'technological' solutions to the management of heterogeneity in the clinical encounter. Technological solutions themselves, we argue, embody and enact these tensions, but may also be opening up a new array of practices--technogovernance--in which the heterogeneous narratives of the patient-centred encounter can be resituated and guided.
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Affiliation(s)
- Carl May
- Centre for Health Services Research, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4AA, UK.
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22
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Koizumi T, Takizawa M, Nakai K, Yamamoto Y, Murase S, Fujii T, Kobayashi T, Hatayama O, Fujimoto K, Kubo K. Trial of Remote Telemedicine Support for Patients with Chronic Respiratory Failure at Home through a Multistation Communication System. Telemed J E Health 2005; 11:481-6. [PMID: 16149895 DOI: 10.1089/tmj.2005.11.481] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To create and test a multistation telemedicine support system, three remote locations were connected: the homes of two patients with chronic respiratory failure, the hospital of the attending physician, and the hospital of the pulmonary specialist. Real-time connections were set up between the three locations. Medical history and biologic variables were noninvasively recorded, including blood pressure, arterial oxygen saturation, three-lead electrocardiogram, and end-tidal carbon dioxide. Both physicians shared in these data real-time. If necessary, the respiratory specialist could provide medical advice to the attending physician based on the patient's condition. The trial program resulted in the same information being exchanged remotely using the multi-station telemedicine system that would be exchanged in a direct, face-to-face encounter. This result, together with the improvement in quality of life and the establishment of appropriate treatment and cooperation between the respiratory specialist and attending physician, suggests our system can be considered useful and promising for further use.
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Affiliation(s)
- T Koizumi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
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23
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Sanford JA, Jones M, Daviou P, Grogg K, Butterfield T. Using telerehabilitation to identify home modification needs. Assist Technol 2004; 16:43-53. [PMID: 15357147 DOI: 10.1080/10400435.2004.10132073] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Teleconferencing technology has great potential for providing cost-effective in-home assessment for home modification services from anywhere to anyone in need. Despite its enormous potential, the use of this technology as a means to deliver these specific services had not been investigated. This project investigated the use of televideo technology to provide remote home assessment services to patients prior to discharge so that they could function as independently as possible in their own homes after being discharged from a specialty clinic. Specifically, an assessment protocol that could be implemented using video-conferencing technology was developed and feasibility of the remote assessment process was determined by validating it against the standard of practice, an in-home assessment by a home modifications specialist. Independent in-home and remote home assessments were completed by two occupational therapists who specialize in home modifications. The results were compared for agreement in identification of specific accessibility problems in and quantitative measurements of the home. The remote assessment correctly identified a total of 51 of the 59 problems (86.4%) identified by the in-home assessment and only identified five problems (8.9%) that were not identified by the on-site assessment. In addition, 54 of 60 (90%) of the quantitative measurements from the remote assessment matched those from the in-home assessment. Findings suggest that remote telerehabilitation assessments have the potential to enable specialists to diagnose potential accessibility problems in home environments and prescribe appropriate modifications regardless of the location of the client, home, or specialist.
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Affiliation(s)
- Jon A Sanford
- Atlanta VA Medical Center, Rehabilitation R & D Center, Decatur, Georgia 30033, USA
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24
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Brooks D, Fancott CA, Falter LB, McFarlane A, Nonoyama ML. The development of a helpline for chronic obstructive pulmonary disease (COPD). PATIENT EDUCATION AND COUNSELING 2004; 54:329-336. [PMID: 15324984 DOI: 10.1016/j.pec.2003.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2003] [Revised: 05/05/2003] [Accepted: 06/30/2003] [Indexed: 05/24/2023]
Abstract
BACKGROUND The goal of the helpline is to assist individuals with chronic obstructive pulmonary disease (COPD) better manage their disease through improved understanding of COPD, its symptoms and treatment. OBJECTIVES The purpose of this project was to develop and validate a protocol for a COPD helpline. METHODS Ten key informants with expertise in helpline development or COPD were interviewed. Fifty individuals with COPD participated in content validation of the protocol. RESULTS An initial protocol for the helpline aimed to provide: (1) information and education regarding COPD and its management via the telephone and with written materials; (2) guidance regarding course of management; (3) resource links to other support services and programs locally, provincially, and/or nationally; and (4) caring support and reassurance to those with COPD and their families. The majority of the calls from individuals with COPD sought medical information (74%) and required 36.6 +/- 14.5 min (range: 15-85) to complete. Many different topics were discussed, with medication and exercise being the most common. The availability of the call center was identified as one means of replacing information sought from other health care providers, mainly physicians and pulmonary rehabilitation staff. CONCLUSION A protocol of a helpline for COPD has been developed based on the literature, theoretical knowledge, and input from key informants and individuals with COPD.
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Affiliation(s)
- Dina Brooks
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, 500 University Avenue, Room 848, Toronto, Ont., Canada M5G 1V7.
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25
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Jennett PA, Affleck Hall L, Hailey D, Ohinmaa A, Anderson C, Thomas R, Young B, Lorenzetti D, Scott RE. The socio-economic impact of telehealth: a systematic review. J Telemed Telecare 2004; 9:311-20. [PMID: 14680514 DOI: 10.1258/135763303771005207] [Citation(s) in RCA: 209] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We reviewed the socio-economic impact of telehealth, focusing on nine main areas: paediatrics, geriatrics, First Nations (i.e. indigenous peoples), home care, mental health, radiology, renal dialysis, rural/remote health services and rehabilitation. A systematic search led to the identification of 4646 citations or abstracts; from these, 306 sources were analysed. A central finding was that telehealth studies to date have not used socio-economic indicators consistently. However, specific telehealth applications have been shown to offer significant socio-economic benefit, to patients and families, health-care providers and the health-care system. The main benefits identified were: increased access to health services, cost-effectiveness, enhanced educational opportunities, improved health outcomes, better quality of care, better quality of life and enhanced social support. Although the review found a number of areas of socio-economic benefit, there is the continuing problem of limited generalizability.
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Affiliation(s)
- P A Jennett
- Health Telematics Unit, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
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26
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de Castro CR, Ordóñez AJ, Navarrete P, Gómez Jiménez FJ, Castillo MJ. Aplicación de la telemedicina al control de enfermedades crónicas: telecontrol de pacientes con enfermedad pulmonar obstructiva crónica. Med Clin (Barc) 2002. [DOI: 10.1016/s0025-7753(02)73395-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Valero MA, Arredondo MT, del Nogal F, Rodríguez JM, Frías E. Patient satisfaction with a home televisiting service based on interactive television over a cable network. J Telemed Telecare 2000; 6 Suppl 1:S99-101. [PMID: 10793987 DOI: 10.1258/1357633001934311] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Experience shows that high-quality audiovisual contact between remote health carers and patients facilitates a telemedicine service. However, the lack of broadband communication to the home usually prevents domestic televisiting. Deployment of cable networks in Spain has allowed the implementation of a home televisiting service designed for patients with chronic diseases. In a trial, 15 patients received televisits by three specialists and three nurses from the Severo Ochoa Hospital in Madrid. Five patients suffered from chronic pain, five were from the nephrology unit and five had been treated at the intensive-care unit after acute myocardial infarction. Each patient participated in three televisiting sessions, two provided by a specialist and the other by a nurse. The average length of a televisit was 12 min (range 5-21 min). The patients expressed their satisfaction with the service.
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Affiliation(s)
- M A Valero
- Grupo de Bioingeniería y Telemedicina, Technical University of Madrid, Spain.
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28
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Dimmick SL, Mustaleski C, Burgiss SG, Welsh T. A case study of benefits & potential savings in rural home telemedicine. HOME HEALTHCARE NURSE 2000; 18:124-35. [PMID: 11040644 DOI: 10.1097/00004045-200002000-00013] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This case study reports results from a federally funded home telemedicine program in rural Grainger County, Tennessee. Patients, family caregivers, and providers were generally satisfied with this low-cost, user-friendly telemedicine program that used the plain-old-telephone system. Mileage and nurse drive time were reduced and nursing productivity was improved during this demonstration project.
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Affiliation(s)
- S L Dimmick
- University of Tennessee, College of Communication, Knoxville 37920, USA.
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