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Biomedical subjects

Heikki Lamminen

Publications and source records attributed to Heikki Lamminen.

12 recordsLinked to original sources
PubMed2006

Reorganization of oral anticoagulant (warfarin) treatment follow-up.

OBJECTIVE: To evaluate the impact of the reorganization of oral AC treatment management in a primary healthcare setting in terms of quality of care and cost of care. The evaluated reorganization involved the adoption of an AC nurse service model supported by the use of information and communication technology for storing and handling follow-up data. DESIGN: Statistical analysis of AC follow-up data, personnel task distribution and resource use analysis, and survey of personnel experiences. SETTING: The Paloheinä health station in Helsinki, Finland. SUBJECTS: All 122 Paloheinä patients on oral AC treatment and the related Paloheinä personnel. Also, follow-ups from two comparison health stations from Helsinki were used. MAIN OUTCOME MEASURES: Laboratory P-INR and follow-up density distributions before and after follow-up reorganization for Paloheinä and comparison station patients, task distribution, and personnel resource use in treatment guideline assignment before and after reorganization and gathered personnel experiences. RESULTS: No statistically significant changes (Pearson's chi-square test, p < 0.05) were observed in P-INR distributions, considering also the comparison stations. Adoption of the AC nurse model resulted in a 66%/34% task distribution between nurses and physicians in guideline assignment. Personnel resource use analysis showed a cost decrease of 1.61 euros per follow-up in guideline assignment. Users who responded to the survey were generally satisfied with the reorganization and its subjective impacts. CONCLUSION: Reorganization resulted in a potential reduction in cost of care per follow-up without a change in the observed quality of care in the Paloheinä setting. Personnel generally accepted the reorganization.

Administration, Oral↗
PubMed2006

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMed2003

A cost study of new media supported near oral anticoagulant treatment follow-up.

OBJECTIVE: In this study we sought to develop a comparative cost evaluation between conventional and new media, e.g. web, mobile communication technology and digital television, and near patient testing supported anticoagulant (ac) treatment follow-up in a primary health care setting. METHOD: The comparison was done for two patient groups, self-care and home-care patients, on oral ac treatment in the primary health care centre of the rural and sparsely populated municipality of Ikaalinen. In practise case analysis was used to develop cost functions from collected economic data, which were analysed to determine the break-even point in total cost between conventional and new media supported follow-up for the two patient groups. RESULTS: In the home-care setting the break-even point is 14 patients; in the self-care setting new media supported follow-up is always more cost-effective. CONCLUSION: The results illustrate that the use of new media and near patient testing in ac treatment follow-up brings about an economic benefit even with a small number of patients in the Ikaalinen setting. However, the sensitivity of break-even to perturbations in the individual costs of the used economic models remains high. Still, when the economic benefits are considered together with the clinical and practical benefits shown to result from self-testing, self-management and use of new media technologies the new service models can be said to provide noticeable benefits both in terms of quality of care and economics in our specific setting.

Administration, Oral↗
PubMed2003

Telemedicine in ophthalmology.

OBJECTIVES: To give an overview of telemedical applications in ophthalmology and to provide background information on new tele-ophthalmological applications. METHODS: We carried out a literature review, a database search and an Internet search. RESULTS: According to published research, the cost-efficiency of telemedicine in ophthalmology has not been established. It has been found to have educational benefits and patients have been satisfied with the possibility of obtaining specialist care without having to travel. CONCLUSIONS: Most studies have been pilot studies and telemedicine is still seldom the primary mode of operation. Technical problems have not been significant, but many open questions about organizational and operational issues remain. Further studies should be directed towards solving these problems and establishing technical standards.

Health Care Costs↗
PubMed2003

Picture archiving and fundus imaging in a glaucoma clinic.

Ophthalmological image archiving and distribution can be automated using a picture archiving and communication system (PACS). A fundus PACS has been in clinical use since February 2000 at the ophthalmology clinic of Tampere University Hospital. It consists of a digital fundus camera, an imaging workstation, from which new patients can be added to the archive, 10 viewing stations and an image archive server. In glaucoma imaging, the fundus images taken from a patient are transferred from the imaging workstation to the image archive server and are then immediately available from the physician's viewing workstation; the transfer time of an average image, of 350 kbit, is 0.0035 s, even though the archive is located 5 km away. After 18 months of operation there were over 16,000 images archived; these took 5.3 GByte of a total storage capacity of 41.9 GByte. The network and archive server achieved 99% reliability in use. Digital imaging makes it possible to shift ophthalmology clinics towards more patient-oriented treatment procedures.

Glaucoma↗
PubMed2002

Telemedical devices in diabetes management.

This paper reviews telemedicine and its recent expansions within diabetes management. Diabetes mellitus continues to be one of the major chronic diseases with up to 11% of national health care expenditure, when all late complications are taken into account. Over and above this, the incidence of diabetes is increasing in pandemic fashion. Diabetes has been the focus of telemedicine and information technology over the past two decades. Useful applications supporting high quality treatment exist in clinical management, education, decision support and modelling. Development of high-speed networks enables transmission of good quality photographs making consultations from distant locations possible. Databases and data analysis are fundamental to diabetes outcome research. Less successful has been the development of electronic medical records although this is a dream of many. Evidence of improved clinical outcome using telemedical applications still awaits the breakthrough.

Blood Glucose Self-Monitoring↗
PubMed2002

Health-related services on the internet.

The primary objective of this study is to evaluate a sample of health-related services available on the internet. In addition, types of new services and service qualities that may be required in the future were estimated. A registered nurse using a questionnaire containing items about usability, quality, and other characteristics related to the subject carried out an evaluation of 100 health-related internet sites, and the results were processed to determine average qualities and graphical presentations for the studied parameters. The services studied differed greatly from each other both in terms of content and quality. A general observation was that sites of larger organizations were, typically, both in terms of presentation and content, more sophisticated than sites of smaller producers. A typical characteristic was the superficiality of the information presented. In conclusion, the internet is an emerging medium for health-related information, and standards for the production and presentation of health content for the internet are still in development. However, even at this early stage, the internet represents a valuable source of information for those in need of health-related information for both health care professionals and consumers.

Finland↗
PubMed2002

Proposed model of a digital video-based home telecare system.

The purpose of our study was to develop a generic reference model for home telecare in a digital television environment and to suggest how it might be deployed at a test village. We describe here an architecture based on digital video broadcast standards, its components, services, and required additional technical solutions to provide a unified home telecare solution. We also suggest different user groups within the village context and possible service scenarios for them. We conclude that, in general, digital television provides a potentially flexible and promising platform for home telecare services.

Computer Communication Networks↗
PubMed2002

Fundus imaging and the telemedical management of diabetes.

Diabetes is the major preventable form of blindness among people of working age in the Western world, despite the improvements in laser photocoagulation treatments. It is known that regular glycaemic control and annual retinal screening of people with diabetes can reduce its incidence. Effective treatment needs to be available but also screening methods which are simple to perform and cost-effective should be implemented. It will be important in future to integrate digital images of the fundus into the health records of diabetic patients. Screening programmes for the detection of diabetic retinopathy aided by image-processing software for processing fundus images will save manpower and increase quality. Before this can happen, we need more clinical studies of store-and-forward techniques, so that they can be standardized and their effectiveness established against that of traditional analogue screening.

Diabetic Retinopathy↗
PubMed2002

Personal health care and the new media in anticoagulant treatment.

OBJECTIVE: To determine the feasibility of a more personal anticoagulant treatment follow-up routine involving the use of a personal measurement device along with the new media (e.g. the Internet). DESIGN: A telephone interview. SETTING: The municipality of Ikaalinen with a total population of 7795. SUBJECTS: Forty patients on anticoagulant treatment who have personal responsibility for their treatment follow-up. MAIN OUTCOME MEASURES: Demographic data, data and opinions on anticoagulant treatment and data and opinions on personal health care and the new media. RESULTS: More than two-thirds of the interviewed were generally pleased with the current AC treatment routine in the Ikaalinen area. Sixty-eight percent of the patients feel that they are able to determine the anticoagulant dosage from the follow-up test results and almost a third have independently changed their dosage. Approximately half of the interviewed were willing to take various health-related measurements at home, but approximately only 20% of the interviewed were ready to use health-related services; for example, related to the follow-up of anticoagulant treatment, through the new media. CONCLUSION: Part of the population receiving anticoagulant treatment is ready to move to a more personal treatment routine involving home measurements in follow-up tests. However, most interviewed patients were not interested in using the new media as part of the new routine.

Aged↗