Biomedical subjects

M T Arredondo

Publications and source records attributed to M T Arredondo.

At least 19 recordsLinked to original sources

PubMed2002

Multimedia telehomecare system using standard TV set.

Nowadays, there are a very large number of patients that need specific health support at home. The deployment of broadband communication networks is making feasible the provision of home care services with a proper quality of service. This paper presents a telehomecare multimedia platform that runs over integrated services digital network and internet protocol using videoconferencing standards H.320 and H.323, and standard TV set for patient interaction. This platform allows online remote monitoring: ECG, heart sound, blood pressure. Usability, affordability, and interoperability were considered for the design and development of its hardware and software components. A first evaluation of technical and usability aspects were carried forward with 52 patients of a private clinic and 10 students in the University. Results show a high rate (mean = 4.33, standard deviation--SD = 1.63 in a five-points Likert scale) in the global perception of users on the quality of images, voice, and feeling of virtual presence.

Computer Communication Networks↗

PubMed2002

Integration of telemedicine into emergency medical services.

We developed an integrated model of telemedicine services in emergency medical care. The architecture was designed to support pre-hospital management. The experimental work was carried out with the collaboration of the emergency medical services (EMS) in Madrid. Two different study populations were defined: a control population using conventional EMS protocols and a population using the telemedicine system. The telemedicine system was based on a telepresence service; electrocardiograms and images were transmitted from the ambulance to the health emergency coordination centre. The cost of dealing with 100 patients using telemedicine was C6030 less than the cost of conventional care. The response times using telemedicine were significantly lower.

Attitude of Health Personnel↗

PubMed2002

An assistive home care environment for people with special needs.

We have developed a system for supporting people with special needs. It allows remote monitoring of electrocardiographic and other signals together with multimode environmental control. The multimodal approach allows users with disabilities to interact more with the home environment. Telemedicine devices were integrated into the system to provide a link to health services. The system provided support for the independent living of people with special needs. The pilot site was a rehabilitation service attached to the National Paraplegic Hospital of Toledo, Spain. During the six-week trial period, the system did not fail, nor was any unauthorized access reported. Twelve people with special needs and three staff evaluated aspects of the system on a scale from 0 to 9, on which higher scores indicated a positive assessment. The mean score for efficiency was 7.8, for satisfaction 8, for helpfulness 7.4, for controllability 7.2 and for learnability 8.

Persons with Disabilities↗

PubMed2002

Theoretical efficiency of a televisiting service for home care support.

We have made a theoretical study of the potential for televisiting. All journeys made by the home care support team in an area of Madrid were reviewed to study the possibility of using televisiting. During the year 2000 the team provided an average of seven home visits a day. The home visits took 30 min on average, and the journey time was 30 min for urban areas and 45 min in the suburbs. We estimated that two of each day s visits could be carried out by telemedicine, with a mean duration of 15 min each. A model was used to calculate the resource demands and the potential cost-savings of televisiting compared with traditional home care. Using televisiting, 62% more suburban oncology patients could be managed and a cost reduction of euro;6 per visit could be achieved after 10 weeks.

Aged↗

PubMed2002

A telemedicine model for integrating point-of-care testing into a distributed health-care environment.

Centralized testing demands costly laboratories, which are inefficient and may provide poor services. Recent advances make it feasible to move clinical testing nearer to patients and the requesting physicians, thus reducing the time to treatment. Internet technologies can be used to create a virtual laboratory information system in a distributed health-care environment. This allows clinical testing to be transferred to a cooperative scheme of several point-of-care testing (POCT) nodes. Two pilot virtual laboratories were established, one in Italy (AUSL Modena) and one in Greece (Athens Medical Centre). They were constructed on a three-layer model to allow both technical and clinical verification. Different POCT devices were connected. The pilot sites produced good preliminary results in relation to user acceptance, efficiency, convenience and costs. Decentralized laboratories can be expected to become cost-effective.

Clinical Laboratory Information Systems↗

PubMed2002

User satisfaction with home telecare based on broadband communication.

Home telecare services based on broadband communication were established in five locations in Europe. Two different types of telecare unit were developed: one based on a PC or set-top box containing a videoconferencing codec and another on off-the-shelf videoconferencing units. The participants in the project were 13 medical staff, 135 patients and 88 people informally caring for the patients. Questionnaires were used to evaluate user satisfaction with eight telecare services. Almost all participants rated the usability of the system as good or excellent. A total of 105 telecare sessions were scored by the medical staff. Overall, the quality of audio and video communication was judged satisfactory. For the patients and carers, the perceived quality of communication was also satisfactory and did not vary significantly between sites. The medical staff were reasonably satisfied with how the service supported them in their work. Except for the item about being able to support patients in a critical situation, medical staff agreed that an improved quality of health services was offered through telecare. All participants agreed that personal information was treated confidentially and that there was little risk in using the telecare services. The medical staff trusted the assessments they could make remotely while using the telecare system. Although the findings cannot be generalized due to the small number of telecare sessions and the relatively short duration of the experiment, the results encourage further research.

Adolescent↗

PubMed2001

Transmission trials with a support system for the treatment of cardiac arrest outside hospital.

A mobile electrocardiogram (ECG) transmission system was developed which could transmit single-lead ECG data via GSM mobile telephony. Ambulance transmission trials comprised a total of 72 communications, of which 94% were successful. The system was able to redial up to a predetermined number of times until the GSM call was re-established (during the trials this value was set to five). The average number of GSM call tries was 1.3 per connection. The mean time required to establish a connection was 45 s; the minimum was 34 s, when only one attempt was needed to establish a GSM call. The average duration of ECG transmission between communication breakdowns was 5 min 12 s. When a link breakdown occurred, the user had to wait for an average of only 42 s to continue monitoring the signal.

Electrocardiography↗

PubMed2001

Modelling home televisiting services using systems dynamic theory.

A quantitative model was developed to study the provision of a home televisiting service. Systems dynamic theory was used to describe the relationships between quality of care, accessibility and cost-effectiveness. Input information was gathered from the telemedicine literature, as well as from over 75 sessions of a televisiting service provided by the Severo Ochoa Hospital to 18 housebound patients from three different medical specialties. The model allowed the Severo Ochoa Hospital to estimate the equipment needed to support increased medical contacts for intensive cardiac and other patients.

Adult↗

PubMed2001

Mobile technologies in the management of disasters: the results of a telemedicine solution.

Nowadays a great number of applications are used to compile and transmit casualties and disasters information but there are many troubles associated with the technology as can be the communications reliability and the size and weight of the devices medical staff has to carry with. Telecommunication infrastructures support information movement among geographically dispersed locations. Recently a large family of little devices has appeared in the buyer's market. They are called Personal Digital Assistants and because of their physic and technical features, they are very useful in the emergency field. As for the communications reliability, many technologies have been developed in the last years but it is necessary to find a solution that can be used in whatever situation independently of the emergency circumstances. Facing this reality, the Spanish government funded REMAF, an ATYCA (Initiative of Support for the Technology, Security and Quality in the Industry) project. REMAF joined research groups (UPM), phone operators (Fundación Airtel Móvil) and end users (SAMUR) to build a disaster data management system conceived to use modern telemedicine systems to optimize the management in these situations, taking the advantage of the above mentioned mobile communication tools and networks.

Disasters↗

PubMed2001

Impact of a broadband interactive televisit/teleconsultation service for residential and working environments.

The availability of health care attention at the point of need is one of the key benefits of telemedicine. Home environment and working place are the two scenarios selected in this article to evaluate the impact of a televisit and teleconsultation service. 31 users from four different medical and patient groups participated in this study supported by European Commission ATTRACT project. The experiences, carried out in Madrid and Valencia Spanish sites, benefited from interactive broadband access networks to provide cost-effective telecare services. Key areas analyzed encompass systems usability, clinical outcomes, patients quality of care and infoethic issues. Services advantages were verified and compared both from patients and medical staff points of view. Main benefits pointed out refer to displacement reduction, better communication doctor/patient, provision of comfort or friendliness, more precise therapy follow-up and increases in patients sense of well being.

Attitude of Health Personnel↗

PubMed2000

Patient satisfaction with a home televisiting service based on interactive television over a cable network.

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.

Aged↗

PubMed1999

Using cable television networks for interactive home telemedicine services.

Most recent cable television network infrastructures can be used to deliver broadband interactive telemedicine services to the home. These facilities allow the provision of social and health services like medical televisiting for elderly, disabled and chronically ill patients; health tele-education; and teleconsultation on demand. Large numbers of patients could benefit from these services. There is also the increasing European tendency to offer customized home-care services. These applications are being developed and validated by a pilot project in Madrid as part of the ATTRACT project of the European Commission. The long-term aim is to develop broadband applications on a large scale to support low-cost interactive home telemedicine services for both patients and institutions.

Aged↗

PubMed1996

A telemedicine system for remote cooperative medical imaging diagnosis.

Telemedicine is changing the classical form of health care delivery, by providing efficient solutions to an increasing number of new situations: here we consider those which require some type of computer-supported cooperative work (CSCW) between health care professionals located in different clinical sites. This paper presents the design and development of a telemedicine system for remote computer-supported cooperative medical imaging diagnosis. The main and novel component of our system is a new CSCW distributed architecture, comprised by a collaborative toolkit to add audioconferencing, telepointing, window sharing, user's coordination and application synchronization facilities, either to existing or new medical imaging diagnosis applications. In comparison with existing CSCW products, mainly based on centralized architectures, our distributed toolkit is specially designed for telemedicine applications: to allow different levels of sharing between participants, to improve user feedback in highly interactive user interfaces, and to optimize the required communication bandwidth in order to implement a telemedicine CSCW application on almost any telecommunication network. This telemedicine CSCW system has been applied to build a cooperative medical imaging diagnosis application, in which two doctors, located in different hospitals, need to achieve a cooperative diagnosis on haemodynamic studies using cardiac angiography images. The design of the graphical user interface for this kind of telemedicine CSCW systems, a critical component which conforms any telemedicine application, is also addressed with a new methodological approach, to assure the system usability and final user acceptance. The telemedicine cardiac angiography pilot has been implemented, tested and evaluated within the Research Project 'FEST-Framework for European Services in Telemedicine' funded by EU AIM Programme.

Attitude to Computers↗

PubMed1995

A home telecare management system.

The increasing tendency to discharge chronic patients from hospital, as well as the growing expectation of improved quality of life for elderly and disabled people at home, was the original motivation for the development of a home telecare management system. The system allows a service centre to perform remote monitoring of biological signals and other data via the public telephone network, as well as to manage different emergency situations arising at home. The system is part of the FU-funded EPIC project (European Prototype for Integrated Care). It was tested in Belfast (Northern Ireland) and is currently being installed in Torre del Mar (Spain). This paper describes the system design and preliminary evaluation. The results indicate that the system operators find it highly acceptable in terms of efficiency, effectiveness, helpfulness, control and learnability. Integration of home telecare data with community-care information systems is essential if data captured at home are to be incorporated into the care process effectively.

Aged↗

PubMed1994

Telehygiene system for preventive chronopharmacology in space.

A remote computerized health care (telehygiene) system for space travel includes monitoring devices and pharmaceuticals aimed at the optimization of health and the environment. Early risk indicators are provided by dynamic characteristics of rhythms of several frequencies describing variation inside the physiologic range. These rhythm characteristics, assessed as one goes, can be updated and compacted as data accumulate by the use of chronobiologic software that resolves anticipated components of lower and lower frequency, thus providing summaries of data at intervals of differing length. At any time, harbingers of risk, including characteristics of circannual rhythms, can be retrieved in an instant. On their basis, early preventive action can be instituted for risk lowering and for delivery of timed treatment when needed. Preventive or curative health care in space and terrestrial spin-offs are the more effective the more of the chronome (time-structure) is resolved.

Aerospace Medicine↗

PubMed1994

A telemedicine distributed system for cooperative medical diagnosis.

Telemedicine is changing the classical form of health care delivery, dramatically increasing the number of new applications in which some type of distributed synchronous cooperation between health care professionals is required. This paper presents the design and development of a telemedicine distributed system for cooperative medical diagnosis based on two new approaches: 1) a distributed layered architecture specially designed to add synchronous computer supported cooperative work features either to new or existing medical applications; 2) the definition of a methodological procedure to design graphical user interfaces for telemedicine cooperative working scenarios. The cooperative work is supported by a collaborative toolkit that provides telepointing, window sharing, coordination and synchronization. Finally, we have implemented and installed the telemedicine system in clinical practice between two hospitals, providing teleconferencing facilities for cooperative decision support in haemodynamics studies. This specific implementation and a preliminary evaluation were accomplished under the Research Project FEST "Framework for European Services in Telemedicine" funded by the EU AIM Programme.

Computer Communication Networks↗

PubMed1994

A hybrid knowledge based system for therapy adjustment in gestational diabetes.

This poster describes a system to analyze self-monitoring data of gestational diabetic patients, for obtaining an assessment of their metabolic control with the final goal of supporting decision-making in therapy adjustment. The system is able to manage incomplete data and to make temporal reasoning under uncertainty, the two most important constraints when analyzing ambulatory monitoring data. Two different formalism have been used to represent and manage the knowledge: a dynamic Bayesian network and a production system based on rules. The outcomes provided by the whole system are: information on possible patient transgressions of the prescribed treatment and recommendations of treatment adjustments.

Artificial Intelligence↗

PubMed1993

A pen-based system to support pre-operative data collection within an anaesthesia department.

This paper describes the design and implementation of a pen-based computer system for remote preoperative data collection. The system is envisaged to be used by anaesthesia staff at different hospital scenarios where pre-operative data are generated. Pen-based technology offers important advantages in terms of portability and human-computer interaction, as direct manipulation interfaces by direct pointing, and "notebook user interfaces metaphors". Being the human factors analysis and user interface design a vital stage to achieve the appropriate user acceptability, a methodology that integrates the "usability" evaluation from the earlier development stages was used. Additionally, the selection of a pen-based computer system as a portable device to be used by health care personnel allows to evaluate the appropriateness of this new technology for remote data collection within the hospital environment. The work presented is currently being realised under the Research Project "TANIT: Telematics in Anaesthesia and Intensive Care", within the "A.I.M.--Telematics in Health CARE" European Research Program.

Anesthesia Department, Hospital↗