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At least 19 recordsLinked to original sources
PubMed1977

Telemedicine in critical care: an experiment in health care delivery.

We hypothesized that telemedicine -- medicine practiced from a distance using telecommunications -- can solve some problems related to the scarcity and maldistribution of specialists in critical care medicine. Using a two-way audiovisual link between a small private hospital and a large university medical center, we have provided daily consultations by an intensivist to patients in the small institution. During the first 175 days of the project we found: 1) regular consultations in critical care can be provided using the audiovisual link; 2) current technology is adequate but expensive; 3) telemedicine consultations can be made acceptable to users and providers; 4) telemedicine can be a valuable educational resource; 5) telemedicine can influence the process and probably the outcome of patient care; 6) the audiovisual link is superior to the telephone for these consultations; and 7) telemedicine can serve as an important link between a small hospital and a large medical center favorably influencing the quality of care in the critical care unit of the small hospital.

Audiovisual Aids↗
PubMed1977

Cost factors in urban telemedicine.

This paper reports on the cost effectiveness of a pediatric primary care system utilizing nurse practitioners (NPs) linked to a physician consultant through bidirectional interactive cable television. In addition, it discusses ways in which multiple uses enhance the economic feasibility of a telemedicine consultation link in a given geographic area. The overall consultation rate during periods of remote physician coverage was 21 per cent, compared with 24 per cent during on-site coverage. The telephone became a partial substitute for the TV for some uses but could not replace it in diagnostic decisions. As telemedicine is obviously underutilized in a one-satellite system, we compare a five-satellite network with other ways of delivering service. The resulting estimated cost of $18.50 an hour, or 2/3 of the cost of a physician providing direct care, includes a TV component of $5.30 an hour of use in a 1,750-hour year. The critical factor is that the NP can be a physician substitute if there is TV backup. The TV appears to prevent unnecessary referrals compared to a physician on site. Whether TV increases the length of the consult compared to the phone for conditions of equal severity is not entirely clear. If TV is compared to transporting a patient to a central place, the implicit value of transport time and disutility required to justify using TV is $7.55 per consult in a five-clinic network. Geographic and other barriers to physician availability enhance the potential for application fo telemedicine.

Child↗
PubMed1979

Provider attitudes toward STARPAHC: a telemedicine project on the Papago reservation.

Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC), is a large-scale telemedicine project, sponsored jointly by the Indian Health Service (IHS), NASA, and the Papago tribe, and in operation on the Papago Indian Reservation outside Tucson Arizona, for the past two years. STARPAHC uses a mobile health unit (MHU), staffed by non-M.D. providers and linked by two-way television, radio, and remote telemetry to an IHS hospital up to 100 miles away, to make medical care available in remote areas of the reservation. Over a two-year-period beginning in January, 1975, 47 individual providers, including 21 physicians, were interviewed, at five intervals, to determine their receptivity to and acceptance of telemedicine; because of staff turnover, not all providers were interviewed at each different interval. Data suggests that television equipment was considered costly and in some cases inconvenient to M.D. providers; it was not considered always essential for providers to be able to diagnose and treat patients. The major problems providers cited were the unreliability of equipment and the time required for television consultations. The major benefit cited was improved access to health care for a population not previously receiving such care near their homes. Non-M.D. providers considered the link they were provided to physicians via television and voice communications from remote areas to be a major benefit.

Arizona↗
PubMed1992

Using telemedicine to improve health care in distant areas.

Many users consider telemedicine a partial solution to problems of delivering health care to remote areas or areas underserved by clinicians. Current telemedical technology benefits from recent developments such as the decreased cost and improved quality of the coder-decoder (codec) equipment used in interactive digital video systems and the expansion of fiber-optic cable networks. The authors outline some pioneering telemedicine programs of the 1960s and 1970s and describe two recently activated systems in Texas. One network, serving the western two-fifths of the state, links faculty members from four campuses of Texas Tech University Health Sciences Center with almost 40 rural communities. The other connects the state hospital and three other facilities in Austin with four health care sites in the town of Giddings, 65 miles away. Besides serving patients, the systems provide continuing medical education and support to reduce the isolation of rural health care professionals. Primary goals include evaluation and certification of telemedical training and analysis of the cost feasibility of telemedical services.

Delivery of Health Care↗
PubMed1992

[Good experiences with telemedicine in the regional hospital of Tromsø].

The University Hospital of Tromsø and the Norwegian Telecom Research project "Telemedicine in North Norway" has used video conferences as a tool in making remote diagnosis in the medical areas: Pathology, diagnosis from microscope images; dermatology, endoscopy in otorhinolaryngology, echocardiology and radiology. The project has also developed a communication system between general physicians and the department of the clinical chemistry in which test results are transported electronically from the laboratory to the physicians. Experience to date suggests that the quality of telecommunication in diagnostic services is good and that access to such facilities is beneficial to the users.

Diagnostic Imaging↗
PubMed1992

Telemedicine: military applications.

Communications technology has enjoyed enormous growth in recent years and should be fully exploited by the medical community. Its application as part of disaster response was well demonstrated in the aftermath of the tragic earthquake in Soviet Armenia in 1988. Besides disaster response, telemedicine also has application for patient care, diagnostic imaging, and training and education. This capability would be particularly beneficial to the armed forces of many nations. If the communications equipment were portable, it could be well employed during peacetime, yet easily deployed to the battlefield. Therefore, armed forces should fully exploit telecommunications technology for the practice of military medicine.

Armenia↗
PubMed1987

Continuing education through Telemedicine for Ontario.

Telemedicine for Ontario (TFO) is a continuing education program for health professionals. It is an interactive audio system, organized and operated by the five provincial medical schools, that is designed to offer otherwise unavailable educational programs to health professionals in northern or other isolated areas of Ontario. TFO has provided programs in three categories--medicine, nursing and allied health--and has covered a wide range of topics; the programs have been tailored to the stated needs and interests of the participants. By 1986 there were 199 sites throughout Ontario that participated regularly, and there were approximately 25,000 individual registrations in the 1985-86 seasons. Our results from this 3-year pilot study have indicated the feasibility of the medium and its acceptance by health professionals. The next stage of the program's evaluation will include analyses of its impact on clinical practice and on the health status of patients.

Allied Health Personnel↗
PubMed1977

A clinical evaluation of four alternative telemedicine systems.

A comparison was made of four alternative telecommunication systems used in delivering primary health care to remote populations. The media were color television, black and white television, still frame black and white television, and hands-free telephone. The patient population was that of a large organization in a Canadian province, a major component of a societal system. Over 1000 patients who came to a clinic seeking medical attention were examined remotely by one of the four systems. In addition, they were examined in the physical presence of a doctor at the clinic. The diagnoses, patient management programs, etc., of the clinic physician were used as the basis for comparison. We found no significant differences in diagnostic accuracy, proportion of supporting investigations requested, e.g., laboratory tests and X rays, time taken for the diagnostic consultations and the effectiveness of patient management across the four communication modes. On the contrary, in some instances it was found that behavior across the modes was significantly similar. Even patient attitudes showed only a slight preference for the more sensory rich modes of communication. It was concluded that there is little to distinguish the effectiveness of the four telecommunication modes when used for remote diagnostic consultations. Therefore, the cheapest mode is the most cost-effective. Phase four of the research program will compare the effects of the two least costly modes, still frame television and hands-free telephone, in an operational system in northern Ontario.

Attitude↗
PubMed1989

Telemedicine.

Ideally, health care is a communication-intensive process and information that relates to problem-solving and treatment regimens is exchanged constantly among health workers and between patients and their health-care providers. The primary health-care teams in a remote area of Queensland were linked with their base hospital, regional hospitals, a teaching hospital and an aerial retrieval team by means of AUSSAT 1. This article describes the changes in the health workers' consultations and in their patient-management practices when they used the satellite communications network. These changes resulted in improved health care and reduced some health-care costs.

Allied Health Personnel↗