Effect of telemedicine on patients' diagnosis and treatment
ABSTRACT We conducted a post-consultation survey during 1998-2002 (n = 412 consultations) in the Rural Hospital Telehealth Project run by the University of Arkansas for Medical Sciences. Changes in the patient's diagnosis and treatment plan as a result of the telemedicine session were assessed. There were 47 consultants, who conducted 2-82 consultations each. The teleconsultants established a diagnosis in 74 consultations. This was 26% of the 286 respondents. Of the 63 respondents for cases where there was a prior diagnosis and a change was applicable, 17 consultants (27%) reported that there was a change in the patient's diagnosis. The consultants established a patient treatment plan in 139 consultations. This was 52% of the 268 respondents. Of the 123 respondents for cases where there was a prior treatment plan and a change was applicable, 82 (67%) consultants reported a change in the treatment plan. The changes in diagnosis and management imply benefits for the rural population in Arkansas as a result of the use of telemedicine.
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ABSTRACT: Telemedicine is changing the way medicine can be practiced, and how medical knowledge is communicated, learnt and researched in today’s technologically oriented society. The adoption of internet based communication has significantly expanded the patients’ ability to access a multitude of world class medical information. Research has shown that patients would welcome the ability to consult a doctor using the same computing tools they use to communicate with family, friends and work colleagues. This paper discusses the use of telemedicine today and how it could be used to access medical services from home. Further, it investigates the incentives and barriers to widespread adoption of such services in Australia with particular reference to the issues of information security. The technology to make home telemedicine a reality is already available and all that remains for this to come to fruition is a shift in culture to accept it as a suitable alternative to current medical consultation practice.
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ABSTRACT: Ces recherches s'inscrivent dans la continuité du projet européen EPI-MEDICS qui a pour objectif la réalisation d'un moniteur personnel d'ECG (PEM). Le PEM est capable d'enregistrer un ECG 3D simplifié et capable d'envoyer par GPRS ou UMTS différents types de messages ou d'alarmes convoyant des ECG et un dossier médical de l'utilisateur. C'est dans ce contexte que nous avons cherché à améliorer l'intelligence du système en développant une plateforme auto-adaptative et auto-évolutive de détection automatique des dysfonctionnements du coeur. Cette plateforme permet de stratifier le risque de la survenue d'un évènement cardiovasculaire moyennant l'interprétation de l'ECG combinée avec l'historique médical de l'utilisateur. Nous avons également étudié un formalisme permettant de rendre l'ECG simplifié du PEM accessible, sous un format compréhensible et interprétable, aux professionnels de santé. Il s'agit de synthétiser un ECG standard 12D à partir de l'ECG 3D du PEM.
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ABSTRACT: This study was conducted in the context of health service planning in an environment of changing government strategies for regional, rural and remote area health care and telecommunications infrastructure planning in Western Australia. The study provides an account of the State Government of Western Australia's planning for the implementation of a telecommunications network infrastructure, and specifically the Telehealth Project, conducted between 1998 and 2002. The purpose of this study was to examine influences on community participation in planning within the dynamic political, economic and social forces that impact on the development of regional, rural and remote area health services. Specifically, the study outlines the issues and barriers in providing for significant local participation in projects that are centrally initiated and controlled. It examines the influences in planning for projects that incorporate local community based beliefs and needs, the requirements of collaborating with multiple state and national government departments, and the private sector. This study was situated within the interpretive paradigm, and is conceptualised within Donabedian's (1969) framework for assessing and assuring quality in health care. The methodological approach is bound within a case study and consists of a participatory action research approach. The research method uses the single case to undertake in-depth interviews, observations and a survey to collect data from community, government and industry members as a basis for reflection and action. The findings of the study clearly indicated that there was consensus between all rural, remote and metropolitan area participants that telecommunications did offer the opportunity to provide increased, improved or alternative health services. However, there were a number of obstacles to the success of the planning process, including a lack of local community inclusion in planning committees, poor communication within central government agencies, overuse of external consultants, a bias toward the medical view, a limited scope of invitation to contribute, and local information being overlooked in the final implementation plan. Analysis of planning for the Telehealth Project reveals the implications of organisational and political stakeholders making final decisions about outcomes; and provides a reminder of the importance of engaging communities authentically when planning for health and telecommunications services which involve the public and private sectors. The originality and significance of this study stems from understanding how technology can advance community health; through measures such as the use of community participation strategies, through authentic community based leadership, truly representative participants, decentralised decision making, a focus on community based health needs and change management strategies that include all of these. Consequently, the study advances knowledge of community participation in planning and the evidence suggests implications for practice, education and further research.