Researchers Target Devices, EHRs

“HIMSS Analytics and the American College of Clinical Engineering, Plymouth Meeting, Pa., will survey hospitals to evaluate the patient safety and quality of care benefits of medical devices that share data with electronic health records.”
Article
Health Data Management, 9 October 2008

Robot suit rentals in Japan for disabled, elderly reads brain signals to help move legs

“A robotic suit that reads brain signals and helps people with mobility problems will be available to rent in Japan for US$2,200 a month starting Friday — an invention that may have far-reaching benefits for the disabled and elderly.
HAL — short for “hybrid assistive limb” — is a computerized suit with sensors that read brain signals directing limb movement through the skin.”
Article
Mainichi Daily News, 7 October 2008

IBM introduces new mobile services for healthcare organizations

“IBM has announced new services to help healthcare organizations implement wireless mobility solutions.
IBM Enterprise Mobility Services is designed to give clinicians and nursing staff wireless communications and real-time access to patient records anywhere on the facility premises, according to IBM.”
Article
Bernie Monegain, Healthcare IT News, 12 September 2008

Journal of Telemedicine and Telecare, TOC, September 2008

Telemedicine can improve the health of youths in detention
“Young people in correctional care facilities often have physical or psychological disorders that contribute to their behavioural problems. In the US, the need for medical services in youth facilities far exceeds current resources, especially for paediatric mental health and specialty services. There is obvious potential for telemedicine to improve access to care and thus the level of health care for juvenile detainees. A few studies have indicated that in specific instances telemedicine has improved access to care, referrals, contact between providers, and has also reduced unnecessary referrals. The question remains, however, whether this improved access and timeliness to care has any effect on the major goals of the incarceration: treatment, education and rehabilitation. Further investigation of this linkage is needed.”
Abstract
Karen C Fox and Anna Lyn Whitt, J Telemed Telecare 2008;14 275-276, doi:10.1258/jtt.2008.008002

Emergency telepsychiatry
“Telepsychiatry can be used in two kinds of psychiatric emergencies: one-time clinical events and public health situations associated with mass disaster. Emergency telepsychiatry delivered by videoconferencing has the potential to improve patient care in many settings. Although experience is limited, it has been found to be safe and effective, as well as satisfactory to both emergency department staff and the psychiatric patients treated. The development of comprehensive and standardized guidelines is necessary. There has been little use of acute telemedicine in disaster situations to date. However, telemedicine is becoming part of routine emergency medical response planning in many jurisdictions. Emergency telepsychiatry has the potential to reduce emergency department overcrowding, provide much needed care in rural areas and improve access to psychiatric care in the event of a natural or manmade disaster.”
Abstract
Peter Yellowlees, Michelle M Burke, Shayna L Marks, Donald M Hilty, and Jay H Shore, J Telemed Telecare 2008;14 277-281, doi:10.1258/jtt.2008.080419

Hageseth’s principle of extraterritorial jurisdiction and international telemedicine
“At what point does an international telemedicine transaction create a sufficient commercial nexus to allow one country the authority to impose its laws on a foreign telemedicine providers? Some light on this matter was shed by the US case of Hageseth versus Superior Court. The authority for extraterritorial jurisdiction is found in the US Constitution, which requires the states to cooperate in matters of law enforcement. Similar cooperation from foreign nations cannot be expected. Unless a defendant is charged with a capital offence, nations are rarely willing to extradite their citizens. As the unlicensed practice of medicine is not a capital offence, it is unlikely that an unlicensed telemedicine provider would be extradited to the US. Because low-volume unlicensed offshore telemedicine providers are unlikely to be extradited or to be subject to trade sanctions, they may be able to operate beyond the law.”
Abstract
Thomas R McLean and Alexander B McLean, J Telemed Telecare 2008;14 282-284, doi:10.1258/jtt.2008.080416

The use of information and communications technology for health service delivery in Namibia: perspectives of the health service providers
“We surveyed health service providers in Namibia to find out how they used information and communication technologies (ICTs) to deliver health services to their patients. A structured questionnaire was administered to 21 health service providers in two regions of the country (one urban, one rural). There was overwhelming consensus among the health service providers that ICTs were very important, especially for medical services (100%). Ninety-one percent of health service providers viewed ICT as helping them to interact with other providers in other health institutions. The most commonly used ICT was the telephone, which was used in the admission areas of most health institutions (36%); the next most commonly used ICT was the PC (23%). The most commonly used channels for communication with patients were the telephone followed by TV. Some of the problems common to all health institutions in Namibia were poor budgetary resources and lack of basic infrastructure such as electricity or telephone lines. There is a need to promote ICT use for health service delivery and also to stimulate patients to use ICT to access health services and relevant information.”
Abstract
Meke I Shivute, Blessing M Maumbe, and Vesper T Owei, J Telemed Telecare 2008;14 285-289, doi:10.1258/jtt.2008.071204

Assessment of a remote monitoring system for implantable cardioverter defibrillators
“We conducted a multicentre study in five Italian hospitals to assess the feasibility of a remote monitoring service for the follow-up of implanted cardiac devices. The system was designed to monitor device performance as well as physiological aspects of the patient’s condition. Sixty-seven patients (mean age 64 years) affected by chronic heart failure and with a biventricular implantable cardioverter defibrillator for cardiac re-synchronization therapy (CRT-D) were enrolled for a three-month observation period. A total of 267 device recordings were transmitted through the ordinary telephone network, with a success rate of 99%. The telemonitoring service was more efficient than conventional face-to-face follow-up in terms of the time savings: both for physicians (4.7 minutes versus 15 minutes for remote and conventional monitoring) and for patients (6.6 minutes versus 116.3 minutes). In addition, a total of 23 clinical events occurred during the study, but only two cases required a clinic visit, thus reducing inappropriate hospital admissions. Finally, the service was well accepted by all the users.”
Abstract
Cristina Masella, Paolo Zanaboni, Francesca Di Stasi, Serena Gilardi, Patrizia Ponzi, and Sergio Valsecchi, J Telemed Telecare 2008;14 290-294, doi:10.1258/jtt.2008.080202

Quality of diabetes care among patients managed by teleconsultation
“We studied a new teamwork-based teleconsultation model for treating patients with diabetes, where a specialist in diabetes care, a diabetes nurse and a patient attended by videoconference. The study series consisted of all the patients (n = 101) at three health centres in northern Finland whose care was provided by a single physician at a remote diabetes clinic. A total of 101 patients with diabetes (19 of type 1 and 82 of type 2) were studied at baseline and at 10–14 months after the first consultation. Mean HbA1c was 8.0% at baseline and 7.6% at follow-up (P = 0.007). The proportion of patients with poor glycaemic control decreased from 32% to 13%. Mean LDL cholesterol was 3.3 mmol/L at baseline and 2.7 mmol/L at follow-up (P < 0.001). The percentage of patients with optimum lipid levels increased from 20% to 50%. Mean systolic blood pressure was 146 mmHg at baseline and had decreased by 6 mmHg at follow-up (P = 0.004). The percentage of patients with poor blood pressure control decreased from 19% to 8%. The most common changes in medication were the introduction or modification of insulin treatment and the introduction of statin and antihypertensive drugs and acetylsalicylic acid. Although the study was uncontrolled, there were improvements in glucose and LDL cholesterol levels and blood pressure in patients who were managed by teleconsultation.”
Abstract
Tuula Nikkanen, Markku Timonen, Kirsti Ylitalo, Olavi Timonen, Sirkka Keinänen-Kiukaanniemi, and Ulla Rajala J Telemed Telecare 2008;14 295-299, doi:10.1258/jtt.2008.080313

Impact of telemonitoring at home on the management of elderly patients with congestive heart failure
“We studied the effects of home telemonitoring in elderly patients with congestive heart failure (CHF) on mortality and rate of hospitalization, compliance with treatment, quality of life and costs of CHF management, by comparison with a group receiving usual care. Fifty-seven elderly CHF patients were randomized to standard care or to home telemonitoring-based care and followed for 12 months. In the subjects who were monitored, weekly reports on their clinical status were obtained and their management was modified accordingly. Home telemonitoring was associated with improvements in the composite endpoint of mortality and rate of hospitalizations (P = 0.006), a better compliance with therapy, more frequent use of beta-blockers and statins, lower total cholesterol level and a better reported health perception score. The improved results with home telemonitoring in CHF were probably due to better compliance and to closer monitoring of the patients.”
Abstract
Roberto Antonicelli, Paolo Testarmata, Liana Spazzafumo, Cristina Gagliardi, Grzegorz Bilo, Mariaconsuelo Valentini, Fabiola Olivieri, and Gianfranco Parati, J Telemed Telecare 2008;14 300-305, doi:10.1258/jtt.2008.071213

Acceptability to primary care providers of telemedicine in diabetes case management
“We studied the perceptions of primary care providers (PCPs) about the telemedicine intervention in a trial of telemedicine for management of diabetes in medically under-served areas of New York State. A survey was mailed to 206 rural and 159 urban PCPs. The response rates were 25% and 22%, respectively. Eighty percent of respondents believed that a diabetes telemedicine case management system would help their practice. An overall satisfaction score (possible range 0–80) suggested good acceptability (mean 66, SD 12). In multiple linear regression, the rural location and younger age of the PCPs were independent predictors of higher satisfaction (both P < 0.01). Within-PCP comparisons showed a higher perceived impact on patients, as compared to impact on PCP practices (P < 0.001). However, the findings should be interpreted with caution due to the low response rates."
Abstract
Walter Palmas, Jeanne Teresi, Ruth S Weinstock, and Steven Shea, J Telemed Telecare 2008;14 306-308, doi:10.1258/jtt.2008.080410

The use of telemedicine to aid in assessing patients prior to aeromedical retrieval to a tertiary referral centre
“We evaluated the effect of telemedicine compared with traditional telephone conversations when evaluating patients for aeromedical retrieval. A convenience sample of consecutive patients referred for retrieval from Palm Island over a six-month period was compared retrospectively with patients referred during the previous six months. There was a significant difference (P = 0.014) in the number of patients referred in the telemedicine period (113) compared to the previous six months (78), which may have been a seasonal fluctuation. There was a smaller proportion of aeromedical retrievals in the telemedicine period (78%) compared to the control period (92%), P = 0.009. Other significant differences between the telemedicine and control period included a larger proportion of patients not transferred at all (16% compared to 5%, P = 0.022) and a smaller percentage of rotary flights (52% compared with 73%, P = 0.004). Retrieval coordinators perceived that telemedicine use prevented 10 aeromedical flights and six night flights. The coordinators and referrers felt that telemedicine improved patient care in 75% and 65% of consultations, respectively. The coordinators felt that it improved communication with the referring doctor for 84% of the consultations.”
Abstract
Kate A Mathews, Mark S Elcock, and Jeremy S Furyk, J Telemed Telecare 2008;14 309-314, doi:10.1258/jtt.2008.080417

A pilot study of videotelephone-based support for newly diagnosed paediatric oncology patients and their families
“As part of the preparation for a randomized controlled trial, we conducted a pilot study to investigate the feasibility of providing videotelephone-based support to a sample of families (,em>n = with a child diagnosed with cancer, returning home for the first time after diagnosis and initial treatment. Seven of these families received support via videotelephone over a three-month period. Twenty videotelephone calls were made totalling 400 minutes (median 21 min, IQR 16–24). All videotelephone calls involved the specialist nurse providing support to mothers (85%) or fathers (15%) and involved communicating directly with the patient in most of the calls (55%). Social workers were involved in three calls (15%). All families expressed satisfaction with services delivered in this way. There were few technical problems. The use of a hybrid approach to providing videotelephony, using the family home computer and Internet connection for video and the home telephone line for full-duplex audio, was less costly than the custom-made device used in past studies.”
Abstract
Mark Bensink, Nigel Armfield, Helen Irving, Andrew Hallahan, Deborah Theodoros, Trevor Russell, Adrian Barnett, Paul Scuffham, and Richard Wootton, J Telemed Telecare 2008;14 315-321, doi:10.1258/jtt.2008.080505

Telemedicine in the work site: a study of feasibility, and patient and provider satisfaction
“We examined the use of telemedicine for improving access to care in a work-site clinic. A prospective study of 100 patients was conducted over a four-month period in a work site that housed 700 employees. Sinusitis (10 visits), upper respiratory tract infections (9 visits), otitis media (9 visits), hypertension (9 visits) and back pain (8 visits) were the most common reasons for the visits. In 99 visits, clinicians were of the opinion that the telemedicine visit felt similar to a face-to-face visit. For most of the visits (67), patients strongly agreed or agreed that telemedicine had a positive effect on their relationship with the health-care provider. The otoscope, microscope and stethoscope telemedicine peripherals were important in aiding diagnosis (and ruling out other causes) in about 55% of the visits (upper respiratory tract infection, sinusitis, otitis media, cough, sore throat, nevi, rhinitis and ear wax related concerns). The ability for the patient to watch their ENT examination and see any associated abnormalities was appreciated by many patients. Physicians, nurses and patients were capable of using the technology with little training.”
Abstract
Prathibha Varkey, Kay Schumacher, Claudia Swanton, Barbara Timm, and Philip T Hagen, J Telemed Telecare 2008;14 322-325, doi:10.1258/jtt.2008.080512

FDA OKs Intel Telemedicine Device

“The chip maker will work with a yet-to-be-announced manufacturer to produce an Intel-branded computer with a touch-screen for use in the homes of patients, especially those with chronic illnesses, says Ray Askew, Intel’s chronic disease management market segment manager. The small devices, measuring 11 inches by 3.5 inches by 10.5 inches, will include a camera for video conferencing between patients in their homes and clinicians. The devices also will have storage capability so that patients can enter data when Internet access is interrupted, Askew says.”
Article
Health Data Management, 1 September 2008

Meeting the Requirements of Project HealthDesign: Comparative Analysis with Respect to Existing and Emerging Clinical Data Standards and Commercial PHR Data Repositories

“Funded by the Robert Wood Johnson Foundation (RWJF), in collaboration with the California HealthCare Foundation, Project HealthDesign is a $5 million national program of PHR systems. Administered by a national program office at the University of Wisconsin-Madison, Project HealthDesign’s goal is to design and test a variety of PHR tools and applications that work together to help people achieve their various and specific health goals in an integrated fashion.
The program is supported by the Foundation’s Pioneer Portfolio, which funds innovative projects that can lead to breakthrough improvements in the future of health and health care.”
Report
Sujansky & Associates, LLC, Project HealthDesign, August 2008

Security in Medical Devices, implications

“There are more and more examples of how standard hacking techniques apply in healthcare, with serious consequences. Recent issues include RFID hacking and interference issues.
Recently, a talk at BlackHat regarding hacking medical devices, including pacemakers, has begun appearing in popular blogs.
What is most dangerous about this is not actually the hack itself, but the fact that the hacks could become widespread. Think about it; there is no real benefit to a hacker to simply kill a person. It is a serious crime and unless there is something to gain by doing it, it is unlikely to generate new interest with blackhat hackers.”
Article
Fred Trotter, 9 August 2008

House calls

“In the future, our homes will not only be the place we lay our heads, but our pillows could even know if we need medical attention.”
Article
Donna Laporte, Toronto Star, 2 August 2008

Platform for wearable health devices launched

“Irish developer Realtime Technologies has launched a new hardware research platform called Shimmer, designed for wearable health sensing in both connected and wireless environments.
Shimmer stands for Sensing Health with Intelligence, Modularity, Mobility, and Experimental Reusability, and uses Intel technology to help find new ways to monitor vital signs from devices worn by patients.”
Article
e-Health Europe, 30 July 2008

Doctors On The Go Drive Wireless Healthcare

“The increase in the level of healthcare being delivered by mobile medical practitioners outside of hospitals will become a key driver within the medical device market over the next decade. According to a report by Cambridge UK based analysts Wireless Healthcare, as healthcare providers are pushing more diagnostic and monitoring processes out to the edge of their care networks, medical device vendors are responding by adding more advanced communications technology to their products.”
Article
Wireless Healthcare, 23 July 2008

Device Identification, Synchronization Can Boost Patient Safety

“When peanut butter contaminated with salmonella was recalled last year, it was quickly and efficiently removed from grocery store shelves. Health care providers and suppliers, however, can’t reliably identify potentially life-threatening recalled or defective devices. Unlike virtually every other product in commerce, medical supplies and devices cannot be identified in a systematic and consistent manner.”
Article
Joseph Pleasant, HHNMostWired, 23 July 2008

Der elektronische Gesundheits-Check

“Wenn der Nachwuchs noch klein ist, wollen Eltern ihn am liebsten lückenlos überwachen. Sie wollen wissen, wo er ist, was er macht und wie es ihm geht. Irgendwann aber dreht sich das um: Haben die Eltern das Rentenalter erreicht und steht es mit ihrer Gesundheit nicht mehr zum Besten, sind es die Kinder, die stets über das Wohlbefinden von Mutter und Vater informiert sein wollen.”
Article (German)
Alexander Stirn, F.A.Z., 21 July 2008

Intel gets approval for telecare device

“Intel has received market clearance from the Food and Drug Administration (FDA) for a new personal telehealth system, called Intel Health Guide.
The new telecare device, which has been tested in the US and UK, is described as a care management tool for healthcare professionals who manage patients with chronic conditions.
Intel says the device serves as a new category of ‘personal health system’ that can be connected to a range of wired and wireless patient monitoring devices, sending personal data to a secure server.”
Article
e-Health Insider, 14 July 2008

Public views of mobile medical devices and services: A US national survey of consumer sentiments towards RFID healthcare technology

“A 2007 national public opinion survey of 1404 Americans revealed variations in sentiments concerning the desirability of several mobile healthcare technologies based on RFID. The survey appears to be the first reasonably national public opinion survey of US adults concerning their attitudes towards mobile healthcare technology. The survey revealed high levels of interest in emergency intervention services, but much less so in health information and monitoring services. Interest in RFID personal medical technology was positively associated with high levels of trust in others and social support. At the same time, a small minority were negatively disposed towards such applications. In those cases, the negative sentiment appears heightened when the mobile healthcare application is offered in a modality attached to the body as opposed to a somewhat more physically remote option, i.e., attached to one’s cell phone.”
Abstract
James E. Katz and Ronald E. Rice, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 10 July 2008, doi:10.1016/j.ijmedinf.2008.06.001

Intel gets FDA OK for personal health system

“Intel Corp, the world’s biggest computer chip maker, said on Thursday it won clearance from the U.S. Food and Drug Administration to sell a personal in-home health monitoring system for patients with chronic conditions.
The system, called Health Guide, combines an in-home patient device as well as online access that enables healthcare professionals to monitor patients and remotely manage care.”
Article
Reuters UK, 10 July 2008

Microsoft and Kaiser Permanente Partner on Health Data Project

“Kaiser Permanente and Microsoft Corp. announced they will pilot health data transfers between Kaiser Permanente’s My Health Manager and the Microsoft HealthVault consumer health platform to expand consumer access to online health information and management tools. My Health Manager’s more than 2 million users have online access to clinical information and health management tools, including e-mail communications with their doctors, online prescription refills, and appointment scheduling. Connecting to the HealthVault platform will allow users to combine personal health information from Kaiser Permanente and a range of health and wellness management applications and devices, such as blood pressure monitors.”
Article
Nurse.com, 7 July 2008

Multiple benefits of remote patient monitoring devices increase their potential

“In the past, healthcare executives were not supportive of remote patient monitoring (RPM) devices because of the costs involved. However, the quality and benefits of available RMP technology are making the devices increasingly attractive.”
Article
HealthTech Wire, 1 July 2008

Flaws in medical coding can kill

“After a routine piece of medical equipment started mysteriously killing hospital patients a few years ago, the federal government turned to a small team of its software experts in suburban Maryland for help.
The team’s discovery - a flaw in a computer code that caused a drug pump to administer heavy overdoses - led to a recall, warnings and rewriting of the equipment’s software. The discovery also illustrated a new threat behind some lifesaving medical devices.”
Article
Jonathan D. Rockoff, The BAltimore Sun, 30 June 2008

Telemedicine and eHealth, TOC, June 2008

Mobile Health Clinics and Telemedicine
“Think of mobile health clinic and what comes to mind? Depending on where you live, it might mean Tommy the Tooth van dispensing free brushes and toothpaste to the community. Maybe a loved one received a mammogram in their small town or received diabetes education. The Lions Club may have sponsored a mobile vision clinic where senior citizens were screened for glaucoma. Perhaps migrant farm workers lined up for
hours to get free medical care while working in the fields. Whether you live in the city or the country, chances are some type of mobile health clinic has visited your community sporting colorful graphics on the outside and various medical/dental services on the inside.”
Article
Kevin D. Blanchet,Telemedicine and e-Health. June 2008, 14(5): 407-412.

Acceptance of Telemonitoring to Enhance Medication Compliance in Patients with Chronic Heart Failure
Sixty-two congestive heart failure patients participated in a controlled, longitudinal study at two ambulatory medical centers in Hamburg, Germany. Two groups, a control (no telemedicine intervention) and the study group (telemedicine) were evaluated for medication intake. A medication box, networked to the patient’s electronic health record, was used for the telemedicine group. The main objective was to evaluate noncompliance of medication intake. The research showed that the system was effective. However, nearly 50% felt it was not necessary to continue the reporting after the study.
Article
Silke Schmidt, Sarah Sheikzadeh, Britta Beil, Monica Patten, Jürgen Stettin, Telemedicine and e-Health. June 2008, 14(5): 426-433.

Clinical Management and Patient Outcomes Among Children and Adolescents Receiving Telemedicine Consultations for Obesity
A retrospective review of patient medical records was conducted of children and adolescents who received pediatric weight management consultations using telemedicine. Ninety-nine patient files were reviewed. Analysis indicated that weight management using telemedicine can result in modification in patient care plans and outcomes.
Article
Ulfat Shaikh, Stacey L. Cole, James P. Marcin, Thomas S. Nesbitt, Telemedicine and e-Health. June 2008, 14(5): 434-440.

Optometric Referrals to Retina Specialists: Evaluation and Triage via Teleophthalmology
A teleophthalmology program linked Canadian optometrists to retina specialists for 171 patients and 190 consultations. In this carefully described study, 21/25 patients who required treatment condensed their visit to the specialist to a single day by having diagnostics done by telemedicine. Office visits to the specialist were reduced by 48%.
Article
Chris Hanson, Matthew T.S. Tennant, Chris J. Rudnisky, Telemedicine and e-Health. June 2008, 14(5): 441-445.

The Value of Provider-to-Provider Telehealth
The Center for Information Technology examined the value of providers with the patient and a distance site using three models of telehealth: store-and-forward, real-time video, and hybrid systems. A detailed literature review was conducted to elucidate where value had been reported. The data was evaluated by a computer simulation, which calculated the national value of provider-to-provider telehealth. Overall, the potential benefits of telehealth far outweigh the implementation costs, especially in emergency departments.
Article
Eric Pan, Caitlin Cusack, Julie Hook, Adam Vincent, David C. Kaelber, David W. Bates, Blackford Middleton, Telemedicine and e-Health. June 2008, 14(5): 446-453.

A Wireless Medical Information Query System Based on Unstructured Supplementary Service Data (USSD)
Wireless data management and data access for telemedicine extend far beyond the realities of short text messaging limits. This report offers a query system based on Unstructured Supplementary Service Data (USSD) that can work at 100 bit/sec with the advantage to limited system consumption, terminal support, and expense.
Article
Zhelong Wang, Hong Gu, Dewei Zhao, Weiming Wang, Telemedicine and e-Health. June 2008, 14(5): 454-460.

Acceptability of Telepsychiatry in American Indians
The acceptability of conducting psychiatric assessments with rural American Indian veterans by real-time videoconferencing versus in person visits was evaluated. Fifty-three North Plains American Indian veterans from the Vietnam Era participated in this study. A videoconferencing link between the University of Colorado at Denver Health Science Center and the rural community was established. Participants were administered the Structured Clinical Interview for DSM-III-R (SCID) for psychiatric assessments using this videoconferencing link. This assessment tool was administered face-to-face by telehealth in different ways and by different interviewers. Telepsychiatry was well received and was comparable to in-person interactions.
Article
Jay H. Shore, Elizabeth Brooks, Daniel Savin, Heather Orton, Jim Grigsby, Spero M. Manson, Telemedicine and e-Health. June 2008, 14(5): 461-466.

An Experience of Health Technology Assessment in New Models of Care for Subjects with Parkinson’s Disease by Means of a New Wearable Device
This report characterizes a system combining gastrocnemius expansion measurement unit (GEMU), a step-counting device, with a telemedicine application for patients with Parkinsonism. GEMU by telemedicine correlated strongly with motion decrement in a robust and reliable system, which enjoyed high user acceptance.
Article
Daniele Giansanti, Giovanni Maccioni, Sandra Morelli, Telemedicine and e-Health. June 2008, 14(5): 467-472.

Development of a Multidisciplinary Osteoporosis Telehealth Program
This report from Toronto details a comprehensive women’s bone health program with referrals from 20 family doctors. The patients engaged in an average 2-hour consultation with very positive perceptions. Increased access to care was the principle outcome.
Article
Leigh Dickson, Cathy Cameron, Gillian Hawker, Azeena Ratansi, Ina Radziunas, Vinita Bansod, Susan Jaglal, Telemedicine and e-Health. June 2008, 14(5): 473-478.

Uncompressed Video Image Transmission of Laparoscopic or Endoscopic Surgery for Telemedicine
A robust, high-speed telecommunications link was established between Shanghai, China and Fukuoka, Japan for videoconferencing. This system was utilized to support real-time interactions during laparoscopic and endoscopic surgical procedures. Images, transmitted via a digital video transfer system (DVTS), were evaluated by participating physicians who completed a mini-questionnaire. A number of hospitals across the region participated, including Japan, Korea, Hong Kong, and Taiwan. Thirty-eight physicians completed the questionnaire. The majority (73.8%) indicated the images were very good. This tool has been viewed as an efficient and useful tool for the medical community in this region.
Article
Ke-Jian Huang, Zheng-Jun Qiu, Chun-Yu Fu, Shuji Shimizu, Koji Okamura, Telemedicine and e-Health. June 2008, 14(5): 479-485.

Using e-Health to Enable Culturally Appropriate Mental Healthcare in Rural Areas,br /> Relevant research issues in providing culturally appropriate e-mental health care were reviewed with intent to determine where research efforts could be expanded or prioritized. A workshop was held in California to address the provision of mental health care in rural areas due to a variety of barriers, including language, culture, and poverty. A set of recommendations for expanding and prioritizing research efforts was developed in both science and policy.
Article
Peter Yellowlees, Shayna Marks, Don Hilty, Jay H. Shore, Telemedicine and e-Health. June 2008, 14(5): 486-492.

Study: RFID Tags Can Mess Up Medical Devices

“Radio-frequency identification — a system of using tiny tags to track all sorts of products — could be a smart way for hospitals to keep tabs on everything from surgical sponges to patient beds. Indeed, some hospitals have already started adopting the technology.
Article
Jacob Goldstein, WSJ Health Blog, 24 June 2008

Electromagnetic Interference From Radio Frequency Identification Inducing Potentially Hazardous Incidents in Critical Care Medical Equipment

“Context: Health care applications of autoidentification technologies, such as radio frequency identification (RFID), have been proposed to improve patient safety and also the tracking and tracing of medical equipment. However, electromagnetic interference (EMI) by RFID on medical devices has never been reported.
Objective: To assess and classify incidents of EMI by RFID on critical care equipment.
Design and Setting: Without a patient being connected, EMI by 2 RFID systems (active 125 kHz and passive 868 MHz) was assessed under controlled conditions during May 2006, in the proximity of 41 medical devices (in 17 categories, 22 different manufacturers) at the Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. Assessment took place according to an international test protocol. Incidents of EMI were classified according to a critical care adverse events scale as hazardous, significant, or light.
Results: In 123 EMI tests (3 per medical device), RFID induced 34 EMI incidents: 22 were classified as hazardous, 2 as significant, and 10 as light. The passive 868-MHz RFID signal induced a higher number of incidents (26 incidents in 41 EMI tests; 63%) compared with the active 125-kHz RFID signal (8 incidents in 41 EMI tests; 20%); difference 44% (95% confidence interval, 27%-53%; P < .001). The passive 868-MHz RFID signal induced EMI in 26 medical devices, including 8 that were also affected by the active 125-kHz RFID signal (26 in 41 devices; 63%). The median distance between the RFID reader and the medical device in all EMI incidents was 30 cm (range, 0.1-600 cm).
Conclusions: In a controlled nonclinical setting, RFID induced potentially hazardous incidents in medical devices. Implementation of RFID in the critical care environment should require on-site EMI tests and updates of international standards.
Abstract
Remko van der Togt; Erik Jan van Lieshout; Reinout Hensbroek; E. Beinat; J. M. Binnekade; P. J. M. Bakker, AMA 2008;299(24):2884-2890

European Commission Unleashes €600m for Development of New Digital Solutions for Elderly People

“By 2020, 25% of the EU’s population will be over 65. To respond to this growing demographic challenge, the Council of Ministers approved today a Commission plan to make Europe a hub for developing digital technologies designed to help older people to continue living independently at home. The proposal, presented by the Commission on 14 June 2007, will provide some additional €150 million funding to a new European Joint Research Programme, resulting in a total investment of over €600 million. Through this new programme companies will be able to develop highly innovative digital products and services to improve the lives of older people at home, in the workplace and in society in general.”
Article
eHealthNews.eu, 24 June 2008

German communications firm brings Bluetooth to Continua

“Stollmann Entwicklungs, a German supplier of Bluetooth SIG’s Health Device Profile for medical devices, has made the mobile technology available to members of the Continua Health Alliance.”
Article
Chip Means, Healthcare IT News EU, 13 June 2008

Consumer acceptance of self-monitoring devices

“Interesting to see that consumers recognize the costs that come with (potentially) unnecessary visits to the office to monitor chronic conditions.”
Article
Ted Eytan, 3 June 2008

Prescribing Assistive-Technology Systems: Focus on Children With Impaired Communication

“Abstract
This clinical report defines common terms of use and provides information on current practice, research, and limitations of assistive technology that can be used in systems for communication.The assessment process to determine the best devices for use with a particular child (ie, the best fit of a device) is also reviewed. The primary care pediatrician, as part of the medical home, plays an important role in the interdisciplinary effort to provide appropriate assistive technology and may be asked to make a referral for assessment or prescribe a particular device. This report provides resources to assist pediatricians in this role and reviews the interdisciplinary team functional evaluation using standardized assessments; the multiple funding opportunities available for obtaining devices and ways in which pediatricians can assist families with obtaining them; the training necessary to use these systems once the devices are procured; the follow-up evaluation to ensure that the systems are meeting their goals; and the leadership skills needed to advocate for this technology. The American Academy of Pediatrics acknowledges the need for key resources to be identified in the community and recognizes that these resources are a shared medical, educational, therapeutic, and family responsibility. Although this report primarily deals with assistive technology specific for communication impairments, many of the details in this report also can aid in the acquisition and use of other types of assistive technology.”
Article
Larry W. Desch, Deborah Gaebler-Spira and the Council on Children With Disabilities, Pediatrics Vol. 121 No. 6 June 2008, pp. 1271-1280 (doi:10.1542/peds.2008-0695)

Evaware launches new telehealth platform

“Software developer, Evaware has launched a new telehealth device, which wirelessly connects with its Project E-vita web-based electronic patient record, enabling clinicians to remotely monitor the vital signs of their home-based patients.”
Article
e-Health Insider Primary Care, 22 May 2008

Researchers develop mobile diagnosis system

“A new system to transmit medical images via mobile phones has been developed by researchers at the Hebrew University of Jerusalem.
Developed by Yissum, the Hebrew University’s technology transfer company, the system provides an independent data acquisition device (DAD) at a remote patient site where users have no image display capabilities. The device is then connected to a hardware control multiserver unit at a central site via mobile phone technology with an advanced image reconstruction capabilities, with the processed data then returned to the DAD site.”
Article
eHealth Europe, 15 May 2008

Continua promises products by year end

“Continua Health Alliance says the first interoperable personal telehealth products, able to work with each other out ‘of the box’, will be in stores by year end.
The first standards produced by the industry Alliance, including health USB and Bluetooth standards, are due for publication in the next month.
Continua is a Intel-championed open industry alliance, that for the past two years has been fast-tracking efforts to develop standards for interoperable personal health systems and devices.”
Article
eHealth Europe, 14 May 2008

New electronic handover device launched

“A new Windows Mobile application called MedicMate, designed to provide doctors and consultants with handover electronic copies of patient notes, has been developed by CMO Global.
Based on US style ‘track and bill’ systems, the software allows users to securely log onto a web application and electronically enter patient notes on PDA or smartphone devices, which can then be read by the next user, once they securely log on.”
Article
e-Health Insider, 9 May 2008

EHR - Patient Managed?

It was said, it was said loudly and not by the least of persons. Don Holmquest, President and CEO of CalRHIO in his interview with HISTalk made it very clear:

“First we’ve got to figure out what a personal health record is. There’s lots of ideas about that. They sound wonderful. I would love to have one. Every time I try to create one for myself, I run out of time and interest.
We don’t think they will be practical until somebody other than the patient is putting the information into that record in a reliable way. Of course you have to permit the patient to interact with it – add stuff, comment on stuff, and correct stuff. It will be challenging to figure out what that is.“

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