Health IT behind bars

“Until recently, California’s record of health care for its prison inmates was abysmal. After lawsuits and a federal takeover, however, the state stands to have one of the best systems in the country in the next few years. It will be fueled by a massive investment in health information technology.
By the end of next year, if things go as planned, a high-speed fiber-optic network will link California’s 33 prisons, and each institution will have a fast local-area network connecting all its buildings. The goal is to have the entire system’s medical recordkeeping and other processes fully electronic by 2013.”
Article
Brian Robinson, GHIT Notebook, 8 October 2008

Cox Business Hooks Up Oklahoma Hospitals with Remote Data Tools

“Oklahoma’s largest not-for-profit health organization is expanding its telemedicine capabilities with an advanced data solution from Cox Business.
The data connections allow facilities in the Integris Health network to execute remote video consultations, real-time information exchange, imaging and voice-over-Internet-protocol applications.”
Article
Linda Haugsted, Multichannel News, 2 October 2008

Live Chat with Dr. Jason Hwang on Disruptive Innovation

“At a Live Chat today with Dr. Jason Hwang co-author of The Innovator’s Prescription: A Disruptive Solution for Health Care, (Sponsored by the World Healthcare innovation and Technology Congress) I asked him how he saw the recent and fast paced developments in mobile phone applications and technology having an impact on health care.”
Article
Fred Fortin, AJFortin.com, 23 September 2008

Kansas a telemed leader, schools also connecting

“Kansas has been a leader in the development of telemedicine technology.
“Kansas has been involved since, really, the very early stages. It’s one of the pioneers — especially the people at the University of Kansas Medical Center,” said Jonathan Linkous, CEO at the American Telemedicine Association.”
Article
Dave Ranney, KHI News Service, 15 September 2008

Hybrid Telemedicine Program Connects Rural Providers, Part 2

“Many regional health information organizations and telemedicine applications have fallen short of their potential. But by combining the two forms of technology, Louisiana health care providers are able to improve patient care in the state’s rural areas.”
Article
Jamie Welch, Andrew Hurd, HHNMostWired, 17 September 2008

Telemedicine supports patients on warfarin

“A clinical study has shown that telemedicine can be used to effectively support patients in the self-management of oral anticoagulation therapy. The study of 1,300 patients showed that one year of telemonitoring led to good results and increased patient self-confidence.”
Article
e-Health Europe, 15 September 2008

Mental health help for patients is just video screen away

“Fred Ramirez, a psychiatric nurse, watches a patient as she relates that her medicine hasn’t been completely effective.
He notes the tremors in her hand, studies her face and, in the end, agrees with her.
All this happens with patient and counselor separated by 400 miles — Ramirez in his office at JSA Health in Houston and the patient at a clinic in the West Texas town of Big Spring.”
Article
Bill Murphy, Houston Chronicle, 10 September 2008

Hybrid Telemedicine Program Connects Rural Providers, Part 1

“Louisiana last year showed a slight improvement in terms of overall health: Its ranking among the 50 states by the United Health Foundation crept to 49th place from 50th. With 21 percent of Louisiana residents uninsured and 32 percent residing in medically underserved rural communities, the state faces undeniable challenges in providing access to quality health care.”
Article
Jamie Welch, Andrew Hurd, HHNMostWired, 10 September 2008

My motivations

“I am a physician and researcher passionate on the “new” patient-health care provider relationship, specifically on topics of patient engagement and empowerment , virtual communities and support groups, new models of care for patients, remote patient monitoring, shared decision making, and equity in health through technology.
I am a ’survivor’ of three near-death experiences in early 2006 (an accident, a medical error, and a complicated surgery). My body shows the scars of lessons learned and my mind is filled with ideas and solutions on how to improve the patient experience and outcomes.”
Article
Carlosrizo.com, 9 September 2008

Assessment models for telemedicine services in national health systems

“Nowadays, decision makers of all national health systems have to correctly assess telemedicine services in order to take responsible decisions on the their adoption into the routine clinical practice. Since the 90s, a wide range of applications were tested, but evidence of benefits is still quite lacking. Scientific literature is mainly characterised, from the one hand, by few relevant theoretical studies which deepen the assessment dimensions or suggest guidelines about the implementation process. From the other hand, empirical and well-designed studies are generally focused on a single dimension, lacking in giving a comprehensive appraisal of the application. As consequence, the aim of this research consists, first of all, in presenting a complete framework that links the main assessment dimensions to the phases of the assessment process. Secondarily, the framework has to be supported by a good empirical analysis and a systematic methodological approach in order to support decision making.”
Abstract
Cristina Masella,  Paolo Zanaboni, International Journal of Healthcare Technology and Management 2008 - Vol. 9, No.5/6  pp. 446 - 472, DOI: 10.1504/IJHTM.2008.020198

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

Developing a National Inventory of Telehealth Resources for Rapid and Effective Emergency Medical Care: A White Paper Developed by the American Telemedicine Association Emergency Preparedness and Response Special Interest Group

“The unprecedented and growing threats to the safety and security of the U.S. population and many other countries around the world from Mass Casualty Incidents (MCIs), both natural and manmade, range in scope from the general and massive to directed and local. In a post-9/11 world, there is renewed emphasis to develop a global, systematic, coordinated, comprehensive strategy to improve medical response to catastrophic events. Such strategy must address all aspects of preparedness and response, including early detection, local risk awareness, containment, treatment of victims for each region or county involved, and subsequent prevention of injury or illness (mitigation). Communication from MCI sites to outside resource providers is a common problem. Communication gaps regarding medical needs may lead to delays in critical care.
This white paper focuses on ways to improve the quality of medical response to MCIs, using portable telemedicine technology and existing telemedicine installations. This document proposes a framework for the development of a seamless, hierarchical network that links health information and medical expertise to the point of need from the point of care at the national, regional, state, and local levels in MCIs.”
Article
David Balch. Telemedicine and e-Health. August 1, 2008, 14(6): 606-610. doi:10.1089/tmj.2007.0127.

Text Messaging in Healthcare: The Elephant Knocking at the Door

“In discussions of telemedicine modalities, text messaging, also more technically referred to as SMS for Short Message Service, isn’t the elephant in the room, the one everybody’s ignoring and afraid to talk about. Text messaging is the elephant at the door, the one everybody knows is trying to get into the room, but nobody’s quite sure how it’ll fit through the door, how big it is, or what exactly they’re going to do with it once it gets through.
Comparatively, the U.S. is behind the rest of the world in terms of text messaging. Research company SNL Kagan (Charlottesville, VA) released a report in 2007 estimating that 84% of the U.S. population—including consumers, business users and people with multiple units—would have mobile phones by the end of 2007, which would surpass 100% by 2013. Yes, that’s ‘surpass’ 100% due to the number of multiple unit owners. Informa Telecoms and Media (London, UK) reported in 2006 that thirty countries had exceeded 100% cell phone penetration in that year.
It is further estimated that 50% of the global population currently owns a mobile phone and 98% of those phones have text messaging capabilities. Here’s one more statistic to further drive home the growth of text messaging: According to messaging services provider Acision (Nieuwegein, Netherlands), on New Year’s Day, January 1, 2008, 43 billion text messages were sent globally.”
Article
Mark Terry. Telemedicine and e-Health. August 1, 2008, 14(6): 520-524. doi:10.1089/tmj.2008.8495.

Foundation of National Telemedicine and eHealth Council of Pakistan (NTmeHCP)

The Federal Ministry of Health, under the leadership of its Director General-Prof. Dr. Rasheed Jooma took this initiative in collaboration with WHO and organized a National eHealth policy Workshop. I on behalf of the Ministry of Health (MOH) coordinated & organized the workshop and gathered all the current & potential stake holders in Telemedicine and eHealth in Islamabad for 2 days ( August 21 & 22, 2008) where we deliberated extensively on formation of this group with its aims and objectives and a road map for the MOH to initiate a master plan for Telemedicine / eHealth in Pakistan. The group has an official status and will be formally notified by the MOH soon. Read the rest of this entry »

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

The Case for Telemedicinee

“In an article from NATIONAL CENTER FOR POLICY ANALYSIS, one of the key arguments is the shortage of primary care physicians and how telemedicine can extend their reach. Could it also reduce emergency room use - perhaps for the chronically ill especially with remote monitoring over the internet for blood pressure, glucose readings, etc. Telemedicine, if done right, can improve adherence to protocols and improve care. Two barriers noted is the reluctance of payers to approve this care and not allowing foreign doctors to provide care remotely, although I am not sure that I would agree with the latter.”
Article
John Sharp, eHealth, 25 August 2008

E-mail used to help Iraq doctors treat patients

“When a young Iraqi woman developed life-threatening complications during her pregnancy last year, the remedy came from an unusual source: e-mail.
Fearing they would have to abort the baby to save the mother, her doctors asked for help from the Swinfen Charitable Trust — a British charity that links up doctors in wartorn or impoverished nations with Western specialists through the Internet.”
Article
International Herald Tribune Europe, 14 August 2008

Geneva boosts telemedicine in Francophone Africa

“The decentralised nature of the Swiss confederation has given cantonal governments wide autonomy to spend their money, and Geneva authorities are now using their authority to boost telemedicine in a growing number of African nations.”
Article
e-Health Europe, 4 August 2008

Telemedicine allows better stroke treatment decisions than telephone consultations

“Establishing audio-video contacts between doctors and patients through the internet may have an immediate and profound impact on the treatment of stroke patients throughout the world, say researchers.
Dr. Brett C. Meyer, Co- Director of the UC San Diego Medical Center Stroke Center, describes this approach as telemedicine.”
Article
Malaysia Sun, 4 August 2008

Mobile Medicine for the Developing World

“Mention telemedicine and mobile health care in the United States or Europe and thoughts turn to multimillion-dollar suites of high-tech equipment or personal digital assistants (PDAs) with hefty monthly data charges.
In the developing world, however, the concept is as simple as a cell phone.”
Article
Neil Versel, Digital Healthcare & Productivity, 29 July 2008

Wal-Mart launches telemedicine business

“Leave it to Wal-Mart to continue to grow its franchise in health through yet another revenue center. This time it’s telemedicine.
The company will pilot telemedicine through retail clinics in Houston, and will be trademarked as Walk-In Telemedicine Health Care. Wal-Mart will be partnering with My Healthy Access and NuPhysicia, the private company that comes out of the long-successful telemedicine program at the University of Texas Medical Branch at Galveston. Telemedicine was been pioneered at U-T in Galveston over the past 10 years, and the program has global reach.”
Article
Jane Sarasohn-Kahn, The Health Care Blog, 29 July 2008

Newsletter Australasian Telehealth Society

Newsletter
25 July 2008

Leavitt visits southern Alaska, sees how telehealth is increasing access to care

“By using telemedicine and telehealth, patients who live in rural Alaska have better and timely access to critical care through medical specialties, such as cardiology, pediatrics and radiology.”
Article
Molly Merrill, Healthcare IT News, 24 July 2008

Journal of Telemedicine and Telecare, TOC, July 2008

Telerehabilitation for service delivery in speech-language pathology
“Communication disorders in adults and children can have a significant effect on their quality of life and on that of their families. Speech-language pathologists face several challenges in providing assessment and treatment services to such people. Challenges include facilitating equitable access to services and providing appropriate management within a changing social and economic context. Telerehabilitation has the potential to deliver services in the home or local community via videoconferencing and through interactive computer-based therapy activities. This form of service delivery has the capacity to optimize functional outcomes by facilitating generalization of treatment effects within the person’s everyday environment, and enable monitoring of communication and swallowing behaviours on a long-term basis. A number of image-based telerehabilitation applications have been used in the management of adult neurogenic speech and language disorders, stuttering, voice disorders, speech and language disorders in children, laryngectomy and swallowing dysfunction. Further development of such applications and other computer-based therapies, cost-benefit and cost-effectiveness analyses, and professional education are needed if telerehabilitation is to become an integral part of speech-language pathology practice.”
Abstract
Deborah G Theodoros, J Telemed Telecare 2008;14 221-224, doi:10.1258/jtt.2007.007044

Telehealth: a child and family-friendly approach to mental health-care reform
“Limited access to paediatric mental health services and high drop-out rates from treatment result in poor health outcomes for families with children with mental health problems. New ways of delivering care are required. Telehealth is a promising approach. The Family Help programme employs manualized, distance treatment by telephone. Participants in the Family Help programme (both adults and children) have reported a strong therapeutic alliance with their telephone coach. Participants also described how during treatment sessions they felt comfortable and safe in their own home; they did not feel stigmatized or judged; they had little apprehension about self-disclosure and they felt that treatment was delivered at their convenience. Treatment calls were often scheduled after typical working hours. Attrition rates were found to be very low and children actively engaged in the structured, distance treatment. Evidence-based, distance delivery using non-professionals is a promising approach to the delivery of paediatric mental health care.”
Abstract
Patricia Lingley-Pottie and Patrick J McGrath, J Telemed Telecare 2008;14 225-226, doi:10.1258/jtt.2008.008001

Effect of a behavioural health and specialty care telemedicine programme on goal attainment for youths in juvenile detention
“We conducted a pre-post study of the effect of a telepsychiatry counselling service on youths housed in three juvenile detention facilities. In the first year of the telemedicine programme, 321 psychiatry consultations were conducted via telemedicine; in the second year of the programme, 573 psychiatry consultations were conducted. Records for 190 students were then examined by two raters. The total number of behavioural goals for each adolescent increased from 8.2 in the pre-telemedicine year to 8.7 in the first year of telemedicine and then to 10.0 in the second year (P < 0.05). In Year 2 of the study, subjects also had a significantly higher number of goals in four of the five categories: education, family, health and social skills (P < 0.05). Although other changes at the youth detention facilities or in the juvenile justice system may have been partly responsible for the effects observed, the study suggests that telemedicine may be useful for improving the rate of attainment of goals associated with family relations and personality/behaviour."
Abstract
Karen C Fox, Pamela Connor, Elizabeth McCullers, and Teresa Waters, J Telemed Telecare 2008;14 227-230, doi:10.1258/jtt.2008.071102

Non-invasive monitoring of the activities of daily living of elderly people at home – a pilot study of the usage of domestic appliances
“We conducted a feasibility study of a system for non-invasive monitoring of subjects at home. Electrical activity was recorded from room lights and from electrical domestic appliances; this was translated into the probability of physical activity or a particular Activity of Daily Living (ADL). Thirteen volunteer subjects were monitored for a period of 6.4 months (range 3–8). The mean age of the subjects was 80 years and they all lived alone at home; one had moderate Alzheimer’s disease. A one-week validation was carried out to ascertain whether the recorded activity actually occurred. The results showed that daily and nocturnal activity could be well differentiated. The probability of having eaten, taken a bath and going to the toilet could be calculated each day. Eating was the most accurately measured ADL; toileting and bathing results were less accurate. The system appears to be a promising component of home telecare.”
Abstract
Georgina Corte Franco, Floriane Gallay, Marc Berenguer, Christine Mourrain, and Pascal Couturier, J Telemed Telecare 2008;14 231-235, doi:10.1258/jtt.2008.071207

A paediatric therapeutic alliance occurs with distance intervention
“We investigated whether a distance therapeutic alliance occurs when children receive manualized, cognitive-behavioural treatment via telephone, in the absence of face-to-face contact. The therapeutic alliance scores were measured in 55 child–parent pairs. The mean total Working Alliance Inventory child scores were 236 (95% confidence interval [CI]: 232, 240) and the mean parent scores were 245 (95% CI: 242, 247). Parent scores were significantly higher than child scores, although the difference may not be clinically meaningful. This study provides evidence that a strong therapeutic alliance does occur between child–coach and parent–coach pairs when treatment is delivered from a distance by non-professionals. The term ‘child’ encompasses both children and adolescents.”
Abstract
Patricia Lingley-Pottie and Patrick J McGrath, J Telemed Telecare 2008;14 236-240, doi:10.1258/jtt.2008.080101

International telepsychiatry: a study of patient acceptability
“An international telepsychiatry service was established between Denmark and Sweden for cross-cultural patient groups, such as asylum seekers, refugees and migrants. Over an 18-month period starting in mid 2006, 30 patients were treated by telepsychiatry (21 men and 9 women). The patients received mental health care by videoconferencing from providers who spoke the patients’ own language, i.e. without the assistance of interpreters. The total number of telepsychiatry sessions was 203 (range 1–22; average 6.8 sessions per patient). Patients completed a satisfaction questionnaire at the end of treatment. Seven patients (23%) were not able to complete a questionnaire, due to illiteracy and/or a psychotic condition. The rest of the patients (n=23) reported a high level of acceptance and satisfaction with telepsychiatry, as well as a willingness to use it again or recommend it to others. Any disadvantages of telemedicine were compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. Mentally ill asylum seekers, refugees and migrants are under-served in their mother tongue and telepsychiatry can improve access to scarce health-care resources.”
Abstract
Davor Mucic , J Telemed Telecare 2008;14 241-243, doi:10.1258/jtt.2008.080301

The availability of telecardiology consultations and transfer patterns from a remote neonatal intensive care unit
“We examined records of all admissions to an isolated community neonatal intensive care unit (NICU) in California between 2001 and 2006. We also reviewed the echocardiograms for diagnosis, disposition of patient and necessity for transport. In 2004, a telemedicine link (mainly store-and-forward) was established to a university children’s hospital (UCH) 290 km away. The number of NICU patients having an echocardiogram increased from 280 (27% of 1029 admissions) to 385 (40% of 963, P = <0.001) after telemedicine became available. There was an increase in the proportion of normal studies, from 31% to 37% (P = 0.03), and an increase in the number of patients diagnosed with cardiac pathology from 192 (19% of all admissions) to 241 (25%, P < 0.001). Twenty-four patients were transferred for cardiac reasons during each three-year period; however seven pre-telemedicine transfers were avoidable, compared with two post-telemedicine transfers (P = 0.06). There was a change in referral pattern (65% to the UCH pre-telemedicine, compared with 78% post-telemedicine) although it was not significant (P = 0.10). Thus the availability of the telecardiology link was associated with increases in the utilization of echocardiography, in the proportion of normal studies, and in the percentage of neonates diagnosed with cardiac pathology without an increase in the number transferred for cardiac reasons. There was a reduction in unnecessary transfers and a strengthened relationship with the centre providing the telecardiology service."
Abstract
Tannie Huang, Anita J Moon-Grady, Craig Traugott, and James Marcin, J Telemed Telecare 2008;14 244-248, doi:10.1258/jtt.2008.080102

Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis
“We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function. Eighty-one patients with affected arm/hand function resulting from either stroke, MS or TBI were recruited in Italy, Spain and Belgium; 11 were lost during follow-up (14%). The outcome measures were the Action Research Arm Test (ARAT) and the Nine Hole Peg Test (NHPT). There were no significant differences between the two groups on the outcome measures (ARAT and NHPT); in both groups, patients maintained or even improved their arm/hand function. The HCAD training was found to be as feasible as usual care in terms of clinical outcomes, and both therapists and patients were satisfied with the HCAD intervention. A telerehabilitation intervention using HCAD may increase the efficiency of care.”
Abstract
Barbara CH Huijgen, Miriam MR Vollenbroek-Hutten, Mauro Zampolini, Eloy Opisso, Montse Bernabeu, Johan Van Nieuwenhoven, Stephan Ilsbroukx, Riccardo Magni, Claudia Giacomozzi, Velio Marcellari, Sandro Scattareggia Marchese, and Hermie J Hermens, J Telemed Telecare 2008;14 249-256, doi:10.1258/jtt.2008.080104

Satisfaction with care in post-stroke patients undergoing a telerehabilitation programme at home
“We conducted a pilot telerehabilitation study with post-stroke patients with arm motor impairment. We compared the degree of satisfaction of patients undergoing a virtual reality (VR) therapy programme at home (Tele-VR group) to satisfaction experienced by those undergoing the same VR therapy in a hospital setting (VR-group). The rehabilitation equipment used a 3D motion tracking system to create a virtual environment in which the patient’s movement was represented. In tele-therapy, the patient equipment was installed in their homes, connected to the hospital by four ISDN lines at a total bandwidth of 512 kbit/s. Rehabilitation data were transmitted via one line and videoconferencing via the other three. Ten patients with mild to intermediate arm motor impairment due to an ischaemic stroke, were randomized into VR or Tele-VR groups. A questionnaire was used at the end of treatment to measure each patient’s degree of satisfaction. Tele-VR treated patients showed median values equal to or higher than the VR group patients in all 12 items investigated, except one. In motor performance, the Tele-VR group improved significantly (P ? 0.05), while the VR group showed no significant change. Patients assigned to the Tele-VR group were able to engage in therapy at home and the videoconferencing system ensured a good relationship between the patient and the physical therapist whose physical proximity was not required.”
Abstract
Lamberto Piron, Andrea Turolla, Paolo Tonin, Francesco Piccione, Lisa Lain, and Mauro Dam, J Telemed Telecare 2008;14 257-260, doi:10.1258/jtt.2008.080304

Caregivers’ acceptance of electronic documentation in nursing homes
“A comparative study was conducted in two Australian nursing homes operated by the same organization. One home had implemented an electronic documentation system and the other remained paper-based. Survey questionnaires were answered by 14 of the 17 caregivers at the electronic documentation site (82%) and 10 of the 23 caregivers at the paper documentation site (43%). They provided opinions about satisfaction with their home’s documentation system, and the training and support provided. Information was also obtained on the caregivers’ attitudes towards using electronic documentation. The caregivers at the electronic documentation site quickly adapted to the use of the new technology after receiving effective training and support. Caregivers at both homes were satisfied with their homes’ documentation system, and had positive attitudes towards using electronic documentation systems. As an important communication tool, electronic nursing documentation may lead to improved efficacy of telemedicine in nursing home settings.”
Abstract
Ping Yu, David Hailey, and Haocheng Li, J Telemed Telecare 2008;14 261-265, doi:10.1258/jtt.2008.080310

The use of videoconferencing for mental health services in Finland
“The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.”
Abstract
Arto Ohinmaa, Risto Roine, David Hailey, Marja-Leena Kuusimäki, and Ilkka Winblad, J Telemed Telecare 2008;14 266-270, doi:10.1258/jtt.2008.071212

Use of mobile phone cameras for after-hours triage in primary care
“Mobile phone images might be useful in after-hours triage of primary care. We conducted a study to identify population access to mobile phone cameras and to assess the clinical usefulness of mobile phone cameras. The survey was conducted among 480 patients attending two rural New Zealand practices. There were significantly more Maori owners compared to non-Maori (P = 0.002). Age was a significant factor influencing the ownership of mobile phones. We also conducted a clinical quiz among health professionals to assess how the provision of images on a mobile phone and on CD-ROM (to simulate the image that would be seen if email was used to transmit the images) influenced diagnostic confidence. Ten photographable clinical conditions were used to quiz 30 health professionals who were randomized into three groups of 10 each on diagnostic confidence. Images were found to significantly increase diagnostic confidence in all cases except one. It appears that mobile phone cameras are generally acceptable to patients and likely to be of practical use to rural practitioners in a range of clinical scenarios.”
Abstract
Chandra Jayaraman, Paul Kennedy, Gaelle Dutu, and Ross Lawrenson, J Telemed Telecare 2008;14 271-274, doi:10.1258/jtt.2008.080303

Houston-area Wal-Marts to offer telemedicine clinics

“Select Houston-area Wal-Marts will offer telemedicine clinics thanks to a partnership between Houston-based companies My Healthy Access, Inc. and NuPhysicia, LLC.
The companies will operate under the trade name “Walk-in Telemedicine Health Care”.”
Article
Molly Merrill, Healthcare IT News, 21 July 2008

Telemedicine network is launched

“A new network to expand the use of telemedicine has been launched by the Kings Fund.
The network will ensure that information from pilot schemes in Kent, Cornwall and Newham, who are making use of the latest assisted technology, is shared among experts to help spread best practice.”
Article
OnMedica, 10 July 2008

Yuma patients benefitting from telemedicine program

“The telemedicine program came to Yuma Regional as part of the Arizona Department of Health Services Children’s Rehabilitation Services program. The center’s Neonatal Intensive Care Unit is linked to University Medical Center in Tucson for emergency consultations on infants with serious, often life-threatening conditions.”
Article
Tucson Citizen, 7 July 2008

La mayor parte de las aplicaciones de telemedicina que se realizan en Cataluña son entre médicos

“El 46,2 por ciento de las entidades sanitarias de Cataluña ya llevan a cabo aplicaciones de telemedicina, que se realizan principalmente entre médicos (21,2 por ciento), entre un paciente y su médico local con un médico de referencia (13,5) y entre un paciente y un médico local (11,5 por ciento). Esta es una de las principales conclusiones del Mapa de Tendencias 2008 de la Fundación Tic Salut, dependiente de la Administración sanitaria, que se ha presentado en la sede de CaixaForum en Barcelona. El informe se basa en encuestas realizadas a centros hospitalarios y de Atención Primaria y tiene el objetivo de conocer el nivel de desarrollo de las Tecnologías de la Información y la Comunicación (TIC) en las organizaciones sanitarias de Cataluña e identificar y presentar las tendencias mundiales.”
Article (Spanish)
El Médico interactivo, 5 July 2008

AOK Plus to use ICW telemedicine system

“German health insurers AOK Plus has commissioned InterComponentWare to implement a telemedicine system to care for patients with serious chronic heart failure.
The service will be offered to patients living in the German state of Saxony.”
Article
e-Health Europe, 3 July 2008

Sharing and Caring, PHSCG Conference, 1 July 2008, Chesford Grange, UK

More details on the conference.

View the speech.

Ladies and Gentlemen,

First of all I would like to thank the organisation and Dr. Amir Hannan for inviting me to address this conference.
Secondly I apologize for not being here myself.

This conference deals with sharing and caring and I was specifically asked to highlight the international aspects.

ICMCC introduced 4 years ago the word Compunetics and we were the first to link it to healthcare. Compunetics defines the social, societal and ethical aspects of the use of computing and networking. So we already realised the importance of these issues before Web2.0 and Health2.0 appeared on the horizon. The use of the word compunetics directly and urgently implicates the patient as one of the main focussing points of our foundation. More specifically we concentrate on awareness and information supply. To serve the patient in the best way, we also have to concentrate on the health professional.
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