Stroke patients to test sensors

“Motion sensors similar to those developed for video games like Nintendo Wii may help stroke patients relearn simple tasks, researchers say.
A UK team is assessing such technology to see if it can be used to monitor improvements in upper body movements in patients undergoing physiotherapy.”
Article
BBC News, 15 September 2008

Succes van telemonitoring COPD-patiënten

“Het hulp-op-afstandprogramma voor COPD-patiënten waarmee het Canisius-Wilhelmina Ziekenhuis (CWZ) in Nijmegen in maart de publieksprijs van de NPCF won, behoort nu tot het reguliere zorgaanbod. In het augustusnummer van Vraag in Beeld tonen patiënt en hulpverlener zich enthousiast.”
Article (Dutch)
Zorgvisie, 8 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

ICW selected for US telehealth programme

“German e-health specialist InterComponentWare (ICW) has been selected by US health network Coventry Health Care to provide the infrastructure for a home monitoring programme.
ICW will provide the interoperability platform and infrastructure technology for Coventry Health’s telemonitoring pilot program.”
Article
e-Health Europe, 27 August 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.

Benchmarking ICT use among General Practitioners in Europe

“The European Commission today published a pan-European survey on electronic services in healthcare (eHealth) that shows 87% of European doctors (General Practitioners) use a computer, 48% with a broadband connection. European doctors increasingly store and send patients’ data such as lab reports electronically. In using such eHealth applications, doctors and medical services have already improved healthcare in Europe through, for example, more efficient administration and shorter waiting times for patients. The report also highlights where doctors could make better use of ICT to offer services such as telemonitoring, electronic prescriptions and cross border medical services.”
Article
eHealthNews.eu, 25 April 2008

Report
Alexander Dobrev, Marten Haesner, Tobias Hüsing, Werner B. Korte, Ingo Meyer, Empirica for European Commission, April 2008