International Journal Of Telemedicine And Applications[JOURNAL]
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200 papers
Passive Observer of Activities for Aging in Place Using a Network of RGB-D Sensors.
Payandeh S, Park J
Int J Telemed Appl · 2020 · PMID 33149737 · Full text
Aging in place is a notion which supports the independent living of older adults at their own place of residence for as long as possible. To support this alternative living which can be in contrast to various other types...
Aging in place is a notion which supports the independent living of older adults at their own place of residence for as long as possible. To support this alternative living which can be in contrast to various other types of assisted living options, modes of monitoring technology need to be explored and studied in order to determine a balance between the preservation of privacy and adequacy of sensed information for better estimation and visualization of movements and activities. In this paper, we explore such monitoring paradigm on how a network of RGB-D sensors can be utilized for this purpose. This type of sensor offers both visual and depth sensing modalities from the scene where the information can be fused and coded for better protection of privacy. For this purpose, we introduce the novel notion of passive observer. This observer is only triggered by detecting the absence of movements of older adults in the scene. This is accomplished by classifying and localizing objects in the monitoring scene from both before and after the detection of movements. A deep learning tool is utilized for visual classification of known objects in the physical scene followed by virtual reality reconstructing of the scene where the shape and location of objects are recreated. Such reconstruction can be used as a visual summary in order to identify objects which were handled by an older adult in-between observation. The simplified virtual scene can be used, for example, by caregivers or monitoring personnel in order to assist in detecting any anomalies. This virtual visualization can offer a high level of privacy protection without having any direct visual access to the monitoring scene. In addition, using the scene graph representation, an automatic decision-making tool is proposed where spatial relationships between the objects can be used to estimate the expected activities. The results of this paper are demonstrated through two case studies.
Design and Development of Diabetes Management System Using Machine Learning.
Sowah RA, Bampoe-Addo AA, Armoo SK … +3 more , Saalia FK, Gatsi F, Sarkodie-Mensah B
Int J Telemed Appl · 2020 · PMID 32724304 · Full text
This paper describes the design and implementation of a software system to improve the management of diabetes using a machine learning approach and to demonstrate and evaluate its effectiveness in controlling diabetes. T...
This paper describes the design and implementation of a software system to improve the management of diabetes using a machine learning approach and to demonstrate and evaluate its effectiveness in controlling diabetes. The proposed approach for this management system handles the various factors that affect the health of people with diabetes by combining multiple artificial intelligence algorithms. The proposed framework factors the diabetes management problem into subgoals: building a Tensorflow neural network model for food classification; thus, it allows users to upload an image to determine if a meal is recommended for consumption; implementing K-Nearest Neighbour (KNN) algorithm to recommend meals; using cognitive sciences to build a diabetes question and answer chatbot; tracking user activity, user geolocation, and generating pdfs of logged blood sugar readings. The food recognition model was evaluated with cross-entropy metrics that support validation using Neural networks with a backpropagation algorithm. The model learned features of the images fed from local Ghanaian dishes with specific nutritional value and essence in managing diabetics and provided accurate image classification with given labels and corresponding accuracy. The model achieved specified goals by predicting with high accuracy, labels of new images. The food recognition and classification model achieved over 95% accuracy levels for specific calorie intakes. The performance of the meal recommender model and question and answer chatbot was tested with a designed cross-platform user-friendly interface using Cordova and Ionic Frameworks for software development for both mobile and web applications. The system recommended meals to meet the calorific needs of users successfully using KNN (with = 5) and answered questions asked in a human-like way. The implemented system would solve the problem of managing activity, dieting recommendations, and medication notification of diabetics.
False Alarm Reduction in Self-Care by Personalized Automatic Detection of ECG Electrode Cable Interchanges.
Fayn J, Rubel P
Int J Telemed Appl · 2020 · PMID 32411214 · Full text
INTRODUCTION: False alarm reduction is an important challenge in self-care, whereas one of the most important false alarm causes in the cardiology domain is electrodes misplacements in ECG recordings, the main investigat...
INTRODUCTION: False alarm reduction is an important challenge in self-care, whereas one of the most important false alarm causes in the cardiology domain is electrodes misplacements in ECG recordings, the main investigations to perform for early and pervasive detection of cardiovascular diseases. In this context, we present and assess a new method for electrode reversals identification for Mason-Likar based 3D ECG recording systems which are especially convenient to use in self-care and allow to achieve, as previously reported, high computerized ischemia detection accuracy. METHODS: We mathematically simulate the effect of the six pairwise reversals of the LA, RA, LL, and C2 electrodes on the three ECG leads I, II, and V2. Our approach then consists in performing serial comparisons of the newly recorded 3D ECG and of the six derived ECGs simulating an electrode reversal with a standard, 12-lead reference ECG by means of the CAVIAR software. We further use a scoring method to compare these analysis results and then apply a decision tree model to extract the most relevant measurements in a learning set of 121 patients recorded in ICU. RESULTS: The comparison of the seven sets of serial analysis results from the learning set resulted in the determination of a composite criteria involving four measurements of spatial orientation changes of QRS and T and providing a reversal identification accuracy of 100%. Almost the same results, with 99.99% of sensitivity and 100% of specificity, were obtained in two test sets from 90 patients, composed of 2098 and 2036 representative ECG beats respectively recorded during PTCA balloon inflation, a procedure which mimics ischemia, and before PTCA for control. CONCLUSION: Personalized automatic detection of ECG electrode cable interchanges can reach almost the maximal accuracy of 100% in self-care, and can be performed in almost real time.
Influence of Generational Cohorts on the Preferences for Information and Communication Technologies in Latin American Patients with Obstructive Lung Diseases.
Cherrez-Ojeda I, Mata VL, Vanegas E … +6 more , Felix M, Bernstein JA, Jiménez FM, Calderon JC, Chedraui P, Gavilanes AW
Int J Telemed Appl · 2020 · PMID 32411213 · Full text
BACKGROUND: Advances in information and communication technologies (ICTs) represent a growing platform for the expansion of healthcare related services, but there is little information on how generational differences mig...
BACKGROUND: Advances in information and communication technologies (ICTs) represent a growing platform for the expansion of healthcare related services, but there is little information on how generational differences might account for distinct patterns of use and interest for ICTs. Our study aims to achieve a better understanding on how generational cohorts might influence the use and preferences for ICTs among patients with obstructive lung diseases in Latin America. MATERIALS AND METHODS: We conducted an anonymous cross-sectional survey-based study, involving 968 patients with obstructive lung diseases (OLD) in Latin America. Patients rated their frequency of use and preferences of ICTs through a modified version of the Michigan Questionnaire. Chi-square test for association and adjusted regression analyses were performed. RESULTS: Of all, 63.6% of participants had Internet access. Younger generations, in particular Generation Z and Millennials, had the highest rate of Internet access and smartphone ownership, as well as of overall frequency of ICT use. Web-based Internet was found to be the main source to seek information about the disease (36.9%) across all generational cohorts. Generation Z and Millennials presented the highest odds to be interested in using Twitter (OR 31.79 and 8.86) for receiving health-related information, and email (OR 4.87 and 4.86) as the preferred way to ask physicians information related to their disease through ICTs. CONCLUSION: Generational cohorts influence the use and preferences for ICTs among patients with obstructive lung diseases. Younger generational cohorts were associated with higher access to the Internet and smartphone ownership, as well as higher interest for using ICTs to receive and ask for health-related information.
Wearable Measurement of ECG Signals Based on Smart Clothing.
Li M, Xiong W, Li Y
Int J Telemed Appl · 2020 · PMID 32395127 · Full text
Smart clothing that can measure electrocardiogram (ECG) signals and monitor the health status of people meets the needs of our increasingly aging society. However, the conventional measurement of ECG signals is complicat...
Smart clothing that can measure electrocardiogram (ECG) signals and monitor the health status of people meets the needs of our increasingly aging society. However, the conventional measurement of ECG signals is complicated and its electrodes can cause irritation to the skin, which makes the conventional measurement method unsuitable for applications in smart clothing. In this paper, a novel wearable measurement of ECG signals is proposed. There are only three ECG textile electrodes knitted into the fabric of smart clothing. The acquired ECG signals can be transmitted to a smartphone via Bluetooth, and they can also be sent out to a PC terminal by a smartphone via WiFi or Internet. To get more significant ECG signals, the ECG differential signal between two electrodes is calculated based on a spherical volume conductor model, and the best positions on the surface of a human body for two textile electrodes to measure ECG signals are simulated by using the body-surface potential mapping (BSPM) data. The results show that position 12 in the lower right and position 11 in the upper left of the human body are the best for the two electrodes to measure ECG signals, and the presented wearable measurement can obtain good performance when one person is under the conditions of sleeping and jogging.
App-Based Tele Ophthalmology: A Novel Method of Rural Eye Care Delivery Connecting Tertiary Eye Care Center and Vision Centers in India.
Das AV, Mididoddi S, Kammari P … +4 more , Deepthi Davara N, Loomba A, Khanna R, Taneja M
Int J Telemed Appl · 2019 · PMID 31929788 · Full text
PURPOSE: The study aims to describe a novel method of utilization of the eyeSmart EMR (electronic medical record) app. It describes the demographic distribution, clinical presentation, query requested by the vision techn...
PURPOSE: The study aims to describe a novel method of utilization of the eyeSmart EMR (electronic medical record) app. It describes the demographic distribution, clinical presentation, query requested by the vision technician, and management advised to the patients by using "eyeSmart EMR" app from the vision centers located across a three-tier eye care network in India. METHODS: This is a retrospective review of all patients who required a tele-ophthalmology consultation from January 2017 to August 2018. The demographic, clinical details, and the impact of teleophthalmology using eyeSmart app, in the vision centers of a three-tier eye care network, was analyzed in detail. RESULTS: A total of 15,001 tele-ophthalmology consults were included which is from January 2017 to August 2018. The mean age was 38 ± 19 years and male to female ratio was 1 : 2. Video calls were performed for 6191 (41.27%) consults and the impact was measured. Additional clinical information was received in 65.61% consults through video call. Medical management was advised in 47.07% of patients and 30.30% were referred to higher centers for medical intervention and 0.59% were referred for surgical intervention, 16.23% were prescribed glasses. No intervention required for 0.69% of cases. Hence nil intervention was advised. CONCLUSION: The combination of using tablet and video calls with the help of eyeSmart EMR app is a novel method in teleophthalmology. It helps in connecting the patients at rural areas and the ophthalmologists in higher centers. The use of technology plays a vital role in the appropriate medical management of the patient.
Physicians' Attitude towards The Use of Social Media for Professional Purposes in Saudi Arabia.
Alanzi T, Al-Yami S
Int J Telemed Appl · 2019 · PMID 31885550 · Full text
PURPOSE: In relation to this research, only a few studies have been carried out around the world. However, in Saudi Arabia, there have been no investigations into this subject. In this sense, the objective of this study...
PURPOSE: In relation to this research, only a few studies have been carried out around the world. However, in Saudi Arabia, there have been no investigations into this subject. In this sense, the objective of this study was to investigate the physicians' attitudes towards the use of social media for professional purposes in Saudi Arabia. METHODS: A cross-sectional study was conducted among 235 physicians from different regions of Saudi Arabia. The data were collected by means of a survey. The survey questionnaire was distributed using the WhatsApp application. Descriptive statistics were used to analyze the results. RESULTS: The most common social media used by the respondents was Facebook, and the majority of the participants agreed that social media improved their knowledge and skills. However, most of the participants did not interact with patients using these tools, did not feel comfortable conducting an online consultation, and believed that social media affected the choice of the healthcare provider. Similarly, 30.6% of the respondents opined that it is not appropriate to search online information about patients, and 44.3% of them considered that patients would not trust the medical advice if a physician obtained the information from a website. CONCLUSION: The results showed that the majority of the respondents considered that social media improved the knowledge and abilities of physicians. In addition, the respondents reflected that there were ethical issues that must be taken into account when using social media and more than half of them did not interact with their patients employing these tools. The outcomes of this research will help to develop programs directed at the physicians in Saudi Arabia to enhance their knowledge, professional skills, medicine practice, patient-doctor interaction, and handle the risks involved in the use of social media.
Multi-Sensor-Fusion Approach for a Data-Science-Oriented Preventive Health Management System: Concept and Development of a Decentralized Data Collection Approach for Heterogeneous Data Sources.
Neubert S, Geißler A, Roddelkopf T … +4 more , Stoll R, Sandmann KH, Neumann J, Thurow K
Int J Telemed Appl · 2019 · PMID 31687017 · Full text
Investigations in preventive and occupational medicine are often based on the acquisition of data in the customer's daily routine. This requires convenient measurement solutions including physiological, psychological, ph...
Investigations in preventive and occupational medicine are often based on the acquisition of data in the customer's daily routine. This requires convenient measurement solutions including physiological, psychological, physical, and sometimes emotional parameters. In this paper, the introduction of a decentralized multi-sensor-fusion approach for a preventive health-management system is described. The aim is the provision of a flexible mobile data-collection platform, which can be used in many different health-care related applications. Different heterogeneous data sources can be integrated and measured data are prepared and transferred to a superordinated data-science-oriented cloud-solution. The presented novel approach focuses on the integration and fusion of different mobile data sources on a mobile data collection system (mDCS). This includes directly coupled wireless sensor devices, indirectly coupled devices offering the datasets via vendor-specific cloud solutions (as e.g., , San Francisco, USA and , Espoo, Finland) and questionnaires to acquire subjective and objective parameters. The mDCS functions as a user-specific interface adapter and data concentrator decentralized from a data-science-oriented processing cloud. A low-level data fusion in the mDCS includes the synchronization of the data sources, the individual selection of required data sets and the execution of pre-processing procedures. Thus, the mDCS increases the availability of the processing cloud and in consequence also of the higher level data-fusion procedures. The developed system can be easily adapted to changing health-care applications by using different sensor combinations. The complex processing for data analysis can be supported and intervention measures can be provided.
Acceptability and Attitude towards a Mobile-Based Home Exercise Program among Stroke Survivors and Caregivers: A Cross-Sectional Study.
Mahmood A, Blaizy V, Verma A … +6 more , Stephen Sequeira J, Saha D, Ramachandran S, Manikandan N, Unnikrishnan B, Solomon JM
Int J Telemed Appl · 2019 · PMID 31186627 · Full text
BACKGROUND: Stroke is a leading cause of disability and requires continued care after hospital discharge. Mobile-based interventions are suitable to reduce the cost of stroke rehabilitation and facilitate self-management...
BACKGROUND: Stroke is a leading cause of disability and requires continued care after hospital discharge. Mobile-based interventions are suitable to reduce the cost of stroke rehabilitation and facilitate self-management among stroke survivors. However, before attempting to use mobile-based home exercise program, it is crucial to recognize the readiness of stroke survivors and their caregivers to opt for such interventions. OBJECTIVE: To assess the acceptability and attitude towards a mobile-based home exercise program among stroke survivors and their primary caregivers. METHODS: A cross-sectional study was conducted among 102 participants to understand their attitude and acceptability towards mobile-based home exercise program. A validated 10-item questionnaire was adapted for the study. The questions which assessed the attitude were rated on a three-point Likert scale, with three denoting agree and one denoting disagree. The acceptability was assessed by their willingness to opt for a mobile-based home program services. A Chi-square analysis and cross-tabulation were performed to test differences between caregivers and patients. A logistic regression was performed to determine the effects of age, gender, and mobile phone on acceptability. RESULTS: Ninety-two percent of caregivers and 90% of patients showed willingness to opt for mobile-based intervention. Majority of the participants showed a positive attitude towards this mode of treatment. There was no difference in the attitude noted among caregivers and patients (p>0.05) towards mobile-based intervention. CONCLUSION: The stroke survivors and caregivers welcomed the concept of mobile-based home exercise program even in a low-resource settings, but further studies to understand treatment and cost-effectiveness of this technology among the stroke survivors would lead to better implementation.
Use of a Tablet Attachment in Teleophthalmology for Real-Time Video Transmission from Rural Vision Centers in a Three-Tier Eye Care Network in India: eyeSmart Cyclops.
Loomba A, Vempati S, Davara N … +4 more , Shravani M, Kammari P, Taneja M, Das AV
Int J Telemed Appl · 2019 · PMID 31057606 · Full text
PURPOSE: This study describes the development of an attachment for a smart tablet to stream live video information of an eye examination through the slit lamp. METHODS: A tablet attachment was developed that enables the...
PURPOSE: This study describes the development of an attachment for a smart tablet to stream live video information of an eye examination through the slit lamp. METHODS: A tablet attachment was developed that enables the live streaming of video from the slit lamp from the rural vision centers of the LVPEI network. A video streaming solution like Skype Lite was used to transmit the same. The eyeSmart app was utilized for the documentation of the clinical information of the patients. RESULTS: A tablet attachment of eyeSmart Cyclops was developed and piloted in 3 vision centers of the LVPEI network. CONCLUSION: The use of real-time video transmission illustrates a novel teleophthalmology solution in low resource settings to screen rural populations. The ability to transmit live video enables gathering more information than static images.
Application of Modified PageRank Algorithm for Anomaly Detection in Movements of Older Adults.
Payandeh S, Chiu E
Int J Telemed Appl · 2019 · PMID 30984259 · Full text
It is a well-known statistic that the percentage of our older adult population will globally surpass the other age groups. A majority of the elderly would still prefer to keep an active life style. In support of this lif...
It is a well-known statistic that the percentage of our older adult population will globally surpass the other age groups. A majority of the elderly would still prefer to keep an active life style. In support of this life style, various monitoring systems are being designed and deployed to have a seamless integration with the daily living activities of the older adults while preserving various levels of their privacy. Motion tracking is one of these health monitoring systems. When properly designed, deployed, integrated, and analyzed, they can be used to assist in determining some onsets of anomalies in the health of elderly at various levels of their Movements and Activities of Daily Living (MADL). This paper explores how the framework of the PageRank algorithm can be extended for monitoring the global movement patterns of older adults at their place of residence. Through utilization of an existing dataset, the paper shows how the movement patterns between various rooms can be represented as a directed graph with weighted edges. To demonstrate how PageRank can be utilized, a base graph representing a normal pattern can be defined as what can be used for further anomaly detection (e.g., at some instances of observation the measured movement pattern deviates from what is previously defined as a normal pattern). It is shown how the PageRank algorithm can detect simulated change in the pattern of motion when compared with the base-line normal pattern. This feature can offer a practical approach for detecting anomalies in movement patterns associated with older adults in their own place of residence and in support of aging in place paradigm.
Corrigendum to "A Way to Understand Inpatients Based on the Electronic Medical Records in the Big Data Environment".
Mao H, Sun Y
Int J Telemed Appl · 2019 · PMID 30804997 · Full text
[This corrects the article DOI: 10.1155/2017/9185686.].
[This corrects the article DOI: 10.1155/2017/9185686.].
Patient Perspectives on Health Data Privacy and Management: "Where Is My Data and Whose Is It?".
Wetzels M, Broers E, Peters P … +3 more , Feijs L, Widdershoven J, Habibovic M
Int J Telemed Appl · 2018 · PMID 30631347 · Full text
New technologies are increasingly evaluated for use within the clinical practice to monitor patients' medical and lifestyle data. This development could contribute to a more personalized approach to patient care and pote...
New technologies are increasingly evaluated for use within the clinical practice to monitor patients' medical and lifestyle data. This development could contribute to a more personalized approach to patient care and potentially improve health outcomes. To date, patient perspective on this development has mostly been neglected in the literature. Hence, this study aims to shed more light on the patient perspective on health data privacy and management. Focus groups with cardiac patients were done at the Elizabeth TweeSteden Ziekenhuis (ETZ) in the Netherlands as part of the DoCHANGE project. The focus groups were conducted using a semistructured protocol which was organized around three themes: privacy regulations, data storage, and transparency and privacy management. Five focus groups with a total of 23 patients were conducted. The majority of the patients preferred to have access to their medical data; however, the knowledge on who has access to data was limited. Patients indicated that they do not want to share their medical data with health insurance companies or the pharmaceutical industry. Furthermore, most patients do not see the added value of supplementing their medical dossier with lifestyle data. Current findings showed patients prefer access to and control over own data but that the knowledge concerning data privacy and management is limited. Sharing of non-medical health data (e.g.,, physical activity) was considered unnecessary. Future studies should address patient preferences and develop infrastructure which facilitates medical data access for patients.
Perception among Healthcare Professionals of the Use of Social Media in Translating Research Evidence into Clinical Practice in Mangalore.
Unnikrishnan B, Rathi P, Shah D … +4 more , Tyagi A, Rao AV, Paul K, Tomy J
Int J Telemed Appl · 2018 · PMID 30584424 · Full text
INTRODUCTION: Social media has a potential to bring about major changes in the healthcare system. OBJECTIVE: To find out the pattern of use of social media among healthcare professionals (HCPs) and perception, facilitato...
INTRODUCTION: Social media has a potential to bring about major changes in the healthcare system. OBJECTIVE: To find out the pattern of use of social media among healthcare professionals (HCPs) and perception, facilitators, and barriers of using social media, to translate evidence into clinical practice. METHOD: We conducted a cross-sectional study among 196 HCPs of institutions attached to a university using a self-administered questionnaire. RESULT: 97.3% used social media; however, only 63.4% used it for research. YouTube was the most preferred media. Majority of people believed that social media enables wide range of evidence over the shorter span of time, poses a threat to privacy, and cannot replace face to face interaction. Perceived barriers were the privacy concern, unprofessional behavior, lack of reliability, and information overload. CONCLUSION: There is a need for the development of appropriate guidelines for sharing the research output among various stakeholders using social media.
Telemental Health in Low- and Middle-Income Countries: A Systematic Review.
Acharibasam JW, Wynn R
Int J Telemed Appl · 2018 · PMID 30519259 · Full text
INTRODUCTION: The rising incidence of mental illness and its impact on individuals, families, and societies is becoming a major public health concern, especially in resource-constrained countries. Consequently, there is...
INTRODUCTION: The rising incidence of mental illness and its impact on individuals, families, and societies is becoming a major public health concern, especially in resource-constrained countries. Consequently, there is an increasing demand for mental health services in many middle- and low-income countries (LMIC). Challenges such as inequality in access, lack of staff and hospital beds, and underfunding, often present in the LMIC, might in part be addressed by telemental health services. However, little is known about telemental health in the LMIC. METHODS: A systematic review was performed, drawing on several electronic databases, including PubMed, PsycINFO, Web of Science, Springer Link, and Google Scholar. Original English language studies on the practice of telemental health in LMIC, involving patients and published between 1 January 2000 and 16 February 2017, were included. RESULTS: Nineteen studies met the inclusion criteria. Most of the articles were recent, which may reflect an increasing focus on telemental health in the LMIC. Eight of these studies were from Asia. Eight of the studies were interventional/randomized controlled trials, and 11 examined general mental health issues. Videoconferencing was the most frequently (6) studied telemental modality. Other modalities studied were online decision support systems (3), text messaging and bibliotherapy (1), e-chatting combined with videoconferencing (1), online therapy (2), e-counseling (1), store-and-forward technology (1), telephone follow-up (1), online discussion groups (1), audiovisual therapy and bibliotherapy (1), and computerized occupational therapy (1). Although many of the studies showed that telemental services had positive outcomes, some studies reported no postintervention improvements. CONCLUSION: The review shows a rising trend in telemental activity in the LMIC. There is a greater need for telemental health in the LMIC, but more research is needed on empirical and theoretical aspects of telemental activity in the LMIC and on direct comparisons between telemental activity in the LMIC and the non-LMIC.
Introducing Videoconferencing on Tablet Computers in Nurse-Patient Communication: Technical and Training Challenges.
Rygg LO, Brataas HV, Nordtug B
Int J Telemed Appl · 2018 · PMID 30420881 · Full text
BACKGROUND: This article examines personnel and patient experiences of videoconferencing (VC) trials on tablet computers between oncology certified nurses (OCNs) and patients with cancer who live at home. The study point...
BACKGROUND: This article examines personnel and patient experiences of videoconferencing (VC) trials on tablet computers between oncology certified nurses (OCNs) and patients with cancer who live at home. The study points to organizational pitfalls during the introduction process. In many different arenas, the use of VC has increased recently owing to improved Internet access and capacity. This creates new opportunities for contact between patients living at home and their nurses. Video conferencing presupposes knowledge about Internet access, training, and usability of technological equipment. The aim of this pilot study was to illuminate patients' and nurses' experiences of the technical functionality, usability, and training of tablet use in VC in primary cancer care. The results point to the drawbacks concerning the introduction of VC. METHOD: A pilot study with an explorative design was used to describe patients' and OCNs' experiences of technical functionality and usability of VC on tablet computers. After a three-month trial, data were gathered, focusing on both patients' and nurses' perspectives. Individual interviews with four female OCNs, aged 32-65 (mean 46), and six patients with cancer, two men and four women aged 49-78 (mean 69), were content-analyzed. RESULTS: The analysis revealed two main categories: and . CONCLUSION: When planning VC implementation, the organizational leadership should consider network access and stability, as well as individualized VC training on tablets. Ensuring patient safety should also be a priority. Further research should provide knowledge of technological and educational pitfalls, and possible implications of VC on the care quality of nursing.
Use of Expectation Disconfirmation Theory to Test Patient Satisfaction with Asynchronous Telemedicine for Diabetic Retinopathy Detection.
Serrano CI, Shah V, Abràmoff MD
Int J Telemed Appl · 2018 · PMID 30405712 · Full text
OBJECTIVE: The purpose of the study is to extend research on patient satisfaction with telemedicine services by employing the theoretical framework of Expectation Disconfirmation Theory (EDT) for diabetic retinopathy scr...
OBJECTIVE: The purpose of the study is to extend research on patient satisfaction with telemedicine services by employing the theoretical framework of Expectation Disconfirmation Theory (EDT) for diabetic retinopathy screenings focusing on rural patients. METHOD: Adult subjects (n=220) with diabetes were recruited from a single family practice office in rural Iowa. Subjects completed a "pre" survey concerning their forward-looking perceptions of telemedicine prior to using telemedicine for detection of diabetic retinopathy and a "post" survey after they received recommendations from the distant ophthalmologists. RESULTS: All hypotheses of the EDT model were supported. Patient satisfaction is influenced by both patients' expectations (<.001) and disconfirmation of expectations (<.001), and patient satisfaction has a positive impact on patient preference for telemedicine services (<.001). Overall, patients who received telemedicine services were highly satisfied with telemedicine and developed a favorable disposition towards telemedicine services. CONCLUSIONS: The EDT model is a viable framework to study patient satisfaction of telemedicine services. While previous feasibility studies have shown that telemedicine for diabetic retinopathy screenings yields diagnostic efficacy, this study applies a theoretical framework to demonstrate the viability of telemedicine for diabetic retinopathy screenings in rural areas.
Application of Teledermoscopy in the Diagnosis of Pigmented Lesions.
Barcaui CB, Lima PMO
Int J Telemed Appl · 2018 · PMID 30405711 · Full text
BACKGROUND: Dermatology, due to the peculiar characteristic of visual diagnosis, is suitable for the application of modern telemedicine techniques, such as mobile teledermoscopy. OBJECTIVES: To evaluate the feasibility a...
BACKGROUND: Dermatology, due to the peculiar characteristic of visual diagnosis, is suitable for the application of modern telemedicine techniques, such as mobile teledermoscopy. OBJECTIVES: To evaluate the feasibility and reliability of the technique for the diagnosis of pigmented lesions. METHODS: Through the storage and routing method, 41 pigmented lesions were analyzed. After the selection of the lesions during the outpatient visit, the clinical and dermatoscopic images were obtained by the resident physician through the cellphone camera and sent to the assistant dermatologist by means of an application for exchange of messages between mobile platforms. Firstly, the assistant dermatologist described the visualized dermatoscopic structures and defined its diagnosis and conduct, based solely on the evaluation of the clinical and dermatoscopic images, without having the knowledge of the anamnesis data. Afterwards, the same assistant dermatologist evaluated the patient face to face, defining the dermatoscopic structures, diagnosis, and conduct. The data obtained through teledermoscopy and face-to-face assessments were compared and accuracy was defined as the concordance between the diagnoses. RESULTS: A match rate of 90% between teledermoscopic and face-to-face diagnosis was demonstrated (McNemar's statistical analysis, whose p value was 0.1366, showed no evidence to support the inferiority of the teledermoscopic method).
Telemedical Coaching Improves Long-Term Weight Loss in Overweight Persons: A Randomized Controlled Trial.
Kempf K, Röhling M, Stichert M … +4 more , Fischer G, Boschem E, Könner J, Martin S
Int J Telemed Appl · 2018 · PMID 30271433 · Full text
BACKGROUND: Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is lack of knowledge whether a telemedical-approach with personal coaching contributes to long-...
BACKGROUND: Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is lack of knowledge whether a telemedical-approach with personal coaching contributes to long-term weight losses in overweight employees. We, therefore, tested the hypothesis that telemedical-based lifestyle interventions accompanied with telemedical coaching lead to larger weight losses in overweight persons in an occupational health care setting. METHODS: Overweight employees (n=180) with a body mass index (BMI) of >27 kg/m were randomized into either a telemedical (TM) group (n=61), a telemedical coaching (TMC) group (n=58), or a control group (n=61). Both intervention groups were equipped with scales and pedometers automatically transferring the data into a personalized online portal, which could be monitored from participants and coaches. Participants of the TMC group received additionally one motivational care call per week by mental coaches to discuss the current data (current weight and steps) and achieving goals such as a healthy lifestyle or weight reduction. The control group remained in routine care. Clinical and anthropometric data were determined after the 12-week intervention. Additionally, weight change was followed up after 12 months. RESULTS: Participants of TMC (-3.1 ± 4.8 kg, p<0.0001) and TM group (-1.9 ± 4.0 kg; p=0.0012) significantly reduced weight and sustained it during the 1-year follow-up, while the control group showed no change. Compared to the control group only weight loss in the TMC group was significantly different (p<0.001) after 12 months. TMC and TM group also reduced BMI, waist circumference, and LDL cholesterol. Moreover, TMC group improved additionally systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, and HbA1c. CONCLUSIONS: Telemedical devices in combination with telemedical coaching lead to significant long-term weight reductions in overweight persons in an occupational health care setting. This study is registered with NCT01868763, ClinicalTrials.gov.
Clinical Outcomes of Telemonitoring for Patients on Warfarin after Discharge from Hospital.
Sudas Na Ayutthaya N, Sakunrak I, Dhippayom T
Int J Telemed Appl · 2018 · PMID 30158972 · Full text
OBJECTIVE: To evaluate the impact of telephone follow-up service on clinical outcomes in patients on warfarin when discharged from hospital. METHODS: This randomized controlled trial was conducted at a general hospital i...
OBJECTIVE: To evaluate the impact of telephone follow-up service on clinical outcomes in patients on warfarin when discharged from hospital. METHODS: This randomized controlled trial was conducted at a general hospital in Thailand. Patients aged ≥20 years who were prescribed warfarin when discharged were eligible to participate in this study. They were randomly allocated, using a computer generated random number, to receive either telephone follow-up intervention or usual care. Participants in the intervention group received telephone follow-up by hospital pharmacists for three months. During each telephone call, pharmacists performed medicine use reviews and addressed any problems identified. KEY FINDINGS: A total of 50 patients participated in this study. The proportion of international normalized ratio (INR) values in the target range for the telephone follow-up group (36/79, 45.6%) was higher than that in the usual care group (19/79, 24.1%), p=0.005. The mean time in the therapeutic range (TTR) in the telephone follow-up group was also higher than that in the usual care group (49.8±34.3 versus 28.0±27.5, p=0.017). All patients in the usual care group experienced one or more out-of-range INR values (25/25, 100%) compared to 21 out of 25 (84%) in the telephone follow-up group, p=0.037. There was no difference between the two groups in the incidence of complications or adverse events associated with warfarin. CONCLUSIONS: The telephone follow-up service in recently discharged patients helps them achieve and maintain their INR target. This anticoagulant supportive service should be promoted to patients receiving warfarin therapy after discharge. This trial is registered with TCTR20180614006 (Thai Clinical Trials Registry).
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