Journal of telemedicine and telecare
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Patients failing to attend hospital appointments contribute to inefficient use of resources. We conducted a systematic review of studies providing a reminder to patients by phone, short message service (SMS) or automated phone calls. A PubMed search was conducted to identify articles published after 1999, describing studies of non-attendance at hospital appointments. ⋯ Cost and savings were not measured formally in any of the papers, but almost half of them included cost estimates. The average cost of using either SMS, automated phone calls or phone calls was €0.41 per reminder. Although formal evidence of cost-effectiveness is lacking, the implication of the review is that all hospitals should consider using automated reminders to reduce non-attendance at appointments.
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We investigated the factors that affected the use of a realtime telemetry system (RTS) in emergency ambulances. During the study, a total of 7144 patients were transported to a hospital in the city of Wonju via ambulance. In 466 of these cases (7%), the Emergency Medical Technician (EMT) used the RTS. ⋯ The results indicated that EMTs with higher levels of expertise were more likely to use the RTS when the level of patient consciousness was low, regardless of transport time. Conversely, EMTs with low levels of expertise were more likely to use the RTS when the transport time from scene to hospital was long and were less likely to use the RTS when the transport time was short. There appear to be several ways of improving RTS usage in the pre-hospital situation.
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In 2009, we established a pilot telehealth service to a sleep laboratory in Garden City, Kansas, approximately 600 km from the Kansas University Medical Center. Videoconferencing was used for polysomnography (PSG) study follow-up, patient monitoring and sleep laboratory medical management. It allowed the sleep specialist to treat patients and collaborate with sleep laboratory personnel from a distance without extensive travel. ⋯ Interviewing and examining patients via telemedicine was very similar to doing it in-person. Telemedicine was effective for the physician-patient interaction and for visualizing airway structures. Although more research is needed, the use of videoconferencing for sleep study follow-up and laboratory oversight appears very promising.
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Randomized Controlled Trial
Video calls for dispatcher-assisted cardiopulmonary resuscitation can improve the confidence of lay rescuers--surveys after simulated cardiac arrest.
Many mobile phones allow two-way video communication, which permits callers to hear and see each other. If used during medical emergencies, bystanders can receive supervision and guidance from medical staff based on visual information. We investigated whether video calls from mobile phones could improve the confidence of lay rescuers. ⋯ Rescuers who had not used video phones had a greater tendency to comment on immature video call technology, while some who had used video phones complained about poor sound quality during video calls. The majority of rescuers in both groups believed that video calls were superior to audio calls during medical emergencies, and this proportion was significantly higher in the video group (P = 0.0002). We found that visual contact and supervision through video calls improved rescuers' confidence in stressful emergencies.
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Randomized Controlled Trial Comparative Study
A pilot study of the Tele-Airway Management System in a hospital emergency department.
We developed a telemedicine system for remote guidance of emergency airway management called the Tele-Airway Management System (TAMS). In a pilot study we examined the usefulness of the TAMS for intubations of actual patients in a hospital emergency department. Twenty-five patients were allocated randomly either to a TAMS group or to an on-scene directed (OSD) group. ⋯ There were no mechanical or technical errors such as disconnection during use of the TAMS. The pilot study demonstrated the feasibility of the TAMS as an alternative to OSD. However, a larger study will be required to determine non-superiority or equivalence.