Journal of telemedicine and telecare
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We conducted a survey of urologists to document their patterns of app usage and perceptions of app quality, and to assess their interest in future app usage. The survey was sent to all urologists on the mailing list of the British Association of Urological Surgeons (BAUS) (n=1613). A total of 115 responses were received (a response rate of 7%). ⋯ There was greatest interest in apps such as logbooks or revalidation ones (87%), reference apps (86%) and ones which aided decision-making (85%). There was considerable support for the implementation of measures to provide urological app quality assurance; most respondents believed app peer review (78%) and validation (78%) would be beneficial and 48% supported regulatory oversight. There appears to be a need for high quality urological apps and opportunities therefore exist for national urological associations and academic units to lead developments.
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Telemedicine can be used to increase access to stroke thrombolysis in rural hospitals but is not widely used for this purpose in Australia. The Victorian Stroke Telemedicine (VST) programme commenced in one hospital in 2011, and is being expanded to a further 15 hospitals. The present study summarises progress in scaling up the VST programme from one to four hospitals. ⋯ For the 28 cases receiving a telephone-only consultation, 21 (75%) were deemed not to require a video consultation by the neurologist. The remaining seven consultations (25%) were telephone-only due to technical problems experienced with the telemedicine equipment. The preliminary results from the expansion of the VST programme to the three hospitals provides evidence of appropriate use, with almost 70% of the telemedicine consultations resulting in a diagnosis of stroke.
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We assessed an early notification system using smartphones to reduce door-to-balloon times (DTBT) in ST-elevation myocardial infarction (STEMI). Text page alarms were sent to cardiologists for all patients presenting with chest pain or an equivalent in the emergency department before acquisition of an electrocardiogram (ECG). A total of 210 patients (with mean age of 59 years) were investigated (109 in the intervention group and 101 in a control group from the previous two-year period). ⋯ In a secondary analysis, the length of hospital stay was also significantly less. However, there was no significant improvement in all-cause one-year mortality. Early text page alarms using smartphones were effective in reducing the DTBT, but had a limited effect on clinical outcome.
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An e-consultation is an asynchronous consultation performed by a specialist without a face-to-face patient visit. E-consultations have been available to primary care providers at the Mayo Clinic for several years. We reviewed e-consultations performed by specialists at the Mayo Clinic for the first six months of 2013. ⋯ For example, intra-specialty e-consultations and surgical e-consultations accounted for 16% of the total. E-consultations appear to have improved access to specialists, and they are integrated into care processes when timely expert opinions are needed. As e-consultations evolve, it will be important to develop a standard, well-defined terminology to compare outcomes of these processes across practices.
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We carried out a cost-benefit analysis of the STAY telecare service (Sandwell Telecare Assisting You) for unpaid carers of people with dementia in the West Midlands. This was done from the perspective of the carers. We employed the willingness to pay (WTP) approach, an established economic method to quantify the benefits of healthcare. ⋯ Carers offered higher values if the cared-for person was suffering from moderate dementia. Carers offered WTP values that were similar to the resource costs of providing telecare services. The pilot study suggests that the provision of telecare for unpaid carers of people with dementia is beneficial to society.