Journal of telemedicine and telecare
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Randomized Controlled Trial Clinical Trial
Telemedicine and cardiopulmonary resuscitation: the value of video-link and telephone instruction to a mock bystander.
We evaluated cardiopulmonary resuscitation (CPR) performed by persons with no previous experience on a resuscitation dummy. Subjects were randomized into four groups, one of which had no instruction. The other three groups were instructed for 3 min in mock CPR by a supervisor using a telephone, a video-link, or directly in person. ⋯ Video-link instruction was comparable with direct observer instruction. There was no significant difference between previously trained subjects and the intervention groups. Video-link instruction can produce significant improvements in the quality of CPR in mock resuscitations for persons with no resuscitation training.
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This article deals with research which attempts to demonstrate the value of health care delivered via telemedicine. A great variety of telemedicine services have been proposed. ⋯ Despite the fact that much work in telemedicine is published as short accounts of pilot projects, there is little research that explicitly addresses the difficulties involved in setting up new telemedicine services. Some studies have been performed which attempt to evaluate telemedicine services, but relatively few studies have been able to collect the data required to provide an unambiguous demonstration of their value.
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In order to examine communication of radiological information under circumstances where rapid exchange of information was essential, we studied communication of non-routine portable chest radiographs to an intensive-care unit (ICU). Images and reports were available through the usual communication channels and through a PACS workstation in the ICU. Data were obtained to determine how quickly and by what means ICU physicians first viewed images and received radiologists' reports of chest radiographs. ⋯ Image viewing and report receipt were tightly coupled, usually for images which were first viewed as hard copy. PACS performance suffered from unreliable film digitization and delayed report transcription. Integration of computed radiography and digital dictation into a PACS could markedly reduce the delays in ICU physicians' access to radiological information.
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Telemedicine developments are intimately linked to the society in which they occur. Some of the salient factors are: the structure of the health-care system, especially its funding arrangements and the relationship between hospital and community care; the telecommunications network environment and business developments in communications technology; geographic factors of distance and isolation; and government policy dealing with interacting sectors. These factors are all considered in this review of the background to telemedicine developments in Australia.