Studies in health technology and informatics
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While telemedicine is now well established in many areas of medical practice, it is only beginning to create impact in some of the more complex medical applications such as critical care. New systems based on advanced technologies such as the Virtual Critical Care Unit and the eICU have recently successfully demonstrated the provision of critical care services from a distance in emergency and intensive care respectively. These specialties make particular demands on a telemedicine system, and studies in computer supported collaborative work as well as studies of work practices suggest that there is a minimum threshold of technology complexity for supporting such applications. ⋯ Other systems rely on complex physiological models. These approaches exemplify two trends in telemedicine systems of the future, with enhanced immersiveness creating a high sense of presence, and ready access to structured patient-specific data providing assistance to decision support. The future of telemedicine technology may see a convergence of these two trends.
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Stud Health Technol Inform · Jan 2008
Case ReportsOur experience with virtual craniomaxillofacial surgery: planning, transference and validation.
Clinical application of virtual craniomaxillofacial surgery (VCMS) planning is demonstrated with four typical cases. An integral component to success is transferring the surgical plan to the operating environment within a reasonable time frame through the design and fabrication of surgical guides and implants.
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Stud Health Technol Inform · Jan 2008
An automated personalised intervention algorithm for remote patient monitoring.
An automated personalised intervention algorithm was developed to determine when and if patients with chronic disease in a remote monitoring programme required intervention for management of their condition. The effectiveness of the algorithm has so far been evaluated on 29 patients. It was found to be particularly effective in monitoring newly diagnosed patients, patients requiring a change in medication as well as highlighting those that were not conforming to their medication. Our approach indicates that RPM used with the intervention algorithm and a clinical protocol can be effective in a primary care setting for targeting those patients that would most benefit from monitoring.
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Stud Health Technol Inform · Jan 2008
Optimizing a head-tracked stereo display system to guide hepatic tumor ablation.
Radio frequency ablation is a minimally invasive intervention that introduces -- under 2D ultrasound guidance and via a needle-like probe -- high-frequency electrical current into non-resectable hepatic tumors. These recur mostly on the periphery, indicating errors in probe placement. Hypothesizing that a contextually correct 3D display will aid targeting and decrease recurrence, we have developed a prototype guidance system based on a head-tracked 3D display and motion-tracked instruments. ⋯ Initial candidates were an augmented reality see-through head-mounted display and a virtual reality "fish tank" system. We describe the system requirements and explain how we arrived at the final decision. We show the operational guidance system in use on phantoms and animals.
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Stud Health Technol Inform · Jan 2008
The relationship between hip flexion/extension and the sagittal curves of the spine.
The objective of this study was to develop a finite element model (FEM) in order to study the relationship between hip flexion/extension and the sagittal curves of the spine. A previously developed FEM of the spine, rib cage and pelvis personalized to the 3D reconstructed geometry of a patient using biplanar radiographs was adapted to include the lower limbs including muscles. ⋯ Additional simulations showed that the hamstrings and gluteal muscles were responsible for the transmission of hip flexion to pelvic rotation with the legs straight and flexed respectively, and the important influence of knee bending on lordosis modulation during lower limb positioning. The knowledge gained through this study is intended to be used to improve operative patient positioning.