Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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This work evaluates the feasibility of using 802.11 g ad hoc and 3G cellular broadband networks to wirelessly stream ultrasound video in real-time. Telemedicine ultrasound applications in events such as disaster relief and first-response triage can incorporate these technologies, enabling onsite medical personnel to receive assistance with diagnostic decisions by remote medical experts. The H.264 scalable video codec was used to encode echocardiographic video streams at various image resolutions (video graphics array [VGA] and quarter video graphics array [QVGA]) and frame rates (10, 15, 20, and 30 frames/s). ⋯ The transmitted ultrasound video streams were subsequently recorded and evaluated by physicians with expertise in medical ultrasonography who evaluated the diagnostic value of the received video streams relative to the original videos. They expressed the opinion that image quality in the case of both 802.11 g and 3G was fully to adequately preserved, but missed frames could momentarily decrease the diagnostic value. This research demonstrates that 3G and 802.11 g wireless networks combined with efficient video compression make diagnostically valuable wireless streaming of ultrasound video feasible.
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Major government efforts to widen the use of health information technology and speed the translation of biomedical research discoveries into clinical practice are converging with the rapid growth of the Internet to create unprecedented opportunities to use telehealth networks to broaden access to high-quality healthcare and expand the scope and reach of clinical and translational research. Recognizing the dual potential of telehealth networks to improve health outcomes and reduce barriers to participation in research, particularly in medically underserved communities, the National Center for Research Resources (NCRR), part of the National Institutes of Health (NIH), convened a national conference at the NIH on June 25-26, 2009, titled "Future of Telehealth: Essential Tools and Technologies for Clinical Research and Care," in collaboration with experts from the Health Resources and Services Administration, the Indian Health Service, the Department of Veterans Affairs, Internet2, and the NIH National Library of Medicine, National Institute of Biomedical Imaging and Bioengineering, and National Center for Minority Health and Health Disparities. The conference brought together over 400 subject matter experts from government, academia, and industry to discuss a wide range of issues in telehealth research and development. Its primary outcome is a set of short papers reporting on recommendations from thematic breakout sessions and some overarching recommendations that can, taken together, stimulate and help guide further research through new multi-agency, interdisciplinary collaborations.
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Congestive heart failure, chronic obstructive pulmonary disease, diabetes, and hypertension are common causes of hospitalization in the elderly. Short-term postdischarge clinical outcomes regarding compliance, symptom control, readmission, functional status, and mortality rates are in need of improvement. This observational study documents the results of a home-based case-managed telemedicine (CMTM) program delivered over a 2-month period postdischarge. ⋯ A majority of patients showed improved quality of health perception, better disease understanding, and high satisfaction rates with telemedicine. This is one of the larger observational studies in a predominantly elderly patient population enrolled in a CMTM program, to date. This model of care was well accepted by the elderly and produced excellent short-term clinical outcomes.
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Telehealth interventions are feasible and efficacious. While patients are the focus of both quantitative and qualitative studies that assess their response to telehealth, little is known about the view of providers of telehealth services. The purpose of this study was to better understand the experiences of providers and the factors that they perceive to contribute to the success of telehealth interventions as well as to their own satisfaction. ⋯ These included opportunities for more frequent contact with patients, greater relaxation and information due to the ability to interact with the patients in their own homes, increased ability to reach the underserved, more timely and accurate medical monitoring, and improved management of data. The primary disadvantages of telehealth they identified were technology problems and a concern about the lack of physical contact with patients. Findings illustrate providers' perspectives on the unique advantages of telehealth and offer insight as to how to make telehealth interventions more effective, as well as more satisfying for those who do the day-to-day work of providing the interventions.