Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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The purpose of this project was to test the efficacy of behavioral telemedicine interventions designed to teach self-regulation skills to chronic pain patients who had not previously been treated. The study sought to determine whether there were differences in outcome and consumer satisfaction with the pain management intervention when delivered by conventional face-to-face methods, by telephone only, and by closed circuit TV (CCTV). ⋯ Thus, it is not known at this time how well the intervention can be generalized to other clinicians. In addition, there was no control on the administration of the protocols across conditions.
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The costs for polysomnography (PSG) and alternative diagnostic procedures for sleep-disordered breathing are challenging public health care systems. We wanted to determine if a telemedicine protocol with online transfer of PSGs from a remote site could be cost-effective and clinically useful while improving patient access to full PSG. Fifty-nine PSGs were performed in 54 pulmonary patients with suspected sleep-disordered breathing at a remote hospital. ⋯ A savings of $550 per study was realized with the telemedicine protocol. The online transfer of PSGs from a remote site to a centralized sleep laboratory is technically feasible and clinically useful. Telemedicine offers an effective alternative for cost reduction in sleep medicine while improving patient access to specialized care in remote areas.
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The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. ⋯ The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.