Organizational Impact and Exploitation of the Results of an Italian Research Project for eHealth and Medical Training

The paper describes the final results and the organisational impact of the HERMES project: an on-line integrated web-based platform to provide multimedia services in tele-medicine and tele-education fields. The project is part of a European Space Agency programme to promote the market of broadband satellite services and the role of satellite systems in the tele-education and tele-medicine domains. The project implemented a pilot to demonstrate the effectiveness of the overall system (application and communications platforms), and to promote the use in real scenarios of innovative telemedicine and teleeducation via satellite services in the Italian healthcare system. After five years, the project concluded its trial phase and the results of such a trial have been analyzed. The high level of investment in the initial phase suggested a very accurate market assessment with several pilot demonstrations. This approach is allowing to minimize the risks connected with the further significant service provisions and is now orienting the market deployment

Using Teledentistr y to Improve Access to Dental Care for the Underser ved

Advances in dental care have documented that early diagnosis, preventive treatments, and early intervention can prevent or reduce the progress of most oral diseases, conditions that, when left untreated, can have painful, disfiguring, and lasting negative health consequences. 1 Unfortunately, millions of American children and adults lack regular access to routine dental care, and many of them suffer needlessly with disease that inevitably results in significant decrements in their quality of life. Problems in access to oral health care cut across economic, geographic, and ethnographic lines. Racial and ethnic minorities, people who have disabilities, and those from low-income families, particularly children, are especially hard hit. In most rural areas in this country, especially, there are many barriers to dental health care, including geographic remoteness, sparse population, adverse seasonal weather and road conditions, poor or no public transportation, poverty and lack of health insurance, a less mobile aging population, culturally specific health care needs of many groups (especially American Indian and immigrant populations); a low number of dentists relative to total population, and a scarcity of specialty and subspecialty dentists. Teledentistry is an exciting new area of dentistry that uses electronic health records, telecommunications technology, digital imaging, and the Internet to link health care providers in rural or remote communities to enhance communication, the exchange of health information, and access to care for underserved patients. This articl

Development of an Integrated Telerehabilitation Information Management System to Support Remote Wheelchair Prescription

Information technology (IT) is central in providing Telerehabilitation (TR), which enables people with disabilities access to limited number of qualified practitioners with specialty expertise, especially at rural areas. Prior to 2008, most TR utilized non-integrated IT systems to provide its basic infrastructure. Using this approach, data management has to be done manually over multiple non-integrated systems, increasing the possibility of outdated or missing data. An integrated system that is open, flexible, extensible, and cost-effective was designed and developed as a solution to mitigate this problem. The work described in this dissertation elaborates the process of developing such system, called the Versatile and Integrated System for Telerehabilitation (VISYTER). VISYTER was intended to become a platform that is capable of delivering any TR, and was first used to support Remote Wheelchair Prescription (RWP), a TR effort to support clinicians in rural Pennsylvania to prescribe wheeled mobility and seating devices. The development process of VISYTER consisted of three main phases: identification and verification of requirements, validation, and evaluation. The requirement identification and verification phase involved a group of expert clinicians from RWP with the purpose of identifying the requirement of the system to support RWP: a system that can provide real-time teleconsultation and documentation support for prescribing a wheeled mobility intervention. Validation studies were conducted with help from ten individuals, including physicians, clinicians, and suppliers participated to validate VISYTER in their workplaces. All participants agreed that VISYTER can be used to properly support both the teleconsultation and documentation phase of RWP. Afterward, the usability of VISYTER was evaluated through a comparison study with a commonly utilized videoconferencing system in TR, POLYCOM. Twenty-six clinicians participated in a counterbalanced experimental study to measure the difference in usability for completing client assessment tasks using both systems. The study found VISYTER to be more efficient and less prone to error when compared to POLYCOM. Based on these findings, the study concluded that an integrated system could improve the usability TR delivery when compared to non-integrated systems approach

Telehealth in the developing world

Co-published with the Royal Society of Medicine Pres

Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship

In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of scholarly literature was developed and validated against other existing taxonomies. Telemedicine has been found to increase the quality and access of health care and decrease health care costs (Heinzelmann, Williams, Lugn and Kvedar 2005 and Wootton and Craig 1999). Patients in rural areas where there is no specialist or patients who find it difficult to get to a doctor’s office benefit from telemedicine. Little research thus far has examined scholarly journals in order to aggregate and analyze the prevalent issues in the discourse community of telemedicine. The purpose of this dissertation is to empiricallydocument the prominent topics and issues in telemedicine by examining the related published scholarly discourse of telemedicine during a snapshot in time. This study contributes to the field of telemedicine by offering a comprehensive taxonomy of the leading authors and journals in telemedicine, and informs clinicians, librarians and other stakeholders, including those who may want to implement telemedicine in their institution, about issues telemedicine