14,935 research outputs found
Chinese Expert Consensus on Critical Care Ultrasound Applications at COVID-19 Pandemic
The spread of new coronavirus (SARS-Cov-2) follows a different pattern than previous respiratory viruses, posing a serious public health risk worldwide. World Health Organization (WHO) named the disease as COVID-19 and declared it a pandemic. COVID-19 is characterized by highly contagious nature, rapid transmission, swift clinical course, profound worldwide impact, and high mortality among critically ill patients. Chest X-ray, computerized tomography (CT), and ultrasound are commonly used imaging modalities. Among them, ultrasound, due to its portability and non-invasiveness, can be easily moved to the bedside for examination at any time. In addition, with use of 4G or 5G networks, remote ultrasound consultation can also be performed, which allows ultrasound to be used in isolated medial areas. Besides, the contact surface of ultrasound probe with patients is small and easy to be disinfected. Therefore, ultrasound has gotten lots of positive feedbacks from the frontline healthcare workers, and it has played an indispensable role in the course of COVID-19 diagnosis and follow up
A Cloud Telemedicine Platform Based on Workflow Management System: A Review of an Italian Case Study
The paper aims to describe a new technological and organizational approach in order to manage teleconsultation and telemonitoring processes involving a Physician, who remotely interacts with one or more Specialists, in order to evaluate and discuss the specific clinical conditions of a patient, based primarily on the sharing of digital clinical data, reports and diagnostic images. In the HINT project (Healthcare INtegration in Telemedicine), a teleconsultation and telemonitoring cloud platform has been developed using a Hub and Spoke architecture, based on a Business Process Management System (BPMS). The specialized clinical centres (Hubs) operate in connection with the territorial hospital centres (Spokes), which receive specific diagnostic consultations and telemonitoring data from the appropriate Specialist, supported by advanced AI systems. The developed platform overcomes the concepts of a traditional and fragmented teleconsultation and consequently the static organization of Hubs and Spokes, evolving towards an integrated clinical workflow management. The project platform adopts international healthcare standards, such as HL7 FHIR, IHE (XDS and XDW) and DICOM for the acquisition and management of healthcare data and diagnostic images. A Workflow Management System implemented in the platform allows to manage multiple and contemporaneous processes through a single platform, correctly associating the tasks to the Physicians responsible for their execution, monitoring the status of the health activities and managing possible clinical issues
Proposal and evaluation of online medical services expansion mode for specialties: a patient perceived value perspective
There is a great imbalance and difference in the distribution of Chinese medical resources in urban and rural areas, as most medical resources are concentrated in urban areas. Against the backdrop of China’s promotion of "Internet + medical healthcare", medical institutions are encouraged to apply Internet and other information technologies to expand the space and content of medical services, but patients in remote places lack independent choice of consultation platform.
Based on the theory of Maslow's hierarchy of needs, customer perception theory, Synergy theory, TAM and ACSIM, the model building of remote patients' perceived value satisfaction with online medical services for specialties is hypothesized. Take F hospital as the subject, The research provides an empirical research on the process rebuilding and redesigning specialized online health services based on the perceived value of remote patients. To obtain the perceived value needs of remote patients’ visits, this study carries out questionnaire survey to understand the main needs of remote patients visiting. The results show that: social contact and respect value need > safety and survival value need > self-value need > cost losses value. Meanwhile, the preliminary evaluation indicators of patients' perceived value are derived based on the results of the questionnaire.
The research is mainly to verify the effect of the implementation of the Internet-based specialized medical partnership medical service access model for remote patients. The post-test questionnaire is designed to understand the overall level of remote patients’ perceived value of online medical services, including the level of perceived ease of use, the level of perceived usefulness, the level of perceived value, the level of satisfaction, and the level of synergy. Among them, the perceived usefulness scores the highest, It is found that the cost of the new model in terms of time, distance, expense, and energy has been significantly reduced.
The research, through building the SEM model, tests the path relationships of relevant dimensions and mediating effect of the model of remote patients’ perceived value satisfaction with online medical services for specialties.Verifica-se um grande desequilíbrio na distribuição dos recursos médicos chineses nas áreas urbanas e rurais, visto que a maioria dos recursos médicos está concentrada nas áreas urbanas. No contexto da promoção chinesa de "Internet + saúde médica", as instituições médicas são incentivadas a recorrer à Internet e a outras tecnologias de informação para expandir o espaço e o conteúdo dos serviços médicos, mas os pacientes em lugares remotos não têm escolha independente da plataforma de consulta.
Com base na teoria da hierarquia de necessidades de Maslow, teoria da perceção do cliente, teoria da sinergia, TAM e ACSIM, realizou-se a construção do modelo de satisfação do valor percebido de pacientes remotos, com serviços médicos online para especialidades. Considerou-se o hospital F como caso de estudo. A investigação fornece uma pesquisa empírica sobre o processo de reconstrução e redesenho de serviços de saúde online especializados, com base no valor percebido de pacientes remotos. Para obter as necessidades de valor percebido das visitas de pacientes remotos, neste estudo realizou-se uma pesquisa por questionário para entender as principais necessidades das visitas de pacientes remotos. Os resultados mostram que: contato social e respeito valor necessidade e > segurança e valor de sobrevivência necessidade > necessidade de valor próprio > valor de perdas de custo. Enquanto isso, os indicadores de avaliação preliminar do valor percebido dos pacientes são derivados com base nos resultados do questionário.
O objetivo principal do presente trabalho é verificar o efeito da implementação do modelo de acesso a serviços médicos especializados, baseada na Internet para pacientes remotos. O questionário pós-teste foi projetado para compreender o nível geral de valor percebido de pacientes remotos de serviços médicos online, incluindo o nível de facilidade de uso percebida, o nível de utilidade percebida, o nível de valor percebido, o nível de satisfação e o nível de sinergia. Entre eles, a utilidade percebida pontua mais alto. Verifica-se que o custo do novo modelo em termos de tempo, distância, despesa e energia foi reduzido significativamente.
Por meio da construção do modelo SEM, testaram-se as relações do caminho de dimensões relevantes, e o efeito mediador do modelo de satisfação de valor percebido de pacientes remotos, com serviços médicos online para especialidades
Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy
Four years ago, a telemedicine project in diagnosis and care of congenital cardiac malformations was developed in Tuscany interconnecting the Heart Hospital of Gabriele Monasterio Tuscany Foundation (FTGM) in Massa with main clinical centers around the region. Both live and store-and-forward tele-echocardiography were implemented, while the FTGM medical record system was applied for collaborative reporting. Mobile medical-grade carts, equipped with videoconferencing and computer units, were installed at main neonatology/pediatric centers throughout the Tuscany region. Today, 13 hospitals are connected to the network, while the MEYER Pediatric University Hospital (MEYER) in Firenze has recently adhered to the project, as HUB center jointly with FTGM, so enabling H24 telemedicine service in pediatric cardiology throughout the region. So far, more than 200 patients were diagnosed and followed by telemedicine
Developing a mHealth-based portable ultrasound platform for breast cancer screening
Background Breast cancer is amongst the 10 most common cancers globally. The disease burden is increasing rapidly in Sub-Saharan African countries, where women living in rural and or remote areas are particularly prone to be diagnosed with late-stage breast cancer. This is due to the limited availability of advanced screening and diagnostic options. Ultrasound is a feasible screening tool for breast cancer, due to its portability, affordability and accuracy. The integration of mHealth with portable ultrasound enables the provision of screening services in rural and remote areas, through electronic consultation by a non-specialist with a specialist for interpretation and reporting of the ultrasound results. This project developed an application for a mHealth-based portable ultrasound platform that could be used by a non-specialist to provide breast cancer screening services with remote specialist support. Methods A systematic review of the literature was conducted for the period of 2004 to 2019 to gather evidence on the use of mHealth-based portable ultrasound platforms for improved access to ultrasound services like breast cancer screening. The evidence from the literature was used to design and develop a prototype of an application for a mHealth-based portable ultrasound platform suitable for breast cancer screening. The prototype application was integrated with a mobile-based portable ultrasound from Philips Lumify. Images generated by scanning a phantom breast using the portable ultrasound were uploaded onto the application and downloaded from the application to demonstrate the concept. Results The systematic review showed only two clinical conditions (obstetrics and cardiovascular disease) which used a mHealth-based portable ultrasound platform. The outcomes from the studies showed improved access to the respective ultrasound services in terms of patient management, early detection, improved quality of care and increased patient attendance, which resulted in access to other services. The integration of the prototype application with a mobile-based portable ultrasound resulted into a mHealthbased portable ultrasound platform prototype intended for breast cancer screening. The ability to upload images onto the platform and download images from the platform satisfied the design requirements for the platform. Conclusion A mHealth-based portable ultrasound prototype was developed, which has potential for improving access to breast cancer screening services. Further research including testing of the application with health professionals and patients is recommended to strengthen the feasibility of the concept
An Internet-Based Telemedicine System in Nigeria
Telecommunication technologies are being used to change the healthcare industry in unprecedented and irreversible ways. These technologies are enabling delivery of healthcare to remotely placed patients and facilitating information exchange between generalists and specialists. For many decades now, the use of advanced telecommunications and information technologies has been investigated in an effort to improve healthcare. In particular, the focus has been centered on telemedicine. Telemedicine has been defined as the delivery of healthcare and the exchange of health information across distances, including all medical activities: making diagnosis, treatment, prevention, education and research (Craig, 1999). Telemedicine is also defined as the use of telecommunication technologies to provide medical information and services (Perednia & Allen, 1995). It may be as simple as two health professionals discussing a patient\u27s case over the telephone, or as sophisticated as using satellite technology to broadcast a consultation between healthcare centres in two countries using videoconferencing equipment. The American Telemedicine Association defines telemedicine as the use of medical information exchanged from one site to another via electronic communication for health and education of the patient or healthcare providers and for the purpose of improving patient care (ATA, 2001). Wootton (1996) considered telemedicine as a process, rather than a technology: telemedicine connects patients and healthcare professional in a chain of care
Telemedicine
Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios
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