The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence

Introduction: Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. Methods: A selective review of the credible literature during the past decade (2005?2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. Findings: The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140295/1/tmj.2016.0149.pd

The organizational implications of medical imaging in the context of Malaysian hospitals

This research investigated the implementation and use of medical imaging in the context of Malaysian hospitals. In this report medical imaging refers to PACS, RIS/HIS and imaging modalities which are linked through a computer network. The study examined how the internal context of a hospital and its external context together influenced the implementation of medical imaging, and how this in turn shaped organizational roles and relationships within the hospital itself. It further investigated how the implementation of the technology in one hospital affected its implementation in another hospital. The research used systems theory as the theoretical framework for the study. Methodologically, the study used a case-based approach and multiple methods to obtain data. The case studies included two hospital-based radiology departments in Malaysia. The outcomes of the research suggest that the implementation of medical imaging in community hospitals is shaped by the external context particularly the role played by the Ministry of Health. Furthermore, influences from both the internal and external contexts have a substantial impact on the process of implementing medical imaging and the extent of the benefits that the organization can gain. In the context of roles and social relationships, the findings revealed that the routine use of medical imaging has substantially affected radiographers’ roles, and the social relationships between non clinical personnel and clinicians. This study found no change in the relationship between radiographers and radiologists. Finally, the approaches to implementation taken in the hospitals studied were found to influence those taken by other hospitals. Overall, this study makes three important contributions. Firstly, it extends Barley’s (1986, 1990) research by explicitly demonstrating that the organization’s internal and external contexts together shape the implementation and use of technology, that the processes of implementing and using technology impact upon roles, relationships and networks and that a role-based approach alone is inadequate to examine the outcomes of deploying an advanced technology. Secondly, this study contends that scalability of technology in the context of developing countries is not necessarily linear. Finally, this study offers practical contributions that can benefit healthcare organizations in Malaysia

The Diffusion of Telehealth: System-Level Conditions for Successful Adoption

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression. Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index, and HDI Index. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available to foster innovation

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

Digital Transformation in Healthcare

This book presents a collection of papers revealing the impact of advanced computation and instrumentation on healthcare. It highlights the increasing global trend driving innovation for a new era of multifunctional technologies for personalized digital healthcare. Moreover, it highlights that contemporary research on healthcare is performed on a multidisciplinary basis comprising computational engineering, biomedicine, biomedical engineering, electronic engineering, and automation engineering, among other areas

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

The Artificial Intelligence in Digital Pathology and Digital Radiology: Where Are We?

This book is a reprint of the Special Issue entitled "The Artificial Intelligence in Digital Pathology and Digital Radiology: Where Are We?". Artificial intelligence is extending into the world of both digital radiology and digital pathology, and involves many scholars in the areas of biomedicine, technology, and bioethics. There is a particular need for scholars to focus on both the innovations in this field and the problems hampering integration into a robust and effective process in stable health care models in the health domain. Many professionals involved in these fields of digital health were encouraged to contribute with their experiences. This book contains contributions from various experts across different fields. Aspects of the integration in the health domain have been faced. Particular space was dedicated to overviewing the challenges, opportunities, and problems in both radiology and pathology. Clinal deepens are available in cardiology, the hystopathology of breast cancer, and colonoscopy. Dedicated studies were based on surveys which investigated students and insiders, opinions, attitudes, and self-perception on the integration of artificial intelligence in this field

PERCEIVED EFFECT OF TELEMEDICINE ON MEDICAL SERVICE DELIVERY BY FEDERAL MEDICAL CENTERS IN NORTH CENTRAL ZONE OF NIGERIA

The study investigated the perceived effect of telemedicine on medical service delivery by the Federal Medical Centers in North Central Nigeria. Six objectives guided the study. The study answered six research questions and tested two null hypotheses at 0.05 level of significance. The study adopted survey research design. The research was conducted in the North Central Zone of Nigeria. The population of the study was one thousand four hundred and seven (1407) medical staff (Doctors, Nurses, Laboratory Technologists and Pharmacists). The sample size was three hundred and eleven (311) respondents comprising 97 doctors, 178 nurses, 19 laboratory technologists and 17 pharmacists; this was determined using Taro Yamane formula. The instrument used for data collection was a structured questionnaire titled: Perceived Effect of Telemedicine Questionnaire (PETQ) developed by the researcher from literature reviewed. Three experts validated the instrument while split-half method was used to determine the internal consistency of the items and a reliability co-efficient of 0.76 was obtained, indicating that the instrument is reliable for the study. The instrument was administered by the researcher and four research assistants. Descriptive statistics of mean and standard deviation were used to answer the research questions while inferential statistics of Chi-square was used to test the null hypotheses at 0.05 level of significance. The findings revealed that nine (9) Telemedicine services are available to a high extent in the Federal Medical Centers in North Central Nigeria. The findings also revealed that Telemedicine exerts twelve (12) effects on medical service delivery, fourteen (14) challenges were discovered to be associated with the use of telemedicine, while eight (8) strategies were identified to mitigate the challenges of the use of telemedicine. It was also found that availability of telemedicine significantly affects medical service delivery in Federal Medical Centers in North Central Nigeria. Further analysis of data revealed that the degree of application of telemedicine exert significant effect on medical service delivery in Federal Medical Centers in North Central Nigeria. It was recommended that Federal Medical Centers should embark on drastic development of telemedicine in line with global trend in order to promote effective utilization of telemedicine services, stake holders should establish a basic understanding of what this medical technology can lead to as it will help policy makers enlighten the telemedicine debate by turning unique insights into more adequate approaches that will enrich and humanize mediated channels of health communication, thereby offering remedies and clarifications for effective health care exchange and delivery

PERCEIVED EFFECT OF TELEMEDICINE ON MEDICAL SERVICE DELIVERY BY FEDERAL MEDICAL CENTERS IN NORTH CENTRAL ZONE OF NIGERIA

The study investigated the perceived effect of telemedicine on medical service delivery by the Federal Medical Centers in North Central Nigeria. Six objectives guided the study. The study answered six research questions and tested two null hypotheses at 0.05 level of significance. The study adopted survey research design. The research was conducted in the North Central Zone of Nigeria. The population of the study was one thousand four hundred and seven (1407) medical staff (Doctors, Nurses, Laboratory Technologists and Pharmacists). The sample size was three hundred and eleven (311) respondents comprising 97 doctors, 178 nurses, 19 laboratory technologists and 17 pharmacists; this was determined using Taro Yamane formula. The instrument used for data collection was a structured questionnaire titled: Perceived Effect of Telemedicine Questionnaire (PETQ) developed by the researcher from literature reviewed. Three experts validated the instrument while split-half method was used to determine the internal consistency of the items and a reliability co-efficient of 0.76 was obtained, indicating that the instrument is reliable for the study. The instrument was administered by the researcher and four research assistants. Descriptive statistics of mean and standard deviation were used to answer the research questions while inferential statistics of Chi-square was used to test the null hypotheses at 0.05 level of significance. The findings revealed that nine (9) Telemedicine services are available to a high extent in the Federal Medical Centers in North Central Nigeria. The findings also revealed that Telemedicine exerts twelve (12) effects on medical service delivery, fourteen (14) challenges were discovered to be associated with the use of telemedicine, while eight (8) strategies were identified to mitigate the challenges of the use of telemedicine. It was also found that availability of telemedicine significantly affects medical service delivery in Federal Medical Centers in North Central Nigeria. Further analysis of data revealed that the degree of application of telemedicine exert significant effect on medical service delivery in Federal Medical Centers in North Central Nigeria. It was recommended that Federal Medical Centers should embark on drastic development of telemedicine in line with global trend in order to promote effective utilization of telemedicine services, stake holders should establish a basic understanding of what this medical technology can lead to as it will help policy makers enlighten the telemedicine debate by turning unique insights into more adequate approaches that will enrich and humanize mediated channels of health communication, thereby offering remedies and clarifications for effective health care exchange and delivery

Guidelines for the effective use of telemedicine in public healthcare in resource constrained settings

On September 8 2000, world leaders gathered at the United Nations summit and resolved to help citizens in the world's poorest countries to achieve a better life by the year 2015. This resolve was outlined in the Millennium Development Goals that were subsequently published with goals 4, 5 and 6 specific to healthcare. The integration of ICT‘s in the remote delivery of services has opened new avenues from which centralised, scarce resources can be accessed remotely for the benefit of the general population. Telemedicine has made great strides in the developed world with remote populations benefiting from the improved access to healthcare. In the Eastern Cape Province of South Africa, the sub-field of teleradiology has shown promise for enabling the wider delivery of specialist services. However, in resource constrained settings such as developing countries, telemedicine has had limited success and as a result, the equitable access to healthcare for remote populations remains inconceivable. This is exacerbated by the migration of healthcare professionals both domestically and internationally. The public sector has suffered the most with acute staff shortages in the public healthcare institutions, more so in rural and remote areas. This study identifies the prevailing challenges posing as barriers to the effective use of telemedicine services in the Public health sector in resource constrained settings and provides recommendations and guidelines aimed at facilitating the adoption and effective use of telemedicine. Challenges are identified from literature and from the first person accounts of specific role-players who are directly involved with telemedicine in their respective institutions. Participants are drawn from institutions offering telemedicine services within the Eastern Cape Province of South Africa. Challenges identified from literature are collated with those identified from the participant interviews to provide a concise list of factors that is used as input to the recommendation and guideline development process. The results thus far point to an enthusiastic environment coupled with a semi-capable infrastructure but however hampered by staff shortages and a general lack of support structures and propulsion mechanisms to adequately encourage the wider use of telemedicine. The proposed guidelines aim to address the challenges at the different role-player levels