Economic Environment and Applications of Telemedicine

Telemedicine is broadly defined as the transmission of electronic medical data across a distance among hospitals, clinicians, and/or patients. This definition is deliberately unlimited to what kind of information is transmitted, how the information is transmitted, or how the information is used once received (HCAB, 2003). Telemedicine has the potential of making a greater positive effect on the future of healthcare and medicine than any other modality. Fueled by advances in multiple technologies such as digital communications, full-motion/compressed video, and telecommunications, providers see an unprecedented opportunity to provide access to high-quality care, independent of distance or location

Transnational comparison : A retrospective study on e-health in sparsely populated areas of the northern periphery

Peer reviewedPublisher PD

Integrating digital Health services : the role of the government and the challenge of cost allocation

eHealth, mHealth and eCare services are growing in numbers at a fast pace. This is mainly driven by technology and the societal challenges of an aging and more chronically burdened population while pressure on both human and financial resources increases. Though the adoption of these digital health services is challenging and experience difficulties. This work focusses on the main barriers that cause a 'gap' in the value network. Via case research following barriers are identified: 1) low willingness to pay, 2) unbalanced cost/benefit ratios of the actors or unfair cost allocation and 3) negative impacted business models. Furthermore the several roles of the government within the value network of digital health services are discussed and reflections and guidelines for digital health service developers are foreseen

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

Global Diffusion of the Internet X: The Diffusion of Telemedicine in Ethiopia: Potential Benefits, Present Challenges, and Potential Factors

Delivery of healthcare services presents many challenges for governments in most developing countries. Some of these challenges include financial and human resources issues that might affect governments\u27 ability to manage and transform scarce resources to meet healthcare needs. Telemedicine, a healthcare delivery technology where physicians examine patients from distant locations using information technologies, is reported to be increasingly helpful in meeting the needs of the healthcare sector in developing nations such as those in sub-Saharan Africa. This conceptual study reports on the sectoral adoption of telemedicine in Ethiopia, a sub-Saharan African country. We examine the potential benefits of telemedicine diffusion in Ethiopia, addressing the country\u27s healthcare needs, and discussing the obstacles and challenges. Based on previous literature, as well as experiences drawn from other developing nations, we address three potential factors that could influence the diffusion of telemedicine in Ethiopia: active participation of institutions of higher education, Ethiopian foreign alliances, and government involvement. Although the initial successes are relatively small and involve isolated projects, they have been promising and have set the stage for researchers to investigate prevailing projects so as to gain better understanding of the aforementioned factors. Our study does not claim that telemedicine can solve all of Ethiopia\u27s medical challenges; however, we contend that it is a starting point to reach Africans that live in areas with limited medical facilities and personnel. Hence, our study could have far reaching implications as the world looks to help this country, and by extension, other developing countries, to overcome their medical challenges and join the information society

Utilizing Telecommunication to Provide Patient Centered Care for Adults Newly Diagnosed with GI Cancer: A Quality Improvement Project

INTRODUCTION: A confirmed diagnosis of GI Cancer causes anxiety and stress as patients become overwhelmed with questions, worries and fears. At diagnosis, patients are not yet formally connected to the support services available to those actively receiving chemotherapy, creating a “gap period”. To help reduce anxiety, as well as, foster therapeutic relationships and improve overall patient experiences, a structured telephone communication by the gastrointestinal cancer oncology nurse practitioner (GI NP) was proposed. AVAILABLE KNOWLEDGE: Reduction of anxiety has been shown to enhance the quality of life, increase compliance with a prescribed treatment plan and foster the ability to sign informed consent. Nurses play an important role in reducing anxiety by creating an environment in which patients are able to develop trusting relationships to communicate their concerns. A navigation program helps to reduce the gap in oncology care between diagnosis and the start of treatment and connect patient to services which can provide support, education and guidance to the newly diagnosed GI oncology patient. METHODS: The self-reported PROMIS Anxiety Scale short form and the NCCN Distress Thermometer were used to measure anxiety and distress pre and post-intervention along with the Patient Satisfaction with Cancer Care (PSCC) satisfaction tool post-intervention to gauge patient satisfaction. A Paired t-test was utilized to evaluate the effect of the intervention on the PROMIS anxiety scores and the NCCN distress scores. INTERVENTION: Telephone communications were made to patients by the GI NP within 48 hours of the diagnostic visit. Weekly communications were then scheduled as needed until the patient’s treatment began, as requested by the patient, or as determined necessary by any issues or concerns that arose. A final visit was made at the start of care. RESULTS: In this quality improvement study, 16 patients were evaluated over 3 months. Anxiety scores demonstrated a statistically significant reduction from pre to post intervention m=4.375, 95% CI [SD 7.92, p .043). There was no significant difference in distress scores. Patient satisfaction responses (n=8) indicated very high levels of satisfaction with the telephone communications. CONCLUSIONS: Although this QI study was small, results indicate a significant improvement in anxiety levels with telephone communications during the gap period between diagnosis and the start of care. This demonstrates an important role for navigators in increasing the outreach to patients at this time. Our feedback indicated patients felt more connected to the clinic and more trusting of their relationship with their providers at the initiation of treatment. Ideally, this project should be continued on a much larger scale for more valid results

Impact of Social Marketing on Nurse Practitioners\u27 Acceptance of Clinical Video Telehealth for Elderly Patients in Rural Mississippi

Elderly patients 65 years and older who have chronic illness and disabilities living in rural Mississippi have increased difficulty in obtaining timely cost-effective healthcare services from nurse practitioners. The purpose of the capstone project was to utilize social marketing strategies for promoting nurse practitioners’ acceptance of clinical video telehealth (CVT) in improving healthcare access for rural elderly patients in Mississippi. Clinical video telehealth is an innovative way to provide healthcare services to populations in need by reducing barriers to healthcare, such as distances, time, and transportation, and financial resources. However, providing healthcare through the use of technology has not always been well received by nurse practitioners due to concerns related to the lack of human touch, confidence in the reliability of CVT, knowledge of new technology, and provider workload reimbursement challenges. Lee and Kotler’s (2011) principles and techniques of social marketing were used as the framework to promote Mississippi nurse practitioners’ acceptance of new technology for providing healthcare services in rural Mississippi. Additionally, using the American Association of Colleges of Nursing’s (AACN) (2006) Doctoral of Nursing Practice (DNP) Essentials II and IV supported this capstone social marketing telehealth project through technology system redesigns of healthcare. Twelve Mississippi nurse practitioners participated in a focus group survey and CVT educational event. A focus group post-survey was utilized to collect descriptive data regarding nurse practitioners’ perceptions and acceptance of CVT. Data were obtained through five open-ended questions with additional comment section to identify concerns and barriers for acceptance of CVT. The slogan 3 Rs (right service to the right person at the right time and place) was the social marketing campaign platform. Increasing nurse practitioners’ knowledge of new technology through social marketing can be instrumental in changing behavior and increasing acceptance of CVT for improving access to rural elderly as well as being a virtual connection for physician and peer review process

Country, Sector or Style: What Matters Most When Constructing Global Equity Portfolios? An Empirical Investigation from 1990-2001

Equity returns are believed to be strongly influenced by country, sector and style effects. A key issue is to be able to disentangle those various effects from one another. In particular, differences between country returns may simply reflect differences in the sector composition of country markets, which makes it clearly difficult to disassociate both effects. Similarly, from 1999-2001 the relative perfor-mance of Growth versus Value might be solely due to the striking performance of the Technology and Telecommunication sectors. For global equity portfolio man-agers, it is crucial to identify which factors offer the highest diversification benefits and return potential. We apply a multi-factor approach to estimate ”pure” coun-try, sector and style factor returns. Using data going back to 1990, we identify the major changes that have occurred in developed markets until 2001. Our various indicators clearly point out the growing influence of sector factors. However, coun-try effects remain important and there is no clear-cut evidence that sector factors dominate country factors. Style factors such as Growth, Value and Size also remain significant, even once sector and country effects are deduced. Finally, we show that momentum strategies based on sector returns offer substantial gains, while momen-tum strategies based on country returns do not. These findings suggest that, while diversification and return benefits from sector strategies have become substantial, managers should continue to monitor carefully country as well as style rewards and risks.