Using handheld pocket computers in a wireless telemedicine system

Objectives: To see if senior emergency nurse practitioners can provide support to inexperienced ones in a Minor Injuries Unit by using a wireless LAN system of telemedicine transmitting images to a PDA when they were on duty. In addition, whether such a system could be sufficiently accurate to make clinical diagnoses with a high level of diagnostic confidence. This would permit an overall lower grade of nurse to be employed to manage most of the cases as they arrive with a proportionate lowering of costs. Methods: The wireless LAN equipment could roam in the Minor Injuries Unit and the experienced emergency Nurse practitioners could be at home, shopping or even at a considerable distance from the centre. Thirty pictorial images of patients who had been sent to the Review Clinic were transmitted to a PDA various distances of one to sixteen miles from the centre. Two senior emergency nurse practitioners viewed the images and opined on the diagnosis, their degree of confidence in the diagnosis and their opinion of the quality of the image. Results: the images of patients were sharp, clear, and of diagnostic quality. The image quality was only uncertain, as was the level of confidence of the diagnosis if the patient was very dark skinned. Conclusions: The wireless LAN system works with a remote PDA in this clinical situation. However there are question marks over the availability of enough experienced emergency nurse practitioners to staff a service that provides senior cover for longer parts of the day and at weekends

Focal Spot, Spring/Summer 1984

https://digitalcommons.wustl.edu/focal_spot_archives/1037/thumbnail.jp

Using handheld devices for real-time wireless teleconsultation

Recent advances in the hardware of handheld devices, opened up the way for newer applications in the healthcare sector, and more specifically, in the teleconsultation field. Out of these devices, this paper focuses on the services that personal digital assistants and smartphones can provide to improve the speed, quality and ease of delivering a medical opinion from a distance and laying the ground for an all-wireless hospital. In that manner, PDAs were used to wirelessly support the viewing of digital imaging and communication in medicine (DICOM) images and to allow for mobile videoconferencing while within the hospital. Smartphones were also used to carry still images, multiframes and live video outside the hospital. Both of these applications aimed at increasing the mobility of the consultant while improving the healthcare service

Washington University Record, February 22, 1996

https://digitalcommons.wustl.edu/record/1714/thumbnail.jp

The remodelling of patient care pathway for e-health

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The interdependencies within the health care system are seldom taken into account prior to implementation of e-health projects, and there tends to be little change management as part of the plan. Our proposal offers a systems analysis model that gives e-health a framework to consider and manage the introduction, changes and outcomes. This research describes the use of a modified Patient Care Pathway as a method to design and implement e-health projects, presenting as a case study the pre-implementation phase of a teleradiology project in rural Thailand. The proposal is that a modified version of Patient Care Pathways can be used as a prospective design model for e-health services. The method adopts systems engineering principles and applies a ―whole systems approach‖ thereby providing a much richer schematic representation of the patient care pathway illustrating both the patient‘s journey through the system and also the information flow. Our method was applied to the design of a new teleradiology service that was to be established in Thailand, to connect GP‘s in a rural hospital to the radiology department in a tertiary hospital with a further connection to a specialist radiologist in a medical school in Bangkok. By comparing the pre-implementation Patient Care Pathway with the proposed pathway using the teleradiology, a systems analysis model was developed to identify critical points in the system and identify and anticipate how the system would support the changes in clinical practices. The method produced a valuable framework to better understand and thereby manage the implications of change prior to implementation of an e-health project

Mammographic interpretation training: how useful is handheld technology?

In the UK a national self-assessment scheme (PERFORMS) for mammographers is undertaken as part of the National Health Search Breast Screening Programme. Where appropriate, further training is suggested to improve performance. Ideally, such training would be on-demand; that is whenever and wherever an individual decides to undertake it. To use a portable device for such a purpose would be attractive on many levels. However, it is not known whether handheld technology can be used effectively for viewing mammographic images. Previous studies indicate the potential for viewing medical images with fairly low spatial resolution (e.g. CT, MRI) on PDAs. In this study, we set out to investigate factors that might affect the feasibility of using PDAs as a training technology for examining large, high resolution mammographic images. Two studies are reported: 20 mammographers examined a series of mammograms presented on a PDA, specifying the location of any abnormality. Secondly, a group of technologists examined a series of mammograms presented at different sizes and resolutions to mimic presentation on a PDA and their eye movements were recorded. The results indicate the potential for using PDAs to show such large, high resolution images if suitable Human-computer Interaction (HCI) techniques are employed