Implementing a Prototype Diabetic Telemedicine System

Abstract Portable electrocardiogram monitoring devices for use by persons at home or work environments have long been known

Tele-electrocardiography in South-East Asia Archipelago: From a Basic Need for Healthcare Services to a Research Implementation

The fundamental principle for telemedicine implementation in the real world is to address the basic needs of healthcare services. The utilization of telemedicine naturally aimed to overcome distance, time, and financial constraints. Remote areas that are far from the cities and healthcare centers are the main regions that would mostly get benefit from the telemedicine program, for instance, in Indonesia, a country with a big archipelago area in South-East Asia. The primary healthcare center in this country is commonly available, however, the facilities and health workers are still limited. The health services are being centralized in big cities, and thus, the rural areas are far left in the context of healthcare services. Telemedicine could bring both standardized and specialized healthcare services nearer to the patients, irrespective of distance and location constraints. After receiving professional cardiology advice, implementation of telemedicine program, such as tele-electrocardiography (tele-ECG) at the primary care level, may be a financially advantageous way to identify cardiovascular disease in the general population and avoid overtreating patients. This is our first time adopting tele-ECG consultations in East Indonesia under the Makassar Telemedicine Program. This program allows us to maintain a big database of cohorts and connect its implementation to real-world clinical practices, and at the end, could guiding the health workers to improve patient’s outcomes

Survey and classification of functional characteristics in neural network technique for the diagnosis of ischemic heart disease: A systematic review

Background: Nowadays, the prevalence of ischemic heart diseases (IHDs) leads to destructive effects such as patient death. Late diagnosis of such diseases as well as their invasive diagnostic approaches made researchers provide a decision support system based on neural network techniques, while using minimum data set for timely diagnosis. In this regard, selecting minimum useful features is significant for designing neural network structure and it paves the way to attain maximum accuracy in obtaining the results. Methods: In this systematic review, valid databases using sensitive keywords were initially searched out to find articles related to "diagnosing the ischemic heart disease using artificial neural networks" and afterwards, scientific methods were used to analyze and classify the content. Findings: Researchers applied various extractable features from demographic data, medical history, signs and symptoms, and paraclinical examinations, to design the neural network structure. Among them, the features obtained from electrocardiographic test, embedded in paraclinical examinations, had led to a remarkable increase of efficiency in neural network. Conclusion: Utilizing such diagnostic decision support systems in practical environments depends on their high confidence coefficient and physicians� acceptability. Therefore, it can be useful to improve maturity in the design of the neural network structure depending on the choice of the minimum optimal features, and to create required infrastructures to input patients� real, accurate, and flowing data in these systems. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved

Survey and classification of functional characteristics in neural network technique for the diagnosis of ischemic heart disease: A systematic review

Background: Nowadays, the prevalence of ischemic heart diseases (IHDs) leads to destructive effects such as patient death. Late diagnosis of such diseases as well as their invasive diagnostic approaches made researchers provide a decision support system based on neural network techniques, while using minimum data set for timely diagnosis. In this regard, selecting minimum useful features is significant for designing neural network structure and it paves the way to attain maximum accuracy in obtaining the results. Methods: In this systematic review, valid databases using sensitive keywords were initially searched out to find articles related to "diagnosing the ischemic heart disease using artificial neural networks" and afterwards, scientific methods were used to analyze and classify the content. Findings: Researchers applied various extractable features from demographic data, medical history, signs and symptoms, and paraclinical examinations, to design the neural network structure. Among them, the features obtained from electrocardiographic test, embedded in paraclinical examinations, had led to a remarkable increase of efficiency in neural network. Conclusion: Utilizing such diagnostic decision support systems in practical environments depends on their high confidence coefficient and physicians� acceptability. Therefore, it can be useful to improve maturity in the design of the neural network structure depending on the choice of the minimum optimal features, and to create required infrastructures to input patients� real, accurate, and flowing data in these systems. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved

Application of disruptive technologies in telemedicine for universal coverage of health services

[ES] La aplicación de tecnologías disruptivas en telemedicina facilita la accesibilidad a tecnologías diagnósticas de poblaciones remotas sin acceso a especialistas y mejora la cobertura universal de servicios de salud. Este estudio fue realizado por la Unidad de Telemedicina del Ministerio de Salud Pública y Bienestar Social (MSPBS) en colaboración con el Dpto. de Ingeniería Biomédica e Imágenes del Instituto de Investigaciones en Ciencias (IICS-UNA). Objetivo: Evaluar la utilidad de aplicaciones de tecnologías disruptivas en telemedicina para la cobertura universal de servicios de salud entre enero del 2014 y septiembre de 2019. Material y Método: Estudio de diseño observacional y descriptivo incluyó a 540.397 pacientes. Para el efecto se analizaron los resultados obtenidos por la red de telediagnóstico implementado en 67 hospitales del MSPBS. En dicho sentido se analizaron 540.397 diagnósticos remotos realizados entre enero del 2014 y septiembre de 2019. Resultados: D el total, el 33,174 % (179.274) correspondieron a estudios de tomografía, 64,825 % (350.313) a electrocardiografía (ECG), 1,997 % (10.791) a electroencefalografía (EEG) y 0,004 % (19) a ecografía. La concordancia entre el diagnóstico remoto y el diagnóstico “cara a cara” fue del 95 %. Conclusión: Con el diagnóstico remoto se logró una reducción del coste que supone un beneficio importante para cada ciudadano del interior del país. Los resultados obtenidos evidencian que la aplicación de tecnologías disruptivas en telemedicina puede contribuir para lacobertura universal de servicios con tecnologías diagnósticas, maximizando el tiempo y productividad del profesional, aumentando el acceso y la equidad, y disminuyendo los costos. Sin embargo, antes de su implementación generalizada se deberá contextualizar con el perfil epidemiológico regional.[EN] The application of disruptive technologies in telemedicine facilitates accessibility to diagnostic technologies of remote populations without access to specialists and improves universal coverage of health services. This study was carried out by the Telemedicine Unit of the Ministry of Public Health and Social Welfare (MSPBS) in collaboration with the Department of Biomedical Engineering and Imaging of the Institute of Research in Sciences (IICS-UNA). Objective: to evaluate the usefulness of disruptive technology applications in telemedicine for universal coverage of health services January 2014 to September 2019. Material and Method: observational and descriptive design study included 540,397 patients. For this purpose, the results obtained by the telediagnostic network implemented in 67 MSPBS hospitals were analyzed. In this regard, 540,397 remote diagnoses carried out between January 2014 and September 2019 were analysed. Results: of the total, 33.174% (179,274) were CT studies, 64.825% (350,313) electrocardiography (ECG), 1.997% (10,791) electroencephalography (EEG) and 0.004% (19) ultrasound. The concordance between remote diagnosis and "face-to-face" diagnosis was 95%. Conclusion: remote diagnosis achieved a cost reduction that is an important benefit for every citizen of the interior of the country. The results show that the application of disruptive technologies in telemedicine can contribute to the universal coverage of services with diagnostic technologies, maximizing the time and productivity of the professional, increasing access and equity, and lowering costs. However, prior to widespread implementation, the regional epidemiological profile should be contextualized

Evaluación de la eficiencia y valoración del impacto económico y social del sistema de telemedicina para poblaciones dispersas y aisladas en un país de bajo ingreso

103 pEl estudio determinó la efectividad del telediagnóstico para ecografía, electrocardiografía y tomografía, medida por el grado de acierto del diagnóstico confirmado luego clínicamente gracias al diagnóstico cara a cara aleatorio de los pacientes y contrastado finalmente con la evidencia científica a través de la identificación, evaluación, análisis y síntesis de literatura actual. Se estimaron los costos directos relevantes y se utilizó el análisis de minimización de costos para seleccionar la alternativa más eficiente, es decir, la obtención de un beneficio social al menor coste posible, en comparación con las alternativas disponibles. También se estimaron los costos evitados por el sistema de telediagnóstico en comparación con el método tradicional del diagnóstico ¿cara a cara¿ con el especialista. Se valoraron los impactos económico y social en la salud pública por la generalización del sistema de telediagnóstico mediante el análisis del impacto presupuestario. Se observó buena eficiencia del sistema de telediagnóstico para poblaciones dispersas respecto a la modalidad ¿cara a cara¿.Se ha demostrado la conveniencia económica y social en salud del telediagnóstico. Pues en términos monetarios la implementación del telediagnóstico, durante los 17 meses del proyecto piloto en los 25 hospitales regionales, distritales y generales, significó un ahorro promedio de 2.420.037,0 US$(dólares americanos) a los ciudadanos de las 25 comunidades del interior del país. Al extrapolar este resultado a la población nacional, los beneficios totales que se pueden obtener anualmente como un costo potencialmente evitado por el empleo del sistema de telediagnóstico, están en el orden de los US$ 55,7 millones de dólares para el Paraguay a través de la innovación tecnológica para el diagnóstico remoto