Continuing Medical Education via Telemedicine and Sustainable Improvements to Health

Background. This research aims to investigate the quantitative relationship between telemedicine and online continuing medical education (CME) and to find the optimal CME lectures to be delivered via telemedicine to improve the population's health status. Objective. This study examines the following: (1) What factors foster learning processes in CME via telemedicine? (2) What is the possible role of online CME in health improvement? And (3) How optimal learning processes can be integrated with various health services? Methods. By applying telemedicine experiences in Taiwan over the period 1995-2004, this study uses panel data and the method of ordinary least squares to embed an adequate set of phenomena affecting the provision of online CME lectures versus health status. Results. Analytical results find that a nonlinear online CME-health nexus exists. Increases in the provision of online CME lectures are associated with health improvements. However, after the optimum has been reached, greater provision of online CME lectures may be associated with decreasing population health. Conclusion. Health attainment could be partially viewed as being determined by the achievement of the appropriately providing online CME lectures. This study has evaluated the population's health outcomes and responded to the currently inadequate provision of online CME lectures via telemedicine

Dynamic Capabilities in Home Health: IT-Enabled Transformation of Post-Acute Care

Home health care can enable shorter hospital stays, reduce re-hospitalization, and contribute to lowered out-of-hospital morbidity and mortality. However, recent changes in Medicare payments and regulations in the US have challenged home health care providers’ business models. Against this backdrop, we draw on the dynamic capability perspective to examine how one home health care provider responded to this challenge over the period 2000-2009 by combining adaptive organization principles and information technology (IT) to transform its post-acute care delivery. The transformation leveraged the organization’s existing dynamic capabilities; improved nursing practices; engaged physicians, nurses, managers, and patients; and implemented remote patient monitoring and other IT-enabled innovations. Integrating information systems and health services literatures, we identify the processes targeted by the transformation, analyze how the provider built adaptive care delivery capability enabled by IT, and demonstrate how the transformation led to improved clinical and financial outcomes. In addition, we offer new insights into the micro-foundations of dynamic capabilities by distinguishing between capabilities at the transactional and transformational levels, and explaining how different types of IT-enabled capabilities shaped, and were shaped by, the home health care provider’s responses to environmental changes

Delivering Diagnostic Quality Video over Mobile Wireless Networks for Telemedicine

In real-time remote diagnosis of emergency medical events, mobility can be enabled by wireless video communications. However, clinical use of this potential advance will depend on definitive and compelling demonstrations of the reliability of diagnostic quality video. Because the medical domain has its own fidelity criteria, it is important to incorporate diagnostic video quality criteria into any video compression system design. To this end, we used flexible algorithms for region-of-interest (ROI) video compression and obtained feedback from medical experts to develop criteria for diagnostically lossless (DL) quality. The design of the system occurred in three steps-measurement of bit rate at which DL quality is achieved through evaluation of videos by medical experts, incorporation of that information into a flexible video encoder through the notion of encoder states, and an encoder state update option based on a built-in quality criterion. Medical experts then evaluated our system for the diagnostic quality of the video, allowing us to verify that it is possible to realize DL quality in the ROI at practical communication data transfer rates, enabling mobile medical assessment over bit-rate limited wireless channels. This work lays the scientific foundation for additional validation through prototyped technology, field testing, and clinical trials

Electronic Health

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National Telemedicine Initiatives: Essential to Healthcare Reform

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78116/1/tmj.2009.9960.pd