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3D visualization as a communicative aid in pharmaceutical advice-giving over distance.

https://arctichealth.org/en/permalink/ahliterature132831
Source
J Med Internet Res. 2011;13(3):e50
Publication Type
Article
Date
2011
Author
Ostlund M
Dahlbäck N
Petersson GI
Author Affiliation
eHealth Institute, Linnaeus University, Kalmar, Sweden. martin.ostlund@lnu.se
Source
J Med Internet Res. 2011;13(3):e50
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Diabetes Mellitus, Type 2 - drug therapy
Drug Interactions
Drug-Related Side Effects and Adverse Reactions
Female
Health Services Research
Humans
Imaging, Three-Dimensional - methods
Male
Middle Aged
Patient Education as Topic - methods
Pharmaceutical Services - utilization
Program Evaluation
Remote Consultation - methods
Sweden
Telemedicine - methods
Young Adult
Abstract
Medication misuse results in considerable problems for both patient and society. It is a complex problem with many contributing factors, including timely access to product information.
To investigate the value of 3-dimensional (3D) visualization paired with video conferencing as a tool for pharmaceutical advice over distance in terms of accessibility and ease of use for the advice seeker.
We created a Web-based communication service called AssistancePlus that allows an advisor to demonstrate the physical handling of a complex pharmaceutical product to an advice seeker with the aid of 3D visualization and audio/video conferencing. AssistancePlus was tested in 2 separate user studies performed in a usability lab, under realistic settings and emulating a real usage situation. In the first study, 10 pharmacy students were assisted by 2 advisors from the Swedish National Co-operation of Pharmacies' call centre on the use of an asthma inhaler. The student-advisor interview sessions were filmed on video to qualitatively explore their experience of giving and receiving advice with the aid of 3D visualization. In the second study, 3 advisors from the same call centre instructed 23 participants recruited from the general public on the use of 2 products: (1) an insulin injection pen, and (2) a growth hormone injection syringe. First, participants received advice on one product in an audio-recorded telephone call and for the other product in a video-recorded AssistancePlus session (product order balanced). In conjunction with the AssistancePlus session, participants answered a questionnaire regarding accessibility, perceived expressiveness, and general usefulness of 3D visualization for advice-giving over distance compared with the telephone and were given a short interview focusing on their experience of the 3D features.
In both studies, participants found the AssistancePlus service helpful in providing clear and exact instructions. In the second study, directly comparing AssistancePlus and the telephone, AssistancePlus was judged positively for ease of communication (P = .001), personal contact (P = .001), explanatory power (P
Notes
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PubMed ID
21771714 View in PubMed
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Bridging the distance: a prospective tele-oncology study in Northern Norway.

https://arctichealth.org/en/permalink/ahliterature129726
Source
Support Care Cancer. 2012 Sep;20(9):2097-103
Publication Type
Article
Date
Sep-2012
Author
Tom Donnem
Bente Ervik
Kathrine Magnussen
Sigve Andersen
Doris Pastow
Sissel Andreassen
Tone Nørstad
Nina Helbekkmo
Roy M Bremnes
Tone Nordoy
Author Affiliation
Department of Oncology, University Hospital of North Norway, Tromso, Norway. tom.donnem@uit.no
Source
Support Care Cancer. 2012 Sep;20(9):2097-103
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Feasibility Studies
Female
Hospitals, University
Humans
Male
Middle Aged
Neoplasms - therapy
Norway
Oncology Service, Hospital
Palliative Care
Prospective Studies
Questionnaires
Remote Consultation - methods
Telemedicine
Videoconferencing
Young Adult
Abstract
The University Hospital of North Norway (UNN) is a tertiary-level hospital and has the main responsibility of providing specialized cancer health care in the remote area of Northern Norway. Weekly videoconferences (VCs) have been established to enable clinicians at a local hospital and primary cancer health care providers in five different communities to discuss cases with specialist cancer care services at UNN. In this study, we aimed to evaluate the feasibility of these VCs.
This is a prospective registration study. Descriptive data were collected at UNN, and for each patient discussed at the VC, a survey was completed by the local health care provider responsible for the patient.
During an 18-month period, 167 cases were discussed (101 patients). A median of 7 health care providers participated in each VC. According to the local physicians and nurses, the VCs contributed in 96% of cases to give "quite a bit" or "very much" confidence in adequate patient care. They reported that patient care in 85% of cases would be improved "quite a bit" or "very much" due to the VC. The mean number of days waiting for VC were 2.0 days (range, 0-7; SD, 2.0) and was significantly shorter (P
PubMed ID
22076621 View in PubMed
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Building access to specialist care through e-consultation.

https://arctichealth.org/en/permalink/ahliterature113781
Source
Open Med. 2013;7(1):e1-8
Publication Type
Article
Date
2013
Author
Clare Liddy
Margo S Rowan
Amir Afkham
Julie Maranger
Erin Keely
Author Affiliation
Department of Family Medicine, University of Ottawa, Ontario, Canada. CLiddy@bruyere.org
Source
Open Med. 2013;7(1):e1-8
Date
2013
Language
English
Publication Type
Article
Keywords
Focus Groups
Health Personnel - psychology
Health Services Accessibility - organization & administration
Humans
Internet
Ontario
Pilot Projects
Primary Health Care
Program Development
Remote Consultation - methods
Specialization
Abstract
Limited access to specialist care remains a major barrier to health care in Canada, affecting patients and primary care providers alike, in terms of both long wait times and inequitable availability. We developed an electronic consultation system, based on a secure web-based tool, as an alternative to face-to-face consultations, and ran a pilot study to evaluate its effectiveness and acceptability to practitioners.
In a pilot program conducted over 15 months starting in January 2010, the e-consultation system was tested with primary care providers and specialists in a large health region in Eastern Ontario, Canada. We collected utilization data from the electronic system itself (including quantitative data from satisfaction surveys) and qualitative information from focus groups and interviews with providers.
Of 18 primary care providers in the pilot program, 13 participated in focus groups and 9 were interviewed; in addition, 10 of the 11 specialists in the program were interviewed. Results of our evaluation showed good uptake, high levels of satisfaction, improvement in the integration of referrals and consultations, and avoidance of unnecessary specialist visits. A total of 77 e-consultation requests were processed from 1 Jan. 2010 to 1 Apr. 2011. Less than 10% of the referrals required face-to-face follow-up. The most frequently noted benefits for patients (as perceived by providers) included improved access to specialist care and reduced wait times. Primary care providers valued the ability to assist with patient assessment and management by having access to a rapid response to clinical questions, clarifying the need for diagnostic tests or treatments, and confirming the need for a formal consultation. Specialists enjoyed the improved interaction with primary care providers, as well as having some control in the decision on which patients should be referred.
This low-cost referral system has potential for broader implementation, once payment models for physicians are adapted to cover e-consultation.
Notes
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PubMed ID
23687533 View in PubMed
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Callers' ability to understand advice received from a telephone health-line service: comparison of self-reported and registered data.

https://arctichealth.org/en/permalink/ahliterature185104
Source
Health Serv Res. 2003 Apr;38(2):697-710
Publication Type
Article
Date
Apr-2003
Author
Bernard-Simon Leclerc
Lise Dunnigan
Harold Côté
Maria-Victoria Zunzunegui
Louise Hagan
Diane Morin
Author Affiliation
Department of Public Health, Lanaudière Regional Board of Health and Social Services, St-Charles-Borromée, Québec, Canada.
Source
Health Serv Res. 2003 Apr;38(2):697-710
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Adult
Communication
Community Health Nursing - methods - standards
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Health Services Research
Humans
Logistic Models
Male
Nurse-Patient Relations
Nursing Assessment
Outcome Assessment (Health Care)
Quality of Health Care
Quebec
Remote Consultation - methods
Self Disclosure
Telephone
Abstract
To validate users' perception of nurses' recommendations to look for another health resource among clients seeking teleadvice. To analyze the effects of different users' and call characteristics on the incorrectness of the self-report.
This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted in 1997 among users of Info-Santé CLSC, a no-charge telenursing health-line service (THLS) available all over the province of Québec.
Self-reported advice from follow-up survey phone interviews, conducted within 48 to 120 hours after the participant's call were compared to the data consigned by the nurse in the computerized call record. Covariables concerned characteristics of callers, context of the calls, and satisfaction about the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses.
Advice to consult were recorded by the nurse in 42 percent of cases, whereas 39 percent of callers stated they had received one. Overall disagreement between the two sources is 27 percent (12 percent by false positive and 15 percent by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR = 2.5), calls relating to psychological problems (OR = 2.8), perceived seriousness (OR = approximately 2.6), as well as others, were associated with inaccurate reports.
Telephone health-line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, insure better understanding of advice by callers, and contribute to more effective service.
Notes
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PubMed ID
12785568 View in PubMed
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'Carer and gatekeeper' - conflicting demands in nurses' experiences of telephone advisory services.

https://arctichealth.org/en/permalink/ahliterature68891
Source
Scand J Caring Sci. 2002 Jun;16(2):142-8
Publication Type
Article
Date
Jun-2002
Author
Inger Holmström
Gloria Dall'Alba
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Sweden. inger.holmstrom@pubcare.uu.se
Source
Scand J Caring Sci. 2002 Jun;16(2):142-8
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Gatekeeping
Hotlines
Humans
Nurse's Role - psychology
Nurse-Patient Relations
Patient satisfaction
Remote Consultation - methods
Self Care
Sweden
Telephone
Time Management
Triage - methods
Abstract
'Carer and gatekeeper' - conflicting demands in nurses' experiences of telephone advisory services Millions of calls are made to the telephone advisory services in primary health care in Sweden. The patients seem happy with the advice and counselling they receive, but little has been written about nurses' experiences of performing telephone advisory services. Yet, the nurses are expected to be patient, sensitive and have a broad knowledge of medicine, nursing and pedagogy. The aim of this study was to describe how nurses experience the patient encounter when performing telephone advisory services. A strategic sample of five nurses were interviewed and asked to describe how they experienced the central aspects of the patient encounter by telephone. The transcribed interviews were analysed by the Empirical Phenomenological Psychological method. The nurses' experience of the patient encounter when performing telephone advisory services can be characterized in terms of the conflicting demands of being both carer and gatekeeper. The constituents of these conflicting demands were: reading between the lines while pressed for time; educating patients for self-care while fearful of misinterpreting the situation; encountering patients' satisfaction and dissatisfaction. The conflicting demands of being both professional carer and gatekeeper caused stress among the nurses. The organization of the telephone advisory services seems to hinder high-quality care.
PubMed ID
12000667 View in PubMed
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Collaborative work by using videoconferencing: opportunities for learning in daily medical practice.

https://arctichealth.org/en/permalink/ahliterature135376
Source
Qual Health Res. 2011 Aug;21(8):1147-58
Publication Type
Article
Date
Aug-2011
Author
Line Lundvoll Nilsen
Author Affiliation
University Hospital of North Norway, Tromsø, Norway. line.lundvoll.nilsen@telemed.no
Source
Qual Health Res. 2011 Aug;21(8):1147-58
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Anthropology, Cultural
Comorbidity
Continuity of Patient Care - organization & administration
Cooperative Behavior
Decision Making
Female
General practitioners
Humans
Norway
Qualitative Research
Remote Consultation - methods
Specialization
Videoconferencing
Abstract
In this article, I explore what happens when general practitioners (GPs) and specialists meet using videoconferencing to collaborate on a patient's treatment. By using videoconferencing, GPs and specialists are offered opportunities to share and produce knowledge. The data corpus was 42 videotaped videoconferences. The treatment of one specific patient was selected.This patient was discussed over a period of 9 days, which constituted five videoconferences. I describe how GPs and specialists discuss treatment strategies and exemplify how knowledge sharing creates opportunities for learning in boundary zones across activity systems as a part of daily practice.The talk about the treatment occurs by information exchange and by consultation. Information exchange without any dilemmas presented might support decisions already made. Consultations wherein dilemmas are presented and solved by bridging knowledge gaps between the general practitioner and the specialist create opportunities for learning.
PubMed ID
21483025 View in PubMed
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The decision support system for telemedicine based on multiple expertise.

https://arctichealth.org/en/permalink/ahliterature68953
Source
Int J Med Inform. 1998 Apr;49(2):217-29
Publication Type
Article
Date
Apr-1998
Author
V. Terziyan
A. Tsymbal
S. Puuronen
Author Affiliation
Kharkov State Technical University of Radioelectronics, Ukraine. vagan@milab.kharkov.ua
Source
Int J Med Inform. 1998 Apr;49(2):217-29
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Algorithms
Artificial Intelligence
Decision Making, Computer-Assisted
Expert Testimony
Humans
Remote Consultation - methods
Research Support, Non-U.S. Gov't
Abstract
This paper discusses the application of artificial intelligence in telemedicine and some of our research results in this area. The main goal of our research is to develop methods and systems to collect, analyse, distribute and use medical diagnostics knowledge from multiple knowledge sources and areas of expertise. Use of modern communication tools enable a physician to collect and analyse information obtained from experts worldwide with the help of a decision support medical system. In this paper we discuss a multilevel representation and processing of medical data using a system which evaluates and exploits knowledge about the behaviour of statistical diagnostics methods. The presented technique is able to acquire semantically-essential information from the complex dynamics of quasi-periodical medical signals by applying recursively-ordinary statistical tools. A method and an algorithm are elaborated to select automatically the most appropriate diagnostics method for each case under consideration. We suggest the use of a voting-type technique to search for consensus among the different opinions of medical experts. Research results can be applied in the development of a telediagnostics expert medical system and medical teleconsulting support system.
PubMed ID
9741895 View in PubMed
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Delivery of pediatric sleep services via telehealth: the Alberta experience and lessons learned.

https://arctichealth.org/en/permalink/ahliterature154743
Source
Behav Sleep Med. 2008;6(4):207-19
Publication Type
Article
Date
2008
Author
Manisha B Witmans
Bruce Dick
Jackie Good
Greg Schoepp
Cara Dosman
Mary Ellen Hawkins
Rochelle Young
Adrienne Witol
Author Affiliation
Stollery Children's Hospital Capital Health, Department of Pediatrics, University of Alberta, Alberta, Canada. manishawitmans@capitalhealth.ca
Source
Behav Sleep Med. 2008;6(4):207-19
Date
2008
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Behavior Therapy - methods
Child
Child, Preschool
Consumer Satisfaction
Delivery of Health Care - methods
Female
Follow-Up Studies
Humans
Infant
Male
Referral and Consultation
Remote Consultation - methods
Sleep Disorders - diagnosis - therapy
Treatment Outcome
Abstract
Concerns regarding a child's sleep, identified by a caregiver or by the health care practitioner, are commonly raised but often left unexplored. Families in geographically isolated areas, with limited access to specialty services such as pediatric sleep medicine, are at increased risk for unmet treatment needs. Telehealth is a potential vehicle for delivery of these specialty services and overcoming barriers in diagnosing and treating sleep disorders in children by improving access and enhancing support for the families in their communities. This article describes the initiation of a pilot program in the delivery of multidisciplinary pediatric sleep medicine services via telehealth in Alberta, Canada.
PubMed ID
18853305 View in PubMed
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[Distance pediatric radiotherapy. Telemedicine a good tool to be used for discussions, exchange of experiences and competence]

https://arctichealth.org/en/permalink/ahliterature76126
Source
Lakartidningen. 2006 Apr 12-25;103(15-16):1188-90
Publication Type
Article

Evaluation of a telemedicine demonstration project in the Magdalene Islands.

https://arctichealth.org/en/permalink/ahliterature185810
Source
J Telemed Telecare. 2003;9(2):89-94
Publication Type
Article
Date
2003
Author
Jean-Paul Fortin
Marie-Pierre Gagnon
Alain Cloutier
Françoise Labbé
Author Affiliation
Department of Social and Preventive Medicine, Laval University, Québec, Canada. jpfortin@msp.ulaval.ca
Source
J Telemed Telecare. 2003;9(2):89-94
Date
2003
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Evaluation Studies as Topic
Humans
Patient satisfaction
Pilot Projects
Program Evaluation
Quebec
Remote Consultation - methods - standards - utilization
Rural Health Services - standards - utilization
Abstract
The Magdalene Islands are an archipelago located in the middle of the Gulf of St Lawrence, more than 1000 km away from supra-regional medical referral centres. We have implemented and evaluated a telemedicine network for the local hospital on the Magdalene Islands. During a 13-month study period, 118 transmissions were made. Orthopaedics and radiology were the medical specialties that used telemedicine most frequently. Store-and-forward imaging was the technique used most often because of the large number of transmissions in orthopaedics and radiology. Various medical specialties and psychosocial services used videoconferencing, while realtime imaging (ultrasound) was used in gynaecology and obstetrics. A combination of videoconferencing and imaging was used for otolaryngology. A total of 101 individual patients benefited from a teleconsultation during the study period. Eight emergency transfers were avoided and 15 patients who would have required elective transfer were managed locally by telemedicine. For health-care providers, telemedicine seemed to be an acceptable way of delivering specialized services. Nevertheless, demonstration projects in telemedicine are quite different to 'real life' telemedicine utilization. Deployment of telemedicine in the health-care system as a whole will require a more structured approach.
PubMed ID
12699578 View in PubMed
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54 records – page 1 of 6.