Chapter 2: Clinical Applications in Telemedicine/Telehealth

Krupiński, Elizabeth A.; Nypaver, Michelle; Poropatich, Ronald K.; Ellis, David; Safwat, Rihab; Sapci, Hasan

doi:10.1089/15305620252933374

Cited by 85 publications

(32 citation statements)

References 136 publications

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“…Furthermore, it is a viable option for almost all medical specialties, particularly those for which images comprise the main diagnostic tool (4)(5)(6)(7) . Thus, the fields of radiology, dermatology, pathology, ultrasound, and ophthalmology, among others (8)(9)(10)(11)(12) , are especially favorable for the establishment of data transmission protocols with diagnostic purposes (13,14) . Ophthalmology, for example, can greatly benefit from telemedicine (15,16) , as it is crucial to identify patients that present urgent cases in order to avoid morbidity and permanent disorders (17) .…”

Section: Introductionmentioning

confidence: 99%

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Ribeiro

Rodrigues

Guerreiro

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purposes: To validate a teleophthalmology mobile system aimed at improving and providing eye urgency screenings in remote and poor area settings in Brazil. The system enables one or more ophthalmologists to remotely examine a patient's condition and submit a decision describing the gravity of the case. If necessary, the patient can be forwarded to a hospital for further consultation. Methods: A cellphone (Nexus One model, with a 5 megapixel camera) was used to collect data and pictures from 100 randomly selected patients at the Ophthalmology Emergency Room located at the General Hospital of the Federal University of São Paulo (UNIFESP). Data was then sent remotely to an online recording system to be reviewed by an ophthalmologist who provided feedback regarding the state of ocular urgency. Results were then compared to the gold standard diagnosis provided at the hospital. Results: The diagnosis of urgency was given by two ophthalmologists: one in the hospital (gold standard) and one remotely. When we compared both diagnoses we obtained results of 81.94% specificity, 92.85% sensitivity, and 85% accuracy, with a negative predictive value of 96.72%. This work also included a processing time analysis, resulting in an average time of 8.6 min per patient for remote consultations. Conclusions: This study is the first that has used only a cellphone for diagnosing the urgency of ocular cases. Based on our results, the system can provide a reliable distinction between urgent and non-urgent situations and can offer a viable alternative for the servicing of underprivileged areas. In screening techniques, the most important outcome is to identify urgent cases with a high level of sensitivity and predictive negative value. Thus, our results demonstrate that this tool is robust and we suggest that a major study aimed to verify its efficiency in resource-poor areas should be initiated.

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Section: Introductionmentioning

confidence: 99%

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Ribeiro

Rodrigues

Guerreiro

et al. 2014

Arquivos Brasileiros De Oftalmologia

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“…The trend of continuous growth in internet bandwidth allows a rapid development in image transmission and facile remote viewing of the static images and real-time video stream [5,30]. Prior reports reveal that teleultrasound examination with limited technical resources could be clinically useful [10,11,18,31].…”

Section: Discussionmentioning

confidence: 99%

“…Worldwide availability of internet infrastructure has opened the door for exchange of medical information on a global level [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Image Quality in Real-Time Teleultrasound of Infant Hip Exam Over Low-Bandwidth Internet Links: a Transatlantic Feasibility Study

et al. 2012

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Evolution of communication systems, especially internet-based technologies, has probably affected Radiology more than any other medical specialty. Tremendous increase in internet bandwidth has enabled a true revolution in image transmission and easy remote viewing of the static images and real-time video stream. Previous reports of realtime telesonography, such as the ones developed for emergency situations and humanitarian work, rely on high compressions of images utilized by remote sonologist to guide and supervise the unexperienced examiner. We believe that remote sonology could be also utilized in teleultrasound exam of infant hip. We tested feasibility of a low-cost teleultrasound system for infant hip and performed data analysis on the transmitted and original images. Transmission of data was accomplished with Remote Ultrasound (RU), a software package specifically designed for teleultrasound transmission through limited internet bandwidth. While image analysis of image pairs revealed statistically significant loss of information, panel evaluation failed to recognize any clinical difference between the original saved and transmitted still images.

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“…Researchers have shown that telerehabilitation can improve quality of life and lead to more efficient use of health care resources Krupinksi et al, 2002). Bashshur (2001) investigated the cost/ benefit ratio of using a technology like telemedicine.…”

Section: Summary and Preliminary Findingsmentioning

confidence: 99%

Telerehabilitation and Clinical Applications: Research, Opportunities, and Challenges

et al. 2015

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Abstr actRehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent to coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise is troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation.This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper.

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Chapter 2: Clinical Applications in Telemedicine/Telehealth

Cited by 85 publications

References 136 publications

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Image Quality in Real-Time Teleultrasound of Infant Hip Exam Over Low-Bandwidth Internet Links: a Transatlantic Feasibility Study

Telerehabilitation and Clinical Applications: Research, Opportunities, and Challenges

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