Organizing for remote consultations in health care?-?the production process

Monrad, I. H.

doi:10.1080/0044929021000088407

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…Experience in KwaZuluNatal has supported findings that technical issues at startup are the most frequently mentioned problems in process evaluations. 34 • Infrastructure Local referring services access the consultant telepsychiatric services by videoconference using cost effective videoconferencing solutions. Connectivity may be via fixed telephone lines, fibre optic cable, satellite, wireless and wireless cellular telephony.…”

Section: Structural Componentsmentioning

confidence: 99%

A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

2012

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The access of rural Mental Health Care Users in South Africa to specialist psychiatrists and quality mental health care is currently sub-optimal. Health professionals and planners working in psychiatry lack a well-defined and feasible outreach model to facilitate the delivery of services to remote and rural areas. In response to this challenge, a three-year action research telepsychiatry study was undertaken by the Departments of Psychiatry and TeleHealth at the University of KwaZulu-Natal, to develop a telepsychiatry outreach model based on local research and international evidence. The Model draws on needs and infrastructure assessments of the designated psychiatric hospitals in the province, a review of the published international evidence on telepsychiatry and videoconference-based education, and an evaluation of local clinical and educational telepsychiatry implementations in KwaZuluNatal. The Model proposed is "virtual", i.e. not bound to provincial or district referral patterns, aims not to add to the burden on the current workforce and is intended to be integrated into psychiatry outreach services and policy. The Model should be subjected to in situ testing for validation and implementation. It is hoped that an implementation of this Model will improve the access of Mental Health Care Users to specialist psychiatry care.

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Section: Structural Componentsmentioning

confidence: 99%

A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

2012

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“…It is possible that as early adopters of the technology these doctors may be biased by their enthusiasm for something new. In other studies, referring doctors have reported high levels of satisfaction with teledermatology, 12 the educational benefits derived, 14,28 and noted the possibility of teamwork. 29 In time, referring doctors have been found to make fewer referrals 30 and manage more dermatology cases themselves.…”

Section: Discussionmentioning

confidence: 94%

Teledermatology by videoconference: Experience of a pilot project

Mars

Dlova

2008

South African Family Practice

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Background: There is a shortage of medical specialists within the provincial departments of health in South Africa. Telemedicine is a potential way of providing specialist services, at a distance, to rural areas. This study assesses patient and staff satisfaction and issues, technological and operational, associated with the establishment of a videoconference-based teledermatology service.Methods: An ISDN-based videoconference link was established between Port Shepstone Hospital and the Nelson R Mandela School of Medicine in Durban. Patients with a dermatological problem that would have necessitated transfer to the academic hospital for diagnosis and/or management were entered into a prospective study which evaluated the ability to make a diagnosis and prescribe a management plan by videoconference and the patients' and doctors' satisfaction with the consultations.Results: A total of 69 patients were seen during 12 videoconferenced consultation sessions. Seventeen patients (24.6%) were subsequently referred to the academic hospital: nine patients were sent because a definitive diagnosis could not be made; and eight patients were transferred for specialist management based on the diagnosis made. The patients' and referring doctors' satisfaction with the consultation was 80.3% and 82.1% respectively, while the dermatologist was satisfied 67.6% of the time. The dermatologist was dissatisfied with ten (14.7%) of the consultations and this was related to difficulties in making a definitive diagnosis. The referring doctors found 59 (85.9%) of the consultations to be of educational value. No problems were noted in diagnosing lesions in dark-skinned patients. Conclusion:Videoconferenced teledermatology between district hospitals and regional hospitals is possible and can improve services to rural areas. Further studies on widespread implementation and sustainability are warranted. This article has been peer reviewed. Full text available at www.safpj.co.za SA Fam Pract 2008;50(3):70

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“…Though this is a generic institute working on many aspects of work under the effect of modern methods, within this Aas has focused on the effects of the application of Information and Communication Technologies (ICT) within health. This has lead to a significant number of health sector studies (such as [14][15][16][17][18]).…”

Section: A Short History Of Evaluationmentioning

confidence: 99%

Evaluation – The Cinderella Science of ICT in Health

Rigby¹

2006

Yearb Med Inform

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SummaryObjectives: Information systems are expensive to create, and consume resources in their operation. They are justified in order to achieve clearly defined objectives in health service quality and efficiency. To ensure that these objectives are being met, and in order to build up an evidence-base to support well focused policies, systems, and practice, evaluation would seem to be fully justified and indeed essential. However, there are major factors jeopardising good evaluation practice, ranging from reluctance to commit resources or expose decisions to scrutiny, through to lack of appreciation of the full range of dimensions which should be studied. This paper seeks to create fuller appreciation of the issues and their importance. Methods: Experiential and literature reviews form the basis of an exposition of principles, methods, and key current activities. Results: A summary has been produced of the key challenges to health ICT evaluation, and its adverse comparison with other sectors. An explanation of the viewpoints and levels of health information evaluation is followed by a short history of principal milestones, current scientific methodology activity, and key collaborative activities. Conclusion:The need for a stronger commitment to health ICT evaluation is demonstrated if the application of health informatics systems is to receive due recognition as scientifically and empirically justified. Commitment of resources and scientific endeavour are needed, and thus the recent Declaration of Innsbruck, arising out of an event sponsored by the European Science Foundation, is timely and fully justified.

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Organizing for remote consultations in health care?-?the production process

Cited by 10 publications

References 11 publications

A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

Teledermatology by videoconference: Experience of a pilot project

Evaluation – The Cinderella Science of ICT in Health

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