International Journal of Telemedicine and Applications最新文献

{"title":"Clinical Outcomes of Telemonitoring for Patients on Warfarin after Discharge from Hospital.","authors":"Natthaporn Sudas Na Ayutthaya, Itsarawan Sakunrak, Teerapon Dhippayom","doi":"10.1155/2018/7503421","DOIUrl":"10.1155/2018/7503421","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of telephone follow-up service on clinical outcomes in patients on warfarin when discharged from hospital.</p><p><strong>Methods: </strong>This randomized controlled trial was conducted at a general hospital in Thailand. Patients aged ≥20 years who were prescribed warfarin when discharged were eligible to participate in this study. They were randomly allocated, using a computer generated random number, to receive either telephone follow-up intervention or usual care. Participants in the intervention group received telephone follow-up by hospital pharmacists for three months. During each telephone call, pharmacists performed medicine use reviews and addressed any problems identified.</p><p><strong>Key findings: </strong>A total of 50 patients participated in this study. The proportion of international normalized ratio (INR) values in the target range for the telephone follow-up group (36/79, 45.6%) was higher than that in the usual care group (19/79, 24.1%), p=0.005. The mean time in the therapeutic range (TTR) in the telephone follow-up group was also higher than that in the usual care group (49.8±34.3 versus 28.0±27.5, p=0.017). All patients in the usual care group experienced one or more out-of-range INR values (25/25, 100%) compared to 21 out of 25 (84%) in the telephone follow-up group, p=0.037. There was no difference between the two groups in the incidence of complications or adverse events associated with warfarin.</p><p><strong>Conclusions: </strong>The telephone follow-up service in recently discharged patients helps them achieve and maintain their INR target. This anticoagulant supportive service should be promoted to patients receiving warfarin therapy after discharge. This trial is registered with TCTR20180614006 (Thai Clinical Trials Registry).</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2018-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36442166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Emergencies in Rural North Queensland: The Feasibility of Teletraining.","authors":"Tarsh Pandit,&nbsp;Robin A Ray,&nbsp;Sabe Sabesan","doi":"10.1155/2018/8421346","DOIUrl":"https://doi.org/10.1155/2018/8421346","url":null,"abstract":"<p><strong>Introduction: </strong>Historically, the use of videoconference technologies in emergency medicine training has been limited. Whilst there are anecdotal reports of the use of teletraining for emergency medicine by rural doctors in Australia, minimal evidence exists in the literature. This paper aimed to explore the use of teletraining in the context of managing emergency presentations in rural hospitals.</p><p><strong>Methods: </strong>Using a qualitative approach, a mixture of junior and senior doctors were invited to participate in semistructured interviews. Data were transcribed and analysed line by line. Applying the grounded theory principles of open and axial coding, themes and subthemes were generated.</p><p><strong>Results: </strong>A total of 20 interviews were conducted with rural doctors, rural doctors who are medical educators, and emergency medicine specialists. Two major themes-(1) teletraining as education and (2) personal considerations-and ten subthemes were evident from the data. Most participants had some previous experience with teletraining. Access to peer teaching over videoconference was requested by rural generalist registrars. There was a preference for interactive training sessions, over didactic lectures with little mention of technical barriers to engagement. The ability of teletraining to reduce professional isolation was a major benefit for doctors practicing in remote locations.</p><p><strong>Discussion: </strong>For these rural doctors, teletraining is a feasible method of education delivery. Wider application of teletraining such as its use in peer teaching needs to be explored. The benefits of teletraining suggest that teletraining models need to be core business for health services and training providers, including specialist colleges.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2018-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8421346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36178244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia.","authors":"Juan Pablo Sáenz,&nbsp;Mónica Paola Novoa,&nbsp;Darío Correal,&nbsp;Bell Raj Eapen","doi":"10.1155/2018/1496941","DOIUrl":"https://doi.org/10.1155/2018/1496941","url":null,"abstract":"<p><strong>Background: </strong>The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies-sets of concepts that represent knowledge in a given domain-are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology.</p><p><strong>Objective: </strong>Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas.</p><p><strong>Methods: </strong>A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system.</p><p><strong>Results: </strong>The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated.</p><p><strong>Conclusions: </strong>This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2018-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/1496941","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36118089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics.","authors":"Todd Molfenter,&nbsp;Roger Brown,&nbsp;Andrew O'Neill,&nbsp;Ed Kopetsky,&nbsp;Alexander Toy","doi":"10.1155/2018/3932643","DOIUrl":"https://doi.org/10.1155/2018/3932643","url":null,"abstract":"<p><p>Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations in the United States of America. Fifty percent of the organizations expressed high rates of interest in seven of the telemedicine applications, demonstrating the appeal of telemedicine within this field. The top three self-reported telemedicine applications being used were (1) computerized screening/assessments (44.6%), (2) telephone-based recovery supports (29.5%), and (3) telephone-based therapy (28.37%). The greatest gaps between interest and use were for (1) texting appointment reminders (55.2% differential), (2) mobile apps for posttreatment recovery (46.6% differential), and (3) recovery support chats (46.6% differential). A Latent Class Analysis (LCA) of the organizations' telemedicine use behavior identified three groupings: \"Innovators\" that were using a range of technologies (<i>n</i> = 27, 7.4%); \"Technology Traditionalists\" that limited their use to telephone, video, and web portal technologies (<i>n</i> = 101, 27.8%); and \"Low Tech\" that had low overall technology use (<i>n</i> = 235, 64.7%). Future studies should build on how telemedicine could be applied in SUD settings, organizational behaviors towards its adoption, and telemedicine's effect on treatment adherence and clinical outcomes.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2018-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/3932643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36060534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Kind of Information and Communication Technologies Do Patients with Type 2 Diabetes Mellitus Prefer? An Ecuadorian Cross-Sectional Study.","authors":"Iván Chérrez-Ojeda, Emanuel Vanegas, Erick Calero, Karin Plaza, Jose A Cano, Juan Carlos Calderon, Jorge Valdano, Jorge Oswaldo Gutierrez, Jose Guevara","doi":"10.1155/2018/3427389","DOIUrl":"10.1155/2018/3427389","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to assess the frequency of use of information and communication technologies and patterns of preference among Ecuadorian patients with diabetes.</p><p><strong>Methods: </strong>We conducted an anonymous cross-sectional survey on type 2 diabetes mellitus. A chi-square test for association and adjusted regression analyses were performed.</p><p><strong>Results: </strong>248 patients were enrolled, with a mean sample age of 57.7 years. SMS was the most used ICT (66.0%). The Internet was used by 45.2% of patients to obtain information about diabetes. SMS and email were rated as the most useful ICTs for receiving information (64.5% and 28.1%, resp.) and asking physicians about diabetes (63.8% and 26.1%, resp.). Patients were also interested in receiving disease information (82.4%) and asking physicians about diabetes (84.7%) through WhatsApp. Adjusted logistic regressions revealed that individuals aged 55 years or younger, those with superior degree level, and those with long diabetes history preferred email for receiving information and asking physicians about diabetes compared to those above 55 years, those with low education level, and those with short diabetes history, respectively.</p><p><strong>Conclusion: </strong>Understanding preferences of ICTs among patients with diabetes could facilitate application development targeted towards specific requirements from patients.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2018-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36019961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Use of Telepsychiatry for Patients with Opioid Use Disorder and Cooccurring Mental Health Disorders in Ontario, Canada.","authors":"Brittanie LaBelle, Alexandra M Franklyn, Vicky Pkh Nguyen, Kathleen E Anderson, Joseph K Eibl, David C Marsh","doi":"10.1155/2018/7937610","DOIUrl":"10.1155/2018/7937610","url":null,"abstract":"<p><p>Rural patients with opioid use disorder (OUD) face a variety of barriers when accessing opioid agonist therapy (OAT) and psychiatric services, due to the limited supply of physicians and the vast geographic area. The telemedicine allows for contact between patients and their physician-regardless of physical distance. <i>Objective</i>. We characterize the usage of telemedicine to deliver psychiatric services to patients with OUD in Ontario, as well as traits of treatment-seeking patients with opioid dependence and concurrent psychiatric disorders. <i>Methodology</i>. A retrospective cohort study was conducted using an administrative database for patients who received psychiatric services via telemedicine between 2008 and 2014 and who also had OUD. <i>Results.</i> We identified 9,077 patients with concurrent opioid use and other mental health disorders who had received psychiatric services via telemedicine from 2008 to 2014; 7,109 (78.3%) patients lived in Southern Ontario and 1,968 (21.7%) in Northern Ontario. Telemedicine was used more frequently to provide mental health services to patients residing in Northern Ontario than Southern Ontario. <i>Conclusion</i>. Telemedicine is increasingly being utilized throughout Ontario for delivering mental health treatment. There is an opportunity to increase access to psychiatric services for patients with opioid dependence and concurrent psychiatric disorders through the use of the telemedicine.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2018-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35971300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Fall Risk Assessment Using Functional Reach Test","authors":"Brianne Y. Williams, Brandon Allen, Zhen Hu, Hanna True, Jin Cho, Austin Harris, N. Fell, Mina Sartipi","doi":"10.1155/2017/2042974","DOIUrl":"https://doi.org/10.1155/2017/2042974","url":null,"abstract":"Falls are common and dangerous for survivors of stroke at all stages of recovery. The widespread need to assess fall risk in real time for individuals after stroke has generated emerging requests for a reliable, inexpensive, quantifiable, and remote clinical measure/tool. In order to meet these requests, we explore the Functional Reach Test (FRT) for real-time fall risk assessment and implement the FRT function in mStroke, a real-time and automatic mobile health system for poststroke recovery and rehabilitation. mStroke is designed, developed, and delivered as an Application (App) running on a hardware platform consisting of an iPad and one or two wireless body motion sensors based on different mobile health functions. The FRT function in mStroke is extensively tested on healthy human subjects to verify its concept and feasibility. Preliminary performance will be presented to justify the further exploration of the FRT function in mStroke through clinical trials on individuals after stroke, which may guide its ubiquitous exploitation in the near future.","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/2042974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48223066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Internet Use for Health Information Seeking among Ghanaian University Students: A Cross-Sectional Study.","authors":"Benedict Osei Asibey,&nbsp;Seth Agyemang,&nbsp;Augustina Boakye Dankwah","doi":"10.1155/2017/1756473","DOIUrl":"https://doi.org/10.1155/2017/1756473","url":null,"abstract":"<p><p>The aim of the study was to investigate university students' use of the Internet for health purpose in the Ghanaian context. The study employed a quantitative cross-sectional design. A total of 650 out of 740 students selected from 3 different universities participated, giving a response rate of 87.7% (650/740). Data were obtained using questionnaires and frequency and percentages were used to analyze data. The results show that university students are active users of the Internet as 78.3% (509/650) used Internet daily and 67.7% (440/650) use Internet for health purposes, for reasons including availability and ease of accessing information, privacy, confidentiality, and affordability. Use of Internet was constrained by unreliable and slow connection, high cost of Internet, and unreliable power supply. Also, 72.4% (315/435) used the online health information obtained as a basis for lifestyle change and only 39.5% (170/430) consulted health professionals after obtaining online information. The study concludes that students use Internet to seek online health support. The use of Internet to communicate with young people in relation to their health must therefore be explored. There is the need to be aware of online safety issues for young adults, including the need to provide information on privacy options.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1756473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35238570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on Optimization of Pooling System and Its Application in Drug Supply Chain Based on Big Data Analysis.","authors":"DengFeng Wu,&nbsp;Hongyi Mao","doi":"10.1155/2017/1503298","DOIUrl":"https://doi.org/10.1155/2017/1503298","url":null,"abstract":"<p><p>Reform of drug procurement is being extensively implemented and expanded in China, especially in today's big data environment. However, the pattern of supply mode innovation lags behind procurement improvement. Problems in financial strain and supply break frequently occur, which affect the stability of drug supply. Drug Pooling System is proposed and applied in a few pilot cities to resolve these problems. From the perspective of supply chain, this study analyzes the process of setting important parameters and sets out the tasks of involved parties in a pooling system according to the issues identified in the pilot run. The approach is based on big data analysis and simulation using system dynamic theory and modeling of Vensim software to optimize system performance. This study proposes a theoretical framework to resolve problems and attempts to provide a valuable reference for future application of pooling systems.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1503298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34812210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Decision Support Systems for Comorbidity: Architecture, Algorithms, and Applications.","authors":"Aihua Fan,&nbsp;Di Lin,&nbsp;Yu Tang","doi":"10.1155/2017/1562919","DOIUrl":"https://doi.org/10.1155/2017/1562919","url":null,"abstract":"<p><p>In this paper, we present the design of a clinical decision support system (CDSS) for monitoring comorbid conditions. Specifically, we address the architecture of a CDSS by characterizing it from three layers and discuss the algorithms in each layer. Also we address the applications of CDSSs in a few real scenarios and analyze the accuracy of a CDSS in consideration of the potential conflicts when using multiple clinical practice guidelines concurrently. Finally, we compare the system performance in our design with that in the other design schemes. Our study shows that our proposed design can achieve a clinical decision in a shorter time than the other designs, while ensuring a high level of system accuracy.</p>","PeriodicalId":45630,"journal":{"name":"International Journal of Telemedicine and Applications","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1562919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34882064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}