Telemedicine

Current state and future possibilities for ambient intelligence to support improvements in the quality of health and social care

by A. Niroshan Siriwardena

Emerging technologies for developing and improving patients' health experience

by A. Niroshan Siriwardena

SATMED: Legal Aspects of the Physical Layer of Satellite-Telemedicine

by Stephen Rooke

Significant disparities exist between the availability of physicians and health care specialists in urban and rural... more Significant disparities exist between the availability of physicians and health care specialists in urban and rural areas, particularly in developing countries. For example, the concentration of medical specialists in Nairobi, Kenya, is 147 times higher than in Kilifi, a relatively large, but rural region. Emerging telemedicine technologies would enable doctors located in urban areas and elsewhere around the globe to serve rural patients. However, the limited availability of telecommunications infrastructure and technology necessary for telemedicine in rural areas inhibits the deployment of such health care applications. For example, in Namtumbo, Tanzania, a region with over 190,000 people, there are no doctors and none of the medical facilities have access to any type of telephone connection. Only twenty percent of Tanzania's health districts are connected by landline telephone.

Satellites' ability to bridge gaps in telecommunications infrastructure gives them a unique capacity to also bridge the urbal-rural health care divide by making telemedicine applications available to rural patients and medical professionals worldwide. Unfortunately, international law provides an expansive grant of national sovereignty over electromagnetic spectrum that supersedes state obligations to provide access to health care. As a result, the physical equipment necessary to provide telemedicine services to rural patients is subject to national regulatory regimes that prevent the widespread and cost-effective availability of life-saving technology.

This paper identifies the body of international law governing satellite-telemedicine including outer space law; conventions governing economic, social and cultural rights and the right to health care; and international telecommunications law including the ITU Constitution, Tampere Convention, and the Global Mobile Personal Communication by Satellite Memorandum of Understanding. It then concludes that an additional international undertaking to eliminate national barriers to entry for satellite-telemedicine technology is necessary.

Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review

by Frances Mair

Co-authored with: Carl May, Catherine O’Donnell, Tracy Finch, Frank Sullivan & Elizabeth Murray

Objective To systematically review the literature on the implementation of e-health to identify: (1) barriers and... more Objective To systematically review the literature on the implementation of e-health to identify: (1) barriers and facilitators to e-health implementation, and (2) outstanding gaps in research on the subject.
Methods MEDLINE, EMBASE, CINAHL, PSYCINFO and the Cochrane Library were searched for reviews published between 1 January 1995 and 17 March 2009. Studies had to be systematic reviews, narrative reviews, qualitative metasyntheses or meta-ethnographies of e-health implementation. Abstracts and papers were double screened and data were extracted on country of origin; e-health domain; publication date; aims and methods; databases searched; inclusion and exclusion criteria and number of papers included. Data were analysed qualitatively using normalization process theory as an explanatory coding framework.
Findings Inclusion criteria were met by 37 papers; 20 had been published between 1995 and 2007 and 17 between 2008 and 2009. Methodological quality was poor: 19 papers did not specify the inclusion and exclusion criteria and 13 did not indicate the precise number of articles screened. The use of normalization process theory as a conceptual framework revealed that relatively little attention was paid to: (1) work directed at making sense of e-health systems, specifying their purposes and benefits, establishing their value to users and planning their implementation; (2) factors promoting or inhibiting engagement and participation; (3) effects on roles and responsibilities; (4) risk management, and (5) ways in which implementation processes might be reconfigured by user-produced knowledge.
Conclusion The published literature focused on organizational issues, neglecting the wider social framework that must be considered when introducing new technologies.

A Systems Engineering Approach to Telemedicine System Implementation in South Africa

by Corne Schutte

Van Dyk, L., Schutte, C. S. L., & Fortuin, J. B. (2011). A Systems Engineering Approach to Telemedicine System Implementation in South Africa. ISEM 2011. Stellenbosch.

The South African National Department of Health (DoH) is recognizing, for more than a decade already, the potential... more The South African National Department of Health (DoH) is recognizing, for more than a decade already, the potential benefit of information and communication technology (ICT) to deliver healthcare to rural areas. However, despite generous funding and proven technology, not many of telemedicine systems sustained after pilot phase. The purpose of this paper is to develop a maturity model that can be used to measure and manage the capability of a health system to sustain health care delivery after the pilot phase of a telemedicine project. Four existing frameworks are used as input to this maturity model, namely the ISO 15288 Systems Engineering Life Cycle Standards, the ISO/IEC 15504 Software Process Improvement and Capability Determination (SPICE), eHealth Readiness Instrument for developing countries and the Layered Telemedicine Implementation Model. The validity of this maturity model is tested by means of a focus group discussion, during a workshop of provincial representatives from a provincial department of health (DoH). In conclusion, follow-up work is proposed for the development and validation of future versions of this framework towards a maturity model for telemedicine projects.

A Maturity Model for Telemedicine Implementation

by Corne Schutte

Van Dyk, L., Fortuin, J. B., & Schutte, C. S. L. (2012). A Maturity Model for Telemedicine Implementation. eTELEMED 2012, The Fourth International Conference on eHealth, Telemedicine, and Social Medicine (pp. 78-84). Valencia, Spain.

The South African National Department of Health (DoH) has, for more than a decade, recognized the potential benefit of... more The South African National Department of Health (DoH) has, for more than a decade, recognized the potential benefit of information and communication technology (ICT) in the delivery of healthcare to rural areas. However, despite generous funding and proven technology, not many telemedicine systems have lasted beyond the pilot phase. The purpose of this paper is to propose a maturity model, which can be used to measure and manage the capability of a health system. Its aim would be to sustain health care delivery, after the pilot phase of a telemedicine project. This maturity model comprises of five existing frameworks, namely the Health Readiness Instrument for developing countries, the Layered Telemedicine Implementation Model, the PACS Maturity Model, the Telemedicine Process Model and the NHS Maturity model. The validity of this maturity model is tested by means of a focus group discussion that occurred during a workshop for provincial representatives

Designing with Care: The Future of Pervasive Healthcare

by Alan Card

Ingrid Mulder, Yvonne Schikhof, Martijn Vastenburg, Alan Card, Tory Dunn, Andreas Komninos, Marilyn McGee-Lennon, Mark Santcroos, Gabriele Tiotto, Mieke van Gils, Jan-Willem van 't Klooster, Annelies Veys, Mohammed Zarifi Eslami, "Designing with Care: The Future of Pervasive Healthcare," IEEE Pervasive Computing, vol. 8, no. 4, pp. 85-88, Oct.-Dec. 2009, doi:10.1109/MPRV.2009.71

Humane care—which is an important design paradigm relevant for pervasive healthcare—means designing systems with care,... more Humane care—which is an important design paradigm relevant for pervasive healthcare—means designing systems with care, keeping in mind both users and other stakeholders. Understanding human values is a key factor in creating any successful healthcare application and is essential to avoid dehumanizing and stigmatizing users. By considering human values, designers and developers can create pervasive healthcare applications that better fit users' needs and desires. The Designing with Care 09 workshop aimed to bring together researchers, designers, and practitioners to share their experiences with incorporating values into the design of pervasive healthcare systems and to help understand the sensitive issues involved in designing for healthcare. Based on the findings from the workshop, the present state of the art is discussed, and a research agenda is presented.

Proposed Design of a low-cost mhealth System

by Rajat Kumar

Rajat Kumar and Arvind Rehalia ,Published in International Journal of Modelling and Optimization, IACSIT Press, Singapore.

This paper proposes a model for low cost design of mhealth solutions. The model presented here is based on RF... more This paper proposes a model for low cost design of mhealth solutions. The model presented here is based on RF transmitter and receiver, microcontroller and cellular network integration and uses F-BUS protocol for transmitting and receiving data using a NOKIA 3310 handset. The proposed design aims at eliminating the need of smart-phone dependent costly mhealth solutions. Also, the current paper presents the essential comparative data and statistics to support the concerned proposed design.

Cite: Rajat Kumar and Arvind Rehalia, "Proposed Design of a Low Cost mHealth System," International Journal of Modeling and Optimization vol. 2, no. 1, pp. 15-18, 2012.

Rajat Kumar is with the Bharati Vidyapeeth's College of Engineering, Guru Gobind Singh Indraprastha University , New Delhi , India (e-mail: rajatk489@gmail.com).

Arvind Rehalia is with the Bharati Vidyapeeth's College of Engineering, Guru Gobind Singh Indraprastha University, New Delhi, India (e-mail: rehaliaarvind@gmail.com).

Telemedicine and the Law: Chapter 8.

by Neera Bhatia

Kanagasingam Yogesan (Editor), Sajeesh Kumar (Editor), Leonard Goldschmidt (Editor), Jorge Cuadros (Editor)

Written by international experts from around the globe, i.e., from the USA, Europe, Australasia, and Africa, this book... more Written by international experts from around the globe, i.e., from the USA, Europe, Australasia, and Africa, this book explains technical issues, digital imaging, and collective experiences of practitioners in different parts of the world practicing a wide range of teleophthalmology applications.

Ophthalmologists, optometrists, nurses, and primary care providers will find valuable and up-to-date information on how to successfully establish programs in this field.

dataNUTES: Uma Proposta de Sistema de Informações para o Gerenciamento de Serviços de Telessaúde

by Alexandre Luna

DIAS, F. C., DE O LUNA, ALEXANDRE J. H., PINTO, E. R., NOVAES, M. A., MELLO, M. R.(2008) dataNUTES: Uma Proposta de Sistema de Informações para o Gerenciamento de Serviços de Telessaúde. In: CBIS208 – XI Congresso Brasileiro de Informática em Saúde, 2008, Campos do Jordão. ANAIS do XI Congresso Brasileiro de Informática em Saúde (CBIS2008), 2008.

This article presents the strategies and methodologies adopted in the development of a web based information system... more This article presents the strategies and methodologies adopted in the development of a web based information system to manage telehealth services, called dataNUTES. The system aim to  support the deployment and maintenance of a telehealth network, the Telehealth Centers Network of Pernambuco, and is underdevelopment by the UFPE  Telehealth Centre.

Desenvolvimento Distribuído de uma Aplicação de Telessaúde com a Metodologia Ágil SCRUM.

by Alexandre Luna

DE O. LUNA, A.J.H., CLEYVERSON P. COSTA, NOVAES, M. A., MELLO, M. R., DIAS, F. C. (2008) Desenvolvimento Distribuído de uma Aplicação de Telessaúde com a Metodologia Ágil SCRUM. In: CBIS208 – XI Congresso Brasileiro de Informática em Saúde, 2008, Campos do Jordão - SP. Anais do CBIS2008 - XI Congresso Brasileiro de Informática em Saúde, 2008.
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LUNA, Alexandre J. H. DE O.; COSTA, Cleyverson P. and NOVAES, Magdala A. (2010d). Desenvolvimento Distribuído de uma Aplicação de Telessaúde com a Metodologia Ágil SCRUM. In Revista Científica Tecnologus 4, no. 1: 6. Disponível em: <http://www.unibratec.com.br/revistacientifica/n4_artigos.html&gt;. Acesso em: 17/08/2010.

This paper presents a complete study case of a Distributed Software Development, supported by the SCRUM agile... more This paper presents a complete study case of a Distributed Software Development, supported by the SCRUM agile methodology. This study case was conducted by setting up a Software Factory to develop a Multimedia Library, a system for sharing learning objects used by the telemedicine and telehealth projects of the Center of Telehealth at UFPE.

ABORDAGEM DA ENGENHARIA DE REQUISITOS EM PROJETOS DE DESENVOLVIMENTO DE SOFTWARE PARA TELESSAÚDE/TELEMEDICINA

by Alexandre Luna

Monografia apresentada ao Curso de pós-graduação em Ciência da Computação, Centro de Informática, Universidade Federal de Pernambuco, como requisito parcial para conclusão da disciplina Engenharia de Requisitos.

Professor: Prof. Ph.D Jaelson Brelaz de Castro

Because of advances in information technology and telecommunications, telemedicine and Telehealth, and other areas of... more Because of advances in information technology and telecommunications, telemedicine and Telehealth, and other areas of research and development of Medical Informatics, took a big boost. The Telemedicine can be defined as the use of information technology and communications to support medical care to patients in remote locations, relying on the exchange of information. Already the Telehealth can be defined as the use of
information technology and communication to provide health services, knowledge on information in contexts where the distance is a critical factor. The terms are confused in
some approaches, but are best described as: complementary.

The Telemedicine and Telehealth can be made with what exists in most modern and sophisticated in terms of technology, but the costs of establishing and maintaining these systems can often prevent the realization of this activity in the routine medical. For this reason, besides having an affordable, a system of telemedicine must also be carefully planned and designed.
In this context the processes of engineering requirements are extremely important to minimize the risks of the cycle of development projects of this nature.

From this perspective we are studying the state of the art of the approach of Engineering Requirements in developing software in the areas of Telehealth and telemedicine, searching work in progress in different groups of searches and presenting the
confrontation of these visions compared the experiences recently experienced by author in a case study.

Telephone consultations in secondary care

by Nicola Roberts

The effect of telephone reminders on attendance in respiratory outpatient clinics

by Nicola Roberts

Telemedicine by email in remote Cambodia

by Paul Heinzelmann

Telemedicine in the Future

by Paul Heinzelmann

A telemedicine environment for Balkans

by Gianluca Zangara

The Telemedicine at Brazilian Public Policy Management

by Ricardo Matheus

Telemedicine; Brazil; e-governance; e-government; Public Health.

The paper analyzes positive and negative effects of the introduction of a broad public health policy based on... more The paper analyzes positive and negative effects of the introduction of a broad public health policy based on telemedicine. From the main concepts and definitions of telemedicine should be analyzed the models used worldwide in the development of this tool of medicine that helps in education, reduction of costs and technological support to other areas of social policies. Best practice in telemedicine will be described in its role in reducing costs of health, minimizing the environmental impact of human activities and generate innovation that encourage citizenship and education.

Technology and Cultural (R)evolution: Can Telemedicine Give Power to the Patients?

by Tanja Ahlin

In medicine, technology may on the one hand support certain economic, and political structures, such as dependency of... more In medicine, technology may on the one hand support certain economic, and political structures, such as dependency of remote local health centers on large clinics in cities. On the other hand, telemedicine and e-health as tools of increasing the circulation of knowledge and information have the opposite effect on the level of the doctor-patient relationship. Thus, they can empower patients by democratizing knowledge that used to be exclusive to doctors, by forming strong social online networks and by enabling patients to be more involved in communication and decision making with regards to their health and treatment.

Virtual Telemedicine Using Natural Language Processing

by Imran Sarwar Bajwa

International Journal of Information Technology and Web Engineering 5(1) pp:43-55

Conventional telemedicine has limitations due to the existing time constraints in the response of a medical... more Conventional telemedicine has limitations due to the existing time constraints in the response of a medical specialist. One major reason is that telemedicine based medical facilities are subject to the availability of a medical expert and telecommunication facilities. On the other hand, communication using telecommunication is only possible on fixed and appointed time. Typically, the field of telemedicine exists in both medical and telecommunication areas to provide medical facilities over a long distance, especially in remote areas. In this article, the authors present a solution for ‘virtual telemedicine’ to cope with the problem of the long time constraints in conventional telemedicine. Virtual Telemedicine is the use of telemedicine with the methods of artificial intelligence.