Teleworks: a CSCW application for remote medical diagnosis supportand teleconsultation

The paper describes methods for the design of both synchronous and asynchronous computer-supported cooperative work (CSCW) procedures suitable for the medical application area and specifically for the purpose of medical teleconsultation and remote diagnosis support. The experimental implementation of a CSCW system built upon a PC/Windows platform is detailed as an example of a low-cost system suitable for adoption in a wide range of medical teleconsultation applications     

Applications of space communications technology to critical human needs: rescue, disaster relief, and remote medical assistance

The applications of space communications technology to various critical human needs are discussed. Satellite communications, telemetry, and biotelemetry have provided timely and crucial communications capabilities over remote distances. The use of satellite/beacon systems have been used for disaster relief as well as search and rescue operations. The combination of telemetry and electronic medical systems (telemedicine) have augmented existing health care delivery and have provided consultation links between remotely located health care specialists working with patients and physicians at a central location. This has been expanded into networks to respond to victims of disasters in need of critical medical assistance with the hope that with further work, telemedicine may become available to all nations through an international network.     

A unified multimedia database system to support telemedicine

A unified approach to managing multimedia medical databases in a telemedicine system is proposed. In order to manage, search, and display patient information more efficiently, we define a patient information package (PIP) as a concise data set of a patient's medical information from each visit. By means of PIPs, both patient-oriented and problem-oriented query strategies, which are most frequently used in daily clinical practice and medical education, can be accommodated. We also provide a unified methodology for accessing various types of patient medical records as well as design two types of user interfaces, high-quality data display and web-based interface, for different medical service purposes. The PIP-based management of databases has been successfully implemented between the National Taiwan University (NTUH), Taipei, and the Chinshan health care center, Chinshan, Taiwan, for teleconsultation, telediagnosis, and tele-education     

An architecture for Naval telemedicine

Navy fleets have a defined overall objective for mission readiness impacted by the health of personnel aboard the ships. Medical treatment facilities on the ships determines the degree of mission readiness. The paper describes the concepts and technologies necessary to establish a Naval telemedicine system, which can drastically improve health care delivery. It consists of various combinations of the following components: Fleet Naval Medical Consultation and Diagnostic Centers, Shipboard Naval Medical Consultation and Diagnostic Centers (hospital ship or combatant ships with medical specialists on board), and Remote Medical Referring Centers such as a ship, a small Naval station annex, or a field hospital. This Naval telemedicine architecture delivers clinical medicine and continuing medical education (CME) by means of computers, video-conferencing systems, or telephony to enhance the quality of care through improved access to research, medical and nonmedical imaging, remote consultations, patient clinical data, and multimedia medical education programs. It integrates the informatics infrastructure and provides a medical telepresence among participants     

New Mexico's proposed physician-monitored remote areas health program

The State of New Mexico is proposing to combine existing technology in biomedical instrumentation, telemetry, data handling, and communications, developed for aerospace applications, with new techniques in public health screening, prevention, and emergency medical treatment, to establish an integrated system of health care for people living in remote areas. The system proposed consists of a physician-monitored central control facility communicating with remote site facilities staffed by paramedical personnel of limited training. Instrumentation at the remote sites, together with simplified laboratory test materials, provides information on patient condition which is transmitted to central data processing equipment and displayed for the center duty physician. The proposed system will provide for: a) remote conduct of multiphasic medical screening and identification of existing health needs, b) emergency medical treatment, and c) limited routine medical care and instruction. A major goal of the program is the development of a systems package as an area utility service which could be obtained for any area using methods similar to those for procuring or establishing hospitals, rural electrification, or telephone utilities.     

Real-time teleconsultation with high-resolution and large-volumemedical images for collaborative healthcare

Real-time consultation between referring physicians or radiologists with an expert is critical for timely and adequate management of problem cases. During consultation, both sides need to: 1) synchronously manipulate high-resolution digital radiographic images or large volume MR/CT images; 2) perform interpretation interactively; and 3) converse with audio. We present a specifically designed teleconsultation system in a digital imaging and communication in medicine picture archiving and communication systems (PACS) clinical environment. The system uses bidirectional remote control technology to meet critical teleconsultation application requirements with high-resolution and large-volume medical images operated in a limited bandwidth network setting. We give the system design and implementation methods, and also describe the teleconsultation procedure and protocol used in this system. Finally, laboratory and clinical evaluation results are discussed     

Networked multimedia for medical imaging

The development of biomedical imaging has revolutionized medical practice and health care delivery. The next wave of change, however, will come from merging medical imaging with multimedia technology. We discuss the necessary information infrastructure and supporting technology for this evolving field. We describe four types of clinical applications to illustrate the use and versatility of networked multimedia systems for image-assisted medical care     

Telemedicine diffusion in a developing country: the case of India (March 2004).

Telemedicine (health-care delivery where physicians examine distant patients using telecommunications technologies) has been heralded as one of several possible solutions to some of the medical dilemmas that face many developing countries. In this study, we examine the current state of telemedicine in a developing country, India. Telemedicine has brought a plethora of benefits to the populace of India, especially those living in rural and remote areas (constituting about 70% of India's population). We discuss three Indian telemedicine implementation cases, consolidate lessons learned from the cases, and culminate with potential researchable critical success factors that account for the growth and modest successes of telemedicine in India.     

远程医疗视频通信融合平台解决方案

远程医疗是网络科技与医疗技术结合的产物。通过其行业背景和需求分析，针对医疗卫生系统的不同应用环境和用途，提出了完善的解决方案。     

Extending healthcare's reach

Telemedicine, or treating patients from afar, promises to alter the medical landscape. Technological solutions are being implemented that can spread critical medical expertise across a region and around the globe. For example, a U.S. company believes that the shortage of physicians specializing in intensive care can be mitigated by its telemedicine system. The performance of transatlantic surgery by remote control proved that, with the right equipment, surgeons can perform and teach advanced procedures from thousands of kilometers away. Finally, in the nations and territories of the Pacific Rim, healthcare information networks are granting the regions widely scattered citizens new access to medical expertise     

Evaluation of telemedical services

With the rapidly increasing development of telemedicine technology, the evaluation of telemedical services becomes more and more important. However, professional views of the aims and methods of evaluation are different from the perspective of computer science and engineering or from medicine and health policy. We propose that a continuous evaluation strategy should be chosen which guides the development and implementation of telemedicine technologies and applications. The evaluation strategy is divided into four phases in which the focus of evaluation is shifted from technical performance of the system in the early phases to medical outcome criteria and economical aspects in later phases. We review the study design methodology established for clinical trials assessing therapeutic effectiveness and diagnostic accuracy and discuss how it can be adapted to evaluation studies in telemedicine. As an example, we describe our approach to evaluation in a teleconsultation network in ophthalmology     

The Emerging Field of Clinical Engineering and Its Accomplishments

Clinical engineering has emerged during the past 20 years as a specialty area to apply the knowledge produced by biomedical engineering research. The clinical engineer is a member of the health care team in a clinical environment and interfaces with physicians, nurses, and allied health care personnel. The role of clinical engineering also includes management, information systems, and health care delivery systems. A survey was performed, and the results of the questionnaire identified the primary contributions of clinical engineering to be as follows: provide technical advice, expertise, and educational services; provide electrical safety programs; provide consultation to resolve and investigate equipment malfunctions or failures; and provide for the centralized management and maintenance of medical instrumentation and equipment. The role of clnical engineering is expanding as the use of advanced technology increases in health care delivery.     

Assessing technological barriers to telemedicine:technology-management implications

Telemedicine, the use of information technology to deliver health care from one location to another, has the potential to increase the quality and access to health care and to lower costs. This growth of telemedicine installations is occurring even as the utilization rates for installed telemedicine projects are falling well below expectations. Drawing on data collected from three operational telemedicine projects involving different clinical telemedicine applications, we examine how the technological barriers to telemedicine are impacting telemedicine utilization rates. Addressing technological barriers is a necessary but not sufficient condition if telemedicine is to fulfil its promise, and it is predominantly only after such barriers are addressed that the other barriers-professional, legal, and financial-come to the fore. Our findings support end-user and technical training as major barriers but do not support the quality of the video, system reliability, or the perceived inconvenience for physicians to use the equipment as barriers to telemedicine. The mismatch between the sophistication of the technology and end-user requirements for clinical activities and patient confidentiality and privacy issues were supported as barriers, but how they impacted telemedicine utilization was different than expected. Finally, unsatisfactory sound quality of the telemedicine equipment was identified as a frequent and unexpected barrier to telemedicine utilization rates     

Biomedical Engineering in Health Care?Potential Versus Reality

Although we have heard a great deal about the potential of biomedical engineering in health care, utilization of engineering and technology in the health care field has not progressed as expected. Reasons for this situation are presented and they include the points of view in industry, engineering and the medical community. Expanded and successful use of clinical engineers in health care institutions, the development of relevant educational curricula and a continuum of medical engineering education, as well as early involvement of biomedical engineering in the planning of health care delivery at Federal, State and district levels, could expedite the engineering medical interaction.     

构建辐射全国的远程医疗平台,助力分级诊疗

随着“健康中国”战略规划的陆续发布与深入实施,医疗健康行业与信息化深度融合的进一步升级,信息技术成为推动医疗改革的重要驱动力。中国移动在国家指导下响应医改方向,充分发挥自身在资源、渠道、运营等方面的优势,积极支持卫生计生事业的改革与发展,服务政府、医疗机构和大众健康,打造运营商级远程医疗解决方案,覆盖远程会诊、远程心电、远程影像、远程医疗教学、远程急救等五大业务领域,为医疗机构提供安全、高效、创新的远程医疗信息技术服务。     

Medical applications in a B-ISDN field trial

The need for high-speed communications networks that enable users to access remote resources will accelerate the development of many innovative distributed applications in the health care industry. A B-ISDN field trial network has been developed in North Carolina as a multiservice testbed for advanced applications research and development. The paper describes the research on two high-performance medical applications, the network equipment, and terminal interface adapters that have been implemented to serve those applications, and the insights that have been gained from this field trial experience     

Remote Patient Monitoring Within a Future 5G Infrastructure

Systems of wearable or implantable medical devices (IMD), sensor systems for monitoring and transmitting physiological recorded signals, will in future health care services be used for purposes of remote monitoring. Today, there exist several constraints, probably preventing the adoption of such services in clinical routine work. Within a future 5G infrastructure, new possibilities will be available due to improved addressing solutions and extended security services in addition to higher bandwidth in the wireless communication link. Thus 5G solutions can represent a paradigm shift regarding remote patient’s monitoring and tracking possibilities, with enhancement in transmitting information between patients and health care services. Some aspects of new possibilities are highlighted in describing a realistic scenario within a future 5G framework.     

一种应用于移动健康医疗的Android客户端的研究

目前,医疗护理在生活中的作用越来越重要,而传统健康医疗大都局限于医院等固定场所,不便于用户的移动。为了实现医疗护理移动化的目的,可以结合先进的移动通信技术,设计一种新型的医疗健康系统,并采用Android手机作为系统协调器,Android手机不但可以接收节点采集到的数据,还可以把这些实时数据发送到远端服务器。通过在Eclipse软件下的编程测试结果表明,Android手机可以成功实现对数据的收发,这对于医疗护理实现移动化具有重要的参考价值。     

Robust medical ad hoc sensor networks (MASN) with wavelet-based ECG data mining

Heart disease is the top elder killer in the world. To reduce the healthcare cost, it is a necessary tendency to deploy self-organized, wireless heart disease monitoring hardware/software systems. Telemedicine platform based on ad hoc interconnection of tiny ECG sensors, called medical ad hoc sensor networks (MASN), can provide a promising approach for performing low-cost, real-time, remote cardiac patient monitoring at any time. The contribution of this research is the design of a practical MASN hardware/software platform to perform real-time healthcare data collections. It has reliable, cluster-based communication scheme. Due to the radio broadcasting nature of wireless networks, a MASN has the risk of being attacked. This research also designs a low overhead medical security scheme to achieve confidential ECG data transmission in the wireless medium. Finally, our MASN system has the capability of keeping track of cardiac patients and extracting ECG features based on wavelet theories. Our MASN platform is very useful to practical medical monitoring applications.