Abstract:
:Background Ischemic stroke is a time-sensitive disease, with improved outcomes associated with decreased time from onset to treatment. It was hypothesised that ambulance-based assessment of the National Institutes of Health Stroke Scale (NIHSS) using a Health Insurance Portability and Accountability Act (HIPAA)-compliant mobile platform immediately prior to arrival is feasible. Methods This is a proof-of-concept feasibility pilot study in two phases. The first phase consisted of an ambulance-equipped HIPAA-compliant video platform for remote NIHSS assessment of a simulated stroke patient. The second phase consisted of remote NIHSS assessment by a hospital-based neurologist of acute stroke patients en route to our facility. Five ambulances were equipped with a 4G/LTE-enabled tablet preloaded with a secure HIPAA-compliant telemedicine application. Secondary outcomes assessed satisfaction of staff with the remote platform. Results Phase one was successful in the assessment of three out of three simulated patients. Phase two was successful in the assessment of 10 out of 11 (91%) cases. One video attempt was unsuccessful because local LTE was turned off on the device. The video signal was dropped transiently due to weather, which delayed NIHSS assessment in one case. Average NIHSS assessment time was 7.6 minutes (range 3-9.8 minutes). Neurologists rated 83% of encounters as 'satisfied' to 'very satisfied', and the emergency medical service (EMS) rated 90% of encounters as 'satisfied' to 'very satisfied'. The one failed video attempt was associated with 'poor' EMS satisfaction. Conclusion This proof-of-concept pilot demonstrates that remote ambulance-based NIHSS assessment is feasible. This model could reduce door-to-needle times by conducting prehospital data collection.
journal_name
J Telemed Telecarejournal_title
Journal of telemedicine and telecareauthors
Barrett KM,Pizzi MA,Kesari V,TerKonda SP,Mauricio EA,Silvers SM,Habash R,Brown BL,Tawk RG,Meschia JF,Wharen R,Freeman WDdoi
10.1177/1357633X16648490subject
Has Abstractpub_date
2017-05-01 00:00:00pages
476-483issue
4eissn
1357-633Xissn
1758-1109pii
1357633X16648490journal_volume
23pub_type
杂志文章abstract::The Mental Health Emergency Care-Rural Access Programme (MHEC) aims to improve access to specialist emergency mental health care in rural and remote communities in New South Wales. It provides a range of services including emergency telephone triage and video assessment. The present report provides a detailed descript...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1177/1357633X14552372
更新日期:2014-10-01 00:00:00
abstract::In the USA, children in low-income, medically understaffed areas have difficulty accessing health care. A pilot telemedicine service was established in Kansas, linking four elementary schools with a local hospital at 128 kbit/s. PC-based videoconferencing systems, a stethoscope, an otoscope and fax machine were instal...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633991932423
更新日期:1999-01-01 00:00:00
abstract::We investigated why hospice nurses were slow to adopt videophones to care for their patients. We used the unified theory of acceptance and use of technology (UTAUT) model and the organizational readiness for change (ORC) assessment via interviews and focus groups with hospice staff. Twenty-five hospice employees parti...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/jtt.2009.080911
更新日期:2009-01-01 00:00:00
abstract::Between 1996 and 2003, a network of 85 telehealth videoconference sites was implemented in Western Australia (WA), together with 19 teleradiology facilities. Telehealth services have been growing steadily, and in 2002 there were over 30,000 teleradiology transmissions and 1250 clinical occasions of service via videoco...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/135763303322596147
更新日期:2003-01-01 00:00:00
abstract::Over one-third of adults are at risk of developing sleep disorders. Telemedicine is emerging as an effective tool in sleep medicine by allowing people to undergo sleep studies without overnight hospital stays (e.g. monitoring at home). Telemedicine has the potential to overcome several obstacles in the diagnosis and t...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/135763306779378681
更新日期:2006-01-01 00:00:00
abstract::Background Madagascar's maternal health mortality ratio in 2013 was 478 deaths per 100,000 live births. Most deaths are related to direct complications during pregnancy and childbirth and could be reduced by providing comprehensive antenatal care (ANC). Objective The objective of the study was to assess the usability ...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1177/1357633X16653540
更新日期:2017-06-01 00:00:00
abstract::We assessed the clinical course of patients after store and forward teledermatology in comparison with conventional consultations. Patients being referred from primary care to dermatology clinics were randomly assigned to teledermatology or a conventional consultation. A total of 392 patients were randomized; 261 pati...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,随机对照试验
doi:10.1177/1357633x13487116
更新日期:2013-06-01 00:00:00
abstract::We studied a web-based triage system which was accessible to the general public in the Netherlands. In a retrospective analysis we investigated the type of complaints that were submitted and the kind of advice provided. Over a period of 15 months, 13,133 different people began using the web-based triage system and 381...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/jtt.2009.001004
更新日期:2010-01-01 00:00:00
abstract::A telemedicine link was established in 1996 between the island of Inishmore and the department of psychiatry in University College Hospital, Galway. The link was mainly used to facilitate emergency consultations between patients on the island and the duty psychiatrist, always at the request of the island's general pra...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633981931498
更新日期:1998-01-01 00:00:00
abstract::We tested the efficacy of the Healthy Workplace programme for metabolic syndrome. A total of 226 workers with metabolic syndrome from 12 companies enrolled in the study and completed baseline and 6-month follow-up. The Healthy Workplace programme consisted of a 4-week structured education module, telephone counselling...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/jtt.2012.120318
更新日期:2012-09-01 00:00:00
abstract::We assessed the reliability of three digital capture devices: a film digitizer (which cost US $15,000), a flat-bed scanner (US $1800) and a digital camera (US $450). Reliability was measured as the agreement between six observers when reading images acquired from a single device and also in terms of the pair-device ag...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/jtt.2011.110708
更新日期:2012-03-01 00:00:00
abstract::We have piloted a monthly series of multidisciplinary case discussions via videoconference in the area of child development. The project provided a forum for clinical discussion of complex cases, peer review, professional development and networking for allied health professionals and paediatricians. Six sites in Queen...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/13576330260440736
更新日期:2002-01-01 00:00:00
abstract::We assessed the clinical effectiveness and patient satisfaction with nurse-led telephone follow-up of women with lower urinary tract symptoms. Participants were offered telephone follow-up with a nurse instead of a conventional outpatient appointment. Suitability was decided by the doctor who saw the women at her last...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/135763307782215424
更新日期:2007-01-01 00:00:00
abstract::We evaluated the performance of an experimental teleradiology system based on a high-speed ATM backbone network. Image acquisition, transmission and the disk-to-display processing times were measured. Computerized tomography (CT) scans printed on 14 inch x 17 inch (36 cm x 43 cm) films were digitized and transferred o...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633001935149
更新日期:2000-01-01 00:00:00
abstract::We are currently evaluating the use of telemedicine for improving the care of patients admitted with neurological symptoms to hospitals that do not have specialist neurologists on site. To do this we have been comparing the outcome of patients admitted to two small hospitals. In one hospital all patients with neurolog...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633001934122
更新日期:2000-01-01 00:00:00
abstract::We conducted a randomized controlled trial to test whether a Brief Mobile Treatment (BMT) intervention could improve outcomes relative to usual care among suicide attempters. The intervention included training in problem solving therapy, meditation, a brief intervention to increase social support as well as advice on ...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,随机对照试验
doi:10.1258/jtt.2012.SFT107
更新日期:2012-04-01 00:00:00
abstract::Information on the health status of the population of a small Greek island was collected. The information consisted of personal data, clinical history, physical examination, blood pressure evaluation, electrocardiography, and ultrasound scans of neck, breast and abdomen. Ninety-six per cent of the entire island popula...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633991932531
更新日期:1999-01-01 00:00:00
abstract::Videoconferencing was introduced in the Queensland health service in 1995. By the end of 1999, there were more than 150 videoconferencing units in health facilities around the state. Six audits of videoconferencing usage were conducted using similar methodology at six-month intervals from November 1997 to May 2000. Be...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633011936516
更新日期:2001-01-01 00:00:00
abstract::We conducted a retrospective chart review to estimate the extent to which palliative home care visits could be carried out using videophones and to explore factors that might inform the eligibility criteria for video-visits. Four hundred palliative home care health records of deceased clients from 2002 were randomly s...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/135763307780096203
更新日期:2007-01-01 00:00:00
abstract::Searches were conducted of two legal databases dealing with civil law in Austria. The searches produced 12 references relevant to telemedicine, which were obtained from a university legal library. From the literature, it can be concluded that Austrian civil regulations are sufficient to clarify the questions of liabil...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,评审
doi:10.1258/1357633971931066
更新日期:1997-01-01 00:00:00
abstract::Chronic heart failure (CHF) remains a common cause of disability. We have investigated the use of home-based telecardiology (HBT) in CHF patients. Four hundred and twenty-six patients were enrolled in the study: 230 in the HBT group and 196 in the usual-care group. HBT consisted of trans-telephonic follow-up and elect...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633054461688
更新日期:2005-01-01 00:00:00
abstract::We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data ...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章,多中心研究
doi:10.1258/jtt.2009.090813
更新日期:2010-01-01 00:00:00
abstract::A distance continuing medical education programme was established at the Katholieke Universiteit Leuven using multipoint videoconferencing via ISDN lines at 384 kbit/s. During each academic year, 24-26 sessions were organized. During the first three years, a questionnaire was completed by 29% of the 13,489 participant...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/135763303767149997
更新日期:2003-01-01 00:00:00
abstract::This paper describes a distributed visualization of the operation of a reovirus. This visualization allows several groups of users at different locations to view how the virus behaves in normal and cancer cells. The users at each location can interact with the visualization and the other users. The techniques used to ...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633001935446
更新日期:2000-01-01 00:00:00
abstract::Introduction Access to specialised multidisciplinary healthcare services is difficult for many patients with chronic musculoskeletal conditions. A possible solution could be delivery of care via telehealth. This study aims to identify current barriers in accessing healthcare services, and to determine if telehealth is...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1177/1357633X17706605
更新日期:2018-08-01 00:00:00
abstract::The number of people with pacemakers has been steadily increasing over the past 20 years. At present there are about 2,500,000 in the world. All these patients must have a checkup twice a year in hospital, which involves the allocation of significant resources by the national health systems, not to speak of the inconv...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/1357633971930931
更新日期:1997-01-01 00:00:00
abstract:AIMS:Our study aimed to compare the effectiveness of telemonitoring over structured telephone support in reducing heart failure-related healthcare utilization. METHODS:This was a non-randomised controlled study comparing 150 recently discharged heart failure patients enrolled into telemonitoring and 55 patients who on...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1177/1357633X18825164
更新日期:2020-07-01 00:00:00
abstract::We analysed 46 telecytology cases sent from two rural hospitals about 500 km from a tertiary cancer centre. The cases were submitted for second opinion over a period of two years and evaluated using a static store and forward telecytology approach. A total of 715 digital images were studied (average 15 per case). Fort...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1258/135763306778558132
更新日期:2006-01-01 00:00:00
abstract::Introduction We have conducted a feasibility study on remote autopsy services in order to increase the flexibility of the service with benefits for teaching and interdepartmental collaboration. Methods Three senior staff pathologists, one senior autopsy technician and one junior resident participated in the study. Nin...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1177/1357633X17708947
更新日期:2018-08-01 00:00:00
abstract::Little is understood about factors that influence speech-language pathologists' (SLPs') acceptance of telepractice. The aim of this study was to investigate SLPs' perceptions and experiences of transitioning to a school-based telepractice service to identify factors that contributed to positive clinician attitudes. In...
journal_title:Journal of telemedicine and telecare
pub_type: 杂志文章
doi:10.1177/1357633X15604555
更新日期:2015-12-01 00:00:00