Download Veille documentaire sur la téléréadaptation Résultats du mois d`avril

Veille documentaire sur la téléréadaptation
Résultats du mois d’avril 2013
European Research in Telemedicine / La Recherche Européenne en Télémédecine
Volume 1, Issue 1, March 2012, Pages 1–5
La recherche clinique en télémédecine : évaluer le service médical rendu aux patients
P. Simon
Association nationale de télémédecine, 59, boulevard Henri-Dunant, 91106 Corbeil-Essonnes, France
Telemedicine is a remote medical practice which uses tools related to information and communication technologies (ICT).
Since July 21, 2009, French law permits this new medical practice and the decree of October 19, 2010, indicates the main
procedures (tele-consultation, tele-expertise, medical tele-surveillance, medical tele-assistance, tele-advice from the
hospital call center) and the conditions of their implementation. Clinical research is the practice of clinical trials which have
the aim of evaluating the safety and efficacy of a diagnostic method or a new treatment. Clinical research is the main
purpose of the National Association of Telemedicine (ANTEL) and of its new official journal European Research in
Telemedicine. This editorial is opening the first issue of our journal. Several examples can illustrate the importance of
clinical research in telemedicine. In type 1 diabetes, after the first discordant results due to insufficient or weak
methodologies, the French study TeleDiab 1 brought for the first time a clinical improvement over 6 months in patients
followed-up remotely by Diabeo software and teleconsultation. The main medical service to patients was a decrease of
complication risks due to a significant decrease of HbA1c. Nevertheless, the encouraging results of this pilot study need
confirmation over a longer period (the TELESAGE study over two years). In chronic heart failure, the first results of two
meta-analyses showed a significant 30% reduction in morbidity and mortality. However, these results were not confirmed
by two, more recent, prospective and randomised studies. Most authors think that it is necessary to define several
subgroups of patients with chronic heart failure in order to recognize patient subgroups who could benefit from
telemedicine at home. The medical service to stroke patients brought by telemedicine is not open to debate. Telestroke
allows patients away from neurology centres to benefit from emergency thrombolysis (less than 4h 30min after the first
signs) treatment that can allow the total or partial regression of a neurological deficit. Other telemedicine applications have
been able to demonstrate a medical service to patients, for example remote blood pressure self-monitoring at home in
hypertensive patients, live interactive teledermatology, teledialysis by peritoneal dialysis at home or by haemodialysis by a
remote satellite unit, etc. Teleradiology brings a medical service to patients if it is carried out according to international or
national guidelines. Many other applications of telemedicine may be the subject of clinical research such as telegeriatry,
tele-psychiatry, tele-surgery, tele-rhumatology, tele-obstetric, tele-pathology, etc.). Telemedicine practice can have a
significant economical impact, particularly due to reductions in hospitalisation numbers. Risk factors due to telemedicine
are beginning to be known. Clinical research on the medical service to patients followed-up by telemedicine can prevent
risks.
European Research in Telemedicine / La Recherche Européenne en Télémédecine
Volume 2, Issue 1, March 2013, Pages 1–4
L’an III de la télémédecine en France / Year III of telemedicine in France - Éditorial
Pierre Simon (President of ANTEL),
Thierry Moulin, (Editor in Chief)
http://dx.doi.org/10.1016/j.eurtel.2013.03.001
Telehealth and ergonomics: a pilot study.
Jacobs K., Blanchard B., Baker N.
Technol Health Care 2012 20:5 (445-458)
1
MEDLINE
As an emerging model of health care delivery, telehealth has the potential to provide individuals living in remote regions
with access to health care services that are otherwise not available. This paper provides a review of the feasibility,
comparative effectiveness, cost effectiveness, client and clinician satisfaction, and the barriers to providing telehealth
services. A proof-of-concept study that examined the feasibility of telehealth-based ergonomic assessment and
intervention is included in this paper to demonstrate the application of telehealth in occupational therapy and ergonomics.
Ten computer users received a telehealth ergonomic assessment and intervention for their computer workstations via the
Telerehabilitation Computer Ergonomics System (tele-CES) - a platform for computer users to access web-based
assessments and to communicate with researchers via tele-conferencing. The tele-CES was used to assess participants'
computer workstations and pain and comfort levels at baseline and at 4-month follow-up. Ergonomic recommendations
were also provided via the tele-CES. Although there was no significant improvement in pain and comfort for participants, a
high rate of compliance with ergonomic recommendations - 88% of all recommendations - was observed. Further
research examining the comparative effectiveness of telehealth ergonomic assessment and intervention relative to inperson ergonomic assessment and intervention is warranted.
European Research in Telemedicine / La Recherche Européenne en Télémédecine
Volume 2, Issue 1, March 2013, Pages 23–28
La télémédecine au service de la prise en charge des patients diabétiques : développements actuels et conditions du
succès
P.-Y. Benhamou, , M. Muller, S. Lablanche, I. Debaty
http://dx.doi.org/10.1016/j.eurtel.2013.01.001,
Le défaut d’investissement du patient et l’inertie clinique contribuent à une prise en charge insuffisante du diabète. Ces
obstacles pourraient être levés par les outils informatiques et Internet. Des dossiers de santé personnels, partagés avec
le soignant, favorisent la mise en œuvre des comportements inhérents au diabète (amélioration de l’observance
thérapeutique grâce à un soutien motivationnel). Ces programmes Web fournissent plusieurs fonctions : dossier médical,
téléchargement des glycémies capillaires, carnet glycémique, messagerie sécurisée, feedback manuel ou automatique
sur les glycémies, site Web éducatif, journal en ligne (exercice, alimentation, médicaments). L’étude TeleDiab-3 évalue
chez 700 diabétiques de type 1 une telle plateforme Web de suivi télémédical du diabète. Par ailleurs, l’étude TeleDiab-1
conduite chez 180 diabétiques de type 1 a montré l’intérêt d’un logiciel installé sur un smartphone (Diabeo) permettant au
patient d’avoir en temps réel une aide à la décision sur la dose d’insuline, un carnet glycémique électronique
communiquant par Internet avec le médecin et se prêtant ainsi à des consultations téléphoniques. L’essai TeleSage,
visant à obtenir une reconnaissance institutionnelle de Diabeo, va tester une technologie et un mode de délivrance de la
télémédecine impliquant à la fois médecins et infirmières d’éducation. D’autres exemples (rétinopathie, diabète
gestationnel, diabète type 2, pied diabétique) sont présentés. Les conditions du succès sont analysées. Les obstacles au
déploiement de la télémédecine sont l’adhésion du patient et des soignants à la technologie, l’ergonomie et l’intégration
des divers dossiers médicaux électroniques, et la rétribution financière des soignants. Les études en cours devraient
étayer l’intérêt thérapeutique de la télémédecine en diabétologie et appuyer sa reconnaissance.
Telemedicine and the challenges of medico-economic evaluation
La télémédecine face aux enjeux de l'évaluation médicoéconomique
Pascal C.
Eur. Res. Telemedicine 2012 1:3-4 (125-129)
Embase
En dépit d’un fort engouement intellectuel, la télémédecine souffre d’un faible niveau de diffusion en France. Le manque
de rigueur des évaluations médicoéconomiques est souvent présenté dans la littérature comme l’une des causes de ce
sous-développement, car il freinerait les décisions de financement des pouvoirs publics et conjointement des
investisseurs privés. Faute de financement pérenne, les expérimentations de télémédecine ne parviendraient pas à
dépasser le stade du projet. Si la nature spécifique de l’objet « télémédecine » explique pour partie les difficultés que
rencontrent les démarches évaluatives médicoéconomiques classiques, elle suscite également des interrogations plus
profondes sur le lien entre entrepreneuriat et innovation dans le secteur sanitaire.
BMJ. 2013 Feb 26;346:f653. doi: 10.1136/bmj.f653.
Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator
telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled
trial.
2
Cartwright M, Hirani SP, Rixon L, Beynon M, Doll H, Bower P, Bardsley M, Steventon A, Knapp M, Henderson C, Rogers
Abstract
OBJECTIVE:
To assess the effect of second generation, home based telehealth on health related quality of life, anxiety, and depressive
symptoms over 12 months in patients with long term conditions.
DESIGN:
A study of patient reported outcomes (the Whole Systems Demonstrator telehealth questionnaire study; baseline n=1573)
was nested in a pragmatic, cluster randomised trial of telehealth (the Whole Systems Demonstrator telehealth trial,
n=3230). General practice was the unit of randomisation, and telehealth was compared with usual care. Data were
collected at baseline, four months (short term), and 12 months (long term). Primary intention to treat analyses tested
treatment effectiveness; multilevel models controlled for clustering by general practice and a range of covariates.
Analyses were conducted for 759 participants who completed questionnaire measures at all three time points (complete
case cohort) and 1201 who completed the baseline assessment plus at least one other assessment (available case
cohort). Secondary per protocol analyses tested treatment efficacy and included 633 and 1108 participants in the
complete case and available case cohorts, respectively.
SETTING:
Provision of primary and secondary care via general practices, specialist nurses, and hospital clinics in three diverse
regions of England (Cornwall, Kent, and Newham), with established integrated health and social care systems.
PARTICIPANTS : Patients with chronic obstructive pulmonary disease (COPD), diabetes, or heart failure recruited
between May 2008 and December 2009.
MAIN OUTCOME MEASURES:
Generic, health related quality of life (assessed by physical and mental health component scores of the SF-12, and the
EQ-5D), anxiety (assessed by the six item Brief State-Trait Anxiety Inventory), and depressive symptoms (assessed by
the 10 item Centre for Epidemiological Studies Depression Scale).
RESULTS:
In the intention to treat analyses, differences between treatment groups were small and non-significant for all outcomes in
the complete case (0.480 ≤ P ≤ 0.904) or available case (0.181 ≤ P ≤ 0.905) cohorts. The magnitude of differences
between trial arms did not reach the trial defined, minimal clinically important difference (0.3 standardised mean
difference) for any outcome in either cohort at four or 12 months. Per protocol analyses replicated the primary analyses;
the main effect of trial arm (telehealth v usual care) was non-significant for any outcome (complete case cohort 0.273 ≤ P
≤ 0.761; available case cohort 0.145 ≤ P ≤ 0.696).
CONCLUSIONS:
Second generation, home based telehealth as implemented in the Whole Systems Demonstrator Evaluation was not
effective or efficacious compared with usual care only. Telehealth did not improve quality of life or psychological outcomes
for patients with chronic obstructive pulmonary disease, diabetes, or heart failure over 12 months. The findings suggest
that concerns about potentially deleterious effect of telehealth are unfounded for most patients.
PMCID: PMC3582704 Free PMC Article
PMID: 23444424 [PubMed - indexed for MEDLINE]
Neurology. 2013 Feb 12;80(7):670-6.
doi: 10.1212/WNL.0b013e3182823361.
Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology.
Wechsler LR, Tsao JW, Levine SR, Swain-Eng RJ, Adams RJ, Demaerschalk BM, Hess DC, Moro E, Schwamm LH,
Abstract
OBJECTIVE:
To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice,
military medicine, and current federal policy.
METHODS:
Review of practice models and published literature on primary studies of the efficacy of neurology telemedicine.
RESULTS:
Teleneurology is of greatest benefit to populations with restricted access to general and subspecialty neurologic care in
rural areas, those with limited mobility, and those deployed by the military. Through the use of real-time audio-visual
interaction, imaging, and store-and-forward systems, a greater proportion of neurologists are able to meet the demand for
specialty care in underserved communities, decrease the response time for acute stroke assessment, and expand the
collaboration between primary care physicians, neurologists, and other disciplines. The American Stroke Association has
developed a defined policy on teleneurology, and the American Academy of Neurology and federal health care policy are
beginning to follow suit.
CONCLUSIONS:
3
Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These
underserved locations include geographically isolated rural areas as well as urban cores with insufficient available
neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to
neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state
level is necessary to facilitate expansion of telemedicine into further areas of neurology.
PMCID: PMC3590056 [Available on 2014/2/12]
PMID: 23400317 [PubMed - indexed for MEDLINE]
Telemed J E Health. 2012 Oct;18(8):648-53. doi: 10.1089/tmj.2011.0242.
Telemedicine and its potential impacts on reducing inequalities in access to health manpower.
Nouhi M, Fayaz-Bakhsh A, Mohamadi E, Shafii M.
Abstract
Human resources for health have many diverse aspects that sometimes bring about conflicts in the healthcare market. In
recent decades issues such as attrition, migration, and different types of imbalances in health workers were not only
considered as international problems, but also took on new particular dimensions and complications. Rapid growth in
establishing infrastructure of communications and many diseases such as human immunodeficiency virus/AIDS and
malaria, as well as shortages in skilled healthcare providers in developing countries, interested many health economists
and health professionals to consider telemedicine as an approach to deliver some healthcare and to pursue its effects on
human resources management in healthcare. The objective of this communication is to offer a better understanding of the
value of telemedicine in human resources management in healthcare. This article briefly reviews related literature on
potential contributions of telemedicine in mitigating four different types of imbalances in health workers and points out
some of its capabilities. Although there is a great need for systematic, scientific, and analytical studies in effects of
telemedicine on health workers, expansion of communication infrastructure throughout and especially in remote areas,
political commitment, and provision of useful information and education to reduce problems of human resources for health
are beneficial.
PMID: 23061645 [PubMed - indexed for MEDLINE]
Behav Modif. 2012 Nov;36(6):897-923. doi: 10.1177/0145445512450733. Epub 2012 Sep 5.
Technological advances in the treatment of trauma: a review of promising practices.
Paul LA, Hassija CM, Clapp JD.
Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of
trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting.
Technological innovations in this literature aim to expand availability of empirically based intervention, increase treatment
adherence and acceptability, and overcome barriers commonly encountered with conventional trauma-focused treatment.
Much of the current research on these technological developments consists of brief reviews and case studies of the
separate therapy modalities. Although this work serves to document the appeal and utility of these innovations, it does not
provide comprehensive information about the host of options available. To that end, the three general categories of
technological advances in trauma therapy (i.e., videoconferencing, e-Health, virtual reality) are reviewed here, including
information regarding their empirical support and suggestions for future research and clinical practice.
PMID: 22956588 [PubMed - indexed for MEDLINE]
Telemed J E Health. 2012 Oct;18(8):575-9. doi: 10.1089/tmj.2011.0237. Epub 2012 Aug 8.
Outcomes of a home telehealth intervention for patients with diabetes and hypertension.
Wakefield BJ, Holman JE, Ray A, Scherubel M, Adams MR, Hills SL, Rosenthal GE.
BACKGROUND:
Home telehealth programs often focus on a single disease, yet many patients who need monitoring have multiple
conditions. This study evaluated secondary outcomes from a clinical trial evaluating the efficacy of home telehealth to
improve outcomes of patients with co-morbid diabetes and hypertension.
SUBJECTS AND METHODS:
A single-center randomized controlled clinical trial compared two remote monitoring intensity levels (low and high) and
usual care in patients with type 2 diabetes and hypertension being treated in primary care. Secondary outcomes assessed
4
were knowledge (diabetes, hypertension, medications), self-efficacy, adherence (diabetes, medications), and patient
perceptions of the intervention mode.
RESULTS:
Knowledge scores improved in the high-intensity intervention group participants, but upon further analysis, we found the
intervention effect was not mediated by gain in knowledge. No significant differences were found across the groups in
self-efficacy, adherence, or patient perceptions of the intervention mode.
CONCLUSIONS:
Home telehealth can enhance detection of key clinical symptoms that occur between regular physician visits. While our
intervention improved glycemic and blood pressure control, the mechanism of the effect for this improvement was not
clear.
PMID: 22873700 [PubMed - indexed for MEDLINE]
14.
Psychol Health Med. 2012;17(6):636-51. doi: 10.1080/13548506.2011.652640. Epub 2012 Feb 7.
Internet-delivered behavioral intervention to increase physical activity in persons with multiple sclerosis: sustainability and
secondary outcomes.
Dlugonski D, Motl RW, Mohr DC, Sandroff BM.
Abstract
Physical activity is associated with many benefits, but persons with multiple sclerosis (MS) are less physically active than
the general population. There is a critical need for research on methods of increasing and sustaining the physical activity
levels of this population. This randomized controlled trial examined the efficacy of an Internet-delivered and theory-based
behavioral intervention that was supplemented with video coaching for increasing and sustaining physical activity over
time in persons with MS. Physically inactive, ambulatory persons with MS (N = 45) were randomly assigned to
intervention (n = 22) or control (n = 23) conditions and completed a battery of questionnaires before, after, and three
months after a 12-week intervention period. Data analyses were conducted in PASW 18.0. Partial eta squared ([Formula:
see text]) effect size indicated that there was a large, statistically significant condition-by-time interaction on physical
activity ([Formula: see text]). Cohen's d effect sizes indicated that the intervention group had a large increase in physical
activity after the 12-week trial (d = .98) that was sustained over a three-month follow-up (d = .79). The current study
supports the efficacy of a behavioral intervention for increasing and sustaining physical activity in a sample of persons
with MS.
PMID: 22313192 [PubMed - indexed for MEDLINE]
Response to the systematic review of the evidence for telemedicine in burn care: With a UK perspective
Onyekwelu O., Dheansa B.
Burns 2013 39:3 (532-533)
No abstract available
Is there and do we need evidence on eHealth interventions?
Al-Shorbaji N.
IRBM 2013 34:1 (24-27)
Embase
The proliferation of information and communication technology (ICT) is transforming the healthcare, as an informationintensive sector, in a way that has never been witnessed before. The use of ICT in health or eHealth has the potential to
improve the quality of health services, improve access to services and reduce cost. Huge investments in eHealth
initiatives have been made by many countries based on this potential. A body of evidence is being developed to show the
value of eHealth. Research and evaluation in eHealth should be comprehensive and not only limited to technology. There
is a need for more research in this area using a multidisciplinary approach and teams. © 2013 World Health Organization.
Videophone-based multimodal home telecare support system for patients with diabetes
Kubota M., Hosoda K., Eguchi K., Furuya A., Nishijima Y., Nakao K., Kinoshita A.
Diabetol. Int. 2013 4:1 (52-59)
Embase
Aims: We conducted an intervention study to clarify how effectively a telemedicine system using a multi-functional
videophone could be used in lifestyle guidance, with special focus on diet for diabetic patients cared for at home.
Methods: Patients were assigned to a 3-month intervention group or to a usual care group. In the intervention group,
patients and a medical professional communicated bi-directionally through a videophone-based communication system
for 30 min, once a week. The participants were encouraged to send pictures of each meal online, through the videophone
5
system, in real time. Results: In intra-subjective comparison, the 3-month intervention program resulted in a significant
decrease in body weight (BW) (p < 0. 0005) and average HbA1C level (p < 0. 005) compared with before the intervention
program. Three months after the conclusion of the intervention program, average HbA1C levels returned to almost the
same levels as before intervention (p < 0. 05). In the usual care group, average HbA1C level did not change significantly
for 6 months. Conclusions: 3-month intensive communication using the multimodal videophone system led to a significant
decrease in BW and average HbA1C level. This novel bi-directional communication is useful for improving conditions such
as diabetes, BW, and hyperglycemia for homecare diabetes patients, thus, reducing cardiovascular risk. © 2012 The
Telerehabilitation, virtual therapists, and acquired neurologic speech and language disorders.
Cherney L.R., van Vuuren S.
Semin Speech Lang 2012 33:3 (243-257)
Telerehabilitation (telerehab) offers cost-effective services that potentially can improve access to care for those with
acquired neurologic communication disorders. However, regulatory issues including licensure, reimbursement, and
threats to privacy and confidentiality hinder the routine implementation of telerehab services into the clinical setting.
Despite these barriers, rapid technological advances and a growing body of research regarding the use of telerehab
applications support its use. This article reviews the evidence related to acquired neurologic speech and language
disorders in adults, focusing on studies that have been published since 2000. Research studies have used telerehab
systems to assess and treat disorders including dysarthria, apraxia of speech, aphasia, and mild Alzheimer disease. They
show that telerehab is a valid and reliable vehicle for delivering speech and language services. The studies represent a
progression of technological advances in computing, Internet, and mobile technologies. They range on a continuum from
working synchronously (in real-time) with a speech-language pathologist to working asynchronously (offline) with a standin virtual therapist. One such system that uses a virtual therapist for the treatment of aphasia, the Web-ORLA™
(Rehabilitation Institute of Chicago,) system, is described in detail. Future directions for the advancement of telerehab for
clinical practice are discussed. Thieme Medical Publishers 333 Seventh Avenue,
Communication technologies and decision support systems in type 1 diabetes
Technologies communicantes et aide à la gestion du diabète de type 1
Franc S., Dardari D., Mounier S., Daoudi A., Boucherie B., Laroye H., Peschard C., Canipel L., Charpentier G. Med. Mal.
Metab. 2012 6:6 (495-499)
Embase
In type 1 diabetes (T1D) which treatment is complex, TM is primarily intended to help the patient to better control blood
glucose level and to adjust treatment. Among the many TM experiences that have emerged in type 1 diabetes (T1D), the
Diabeo™ system is the only one to have really proven yet its effectiveness. The system contains: - A smartphone "in the
pocket" of the patient that allows an automated and immediate calculation of insulin doses thanks to predefined algorithms
that have been defined by the physician (a medical electronic prescription); - A system of teletransmission of the data to
the caregiver who can view patients' data on the screen of his computer and provide primarily motivational support via
teleconsultations. If the DiabeoTM system has already demonstrated its effectiveness in Télédiab 1 validation study, it is
now necessary to demonstrate that this efficacy is sustainable for a large population of patients and that the system is
economically profitable, a prerequisite for its implementation for all patients with T1D who wish to use it. That is the
purpose of the French national multicenter study Télésage which should start soon in a population of 700 diabetic patients
over a period of 2 years. In addition to the expected metabolic and economic benefits, this study should assess the
feasibility and the effectiveness of a new healthcare organization involving specialized nurses to insure, in collaboration
with the physician, the monitoring of the data through a protocol of interprofessional cooperation submitted to the French
National Health Authority (HAS), and validated by the French Regional Health Agency (ARS). It should be checked that
such an organization, which give to the physician the ability to focus his intervention on patients who have the most
difficulties to cope with diabetes and to delegate in the same time a number of tasks, is a solution to the insufficiency in
health care organization and that it will finally allow an optimization of healthcare. © 2012 - Elsevier Masson SAS - Tous
Communication technologies and decision support systems in type 1 diabetes
Technologies communicantes et aide à la gestion du diabète de type 1
Franc S., Dardari D., Mounier S., Daoudi A., Boucherie B., Laroye H., Peschard C., Canipel L., Charpentier G. Med. Mal.
Metab. 2012 6:6 (495-499)
6
Embase
Abstract
In type 1 diabetes (T1D) which treatment is complex, TM is primarily intended to help the patient to better control blood
glucose level and to adjust treatment. Among the many TM experiences that have emerged in type 1 diabetes (T1D), the
Diabeo™ system is the only one to have really proven yet its effectiveness. The system contains: - A smartphone "in the
pocket" of the patient that allows an automated and immediate calculation of insulin doses thanks to predefined algorithms
that have been defined by the physician (a medical electronic prescription); - A system of teletransmission of the data to
the caregiver who can view patients' data on the screen of his computer and provide primarily motivational support via
teleconsultations. If the DiabeoTM system has already demonstrated its effectiveness in Télédiab 1 validation study, it is
now necessary to demonstrate that this efficacy is sustainable for a large population of patients and that the system is
economically profitable, a prerequisite for its implementation for all patients with T1D who wish to use it. That is the
purpose of the French national multicenter study Télésage which should start soon in a population of 700 diabetic patients
over a period of 2 years. In addition to the expected metabolic and economic benefits, this study should assess the
feasibility and the effectiveness of a new healthcare organization involving specialized nurses to insure, in collaboration
with the physician, the monitoring of the data through a protocol of interprofessional cooperation submitted to the French
National Health Authority (HAS), and validated by the French Regional Health Agency (ARS). It should be checked that
such an organization, which give to the physician the ability to focus his intervention on patients who have the most
difficulties to cope with diabetes and to delegate in the same time a number of tasks, is a solution to the insufficiency in
health care organization and that it will finally allow an optimization of healthcare. © 2012 - Elsevier Masson SAS - Tous
Foreword treatment of type 1 diabetes: The future? Part 2
Avant-propos Le futur du traitement du diabète de type 1 Partie 2
Hanaire H.
[In Process] Med. Mal. Metab. 2012 6:6 (467)
No abstract available
Factors influencing the adoption of home telecare by elderly or chronically ill people: A national survey
Peeters J.M., De Veer A.J.E., Van der Hoek L., Francke A.L.
J. Clin. Nurs. 2012 21:21-22 (3183-3193)
MEDLINE
Abstract
Aims and objectives. The primary aim is to provide insight into client characteristics and characteristics of home telecare
contacts, which may influence the adoption of home telecare. Secondary aim is to examine the applicability of four
perceived attributes in Rogers' diffusion of innovations theory, which may influence the adoption: relative advantage,
compatibility, complexity and observability. Background. Western countries face strongly increasing healthcare demands.
At the same time, a growing nursing shortage exists. The use of home telecare may be instrumental in improving
independence and safety and can provide support to older and chronically ill people, but a precondition for its uptake is
that clients consider it as a useful and helpful technological tool. Design. A survey conducted among clients of seven
home care organisations in the Netherlands connected to a home telecare system. Methods. In 2007, a postal
questionnaire was distributed to 468 older or chronically ill clients: 254 responded (54%). The data were analysed by
regression techniques, employing a theoretical model. Results. This study showed that clients' perceived attributes relative advantage, compatibility, complexity and observability - have a significant effect on adoption of home telecare
explaining 61% of the variance. The chance of adoption is higher when a client already receives long-term personal
and/or nursing care, he/she lives alone and when there are fixed daily contacts via the home telecare system. The
perception of possible benefits can still be enhanced. Conclusions. The concept of perceived attributes, derived from
Rogers' diffusion of innovation theory, has been useful to explain clients' adoption of home telecare. Relevance to clinical
practice. Home care organisations can best focus on clients already in care and people living alone, in offering home
telecare. Nurses, who aim to enhance the client's adoption of home telecare, have to take into account clients' perceived
attributes of such new technology. © 2012 Blackwell Publishing Ltd.
Customized web-based sound therapy for tinnitus
Mahboubi H., Ziai K., Djalilian H.R.
[In Process] Int. Tinnitus J. 2012 17:1 (26-30)
Embase
Introduction: Traditional masking efforts have presented broadband noises, most typically white noise. Targeted
(customized) sound therapies have been introduced to overcome the limitations of traditional maskers. Objectives: To
7
evaluate the efficacy of a web-based delivery of customized sound therapy in reducing tinnitus loudness and increasing
the residual inhibition. Materials and Methods: Thirty-two subjects matched their tinnitus frequency using a web-based
protocol. A customized Harmonic Sound Therapy file was produced by the web-based software and downloaded by the
patient onto an MP3 player. The subjects listened to the sound file for one hour. Results: Tinnitus loudness mean was 6.0
± 2.3 standard deviation (SD) which decreased to 3.3 ± 1.9 SD after one hour of sound therapy. Some reduction in
loudness was seen in 81%, while 72% experienced a reduction of 25% or more. Tinnitus annoyance decreased from an
average of 6.1 ± 2.6 SD to 3.1 ± 2.0 SD. Median duration of residual inhibition was 32.5 minutes, with an average of 75
minutes ± 132 SD. Conclusion: Customized sound therapy can be delivered via the internet. Harmonic Sound Therapy is
effective in reducing the loudness and annoyance of tinnitus.
The effect of technology and testing environment on speech perception using telehealth with cochlear implant recipients.
Goehring J.L., Hughes M.L., Baudhuin J.L., Valente D.L., McCreery R.W., Diaz G.R., Sanford T., Harpster R.
J. Speech Lang. Hear. Res. 2012 55:5 (1373-1386)
MEDLINE
In this study, the authors evaluated the effect of remote system and acoustic environment on speech perception via
telehealth with cochlear implant recipients. Speech perception was measured in quiet and in noise. Systems evaluated
were Polycom visual concert (PVC) and a hybrid presentation system (HPS). Each system was evaluated in a soundtreated booth and in a quiet office. For speech in quiet, there was a significant effect of environment, with better
performance in the sound-treated booth than in the office; there was no effect of system (PVC or HPS). Speech in noise
revealed a significant interaction between environment and system. Subjects' performance was poorer for PVC in the
office, whereas performance in the sound-treated booth was not significantly different for the two systems. Results from
the current study were compared to results for the same group of subjects from an earlier study; these results suggested
that poorer performance at remote sites in the previous study was primarily due to environment, not system. Speech
perception was best when evaluated in a sound-treated booth. HPS was superior for speech in noise in a reverberant
environment. Future research should focus on modifications to non-sound-treated environments for telehealth service
delivery in rural areas.
Technol Health Care. 2012;20(5):445-58. doi: 10.3233/THC-2012-0692.
Telehealth and ergonomics: a pilot study.
Jacobs K, Blanchard B, Baker N.
OBJECTIVES:
As an emerging model of health care delivery, telehealth has the potential to provide individuals living in remote regions
with access to health care services that are otherwise not available. This paper provides a review of the feasibility,
comparative effectiveness, cost effectiveness, client and clinician satisfaction, and the barriers to providing telehealth
services. A proof-of-concept study that examined the feasibility of telehealth-based ergonomic assessment and
intervention is included in this paper to demonstrate the application of telehealth in occupational therapy and ergonomics.
METHODS:
Ten computer users received a telehealth ergonomic assessment and intervention for their computer workstations via the
Telerehabilitation Computer Ergonomics System (tele-CES) - a platform for computer users to access web-based
assessments and to communicate with researchers via tele-conferencing. The tele-CES was used to assess participants'
computer workstations and pain and comfort levels at baseline and at 4-month follow-up. Ergonomic recommendations
were also provided via the tele-CES.
RESULTS: Although there was no significant improvement in pain and comfort for participants, a high rate of compliance
with ergonomic recommendations - 88% of all recommendations - was observed.
CONCLUSION:
Further research examining the comparative effectiveness of telehealth ergonomic assessment and intervention relative
to in-person ergonomic assessment and intervention is warranted.
PMID: 23079948
BMC Psychiatry. 2012 Sep 11;12:137. doi: 10.1186/1471-244X-12-137.
Internet-based self-help treatment for depression in multiple sclerosis: study protocol of a randomized controlled trial.
Boeschoten RE, Dekker J, Uitdehaag BM, Polman CH, Collette EH, Cuijpers P, Beekman AT, van Oppen P.
Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest,
BACKGROUND:
8
Depression in MS patients is frequent but often not treated adequately. An important underlying factor may be physical
limitations that preclude face-to-face contact. Internet-based treatment showed to be effective for depressive symptoms in
general and could thus be a promising tool for treatment in MS.
METHODS/DESIGN:
Here, we present a study protocol to investigate the effectiveness of a 5 week Internet-based self-help problem solving
treatment (PST) for depressive symptoms in MS patients in a randomized controlled trial. We aim to include 166 MS
patients with moderate to severe depressive symptoms who will be randomly assigned to an Internet-based intervention
(with or without supportive text-messages) or waiting list control group. The primary outcome is the change in depressive
symptoms defined by a change in the sum score on the Beck Depression Inventory (BDI-II). Secondary outcomes will
include measures of anxiety, fatigue, cognitive functioning, physical and psychological impact of MS, quality of life,
problem solving skills, social support, mastery, satisfaction and compliance rate. Assessments will take place at baseline
(T0), within a week after the intervention (T1), at four months (T2) and at ten months follow-up (T3: only the intervention
group). The control group will be measured at the same moments in time. Analysis will be based on the intention-to-treat
principle.
DISCUSSION:
If shown to be effective, Internet-based PST will offer new possibilities to reach and treat MS patients with depressive
symptoms and to improve the quality of care.
TRIAL REGISTRATION:
The Dutch Cochrane Center, NTR2772.
PMCID: PMC3493307 Free PMC Article
Impact of knowledge transfer through the implementation of a telemedicine program in a community hospital in Brazil
Abreu Filho C.A., Steinman M., Andrade A., Cal R., Akamine N., Teixeira J., Silva E., Kanamura A., Cenderoglo M.,
Lottenberg C.
Crit. Care 2013 17: (S193)
Embase
Abstract
Introduction Emergency survival rates vary significantly according to the quality of care, which depends on human and
technological resources. Emergency and critical care medicine physicians must make fast decisions; the presence of
experienced consultants improves survival. In developing countries, there is a shortage of skilled doctors. The aim is to
describe the first Brazilian initiative of realtime teleconferencing telemedicine (TM) providing 24/7 emergency department
(ED) and ICU coverage. Methods Since May 2012 a TM program has been implemented at two hospitals in S ão Paulo,
Brazil -Hospital Municipal Dr. Moysés Deutsch (HMMD), a public, secondary hospital, and Hospital Israelita Albert
Einstein (HIAE), a tertiary private philanthropic entity -due to a partnership with the Brazilian Health Ministry. TM Central
Command was located at HIAE with Endpoint 97 MXP Cisco® Solution and a mobile Intern MXP ISDN/IP Cisco® for the
remote hospital (HMMD) via dedicated GB/sec connection. Imaging examinations were evaluated using PACS
technology. Every recruited patient was assessed by the Central Command through TM with an experienced consultant.
Results Over a 6-month period, 131 teleconsultations (114 patients) were done. Mean age was 50.1 years, 57.1% was
male and mean APACHE II score was 24.3. A total of 64.8% originated from the ICU and 35.2% from the ED. Main
consultation diagnoses were sepsis (31.3%); stroke (29.8%); survival from cardiac arrest (6.1%); trauma (6.1%); and
acute myocardial infarction (5.3%). TM improved diagnosis in 14.5% and influenced the clinical management in 85.5% of
the consultations. Invasive procedures were indicated in 61.1%. Life-saving procedures were TM related in seven patients
(6.1%): stroke thrombolysis (n = 6) and limb amputation (n = 1). Seven patients (6.1%) were transferred and submitted to
surgical procedures (heart surgery (n = 2), neurosurgery (n = 4) and liver transplantation (n = 1)). The majority of the
patients remained at HMMD and were discharged. Conclusion A TM program is feasible to be implemented in a
community hospital. The major benefit is expertise medical transfer from the tertiary hospital to the community setting,
improving diagnosis and management of critical care patients, and avoiding routine transfer to a major urban center.
J Dev Behav Pediatr. 2012 Oct;33(8):656-65. doi: 10.1097/DBP.0b013e3182690741.
Telehealth in developmental-behavioral pediatrics.
Soares NS, Langkamp DL.
David Geffen School of Medicine, Mattel Children's Hospital at University of California Los Angeles, Los Angeles, CA,
Abstract
9
Developmental-behavioral pediatrics (DBP) is recognized as one of the fields with the greatest shortages of pediatric
subspecialists. Families who access care often must travel great distances to tertiary academic medical centers or endure
long waiting lists. While the shortages are likely to persist due to limited provider availability and an increasing number of
children with developmental and behavioral disorders being identified, our field must look to innovative ways to reduce the
barriers to access. One such way is telehealth, the use of videoconferencing to deliver DBP services to underserved
populations. We aim to describe the practical uses of telehealth for the delivery of diagnostic and management clinical
services in a variety of settings and for the additional educational and research benefits of the modality. We will highlight
the obstacles to setting up a successful DBP telehealth practice and direct readers to resources to address these in their
communities. Most of all, we will demonstrate the benefit to families and children, practitioners, and health care systems
of supplementing traditional in-person DBP services with telehealth modalities to enhance outreach and engagement with
communities.
The digital health divide: A new threat to health care quality and cost?
Nicogossian A., Zimmerman T., Kloiber O., Doarn C.R., Stabile B.
[In Process] World Med. Health Policy 2012 4:2
Embase
Abstract
Information technology (IT) and the digital revolution continue to transform the biomedical research and health care
practice landscape worldwide. While contributing to the dissemination of knowledge and the promise of reducing health
care costs, access to this capability is not universal. Many communities, patients and health professionals worldwide do
not have access to digital data repositories or even have Internet access. A major roadblock for developing nations is the
cost of access and rapidly evolving IT tools. Language and "Internet literacy" are the other two major impediments in
achieving access. © 2012 Policy Studies Organization.
PMID: 23027140 [PubMed - indexed for MEDLINE
Chest. 2013 Jan;143(1):19-29.
The costs of critical care telemedicine programs: a systematic review and analysis.
Kumar G, Falk DM, Bonello RS, Kahn JM, Perencevich E, Cram P.
Division of Pulmonary, Critical Care, and Occupational Health, Department of Internal Medicine, University of Iowa Carver
College of Medicine, Iowa City, IA 52242, USA. [email protected]
Comment in • A difference is a difference if it makes a difference. [Chest. 2013]
Abstract
BACKGROUND:
Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these
programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs
and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA)
hospitals.
METHODS:
We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of
tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a
tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature.
RESULTS:
Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined
implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in
patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per
patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed,
depending on the depreciation methods applied.
CONCLUSIONS:
The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is
unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and
economic aspects of tele-ICUs when considering investing in this technology.
PMID: 22797291 [PubMed - indexed for MEDLINE]
Utilization of telemedicine to improve burn care in a developing country
Knittel J., Fuzaylov G.
Crit. Care 2013 17: (S193-S194)
Embase
10
Abstract
Introduction Our objective is to present our experience from Shriner's Hospital and Massachusetts General Hospital in
Boston, MA, USA in using telemedicine to provide acute burn and critical care consultation on pediatric and adult burn
patients in Lviv, Ukraine, as well as in triage and transport of critically ill patients from Lviv to a tertiary-care facility in the
USA for further management. Methods Using a new telemedicine learning center established at City Hospital #8 in Lviv,
Ukraine, consultations regarding acutely injured burn victims occurred between physicians in Ukraine and physicians at
Shriners Hospital and Massachusetts General Hospital in Boston. After the initial presentation, each patient was reviewed
on a daily basis by physicians in Boston. Skype, an Internet-based communication tool, was used in communication with
the Burn Center in Lviv. Radiographic images were scanned and digitalized using an electronic scanner, and JPEG image
compression was used to facilitate the transmission of radiographic images and patient charts. Informed consent and
HIPPA guidelines were followed in transmitting any patient-related information. Results Since 2011 we have provided
consultation on 14 patients in Lviv, Ukraine, ranging in age from 15 months to 63 years. Each patient had an average of
six consultations. We present two of these cases as examples of the capabilities of our telemedicine program. The first
case involved a 15-month-old female with 40% TBSA from scald injury, where telemedicine was instrumental in the
primary assessment as well as to arrange a direct assessment from a nearby burn surgeon. The second case resulted
from a house f re with multiple casualties, where physicians in Boston were able to utilize telemedicine to guide the initial
resuscitation and airway management of three critically burned children, as well as to arrange for transport of one of the
victims, an 11-year-old male with 87% TBSA, from Ukraine to the USA for acute management. Multiple dif culties were
overcome in implementing the system between the two countries including: time zone differences, language barrier, and
different approaches to patient care. Conclusion We have established a telemedicine program linking physicians in
Boston, MA, USA with City Hospital #8 in Lviv, Ukraine to improve care in pediatric and adult burn patients. Our program
has provided consultation on 14 patients since 2011, and it highlights the capabilities of telemedicine for acute
consultation as well as triage and transport of critically ill patients to tertiary-care facilities.
Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology.
Wechsler L.R., Tsao J.W., Levine S.R., Swain-Eng R.J., Adams R.J., Demaerschalk B.M., Hess D.C., Moro E., Alphonso
A.L., American Academy of Neurology Telemedicine Work Group
Neurology 2013 80:7 (670-676)
MEDLINE
Abstract
To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice,
military medicine, and current federal policy. Review of practice models and published literature on primary studies of the
efficacy of neurology telemedicine. Teleneurology is of greatest benefit to populations with restricted access to general
and subspecialty neurologic care in rural areas, those with limited mobility, and those deployed by the military. Through
the use of real-time audio-visual interaction, imaging, and store-and-forward systems, a greater proportion of neurologists
are able to meet the demand for specialty care in underserved communities, decrease the response time for acute stroke
assessment, and expand the collaboration between primary care physicians, neurologists, and other disciplines. The
American Stroke Association has developed a defined policy on teleneurology, and the American Academy of Neurology
and federal health care policy are beginning to follow suit. Teleneurology is an effective tool for the rapid evaluation of
patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural
areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be
better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in
physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into
further areas of neurology.
Am J Psychiatry. 2013 Mar 1;170(3):256-62. doi: 10.1176/appi.ajp.2012.12081064.
Telepsychiatry: videoconferencing in the delivery of psychiatric care.
Shore JH.
The provision of psychiatric treatment via live interactive videoconferencing, frequently termed telepsychiatry, is a viable
option for psychiatrists to provide care to individual patients, populations, and communities faced with limited access and
to move the point of care delivery into patients' living environments. Psychiatric providers new to videoconferencing
should not be intimidated by the technology or its encompassing logistics, but they do need to develop an awareness of
the salient regulatory, administrative, and clinical issues that arise in the practice of videoconferencing-based
telepsychiatry. This article provides an overview of the current evidence base in telepsychiatry and reviews administrative
and clinical issues in videoconferencing-based treatment. These points are then highlighted in a case example.
PMID: 23450286 [PubMed - indexed for MEDLINE]
11
Model construction for the intention to use telecare in patients with chronic diseases
Huang J.-C., Lee Y.-C.
Int. J. Telemed. Appl. 2013 :
Embase
Objective. This study chose patients with chronic diseases as study subjects to investigate their intention to use telecare.
Methods. A large medical institute in Taiwan was used as the sample unit. Patients older than 20 years, who had chronic
diseases, were sampled by convenience sampling and surveyed with a structural questionnaire, and a total of 500 valid
questionnaires were collected. Model construction was based on the Health Belief Model. The reliability and validity of the
measurement model were tested using confirmatory factor analysis (CFA), and the causal model was explained by
structural equation modeling (SEM). Results. The priority should be on promoting the perceived benefits of telecare, with
a secondary focus on the external cues to action, such as promoting the influences of important people on the patients.
Conclusion. The findings demonstrated that patients with chronic diseases use telecare differently from the general public.
To promote the use and acceptance of telecare in patients with chronic diseases, technology developers should prioritize
the promotion of the usefulness of telecare. In addition, policy makers can strengthen the marketing from media and
medical personnel, in order to increase the acceptance of telecare by patients with chronic diseases. © 2013 Jui-Chen
Huang and Yii-Ching Lee.
Current status and future perspectives regarding telemedicine in the management of chronic noncancer pain (CNCP): A
systematic review of the literature
Ni X., Raza U., Wang W., Raik B., Reid M.C.
J. Am. Geriatr. Soc. 2013 61: (S166)
Embase
Introduction: CNCP constitutes a significant public health problem. Advancing age is an important risk factor for under
treatment of pain, providing strong support for efforts to address this problem. Telemedicine is a rapidly emerging field
with potential to enhance communication channels, monitor for symptom improvement and adverse effects, and provide
access to pain management resources. We conducted a systematic literature review to determine what is known about
telemedicine and its impact on CNCP management. Methods: Extensive bibliographic searches (January 1970 through
July 2012) were conducted to identify English-language articles that evaluated the use of telemedicine among adults with
CNCP. Two investigators independently abstracted key information from retained articles to include sample
characteristics (e.g., subject age), estimates of treatment effect, and other relevant outcomes when present. Results: The
search yielded 1317 citations, of which 35 were retained. Most studies (49%) focused on internet-based training, the rest
on smart phone applications and videoconferencing. A majority (66%) were randomized controlled trials. Mean sample
size was 124 (6-593), average study duration was 6 months (5 days - 18 months), and mean subject age was 47 (18-86).
None of the studies enrolled an exclusively older patient population. Most studies (83%) focused on nonspecific chronic
musculoskeletal pain, including neck, shoulder, and back pain. Over 85% of the studies reported that telemedicine was
effective in pain management and/or could play an effective role in monitoring pain symptoms. A majority of the studies
(54%) showed that study subjects were also satisfied with the use of telemedicine in CNCP management. Over half
demonstrated decreased patient pain level and increased awareness of pain conditions with telemedicine use.
Conclusions: The use of telemedicine in CNCP management has the potential to enhance patient satisfaction, improve
pain levels, and increase patient awareness of their pain conditions. Future studies need to determine the effect of
telemedicine on pain care among geriatric populations.
Supporting family members of people with traumatic brain injury using telehealth: a systematic review.
Rietdijk R., Togher L., Power E.
J Rehabil Med 2012 44:11 (913-921)
MEDLINE
To describe the effectiveness of using telehealth programs to provide training or support to family members of people with
traumatic brain injury. Systematic review. Intervention studies were identified by searching Medline, CINAHL, PsycINFO,
Web of Science, Scopus, the Cochrane library, Embase, PsycBITE and ProQUEST. Studies included in the review
reported an intervention involving family members of adults or children with traumatic brain injury, delivered at a distance
through use of technology (including telephone, websites or video-conferencing). Reliability of inclusion of studies in the
review was high (Kappa = 0.816) based on a second reviewer evaluating a random sample of 25% of the 830 references
originally identified from the database search. Data describing the participants, interventions and outcomes were
extracted from each study. The quality of studies was evaluated using the PEDro-P scale. The review identified 7
randomised controlled trials, 4 non-randomised controlled trials and 5 case series studies. The studies involved a variety
12
of program formats and intervention targets. All but one study reported positive outcomes of the telehealth programs,
however very few studies used blinded assessors. Telehealth programs for family members of people with traumatic brain
injury are feasible, with positive outcomes reported. Further research is needed to strengthen the evidence for the use of
telehealth in comparison to face-to-face interventions, and to provide information to guide clinical decision-making.
Abstracts from The American Telemedicine Association Eighteenth Annual
International Meeting and Exposition
Telemedicine and e-Health. May 2013, 19(5): A-1-A-134.
Guest Editorial: Compelling Issues in Telemedicine
Rashid L. Bashshur
Telemedicine and e-Health. May 2013, 19(5): 330-332
Sustaining and Realizing the Promise of Telemedicine
Rashid L. Bashshur, Gary Shannon, Elizabeth A. Krupinski, Jim Grigsby
Telemedicine and e-Health. May 2013, 19(5): 339-345.
The Office for the Advancement of Telehealth
Sherilyn Pruitt
Telemedicine and e-Health. May 2013, 19(5): 346-348.
Telemedicine in an Academic Center—The Arizona Telemedicine Program
Elizabeth A. Krupinski, Ronald S. Weinstein
Telemedicine and e-Health. May 2013, 19(5): 349-356
Telehealth at UC Davis—A 20-Year Experience
Thomas S. Nesbitt, Madan Dharmar, Jana Katz-Bell, Gunnar Hartvigsen, James P. Marcin
Telemedicine and e-Health. May 2013, 19(5): 357-362.
Center for Telehealth and Cybermedicine Research, University of New Mexico
Health Sciences Center: A Model of a Telehealth Program Within an Academic
Medical Center
Dale C. Alverson, Denise Dion, Margaret Migliorati, Adrian Rodriguez, Hannah W. Byun, Glen Effertz, Veronica Duffy,
Telemedicine and e-Health. May 2013, 19(5): 368-372.
The Ontario Telemedicine Network: A Case Report
Edward M. Brown
Telemedicine and e-Health. May 2013, 19(5): 373-376.
J Head Trauma Rehabil. 2012 Nov-Dec;27(6):424-32. doi: 10.1097/HTR.0b013e31823346fc.
In-person versus telehealth assessment of discourse ability in adults with traumatic brain injury.
Turkstra LS, Quinn-Padron M, Johnson JE, Workinger MS, Antoniotti N.
To compare in-person versus telehealth (TH) assessment of discourse ability in adults with chronic traumatic brain injury
PARTICIPANTS:
Twenty adults with moderate-to-severe TBI.
METHOD:
Participants completed conversation, picture description, story-generation, and procedural description tasks. Sessions
were video-recorded and transcribed.
RESULTS:
Significant differences between conditions were not detected in this sample, and feedback from participants was positive.
CONCLUSIONS:
13
These preliminary results support the use of TH for the assessment of discourse ability in adults with TBI, at least for
individuals with sufficient cognitive skills to follow TH procedures.
PMID: 22190010 [PubMed - indexed for MEDLINE]
Challenges and questions upon a new practice: The interest of telepsychiatry for care
Intérêt de la télé-psychiatrie pour la prise en charge des patients : Enjeux et questions d'une pratique nouvelle
Astruc B., Henry C., Masson M.
Ann. Med.-Psychol. 2013 171:2 (61-64)
Objectives: Telemedicine grows differently among the different specialties. Tele-psychiatry, one of the earliest applications
of telemedicine, is struggling to find its full place in patient care, and is often seen only as a geographical distances
stopgap. The main objective of this paper is to summarize the stakes of this new practice and to put some answers to the
question of its place in our current practices. Materials and methods: Literature review focused on patient satisfaction and
comparison with the practice of face-to-face. Review of international recommendations on the practice of tele-psychiatry.
Reminder of its ethical, professional and legal framework in France. Results: The use of video-consultation appears to
improve access to care, may serve to promote patient education, to avoid unnecessary travel to the patient or therapist.
Patient satisfaction appears identical to the face-to-face practice. Conclusions: Tele-psychiatry, used and disclosed
appropriately, can greatly contribute to improve care in numerous fields: consultation-liaison psychiatry, accessibility to
overspecialised consultations, continuing education of physicians. © 2012 Elsevier Masson SAS.
Telemedicine service use: a new metric.
Mars M., Scott R.
J. Med. Internet Res. 2012 14:6 (e178)
Policy makers and funding agencies require relevant information on current practices of the use of telemedicine
infrastructure and services. Several metrics have been used to describe average use of telemedicine services. None are
adequate. To identify and assess a new metric-consultations per site per week (C/S/W). To determine existing usage, all
papers and abstracts published between January 2005 and December 2009 in the Journal of Telemedicine and Telecare
and Telemedicine Journal and eHealth were reviewed. Pilot studies, research projects, services reporting less than one
year's data and teleradiology services were excluded. In total, 210 reports of telemedicine services were identified, 77 of
which provided sufficient data to calculate C/S/W. Average use was low, 1.8±3.5 (median 0.7) C/S/W, with 61% of
services reporting less than 1 C/S/W and 71% reporting 2 or fewer C/S/W. Studies reporting on data from 2006 to 2009
showed less use (average 1.5±2.3; median 0.7 C/S/W) than earlier reports from 1996 to 2005 (1.7±2.5; median 0.7
C/S/W). The use of this new metric, C/S/W, is proposed as a standard measure of telemedicine service use. The
generally low results opens debate about how well current clinical services are used.
High definition 3D telemedicine: The next frontier?
Stranieri A., Collmann R., Borda A.
Stud. Health Technol. Informatics 2012 182: (133-141)
Evidence from the literature indicates that the degree of immersion often referred to as the "sense of being there"
experienced by clinicians and patients is a factor in the success of tele-health installations. High definition and 3D
telemedicine offers a compelling mechanism to achieve a sense of immersion and contribute to an enhanced quality of
use. This article surveys HD3D trials in tele-health and concludes that the way HD3D is integrated into telemedicine
depends on the clinical, organisational and technological context. In some settings real time HD3D is not so desirable
whereas asynchronous transmission of HD3D images and videos is highly desirable. © 2012 The authors and IOS Press.
Tales of Telemedicine—Telepsychiatry at Work - Editorial
Ronald C. Merrell, Charles R. Doarn
Telemedicine and e-Health. April 2013, 19(4): 233-234.
La Veille en téléréadaptation est une initiative du Comité de développement des pratiques cliniques en
téléréadaptation, coordonné par Johanne Lambert, chargée de projet (IRDPQ)
Recherche documentaire effectuée par Ann Murchison, bibliothécaire, CIGI, IRDPQ
Sélection réalisée par Geneviève Bastien, physiothérapeute et coordonnatrice clinique au Programme des grands
brûlés de la Direction des services à la clientèle adultes-aînés, Louis Deschênes, spécialiste en réadaptation
visuelle au Programme de déficience visuelle de la Direction des services à la clientèle et Ann Murchison,
bibliothécaire
14