远程医学信息系统的临床应用

远程医疗是现代远程通讯技术、计算机多媒体技术和现代医学二者紧密结合的产物，它不是一种新的医学科学，而是一种全新的医疗活动。远程医疗的应用范围广泛，其中目前应用最多的是远程医疗会诊。     

基于无线技术的远程病人监护系统

基于无线通信的远程病人监护系统是现代通信技术在医疗领域的最新应用,已经引起越来越多人们的关注。根据监护目的、对象及应用领域的不同对远程监护系统进行了分类,并提出了基于无线传感器网络的远程监护体系结构,最后对基于无线个人域网（wireless personal areanetwork,wPAN）标准的无线通信技术进行概述。该系统可以应用于家庭、社区及医院的远程医疗健康监护,并可以根据需求进行扩展和升级。     

远程医疗在边远地区医疗机构应用可行性和必要性

远程医疗是随着高科技迅猛发展形成的一门新兴学科，它的应用可打破地理区域界限，使广大偏远地区人民将和城市居民一样享受世界各地医疗专家的诊治、健康指导。本文就偏远地区开发远程医疗的可行性和必要性，远程医疗系统运行的环境要求，开展远程医疗的难点，对策及发展前景做了论述。     

产前远程监护电子商务系统结构及模式探讨

为了保障女性妊娠期的安全及胎儿的健康成长，提高人口质量，并且方便孕妇产前检查和减轻医院的门诊负荷，本文初步探讨了孕妇产前检查远程监护电子商务系统的可行性及结构模式。该系统是以电子计算机、电子监护设备及互联网为工具，运用电子商务的结算方式，实现远程的常规产前检查及诊断服务的系统，是不同于远程医疗和传统的电子商务的全新概念，是电子商务在临床医疗服务中的崭新应用，相信产前远程监护电子商务系统概念的提出会为电子商务在其他临床领域的应用提供一个广阔的前蒂。     

家庭心电远程监护系统的新进展

近年来,心血管疾病的发病率呈上升趋势,由于其具有突发性,因此日常对该病的家庭监护显得尤为重要,家庭心电远程监护已成为现代医疗监护发展的一个重要方面.文章主要介绍家庭心电远程监护系统的发展现状,并对未来家庭心电监护系统的发展做一展望.     

基于GPS和GPRS远程医疗监护报警系统的设计*

背景：远程医疗监护系统可以传输医疗信息,实现动态生理监护。 目的：设计一种基于GPS和GPRS的远程医疗监护报警系统。 方法：系统由中心站和多个用户机组成。运用医疗信息监测技术、移动通信技术、嵌入式技术以及GPS技术,由定位传输模块把采集终端实时采集的患者生理信息,连同患者的位置信息一起发送到GSM移动通讯网,供医生进行及时诊断和处理,实现生理参数的远程实时监测与报警。 结果与结论：该系统构建了家庭、社区、医院的三位一体远程医疗信息传输、医疗救治平台,第一时间将患者的医疗信息和位置信息传送到医疗中心,由专家协助诊断并提供救治指导和援助。该系统可用于院前急救、院外监护以及远程医疗与紧急救助,不仅适用于医院、装配在救护车里,也可以用于家庭,对慢性病患者进行有效的院外监测和跟踪。 关键词：远程医疗;移动监护;GPS定位;GPRS通信; Google地球 doi:10.3969/j.issn.1673-8225.2012.13.011     

家庭远程医疗监护数据的传输及处理

介绍了家庭远程医疗监护系统，利用VB编程通过Intemet实现了监护数据的远程传输，医疗中心对接收到的监护数据可以进行去噪、去干扰、特征提取等预处理。在此基础上，实现脑电信号的远程传输，并对医疗中心接收到的脑电信号进行独立成分分析(ICA)分离眼动干扰的处理，取得了较好的效果。     

基于移动远程通信技术的脉搏波无创检测系统

随着生活水平的不断提高,心血管疾病成为威胁人类健康的重要疾病之一。由于医疗资源紧缺,传统到院就诊方式不仅造成了时间、金钱等种种浪费,还降低了医疗品质。本文提出了一种设计,将移动远程通信技术应用于脉搏波无创检测系统中,使其能够在远程上进行应用。该系统在原有脉搏波检测设备的基础上,结合Siemens mc55 GPRS无线通信模块,通过对相关数据的采集、处理、分析、发送、接收,实现对心血管功能无创的检测与远程监测,不仅可以应用于临床,更适合社区以及家庭使用。     

远程医疗信息系统的应用及相关问题

远程医疗信息系统是通过信息网络将分布在不同地点的医学信息源集成到一起，以实现医学信息共享的信息系统。本文综述了目前远程医疗系统在国外的应用状况（包括远程会诊、远程放射学、家庭健康服务）以及发展远程医疗系统面临的技术问题与非技术问题     

应用移动通讯技术设计心电监护系统

远程医疗作为一种病人健康监护手段受到了越来越多的重视。在各类监护参数中，心脏的活动是一个至关重要的生理参数，特别是对患有严重心血管病的病人。为了阻止病人的病情恶化，需要对其进行实时监护。因此，本文提出了一种基于GPRS标准的新型心电图仪系统。这种新型系统，在传统的心电图仪基础上增加了新的功能，能够实时处理病人的信息，使得对病人进行随时随地的监护成为可能。     

Telemedicine: extension to home care.

Although there are multiple challenges facing the use of telemedicine in home health care, it seems likely that they will be resolved. This analysis projects significant increases in productivity and savings to be realized by implementing a telemedicine system (such as the Tevital Home Care System) compared with traditional home care services. Additional savings are expected as a result of the reduction in the utilization of medical services other than home health care. At the same time, telemedicine offers conceivable benefits such as improved access for consumers, extended coverage capability by home health care agencies, decreased inefficiencies attributable to the complications associated with agency personnel travel, improved agency capacity for preventive care, and, ultimately, heightened consumer satisfaction and both physical and psychological well-being. Taken together, these benefits make adoption of telemedicine technology by home care providers highly desirable.     

Telemedicine and rural health care applications

Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication.     

The University of Texas Medical Branch--Texas Department of Criminal Justice Telemedicine Project: findings from the first year of operation.

BACKGROUND: The University of Texas Medical Branch (UTMB) and Texas Tech Health Science Center (TTHSC) are responsible for providing health care for approximately 130,000 inmates of the Texas Department of Criminal Justice through a health maintenance organization (HMO). Telemedicine was considered a way to solve some of the problems presented. OBJECTIVES: To develop approaches to patient care, technology, support systems, evaluation, and uses of the system for applications other than patient care as part of the first stage of implementation. METHODS: Four prison delivery unit models were utilized. After a pilot study, the first patients were seen from October 1994 to November 1995, when 1715 consults were conducted in 18 scheduled specialty telemedicine clinics. Patients and providers were surveyed by interviews and questionnaires for their views on this form of providing care. RESULTS: Ninety-five per cent of the telemedicine consults saved one or more trips to UTMB for outpatient specialty appointments. User surveys indicated a high degree of satisfaction on the part of patients, presenters, and specialty consultants. CONCLUSIONS: Preliminary review of the data indicated favorable care outcomes, and initial economic analyses suggested that telemedicine is likely to be cost-effective in this environment. The project will be continued.     

Public knowledge, perception, and expressed choice of telemedicine in rural West Virginia.

OBJECTIVE: It is doubtful that any new health care delivery system that requires as much adjustment as telemedicine does will be sustained if its users do not fully support it. We sought to determine the familiarity with, perceptions of, and attitudes toward telemedicine among rural adults in West Virginia. METHODS: Data were collected in a statewide telephone survey of 461 non-institutionalized rural adults. The survey contained questions about familiarity with telemedicine, perceptions about its attributes and benefits, and willingness to use it for routine, specialty, and emergency care. Responses were examined in relation to the subjects' age, sex, socioeconomic status, access to care, and insurance coverage. RESULTS: Despite mass media coverage of the subject, only one third of the respondents had heard of telemedicine. Nearly two thirds thought patients would find it less satisfactory than seeing a physician in person. Male subjects, younger subjects, and those with higher incomes were more likely to think telemedicine would be as satisfactory as a face-to-face meeting. There was a general consensus on the benefits of telemedicine, such as greater convenience and easier contact with specialists. For chronic conditions, 47% of the respondents would use telemedicine if no physician was available locally, whereas 27% would go out of town to see another physician in person, and 25% would wait for their own physician. For emergency care, these figures were 41%, 58%, and 0. Three fourths of the respondents were somewhat or very willing to use telemedicine for routine or specialist care. CONCLUSION: More work needs to be done to demonstrate the efficacy of telemedicine and disseminate this knowledge to the public.     

Beyond adoption to sustained use: telemedicine for rural communities.

The objective of this paper is to identify factors that affect the sustained use of telemedicine in rural communities and to suggest possible ways to improve such utilization. We draw on innovation and network theory to develop hypotheses about conditions that will hinder or facilitate sustained use of telemedicine. Telemedicine systems are expected to achieve sustained use in communities with higher physician-to-population ratios, greater availability of nonphysician providers, and greater consumer knowledge of and support for telemedicine. Additionally, telemedicine is more likely to be used in settings where hospital medical staff structures use contractual arrangements that encourage the use of telemedicine or reimburse through capitated systems. Rural physicians are more likely to use telemedicine if they have previous experience in facilities that serve as telemedicine hubs and if they have strong relationships with physicians in a hub location or with local physicians who are supportive of telemedicine. Physicians whose primary offices are geographically closer to the remote telemedicine installation are more likely to order telemedicine consultations for their patients than are their counterparts further away. Also, telemedicine systems that are well managed and easy to use are more likely to achieve sustained utilization by rural physicians. These hypotheses should be considered by supporters, providers, and managers of telemedicine. A proactive approach to managing telemedicine networks, with an emphasis on the issues raised here, should help telemedicine achieve its potential, namely, improved access and enhanced quality and efficiency of health services in rural communities.     

Preparing for change: the plan, the promise, and the parachute.

The University of California's (UC's) medical education programs are on the brink of change. In January 2007, the UC system completed a multiyear health sciences planning effort that is the most comprehensive undertaken in decades. For medical student education, the plan calls for an approximately one-third increase in enrollment across the system -- from approximately 650 current medical school graduates per year to a projected 920 graduates annually by the year 2020. During the same period, California's population is expected to increase in size and diversity in ways unmatched by any other state in the nation.The plan calls for development of new programs that will increase enrollment in unique and unprecedented ways. The first phase of this growth is under way and is planned to continue through a series of programs that seek to address the needs of California's medically underserved communities. Areas of focus include rural health and telemedicine (Davis); the Spanish-speaking Latino community (Irvine); diverse, disadvantaged communities (Los Angeles); health disparities and health equity (San Diego); and the urban underserved (San Francisco and Berkeley). In November 2006, UC medical schools received $200 million in bond funding to support this growth and to create new telemedicine programs to increase access to services provided by faculty physicians. In the coming years, UC medical schools will face demographic and budgetary challenges that will require perseverance, creativity, and certain leaps of faith. Public expectations are high.     

Virtual reality as telemedicine tool: technology, ergonomics and actual applications.

This paper surveys the state of the art in telemedicine applications of virtual environments (VEs) and related technologies for health care. The possible use of VEs as telemedicine tool has attracted much interest in medicine. Actually this technology is commonly used in remote or augmented surgery, and surgical training, which are critically dependent upon eye-hand coordination. Recently, however, different researchers have tried to use VEs in anatomic learning and for the assessment and rehabilitation in neuro-psychology. To date, such applications have improved the quality of health care, and later they will lead to substantial cost savings. Tools that respond to the needs of present VE systems are being refined or developed. However, the possible use of VEs in telemedicine is not linked to the solution of technical problems only. In fact telemedicine is not simply a technology but a complex process whose successful exploitation needs significant attention to ergonomics, human factors and organizational changes in the structure of the relevant health service.     

Telemedicine-a complement to traditional referrals in oral medicine

Abstract Introduction: Introducing telemedicine into clinical practice has not been without difficulties. Within the framework of the European Union project "Health Optimum," telemedicine consultations with specialists at the Department of Oral & Maxillofacial Surgery at Uppsala University Hospital (Uppsala, Sweden) have been offered to dentists in the public dental health service. The aim is to streamline the consultation process, improve/develop the skills of the participating dentists and dental hygienists, and save time and money for patients, healthcare authorities, and society. Subjects and Methods: Patient records are collected in a database for demonstration and discussion, and the system is also available for referrals. Both medical and dental photographs and x-rays are digitized in the same system. These can be viewed during telemedicine rounds and by the consultants at the hospital prior to a consultation. Secure, interactive conferencing software is used, which provides a quick, easy, and effective way to share video and data over the Internet. Both parties can demonstrate different parts of an image using a pointer or a drawing system. Conference phones are presently used for verbal communication. Results: Ten patients were discussed during telemedicine rounds (3 males and 7 females), all of whom would normally have been referred to a specialist. As a result of the telemedicine round, 2 were referred to a specialist, whereas diagnoses were made for the other 8, and treatment was suggested. The dental health clinic could thus provide treatment without the need for referral to a consultant. Conclusions: The telemedicine system described here allows patient care to be provided rapidly and more economically. Future plans include "live" rounds using a videocamera, providing the possibility to relay real-time information about the intraoral situation. A camera is being developed and should preferably be permanently installed chair side.     

Telemedicine: experience at SGPGIMS, Lucknow

Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) located in Lucknow, capital of Uttar Pradesh, a state in Northern India, is a tertiary level referral academic medical center involved in teaching and training of super specialist medical professionals with 22 academic departments. It is the first tertiary care hospital in public healthcare sector in India to adopt Information Technology (IT) for healthcare delivery. The Hospital Information System (HIS) was implemented in 1998 to record, store, process and retrieve health data of all the patients. This software was developed in-house in collaboration with Center for Development of Advanced Computing (C- DAC), Pune. Later in the year 1999, telemedicine activities were initiated in the form of testing the concept and technology. The first research grant was availed of in the year 2001, which helped in creating an infrastructure for telemedicine. Regular tele-healthcare and tele-educational services were introduced for the postgraduate students of medical colleges of Orissa. These services have now been extended to educate the doctors of other medical colleges and community centers in other states. Besides, the Institute is associated with organizational activities and in policy initiatives of the government. All the activities are in project mode and are being financially supported by government agencies such as Indian Space Research Organisation (ISRO) and Department of Information Technology. Looking at the need of skilled manpower in the field of telemedicine and e-health, a school of telemedicine is coming up in the campus, which will also provide core infrastructure for research and development.