Scope of Telemedicine
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Towards Standards for Management and Transmission of Medical Data in Web Technology
Towards standards for management and transmission of medical data in web technology Dr. Francesco Sicurello President @ITIM – Italian Association of Telemedicine and Medical Informatics (Italy) Medical Informatics Unit, CNR-Institute of Biomedical Technology, Milan Health Directorate, Lombardia Region – Research and Innovation Office Medical record consists in a set of patient health information, related to therapeutical and diagnostic processes of care. It is a clinical history of patient, useful to improve quality of life, to exchange knowledge among physicians and for epidemiological and health surveillance of population risk groups. The medical record is made up of medical information concerning the process of diagnosis and care of a patient; these data are collected during hospitalization or ambulatory visits. It sets up the medical history of each patient and is useful for the physician as a support and as a communication-documentation instrument, for statistical and epidemiological research. In other words, as M.S. Blois stated, “A medical record is what a physician (either in his private office or in the hospital) needs in order to take care of patients. During a patient’s visit, it is common for the doctor to need or want the entire medical record. A clinical database, by contrast, is usually designed for purposes other than patient care (although it can help with this). Thus there are important distinctions that can be drawn between the two. For a better management of patient care, the Electronic Patient Record (EPR) or Electronic Medical Record (EMR) must be complete as possible, containing also biomedical signals and images, video, etc. This constitutes the Multimedia Medical Record (MMR). -
Modern Management of Retinal Disease During the Covid-19 Pandemic
MODERN MANAGEMENT OF RETINAL DISEASE DURING THE COVID-19 PANDEMIC Basic Information 1. Gender: • Female • Male • Prefer not to say 2. Age: • 18-30 years • 31-40 years • 41-50 years • 51-60 years • 60-65 years • >65 years • Prefer not to say 3. In what country are you practicing? ___________________________ 4. Choose all the diseases you have particular expertise in. Please select all that apply: • Age-related macular degeneration • Diabetic retinopathy and maculopathy • Retinal vein occlusions • Myopic maculopathy • Retinopathy of prematurity • Epiretinal membrane • Retinal detachment and tears • Uveitis • Retinal Oncology • Other 5. What is/are your current job position(s)? Please select all that apply: • Attending doctor / Clinician • Clinical academic • Purely academic • Employee at or head of a reading center • Clinical Fellow • Research Fellow • Consultant • Head of a department /Program director • Other 6. What is your level of experience in clinical Ophthalmology? • <5 years • 5-10 years • 11-15 years • >15 years 7. In what sort(s) of institution(s) do you currently work? Please select all that apply: • Tertiary ophthalmology center: stand alone • Tertiary ophthalmology center: department within a hospital • Secondary care: private practice • Academia • Other 8. Does your institution have an electronic health record system? • Yes • No • Combined paper-based and electronic system 9. How would you best describe the current state of the IT infrastructure of your institution compared to international standards in healthcare (i.e. speed of access to imaging, dropout rate, imaging storage capacity)? Very Poor Excellent • • • • • 10. How would you best describe the extent of interdisciplinary work among ophthalmologists and i.e. opticians, optometrists, nurses, technicians in your institution? Very Poor Excellent • • • • • Teleophthalmology Teleophthalmology is a branch of tele-medicine that delivers eye care at a distance, which is then transferred via tele-communication technology to remote eye specialists. -
Telerehabilitation Services
May 2021 Toolkit Series Telerehabilitation Services This toolkit addresses the use of telehealth across the professions of Occupational Therapy (OT), Physical Therapy (PT) and Speech Language Pathology (SLP). Included are aspects of practice as it relates to Occupational Therapists, Certified Occupational Therapy Assistants, Physical Therapists, Physical Therapy Assistants, and Speech Language Pathologists. Each profession uses their professional organizations to establish telehealth guidelines and all are heavily involved in advocating for clinical integration and reimbursement of rehab services. The three professional organizations that cover these professions are: American Physical Therapy Association (APTA), American Occupational Therapy Association (AOTA), and American Speech-Language-Hearing Association (ASHA). All three organizations also participate in and guide the work of the American Telemedicine Association (ATA). The terms telehealth, telerehabilitation, telepractice, virtual, and digital are used throughout this document to represent services delivered remotely using technology. The term “telerehab/telerehabilitation” will be used going forward. While OT, PT and SLP each offer distinct rehabilitation expertise, they are typically addressed together as “rehabilitation services” in the areas of policy and reimbursement. More terms and This toolkit will address telehealth as it applies to common themes of practice for these definitions found in professions while calling out specific uses for each profession and client group served. For in-depth guidance, we direct the reader to resources from each professional Appendix A. organization, state and local licensing entity, and reimbursement sources, as payers’ reimbursement policy impacts each practice area differently. Five Foundational Concepts in Telerehabilitation These five concepts give each therapist a good foundation to begin building services delivered through telehealth. -
TSR Guidelines for the Practice of Teleradiology: 2021 Update*
Diagn Interv Radiol 2021; 27:504-510 GENERAL RADIOLOGY © Turkish Society of Radiology 2021 COMMENTARY TSR guidelines for the practice of teleradiology: 2021 update* Mustafa N. Ozmen ABSTRACT Oğuz Dicle This update of Turkish Society of Radiology’s (TSR) guidelines for the practice of teleradiology Utku Şenol is intended to provide a reference framework for all parties involved in delivering imaging services away from the immediate vicinity of the patient. It includes relevant definitions and Üstün Aydıngöz general principles, features organizational modes and qualifications of the practicing parties, lists technical issues, and addresses such management and legal aspects as archiving and documentation, security and privacy, reliability, responsibilities, quality inspection and im- provement, reimbursement and accountability. uidelines in the form of standards for the practice of teleradiology in Turkey were first published in 2010 (1). This decennial update was prepared in consideration of G the evolving nature of imaging technologies and medical informatics as well as the changing character of the patients’ and public’s demands. These guidelines have been prepared with the aim of providing advice on the appropri- ate use of teleradiology applications, thereby increasing the impact of their contribution to public health. They comprise recommendations and are not intended to fill legal gaps. They are prepared—and expected to be implemented—with a view to highlighting a pa- tient-oriented and good clinical practice approach. The application of other requirements and prerogatives not defined in these guidelines, specific to any clinical situation, is at the discretion of the responsible physician who performs or oversees the radiological service or renders its interpretation. -
Telehealth Resource Webliography for COVID-19 Pandemic
Telehealth Resource Webliography for COVID-19 Pandemic Compiled by Michael Edwards, PhD, Northeast Telehealth Resource Center, January 28, 2021 Look for updates at the NETRC website: pdf For customized help in planning telehealth strategies, contact your regional Telehealth Resource Center: https://www.telehealthresourcecenter.org Topic navigation table (hold Control key with Select) Intro to Telehealth for COVID Pandemic --Ophthalmology General Telehealth Guidelines and Policies, COVID era --Otolaryngology (ENT) Reimbursement Policy Changes with Pandemic --Palliative and hospice care Guidelines and Policies by Specialty, COVID Era --Pediatrics --Cancer care --Pharmacy --Cardiology --Primary care --Critical care --Rehabilitation --Dentistry --Respiratory diseases --Dermatology --Rheumatology --Diabetes care --Surgery --eConsulting --Urology and nephrology --Emergency medicine Relevant Pre-COVID Telehealth Policy Resources --Gastroenterology/hepatology Relevant Pre-COVID Guidelines --Home telehealth/remote monitoring --General --Infectious disease --Specific strategies --Mental/behavioral/psychiatry --Home based services --Neurology/stroke --Infectious disease --Nursing --Critical care --Nursing home care --Emergency medicine --Obstetrics/reproductive and perinatal health --eConsulting Introduction to Telehealth for COVID-19 Pandemic Amorim P, Brito D, Castelo-Branco M, et al. Telehealth opportunities in the COVID-19 pandemic early days: What happened, did not happen, should have happened, and must happen in the near future? Telemed. eHealth [epub ahead of print], December 2020 htm Augenstein J. Opportunities to expand telehealth use amid the coronavirus pandemic. Health Affairs Blog, March 16, 2020 htm Bansal P, Bingemann TA, Greenhawt M, et al. Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist. J. Allergy Clin. Immunol Pract. 8(6): 1781-1790, 2020 htm Barnett J. Army wants help with virtual critical-care services in COVID-19 field hospitals. -
Telepathology: Guidance from the Royal College of Pathologists
Telepathology: Guidance from The Royal College of Pathologists October 2013 Author Professor James Lowe, Chair of the Specialty Advisory Committee on Cellular Pathology Unique document number G026 Document name Telepathology: Guidance from The Royal College of Pathologists Version number 2 Produced by Professor James Lowe, Chair of the Specialty Advisory Committee on Cellular Pathology Date active October 2013 Date for review October 2014 Comments This document supersedes the 2005 publication of the same name, written by Dr Jem Rashbass and Professor Peter Furness on behalf of the Specialty Advisory Committee on Histopathology. In accordance with the College’s pre-publications policy, it was on The Royal College of Pathologists’ website for consultation from 13 February to 13 March 2013. Forty items of feedback were received and the author considered them and amended the document as appropriate. Please email [email protected] if you wish to see the responses and comments. Dr Suzy Lishman Vice-President for Advocacy and Communications The Royal College of Pathologists 2 Carlton House Terrace, London, SW1Y 5AF Tel: 020 7451 6700 Fax: 020 7451 6701 Web: www.rcpath.org Registered charity in England and Wales, no. 261035 © 2013, The Royal College of Pathologists This work is copyright. You may download, display, print and reproduce this document for your personal, non-commercial use. Apart from any use as permitted under the Copyright Act 1968 or as set out above, all other rights are reserved. Requests and inquiries concerning reproduction and rights should be addressed to The Royal College of Pathologists at the above address. First published: 2013 PUB 281013 1 V5 Final Contents 1 Introduction ......................................................................................................................... -
Teleophthalmology: Ready for Prime Time?
Teleophthalmology: Ready for Prime Time? Telemedicine has the potential to transform ophthalmology. But some challenges remain before it can fulfill its promise. By Jean Shaw, Contributing Writer ELEMEDICINE’S TIME HAS COME. THANKS TO MULTIPLE TECHNOLOG- ical advances, the push for more affordable and accessible health care, and the Tgradual expansion of reimbursement for electronic health services, telemedicine is in the process of transforming many medical specialties, including ophthalmology. And while ophthalmologists are no strangers to telemedicine—think of the increas- ingly routine process of store-and-forward transmission of diabetic retinopathy images —they are still coming to terms with what it really means for clinical practice. Any major change in how physicians run their practices has the potential to be a disruptive force, and teleophthalmology is no exception. It touches on all aspects of ophthalmic practice, including training, licensure, and reimbursement. www.aao.org/eyenet. “Successful teleophthalmology programs do exist, and that gives all of us faith that such systems are feasible,” said Michael F. Chiang, MD, at Oregon Health & Science Uni- versity’s Casey Eye Institute in Portland. Yet, despite recent progress, he and other experts note that real-world operational challenges still abound. Changes in Attitudes? Most ophthalmologists are keenly aware that information technology (IT) “has trans- formed the way we communicate with each other and exchange medical information,” Dr. Chiang said. They also express “a need and a desire for teleophthalmology,” he said. And an aging population—with a concomitant rise in diseases such as age-related macular degeneration (AMD)—plus a relatively stable supply of ophthalmologists means that demand for ophthalmic care is outpacing supply. -
Telemedicine Primer
Telemedicine Primer CONTENT Telehealth in Emergency Medicine: A Primer History of Telehealth 2 BY NEAL SIKKA, M.D., FACEP; SARA PARADISE, M.S.I.V.; AND MICHAEL Technology 2 SHU, M.S.I.I., GEORGE WASHINGTON UNIVERSITY SCHOOL OF Modern Applications in Emergency 3 MEDICINE Medicine Telestroke 3 Originally founded in 1998, the telehealth interest section of ACEP Teleradiology 4 brings together emergency medicine practitioners interested in expand- Teletrauma 5 ing patient care into the digital world. While not much has changed Mobile Health & Medical Apps 5 in the ideology behind telehealth since the group’s initial conception, Integration with Quality Drivers 6 improved access to high-speed technology and a greater cultural accep- Security & Risk 7 tance of digital communication is revitalizing the field. The purpose of this paper, therefore, is to re-introduce the concepts of telehealth, e-care, Cost of Telehealth 8 and mobile health in light of recent advances, and give a modern take Reimbursement 8 on its applications within emergency medicine. Challenges & Opportunities 9 This paper will give an overview of the definition of telehealth, its Future Innovation 10 history, current technology, practical uses, cost and reimbursement, quality improvement measures integrated with telehealth, as well as potential risks and opportunities to its use. Definition What exactly is telehealth? Telehealth is a conglomerate of Health I.T. methods used in current medical practice to improve a patient’s health via a two-way communication between a patient and practi- tioner at a distant site.1 This includes practices already prevalent in many emergency med- icine settings, including trauma or stroke neurology consultations via real-time video connections, remote monitoring of patient vitals for ICU patients, and online decision-making aids. -
Roshan's Telemedicine
Case Report Page 1 of 4 Roshan’s telemedicine: expanding the frontier of quality healthcare through mobile technology Shainoor Khoja Roshan, Afghanistan Correspondence to: Shainoor Khoja. Roshan, Afghanistan. Email: [email protected]. Abstract: The article highlights the power of mobile technology in expanding access to quality healthcare by telling the story of the first successful operation by Afghan doctors to separate conjoined twins at The French Medical Institute for Mothers and Children (FMIC) in Kabul, Afghanistan’s capital. Roshan, Afghanistan’s leading telecommunications provider, set up the telemedicine link in 2007, connecting three hospitals in Kandahar, Bamiyan and Badakhshan provinces to FMIC in Kabul, and all three to one of the best and most modern hospitals in the region: The Aga Khan University Hospital in Karachi, Pakistan. Keywords: Technology; telemedicine; healthcare; mobile; Roshan; Afghanistan; telecommunications Received: 18 December 2016; Accepted: 27 February 2017; Published: 23 March 2017. doi: 10.21037/mhealth.2017.02.05 View this article at: http://dx.doi.org/10.21037/mhealth.2017.02.05 Haidar Mohammad is an Afghan farmer who lives with But even if they survived, the conjoined twins would 11 members of his family in a remote village tucked away need specialized care, something that is neither available behind the towering mountains of Shahri Buzurug district in Haidar’s home village nor in most of Afghanistan. The of Badakhshan Province in north eastern Afghanistan. nearest health facility to Haidar is about 40 km away in The province is blessed with pristine natural beauty where Faizabad, the capital of Badakhshan Province. villages are surrounded by mountains that rise as high as Haidar and his wife could go for another option to save 25,000 ft. -
Telerehabilitation for People with Low Vision (Review)
Cochrane Database of Systematic Reviews Telerehabilitation for people with low vision (Review) Bittner AK, Wykstra SL, Yoshinaga PD, Li T Bittner AK, Wykstra SL, Yoshinaga PD, Li T. Telerehabilitation for people with low vision. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD011019. DOI: 10.1002/14651858.CD011019.pub2. www.cochranelibrary.com Telerehabilitation for people with low vision (Review) Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 3 METHODS ...................................... 4 RESULTS....................................... 6 Figure1. ..................................... 7 DISCUSSION ..................................... 8 AUTHORS’CONCLUSIONS . 9 ACKNOWLEDGEMENTS . 9 REFERENCES ..................................... 10 CHARACTERISTICSOFSTUDIES . 12 DATAANDANALYSES. 15 APPENDICES ..................................... 15 CONTRIBUTIONSOFAUTHORS . 17 DECLARATIONSOFINTEREST . 18 SOURCESOFSUPPORT . 18 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . .... 18 INDEXTERMS .................................... 18 Telerehabilitation for people with low vision (Review) i Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [Intervention Review] Telerehabilitation for people with low vision Ava K Bittner1, Stephanie L Wykstra2, -
Pdfs/NEI Factsheet July 3 2015 V2.Pdf
Open access Research BMJ Open: first published as 10.1136/bmjopen-2018-022594 on 18 February 2019. Downloaded from Identification of barriers, facilitators and system-based implementation strategies to increase teleophthalmology use for diabetic eye screening in a rural US primary care clinic: a qualitative study Yao Liu, 1,2 Nicholas J Zupan,1 Rebecca Swearingen,1,2 Nora Jacobson,3 Julia N Carlson,1 Jane E Mahoney,4 Ronald Klein,1 Timothy D Bjelland,5 Maureen A Smith2,6 To cite: Liu Y, Zupan NJ, ABSTRACT Strengths and limitations of this study Swearingen R, et al. Objective Teleophthalmology for diabetic eye screening is Identification of barriers, an evidence-based intervention substantially underused in facilitators and system-based ► We used qualitative methods to capture the re- US multipayer primary care clinics, even when equipment implementation strategies to al-world perspectives of patients and providers increase teleophthalmology use and trained personnel are readily available. We sought regarding barriers and facilitators to teleophthalmol- for diabetic eye screening in to identify patient and primary care provider (PCP) ogy use in a rural US multipayer primary care clinic a rural US primary care clinic: barriers, facilitators, as well as strategies to increase with an active teleophthalmology programme. a qualitative study. teleophthalmology use. BMJ Open ► We identified and categorised implementation strat- 2019;9:e022594. doi:10.1136/ Design We conducted standardised open-ended, egies directly suggested by patients and providers bmjopen-2018-022594 individual interviews and analysed the transcripts using using the Chronic Care Model. ► Prepublication history and both inductive and directed content analysis to identify ► All patients were Caucasian and native English additional material for this barriers and facilitators to teleophthalmology use. -
Telehealth Laws State & Reimbursement Policies
FALL 2019 FALL STATE TELEHEALTH LAWS & REIMBURSEMENT POLICIES A COMPREHENSIVE SCAN OF THE 50 STATES & THE DISTRICT OF COLUMBIA & THE DISTRICT OF THE 50 STATES SCAN A COMPREHENSIVE State Telehealth Laws and Medicaid Program Policies INTRODUCTION The Center for Connected Health Policy’s (CCHP) Fall 2019 release of the “State Telehealth Laws and Reimbursement Policies” report highlights the changes that have taken place in state telehealth policy. The report offers policymakers, health advocates, and other interested health care professionals a summary guide of telehealth-related policies, laws, and regulations for all 50 states and the District of Columbia. While this guide focuses primarily on Medicaid fee-for-service policies, information on managed care is noted in the report if it was available. The report also notes particular areas where we were unable to find information. Every effort was made to capture the most recent policy language in each state as of September 2019. Recently passed legislation and regulation have also been included in this version of the document with their effective date noted in the report (if applicable). This information also is available electronically in the form of an interactive map and search tool accessible on our website cchpca.org. Consistent with previous editions, the information will be updated biannually, as laws, regulations and administrative policies are constantly changing. TELEHEALTH POLICY TRENDS States continue to refine and expand their telehealth reimbursement policies though they are not treated across the board in the same manner as in-person delivered services. Limitations in regards to reimbursable modality, services and location of the patient continue to be seen.