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X-ray Vision: Diagnostic X-rays and CT Scans
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
Digital radiography is one reason among many why medicine is becoming increasingly reliant on information technologies; all the imaging technologies discussed in this book similarly produce vast amounts of information that place new demands on hospitals for its storage, distribution, and display. Equally important is establishing standards so images can be shared among a wide variety of different computer programs for treatment and surgery planning, comparison with other imaging methods, etc. Picture Archiving and Storage Systems (PACS) serve this function. PACS define formats for computer files (such as DICOM, for Digital Imaging and Communications in Medicine) that include standards for image information as well as patient records; they help control the sheer size and cost associated with storing such large quantities of information and they interface with other healthcare management software so physicians associated with a patient's case can easily access all relevant scans, for example, even if they are not in the facility that performed the exam. Also, as with other forms of telemedicine, sharing of images via teleradiology means that radiologists can consult with remote colleagues to get expert advice on interpreting challenging cases.
Medical Imaging Informatics
Published in Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam, Introduction to Computational Health Informatics, 2019
Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam
Teleradiology services, used for expert medical consulting since as early as 1947, are often required due to sparse population, radiologist shortage or a need for a more cost-effective radiological reading. Teleradiology offers an opportunity to improve the image interpretation quality through collaboration of specialist clinicians and radiologists. The Internet and PACS have increased the clinicians’ collaboration with their colleagues. Teleradiology now allows small hospitals, clinics, specialty medical practices and urgent care centers to offer coverage not originally possible. Teleradiology is also being adopted for remote monitoring of patients and elderly care from a centralized monitoring station. The computational protocols for the transmission of medical images are explained in Chapter 6.
Telemedicine in South Africa
Published in Richard Wootton, Nivritti G. Patil, Richard E. Scott, Kendall Ho, Telehealth in the Developing World, 2019
Phase One of the National Telemedicine Strategic Plan was implemented between March 1999 and September 2000, establishing 28 telemedicine sites in six of the nine provinces. Telemedicine services offered included store-and-forward teleradiology using scanned X-ray films, tele-ultrasonography (both real-time and store-and-forward), store-and-forward telepathology and tele-ophthalmology. Of these projects, only the teleradiology service linking three rural hospitals with the Pretoria Academic Hospital could really be deemed a success. In the first 9 months of the Pretoria service, 264 radiographic studies (10% of all the studies performed) were sent for specialist radiologist reporting.10 Over the years, this developed into a useful CT scan radiology service with the neurosurgical department, but the service ended when the department moved into a new building with no ISDN line access. Tele-ultrasonography, trialled in the Northern Province and KwaZulu-Natal, was used occasionally and then stopped, and the tele-ophthalmology project in KwaZulu-Natal was beset with software problems and never started.
Curricular needs for training telemedicine physicians: A scoping review
Published in Medical Teacher, 2020
Rebecca G. Stovel, Nadia Gabarin, Rodrigo B. Cavalcanti, Howard Abrams
Telemedicine curricula are aimed at a wide range of physicians. The most common telemedicine curriculum was for telepsychiatry. The WHO lists telepsychiatry as the most common telehealth program with teleradiology, telepathology, remote monitoring, and teledermatology frequently seen (World Health Organization 2016). Our review identified no telepathology and only two teleradiology curricula. Perhaps despite being the more commonly described telehealth programs, telepathology and teleradiology curricula are subject to less frequent publication. Telepathology curricula may not be frequently published because the communication and clinical skills are similar in both traditional and telehealth methods of practice (Di Cerbo et al. 2015). Teleradiology is considered ‘a component of normal working practice in radiology’ (World Health Organization 2016) and was identified by the WHO as the most mature and well-established of the telemedicine disciplines worldwide (World Health Organization 2016). The paucity of published curricula for teleradiology may reflect that it is embedded in routine radiology practice therefore not described independent of other radiology training. Indeed, this notion is supported by one teleradiology curriculum identified in this review in which the curriculum described was embedded into the regular on-call training of the resident (Levine and Lebovitz 2006).
Cost and outcome of a community-based paediatric hearing screening programme in rural India with application of tele-audiology for follow-up diagnostic hearing assessment
Published in International Journal of Audiology, 2018
Vidya Ramkumar, K. R. John, K. Selvakumar, C. S. Vanaja, Roopa Nagarajan, James W. Hall
Our study suggests that integration of remote diagnostic assessment in the community-based hearing screening programme facilitated improved follow-up compliance. Our findings support establishment of large-scale rural hearing screening programmes in resource-constrained areas. Such programmes have the potential to facilitate long-term cost-saving when equipment and human resource costs are kept to minimal levels. Cost saving has been reported in economic analyses of tele-radiology (Roine, Ohinmaa, and Hailey 2001) and also tele-consultation for allied health assessments including speech and language, occupational and physical therapy (Hassall, Wootton, and Guilfoyle 2003) plus tele ENT services for paediatric populations (Xu et al. 2008). When planning a scalable programme, it is important for service providers and policy makers to view cost-outcomes, such as those found in the present study with reference to costs of doing nothing.
Cost-effectiveness of Access to Critical Cerebral Emergency Support Services (ACCESS): a neuro-emergent telemedicine consultation program
Published in Journal of Medical Economics, 2018
Justin Whetten, David N. van der Goes, Huy Tran, Maurice Moffett, Colin Semper, Howard Yonas
Telehealth-enhanced neurosurgical consultation is routinely used in Europe. For example, Fabbri et al.3 showed that observation in a neurosurgical unit or in a peripheral hospital after telehealth-enhanced neurosurgical phone consultation is safe and does not result in worse outcomes. In one of our studies by Moya et al.4, we showed that telehealth-enhanced consultations in New Mexico resulted in care management recommendations or avoided transports in 50% of cases. We saw similar results with our teleradiology program at the Gallup Indian Med. Ctr., where 45% of transfers could be avoided5,6. Implementing this telehealth system in New Mexico will improve efficiency by achieving wider access to effective neuro-emergent care, reducing healthcare costs through appropriate resource management, and improving quality of care at the referral center due to timely expert consultation.