Interactive home telehealth and burns: A pilot study

Hickey, Sean; Gomez, Jason; Meller, Benjamin; Schneider, Jeffrey I.; Cheney, Meredith; Nejad, Shamim H.; Schulz, John; Goverman, Jeremy

doi:10.1016/j.burns.2016.11.013

Cited by 40 publications

(41 citation statements)

References 7 publications

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“…This highlights another limitation of the proposed protocol: a focus on the early clinical management of burn victims. Future research could examine the impacts of telemedicine on other stages of the care continuum, such as the rehabilitation stage [39].…”

Section: Discussionmentioning

confidence: 99%

Early clinical management of severe burn patients using telemedicine: a pilot study protocol

Moreau

Paré

2020

Pilot Feasibility Stud

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Background: Emergency physicians are responsible for assessing the severity of a patient's burns, which determines whether the patient needs to be transferred to a burn center. Such a proper assessment represents a daunting task because severe burn injuries are rare. Inaccurate estimates often result in unjustified and costly transfers and unneeded fluid resuscitation and assisted ventilation procedures. Telemedicine offers a solution to these challenges. The present pilot study aims to investigate the feasibility, acceptability, and potential value of a large telemedicine initiative at the University of Montreal Health Center's burn center and its network of referring hospitals. Methods: A three-stage study protocol is proposed to achieve this objective. First, a proof of concept phase will assess the technical feasibility of telemedicine at one referring hospital with a high volume of patient transfers. Second, the organizational and human feasibility of the project will be evaluated in four referring medical centers. All teleconsultation sessions will be analyzed using the WHO's telemedicine implementation model. The third phase will consist of evaluating the potential impacts of telemedicine in a subset of 10 referring hospitals. The quality of communications between referring physicians and specialists will be assessed using semi-structured interviews. A pre-test/post-test with a comparison group design will be used to assess the effects of telemedicine on patient transfers, ventilation procedures, patient complications, mortality, length of ICU stay, and additional surgical procedures. The economic viability of telemedicine will be assessed using a cost-minimization approach. Discussion: The telemedicine initiative is expected to yield positive and significant outcomes that are relevant to a wide range of medical centers that already use or are considering using a similar technology. The contribution of this pilot study lies in its ability to reveal technological, organizational, and human barriers and provide a preliminary assessment of the clinical and economic value of a large-scale telemedicine initiative in the context of burn medicine.

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Section: Discussionmentioning

confidence: 99%

Early clinical management of severe burn patients using telemedicine: a pilot study protocol

Moreau

Paré

2020

Pilot Feasibility Stud

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“…Video teleconsultation also shows to be as a safe and viable modality for outpatient care of h burn injuries 30 and in the assessment and treatment of common mental disorders. However, in the latter case, the authors warned about being careful in generalizing the results 23 .…”

Section: Teleconsultation Indicationsmentioning

confidence: 99%

“…However, in the latter case, the authors warned about being careful in generalizing the results 23 . Other studies also indicate the need for future studies 30,34,47 , with a promising potential 37 .…”

Section: Teleconsultation Indicationsmentioning

confidence: 99%

“…Regarding the findings in the literature, two US studies mention that for a teleconsultation to occur, both patient and doctor must have access to a HIPAA-compliant system, that is, certified according to the Health Insurance Portability and Accountability Act (HIPAA) 30,48 . Approved in 1996, the HIPPA -Health Insurance Portability and Accountability Law -establishes a set of rules to protect health information.…”

Section: Data Securitymentioning

confidence: 99%

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Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Catapan

Calvo

2020

Rev. bras. educ. med.

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Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.

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“…It has been found that telemedicine is effective in the management of adult malnutrition [11]; asthma [12]; heart disease [13], diabetes-especially type 2 [14]; arterial hypertension [15] and multiple sclerosis [16]. In addition, positive clinical results have been presented for the patient followup and treatment in different situations such as: (1) burned [17]; (2) in palliative care [18]; (3) with acute cerebrovascular accident [19]; (4) with mental disorders [20]; (5) geriatric [21]; and (6) newborns, children and adolescents [22,23].…”

Section: Telemedicinementioning

confidence: 99%

Toward a Design of a Telerehabilitation Program for the Functional Recovery in Post-Hip Arthroplasty Patients

Esparza¹,

Aladro-Gonzalvo²,

Baldeón³

et al. 2019

Assistive and Rehabilitation Engineering

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Telerehabilitation uses new information and communication technologies as an instrument to ensure a distant rehabilitation service. Patients who underwent hip replacement surgery are an excellent case study for the application of this technology. Post-surgical rehabilitation guidelines for hip arthroplasty are well known, and the correct application has a positive effect on the patients' prognosis. However, there are no complementary guidelines for physical therapy that could be used at a distance by patients through a computer platform. This chapter presents a systematic review about conventional physical therapy programs for hip arthroplasty. Based on this review, we proposed therapeutic exercises adapted to a low cost web-platform. In order to reach this objective we will present a brief review of the total hip arthroplasty, telemedicine, telerehabilitation and conventional physical therapy approaches.

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Interactive home telehealth and burns: A pilot study

Cited by 40 publications

References 7 publications

Early clinical management of severe burn patients using telemedicine: a pilot study protocol

Early clinical management of severe burn patients using telemedicine: a pilot study protocol

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Toward a Design of a Telerehabilitation Program for the Functional Recovery in Post-Hip Arthroplasty Patients

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