Special Issue "Telemedicine, Telehealth and e-Health: New Frontiers in Medical Practice"

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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 December 2013)

Special Issue Editors

Guest Editor
Prof. Dr. Ronald S. Weinstein
Department of Pathology, Arizona Health Sciences Center, The University of Arizona, 1501 N. Campbell Avenue, Room 1156, PO Box 245105, Tucson, AZ 85724, USA
Website: https://telemedicine.arizona.edu
E-Mail: ronaldw@u.arizona.edu
Interests: telemedicine; telepathology; medical education; cancer research; genitourinary pathology; diagnostic accuracy; medical errors; health literacy

Guest Editor
Prof. Dr. Elizabeth A. Krupinski
Department of Medical Imaging, Arizona Health Sciences Center, The University of Arizona, 1609 N. Warren Bldg 211, Rm 112, Tucson, AZ 85724, USA
Website: http://www.telemedicine.arizona.edu/app/
E-Mail: krupinski@radiology.arizona.edu
Interests: telemedicine; teleradiology; medical image perception; medical decision making; human factors

Special Issue Information

Dear Colleagues,

This special issue of Healthcare will feature invited papers, by experts, on important topics in the fields of telemedicine, telehealth and mHealth (i.e., mobile Health). After a gestation period of a half a century, since the first multi-specialty telemedicine service was created in Boston at the Massachusetts General Hospital in the late 1960s, telemedicine is now reaching its stride as an important and practical way to deliver a broad spectrum of healthcare services to patients. Over 60 subspecialties of medicine and nursing are involved with telemedicine and telehealth. For example, teleradiology has become a standard-of-care for night time coverage in rural and urban hospitals. Telestroke networks may become the next essential “urgent care” service. Telepsychiatry is commonplace in many practice environments. The “smart phone” is being shown to be well suited for use in many mobile telehealth applications. Today, thousands of healthcare apps are being developed, tested and marketed to healthcare providers as well as patients. This special issue of Healthcare will feature original papers by leaders in telemedicine whose work is at the leading edge of this rapidly advancing field.

Prof. Dr. Ronald S. Weinstein
Prof. Dr. Elizabeth A. Krupinski
Guest Editors

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed Open Access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. For the first couple of issues the Article Processing Charge (APC) will be waived for well-prepared manuscripts. English correction and/or formatting fees of 250 CHF (Swiss Francs) will be charged in certain cases for those articles accepted for publication that require extensive additional formatting and/or English corrections.


Keywords

  • telemedicine
  • telehealth
  • mHealth
  • e-Health
  • telepathology
  • teleradiology
  • telestroke
  • telepsychiatry
  • treatment
  • quality of care
  • robotic surgery
  • home-health monitoring
  • telecommunications

Published Papers (4 papers)

Healthcare 2014, 2(2), 192-206; doi:10.3390/healthcare2020192
Received: 18 November 2013; in revised form: 21 March 2014 / Accepted: 24 March 2014 / Published: 15 April 2014
Show/Hide Abstract | Download PDF Full-text (108 KB) | View HTML Full-text | Download XML Full-text

Healthcare 2014, 2(1), 115-122; doi:10.3390/healthcare2010115
Received: 10 December 2013; in revised form: 13 February 2014 / Accepted: 17 February 2014 / Published: 24 February 2014
Show/Hide Abstract | Download PDF Full-text (85 KB) | View HTML Full-text | Download XML Full-text

Healthcare 2014, 2(1), 94-114; doi:10.3390/healthcare2010094
Received: 6 January 2014; in revised form: 31 January 2014 / Accepted: 7 February 2014 / Published: 19 February 2014
Show/Hide Abstract | Download PDF Full-text (287 KB) | View HTML Full-text | Download XML Full-text

Healthcare 2014, 2(1), 74-93; doi:10.3390/healthcare2010074
Received: 10 December 2013; in revised form: 14 January 2014 / Accepted: 7 February 2014 / Published: 12 February 2014
Show/Hide Abstract | Download PDF Full-text (261 KB) | View HTML Full-text | Download XML Full-text

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Type of Paper: Article
Title
: Sustainable University-Based Teleradiology Services: Secrets to Success
Author
: Tim Hunter
Affiliation
: Department of Radiology, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA; E-Mail: hunter@radiology.arizona.edu
Abstract:
This article examines the University of Arizona’s more than 15 year experience with teleradiology and provides an overview of university based teleradiology practice in the United States. In the United States (U.S.) teleradiology is a major economic enterprise with several hundred private for profit companies offering national teleradiology services (professional interpretation of radiologic studies of all types by board certified licensed radiologists). The initial thrust for teleradiology was for after-hours coverage of radiologic studies, but teleradiology has expanded its venue to include routine full-time or partial coverage for small hospitals, clinics, specialty medical practices, and urgent care centers. It also has expanded to provide subspecialty radiologic coverage ordinarily not available at smaller medical centers and clinics. Many U.S. university based academic departments of radiology provide teleradiology services either as part of their academic mission or more commonly as an additional for profit business to supplement departmental income. Since academic based teleradiology providers have to compete in a very demanding marketplace, their success is not guaranteed. They must provide timely high quality professional services for a competitive price. Academic practices have the advantage of house officers and fellows who can help with the coverage, and they have excellent subspecialty expertise. Many academic practices also have sophisticated credentialing and peer review programs to ensure a high quality practice. The marketplace is constantly shifting, and university based teleradiology practices have to be nimble and adjust to ever changing situations.

Type of Paper: Article
Title
: Human Factors in Telemedicine
Author
: Elizabeth A. Krupinski
Affiliation
: Department of Medical Imaging, University of Arizona, 1609 N. Warren Bldg 211 Rm 112, Tucson, AZ 85724, USA; E-Mail: krupinski@radiology.arizona.edu
Abstract:
When designing a facility for telemedicine, there are several things to consider from a human factors point of view as well as from a practicality point of view. Although the future practice of telemedicine is likely to be more of a mobile-based practice and centered more around the home than it is now, it is still very important to consider ways to optimize the design of clinic-based telemedicine facilities. This is true on both ends of a consultation – where the patient is and where the consultant is. On the patient side, the first thing to realize is that most telemedicine clinics are not going to be newly designed and built. In all likelihood they will be existing rooms converted to telemedicine clinic rooms. Quite often the former room will not even have been used for clinical purposes, but may have simply been a storage area cleared out for telemedicine use. Therefore, design is often a challenge but there are a few basic principles that can be followed to create a workable clinical space. This paper will review some of the basic human factors principals to take into account when designing a working telemedicine environment.

Type of Paper: Article
Title
: Standards and Guidelines in Telemedicine and Telehealth
Author
: Elizabeth A. Krupinski 1 and Jordana Bernard 2
Affiliations
:
1
Department of Medical Imaging, University of Arizona, 1609 N. Warren Bldg 211 Rm 112, Tucson, AZ 85724, USA
2
American Telemedicine Association, Washington, DC, USA; E-Mail: krupinski@radiology.arizona.edu
Abstract:
The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations such as the American Telemedicine Association (ATA) have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices as well being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners as a regular part of their clinical practice, and practice guidelines will be a key factor in fostering this growth. This paper will review some of the recent efforts in developing telemedicine practice guidelines, review some of the data regarding their use, and discuss some of the areas where guidelines are still needed.

Type of Paper: Article
Title
: Telemedicine Workplace Environments: From Call Rooms to Workstations to SmartPhones
Author
: Elizabeth A. Krupinski
Affiliation
: Department of Medical Imaging, University of Arizona, 1609 N. Warren Bldg 211 Rm 112, Tucson, AZ 85724, USA; E-Mail: krupinski@radiology.arizona.edu
Abstract:
The clinical environment for the twenty-first century clinician looks very different than it did even a few short years ago. In fields such as radiology and pathology these changes are especially dramatic, as the physical medium within which practitioners have worked as changed dramatically. Radiologists who used to view film on viewboxes and pathologists who used the light microscope to view glass specimen slides are spending a significant amount of time viewing digital images off of computer display monitors. Increasingly they are even interpreting images from mobile devices such as iPads and SmartPhones. There are numerous questions that arise however when deciding exactly what this digital display viewing environment be like. Choosing a workstation or other viewing device for daily use in the interpretation of digital images can be a very daunting task. This paper will review some of the key factors to consider when setting up a digital viewing platform and choosing what type of device to view images on. One major lesson is that there is no “one size fits all” so users must consider a variety of factors. In this article, we summarize some of the potentially critical elements in a workstation and the characteristics one should be aware of and look for in the selection of one. Issues pertaining to both hardware and software aspects of medical workstations will be reviewed particularly as they may impact the interpretation process.

Type of Paper: Article
Title:
Differences in Surgical Pathologists’ Performance Using a Fifth Generation Dual-Imaging Telepathology System
Authors:
Beth I. Braunhut, Achyut K Bhattacharyya, Anna R. Graham, Elizabeth A. Krupinski and Ronald S. Weinstein
Affiliation:
Departments of Pathology and Medical Imaging, and the Arizona Telemedicine Program, College of Medicine, University of Arizona, 1501 N. Campbell Avenue, Rm 5205, Tucson, AZ 85724, USA; E-Mail: rweinstein@telemedicine.arizona.edu
Abstract:
Five generations of telepathology systems have been developed since the introduction of “television microscopy”, the precursor of modern telepathology, introduced for clinical use at the Massachusetts General Hospital in Boston, in 1968. In this study, a fifth generation telepathology system (e.g., dual image system combining static imaging with robotic- dynamic telepathology imaging) was used in a quality assurance (QA) service offered by our University Medical Center for Arizona rural hospitals with memberships in the state-wide Arizona Telemedicine Program. The protocol was to review, by telepathology, all new cancer cases as well as selected difficult non-neoplastic surgical pathology cases, chosen by an on-site rural pathologist. Five rural institutions subscribed to this QA telepathology service. The largest cohort of cases came from a hospital approximately 300 miles to the West of the diagnostic hub at University Medical Center. There were 1815 analytic cases from this rural institution. For a panel of 10 surgical telepathologists, case deferral rates ranged from 4.8 percent to 21.2 percent. Case deferral rates for glass slide re-reviews or additional studies such as immunohistochemistry, generally decreased over a four year period. Video viewing times were longer for telepathology cases that were eventually deferred for glass slide re-review or additional studies. Thus, efficiency in signing out telepathology QA cases varied significantly among the participating pathologists. We suggest that workflow in a telepathology QA program might be optimized by minimizing the participation of pathologists with relatively high deferral rates.

Type of Paper: Article
Title: The Regional Telehealth Ecosystems Authority Management System (RTEAMS™) Strategy: Linking Multiple Diverse Telehealth Service Providers with Patients in Rural Communities
Authors:
Ronald S. Weinstein, Kristine A. Erps and Michael Holcomb
Affiliation:
Department of Pathology and the Arizona Telemedicine Program, College of Medicine, University of Arizona, 1501 N. Campbell Avenue, Rm 5205, Tucson, AZ 85724, USA. E-Mail: rweinstein@telemedicine.arizona.edu
Abstract:
The state-wide Arizona Telemedicine Program’s Regional Telehealth Ecosystem Authority Management System (RTEAMS™) aims at creating and supporting a menu of telehealth services in specific geographic regions of Arizona and beyond. Often, these various telehealth services could be delivered simultaneously by multiple outside telehealth service organizations, such as the University of Arizona Health Network in Tucson, Arizona, or the Mayo Clinic, in Scottsdale, Arizona. Major challenges have been: 1- to create easy-to-use telehealth service platforms which can be flexible enough to accommodate independent healthcare providers competing for telehealth service contracts; and 2- to facilitate easy patient access to a spectrum of needed specialty telehealth services, originating from these independent telehealth service provider organizations. Ideally, the successful RTEAMS™ would offer a seamless and transparent environment in which telehealth services are easily manageable from the perspectives of all of the stakeholders, ranging from telehealth service providers to the patient-consumers. The reality is that patient-consumers, the typical end users of telehealth services, often have limited tools and resources available to them to deal with the inherent complexities of the multi-service, multi-organization telehealth programs that may become available in their regions. The Arizona Telemedicine Program (ATP) has approached these challenges by providing the RTEAMS™’ service aggregators (e.g., often rural hospitals or rural community health centers) with a suite of training programs, platforms and services that can help them seamlessly bundle telehealth services into an integrated package of telehealth services. The ATP’s platforms and services designed to support Arizona’s RTEAMS™ include: access to a university-housed cost-effective broad band dedicated rural healthcare telecommunication network; 24/7 IT (information technology) support; agnostic proprietary branding; centralized training and education programs; facility design services; a flexible business model; and the assistance of neutral brokers of telehealth services drawn from menus of certified telehealth service providers. In Arizona, the success of RTEAMS™ can be attributed, in part, to the State government’s interest in seeing the ATPs’ RTEAMS™ succeed for the mutual benefit of all stakeholders.

Last update: 19 November 2013

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