Development of infobuttons in a wireless environment.
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At Columbia-Presbyterian Medical Center, a clinical information system (CIS) called WebCIS is used by health care providers. We have developed a palm-based extension to WebCIS, called PalmCIS, which provides physicians access to clinical data through a wireless connection. As part of PalmCIS, we have added links to two on-line information resources: PubMed and Micromedex. (+info)
Modeling virtual healthcare systems: methods for qualitative case analysis and sociometry of institutional infrastructures.
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The objective of this paper is to present a strategy for the qualitative analysis of virtual institutional infrastructures serving complex healthcare systems. Methodologies considered include case analysis, grounded theory, and sociometry. The discussion is illustrated with references to case analyses of diverse healthcare systems. Particular attention is focused on ideological values expressed in market dynamics and system control structures. (+info)
The effects of time delays on a telepathology user interface.
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Telepathology enables a pathologist to examine physically distant tissue samples by microscope operation over a communication link. Communication links can impose time delays which cause difficulties in controlling the remote device. Such difficulties were found in a microscope teleoperation system. Since the user interface is critical to pathologist's acceptance of telepathology, we redesigned the user interface for this system, built two different versions (a keypad whose movement commands operated by specifying a start command followed by a stop command and a trackball interface whose movement commands were incremental and directly proportional to the rotation of the trackball). We then conducted a pilot study to determine the effect of time delays on the new user interfaces. In our experiment, the keypad was the faster interface when the time delay is short. There was no evidence to favor either the keypad or trackball when the time delay was longer. Inexperienced participants benefitted by allowing them to move long distances over the microscope slide by dragging the field-of-view indicator on the touchscreen control panel. The experiment suggests that changes could be made to the trackball interface which would improve its performance. (+info)
Rural health care support mechanism. Final rule; denial of petition for reconsideration.
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In this document, the Commission modifies its rules to improve the effectiveness of the rural health care support mechanism, which provides discounts to rural health care providers to access modern telecommunications for medical and health maintenance purposes. Because participation in the rural health care support mechanism has not met the Commission's initial projections, the Commission amends its rules to improve the program, increase participation by rural health care providers, and ensure that the benefits of the program continue to be distributed in a fair and equitable manner. In addition, the Commission denies Mobile Satellite Ventures Subsidiary's petition for reconsideration of the 1997 Universal Service Order. (+info)
Digital video capture and synchronous consultation in open surgery.
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OBJECTIVE: To achieve real-time or simultaneous surgical consultation and education to students in distant locations, we report the successful integration of robotics, video-teleconferencing, and intranet transmission using currently available hardware and Internet capabilities. SUMMARY BACKGROUND DATA: Accurate visualization of the surgical field with high-resolution video imaging cameras such as the closed-coupled device (CCD) of the laparoscope can serve to insure clear visual observation of surgery and share the surgical procedure with trainees and, or consultants in a distant location. Prior work has successfully applied optics and technical advances to achieve precise visualization in laparoscopy. METHODS: Twenty-five thyroidectomy explorations in 15 patients were monitored and transmitted bidirectionally with audio and video data in real-time. Remotely located surgical trainees (n = 4) and medical students (n = 3) confirmed 7 different anatomic landmarks during each surgical procedure. The study used the Socrates System (Computer Motion, Inc. [CMI], Goleta, CA), an interactive telementoring system inclusive of a telestration whiteboard, in conjunction with the AESOP robotic arm and Hermes voice command system (CMI). A 10-mm flat laparoscopic telescope was used to capture the optical surgical field. As voice, telestrator, or marker confirmed each anatomic landmark the image parameters of resolution, chroma (light position and intensity), and luminance were assessed with survey responses. RESULTS: Confirmation of greater than 90% was achieved for the majority of relevant anatomic landmarks, which were viewed by the remote audience. CONCLUSION: The data presented in this study support the feasibility for mentoring and consultation to a remote audience with visual transmission of the surgical field, which is otherwise very difficult to share. Additionally, validation of technical protocols as teaching tools for robotic instrumentation and computer imaging of surgical fields was documented. (+info)
Education, teleconferencing, and distance learning in respiratory care.
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Among health professions the field of respiratory care (RC) once enjoyed a leadership role in integrating new technologies in teaching, largely because of the excellent match between branching-logic clinical simulations and microcomputer technology. RC can reclaim leadership status by concentrating on effective teaching and the judicious (rather than lavish) deployment of educational technologies. Teleconferencing has been important in RC education, but its role is waning as Internet-based teaching becomes the dominant technology. RC instructors should avoid the media-comparison research pitfall. Research indicates that students who learn at a distance do not learn better or worse than students in traditional classrooms, although student attrition is a serious problem in Internet-based courses. Online courses are time consuming to develop and deploy, effectively serve limited numbers of students per course, and are not suitable for some topics and learners. RC is probably not a good match for courses and programs delivered entirely via the Internet, but RC is an excellent match for Internet-supported courses. Faculty should concentrate on teaching effectiveness, instruction design strategies, and making judicious, conservative used of educational technologies. With or without technology, instructors should develop learner-centered, authentic instruction. In RC education there are abundant opportunities to employ technology, but RC programs will be well served by distilling a detailed vision of effective educational-technology integration, rather than by continuing to pressure programs and faculty to adopt technology without careful consideration of the value added (or subtracted) by each specific technology. (+info)
Ergonomic analysis to characterize task constraint and repetitiveness as risk factors for musculoskeletal disorders in telecommunication office work.
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A modified activity analysis procedure was devised to quantify the presence of two task attributes identified in previous research as contributing to an increase in work demands and ergonomic hazards. The purpose of this study was to develop an exposure index based on the presence of two task attributes. The utility of this job activity analysis will, of course, be determined by the extent to which workers with varying degrees of muscular pain and discomfort correspond to the risk exposure group we have described. The results of both the medical and psychological assessments of the workers--contained in the final HETA report--will be used to assess the utility of our method and determine whether the task attributes of constraint and repetitiveness contribute to the onset of cumulative trauma disorders among clerical workers. (+info)
Predictors of participation in psychosocial telephone counseling following genetic testing for BRCA1 and BRCA2 mutations.
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Although adjunctive educational and psychosocial programs are now being developed for BRCA1 and BRCA2 (BRCA1/2) mutation carriers, limited information is available about whether mutation carriers will want to receive such programs or about the characteristics of individuals who participate. The goals of the present study were to describe rates of completing a psychosocial telephone counseling (PTC) intervention that was offered to female BRCA1/2 mutation carriers and to identify sociodemographic and psychological factors associated with decisions to complete the intervention. Subjects were 66 BRCA1/2 mutation carriers who were randomized to receive a PTC intervention following receipt of genetic test results. Sociodemographic and psychological factors were evaluated before notification of assignment to the PTC intervention. Completion of the intervention was determined from study records. Overall, 75.8% of subjects completed the PTC intervention. Compared to unaffected subjects, those affected with breast and/or ovarian cancer were 76% less likely to complete the intervention [odds ratio (OR) = 0.24, 95% confidence interval (CI) = 0.06, 0.98, P = 0.05]. In addition, subjects with higher levels of cancer-specific distress [OR = 4.74, 95% CI = 1.02, 22.03, P = 0.05] and those with greater perceptions of social support [OR = 5.81, 95% CI = 1.29, 26.16, P = 0.02] were also most likely to complete the intervention. The results of this study suggest that while most BRCA1/2 mutation carriers are likely to complete an adjunctive psycho-educational program, personal history of cancer, cancer-specific distress, and perceptions of social support are likely to influence participation. (+info)