Unsupervised imaging, registration and archiving of tissue microarrays. (57/1282)

Tissue microarray (TMA) technology offers several advantages over traditional methods of specimen preparation by maximizing limited tissue resources and providing the means for visualizing molecular targets. Currently, the primary methods used to evaluate arrays involves the interactive review of TMA samples while they are viewed by microscope and are subjectively evaluated and scored. The process is slow, tedious and prone to error. In order to facilitate large-scale, multi-institutional studies a more automated and reliable means for processing tissue microarrays is needed. We have developed a web-based prototype which features automated imaging, registration and intelligent archiving of tissue microarrays in multi-user, network environments.  (+info)

Quality management practices in telehealth programs: a stakeholder accountability framework. (58/1282)

Improved technologies, distances between providers and patients, and an emphasis on cost-containment have encouraged the use of telehealth as a method of service delivery. Despite the increased use of this technology, few studies have been conducted on management of telehealth programs. Research on quality management is essential for disseminating and generalizing information on best practices in telehealth programs. This study focused on quality management practices used in telehealth programs, using a Stakeholder Accountability Framework. We propose that different indicators of quality are employed to satisfy the expectations of different internal and external stakeholders. A national survey of telehealth programs (N=93) was conducted in January, 2001. Wide variations in practices were found, with the most notable differences between not-for-profit and proprietary programs. The dimensions illustrated in the Stakeholder Accountability Framework were supported empirically. Implications of differences are examined as they relate to advancing quality in telehealth.  (+info)

WEB-WAP based telecare. (59/1282)

We have developed two telecare applications based on mobile telephony (WAP) and WEB. The first can be used to request Basic Life Support (BLS) guidelines any time by using a WAP device and to teach people and non-professionals involved in health care emergency situations. The second is a WEB-WAP based tool for medical data retrieval and at-home health care monitoring of chronically ill patients with congestive heart failure (CHF) or diabetes. Medical education content related to these diseases is available on the WEB and on the WAP device. The WAP application uses the features found in the last generation of mobile phones such as better multimedia information presentations, better interactivity capabilities, and enhanced ease of use. Based on these two applications, a promising platform is offered for developing applications in health care, home care, medical monitoring and health education ensuring continuity of care. In the paper we present the preliminary results of a pilot test at Thessaloniki University (Greece) where the WEB-WAP based tool is used to monitor patients with diabetes or CHF.  (+info)

Pediatric Cancer CareLink--supporting home management of childhood leukemia. (60/1282)

We conducted a descriptive evaluation of an Internet-based system designed to support home management of childhood leukemia (Pediatric Cancer CareLink). Twenty-five parents of children with ALL and thirty-four clinicians were interviewed to identify functional requirements and to demonstrate the system's potential to improve the experience and outcomes of children with acute lymphoblastic leukemia (ALL). Parental interviews focused on: medication and side effect management in the home; communication with the health care team; and the use of a computer for ALL home management. Results from these interviews provide strong evidence that parents of children with ALL are struggling to manage the complexity of their children's care in the home. Parents revealed an urgent need for tools that would help them to safely organize the medicines that their children receive while on ALL protocols. Forty percent of parents needed to know more about what to expect during their child's therapy and how to be prepared for it. Clinician interviews focused on the clinical impact and workflow issues associated with such a system. Decision support, prescription refill management, and educational and emotional support functions were considered key components. Clinicians were concerned that such a system would increase their already overburdened workload. Conversely, parents believed that access to such a system would eliminate unnecessary phone calls to the care team. Our findings show that parents would embrace collaborative Internet-based tools that would help with the home management of their child's leukemia.  (+info)

Professional's Information Link (PiL): a web-based asynchronous consultation service. (61/1282)

Despite the massive growth of on-line information resources, many clinicians still prefer to obtain information from other clinicians, particularly those to whom they refer patients. Based on this notion and an information needs assessment, we developed the Professional's Information Link (PiL), a Web-based asynchronous consultation service to facilitate question answering between rural clinicians and an academic medical center. The system aims to provide answers to questions within two working days. It also includes patient handouts and continuing medical education resources. Our preliminary evaluation demonstrates modest but enthusiastic use of the system.  (+info)

Agent-based monitoring and alert generation for a home care telemedicine system. (62/1282)

In the present paper, a multi-agent system is proposed, which can be integrated in the home care telemedicine system that was developed in the context of the Citizen Health System (CHS) European project, functioning as a contact center for diabetic and congestive heart failure patients. The objective of the multi-agent system is to provide a set of alert/notification mechanisms for the clinicians, helping them to classify the clinical condition of each patient. Therefore, despite the huge amount of data managed by the system, due to the daily use of the contact center's services, these alert mechanisms provide the clinician with an overview of the cases that need further examination and save him/her time from the trivial cases. The multi-agent system consists of different types of agents, each one assigned with specific tasks, which communicate with each other, in order to share knowledge.  (+info)

Communication infrastructure in a contact center for home care monitoring of chronic disease patients. (63/1282)

The Citizen Health System (CHS) is a European Commission (EC) funded project in the field of IST for Health. Its main goal is to develop a generic contact center which in its pilot stage can be used in the monitoring, treatment and management of chronically ill patients at home in Greece, Spain and Germany. Such contact centers, which can use any type of communication technology, and can provide timely and preventive prompting to the patients are envisaged in the future to evolve into well-being contact centers providing services to all citizens. In this paper, we present the structure of such a generic contact center and in particular the telecommunication infrastructure, the communication protocols and procedures, and finally the educational modules that are integrated into this contact center. We discuss the procedures followed for two target groups of patients where two randomized control clinical trials are under way, namely diabetic patients with obesity problems, and congestive heart failure patients. We present examples of the communication means between the contact center medical personnel and these patients, and elaborate on the educational issues involved.  (+info)

Pilot study optimizing MEDLINE queries in an automated disease management telemedicine system. (64/1282)

Clinicians encounter many medical questions while providing outpatient medical care. A significant number of these questions can be answered using MEDLINE; however it has proven to be difficult to incorporate MEDLINE into routine clinical workflow and for clinicians to generate well constructed MEDLINE queries. This study however hypothesized that that well-constructed MEDLINE queries could be semi-automatically generated by an application named LitButton which was incorporated into the TeleWatch telemedicine system. The LitButton application was then prospectively evaluated in a pilot study by four nurse case managers (NCM) who monitored sixty-eight outpatients for three weeks. During this period the NCMs used the LitButton application sixteen times, and they subjectively reported in real-time that they obtained an answer in 56% of the cases, but that none of the successful information retrieval events resulted in a change in a patient's clinical management. The small number of LitButton events and lack of clinical impact was likely due to the fact that the LitButton function was designed to search MEDLINE for treatment related information; however the NCMs had limited medical decision making responsibilities. As a result there was a mismatch between the user's information needs and the system capabilities.  (+info)