Current Issue : July - September Volume : 2013 Issue Number : 3 Articles : 6 Articles
Home telehealth can improve clinical outcomes for conditions that are common among patients with spinal cord injury (SCI).\r\nHowever, little is known about the costs and potential savings associated with its use.We developed clinical scenarios that describe\r\ncommon situations in treatment or prevention of pressure ulcers. We calculated the cost implications of using telehealth for\r\neach scenario and under a range of reasonable assumptions. Data were gathered primarily from US Department of Veterans\r\nAffairs (VA) administrative records. For each scenario and treatment method, we multiplied probabilities, frequencies, and costs\r\nto determine the expected cost over the entire treatment period. We generated low-, medium-, and high-cost estimates based\r\non reasonable ranges of costs and probabilities. Telehealth care was less expensive than standard care when low-cost technology\r\nwas used but often more expensive when high-cost, interactive devices were installed in the patient�s home. Increased utilization\r\nof telehealth technology (particularly among rural veterans with SCI) could reduce the incidence of stage III and stage IV ulcers,\r\nthereby improving veterans� health and quality of care without increasing costs. Future prospective studies of our present scenarios\r\nusing patients with various healthcare challenges are recommended....
Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods.\r\nFifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640nm\r\nexciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images\r\non site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color\r\nfundus and FAF imaging modalities were recorded. Results. Mean �± SD age was 47.4 �± 17.3 years. Fifty-two percent were female\r\nand 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was\r\n20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15mmHg bilaterally. Positive color and/or FAF findings were\r\nidentified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related\r\nmacular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully\r\nintegrated in our ocular screening programand aided in the identification of ocular pathology. Larger studies examining the utility\r\nof this technology in screening programs may be warranted....
The Patient-Centered Medical Home (PCMH) is a primary care model that provides coordinated and comprehensive care to\r\npatients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary\r\ncare practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA). Individual organizations�\r\nexperiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their\r\nexperiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are\r\nresponsive to the practice and patients� needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic\r\nmedical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out\r\nthe intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many\r\nspecifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this\r\nvagueness as allowing for greater flexibility in how a practice implements PCMH....
Objective.This study chose patients with chronic diseases as study subjects to investigate their intention to use telecare. Methods. A\r\nlargemedical institute in Taiwan was used as the sample unit. Patients older than 20 years, who had chronic diseases, were sampled\r\nby convenience sampling and surveyed with a structural questionnaire, and a total of 500 valid questionnaires were collected.\r\nModel construction was based on the Health Belief Model. The reliability and validity of the measurement model were tested\r\nusing confirmatory factor analysis (CFA), and the causal model was explained by structural equation modeling (SEM). Results.\r\nThe priority should be on promoting the perceived benefits of telecare, with a secondary focus on the external cues to action,\r\nsuch as promoting the influences of important people on the patients. Conclusion. The findings demonstrated that patients with\r\nchronic diseases use telecare differently from the general public. To promote the use and acceptance of telecare in patients with\r\nchronic diseases, technology developers should prioritize the promotion of the usefulness of telecare. In addition, policy makers\r\ncan strengthen the marketing from media and medical personnel, in order to increase the acceptance of telecare by patients with\r\nchronic diseases....
We introduce PERCEPT system, an indoor navigation system for the blind and visually impaired. PERCEPT will improve the\r\nquality of life and health of the visually impaired community by enabling independent living. Using PERCEPT, blind users will\r\nhave independent access to public health facilities such as clinics, hospitals, and wellness centers. Access to healthcare facilities is\r\ncrucial for this population due to the multiple health conditions that they face such as diabetes and its complications. PERCEPT\r\nsystem trials with 24 blind and visually impaired users in a multistory building show PERCEPT system effectiveness in providing\r\nappropriate navigation instructions to these users. The uniqueness of our system is that it is affordable and that its design follows\r\norientation and mobility principles.We hope that PERCEPT will become a standard deployed in all indoor public spaces, especially\r\nin healthcare and wellness facilities....
Purpose. The SenseWear Armband (SWA) is a multisensor activity monitor that can be used in daily life to assess an individualâ��s\r\nphysical activity level (PAL). The primary goal of this study was to analyze the impact of different types of feedback on the PAL\r\nof Flemish employees. Methods/Design. We recruited 320 sedentary employees (age, 41.0 �± 10.7 years; BMI, 26.2 �± 4.2 kg/m2) to\r\nparticipate in the 12-month study. Participants were randomized into one of four intervention groups after being measured for 7\r\ndays and nights by means of the SWA: (1) a minimal intervention group received no feedback (MIG, n = 56); (2) a pedometer\r\ngroup was provided only information on their daily step count (PG, n = 57); (3) a display group received feedback on calories\r\nburned, steps taken, and minutes of physical activity by means of the SWA display (DG, n = 57); (4) a coaching group also received\r\nthe display and had weekly meetings with a Personal Coach (CoachG, n = 57).We hypothesize that participants receiving feedback\r\n(SG, DG, and CoachG) will have a greater increase in physical activity outcome variables compared to participants of the minimal\r\nintervention group....
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