Current Issue : April - June Volume : 2018 Issue Number : 2 Articles : 5 Articles
Telemedicine focuses on improving the quality of health care, particularly in out-of-hospital\nsettings. One of the most important applications is the continuous remote monitoring of vital\nparameters. Long-term monitoring of biopotentials requires skin-electrodes. State-of-the-art\nelectrodes such as Ag/AgCl wet electrodes lead, especially during long-term application, to\ncomplications, e.g., skin irritations. This paper presents a low-cost, on-demand electrode approach\nfor future long-term applications. The fully printed module comprises a polymeric substrate\nwith electrodes on a flexible membrane, which establishes skin contact only for short time in\ncase of measurement. The membranes that produce airtight seals for pressure chambers can be\npneumatically dilated and pressed onto the skin to ensure good contact, and subsequently retracted.\nThe dilatation depends on the pressure and membrane thickness, which has been tested up to 150 kPa.\nThe electrodes were fabricated in screen and inkjet printing technology, and compared during\nexemplary electrodermal activity measurement (EDA). The results show less amplitude compared to\nconventional EDA electrodes but similar behavior. Because of the manufacturing process the module\nenables high individuality for future applications....
Telemedicine is the use of Information and Communication Technology (ICT) for clinical\nhealth care from a distance. The exchange of radiographic images and electronic patient health\ninformation/records (ePHI/R) for diagnostic purposes has the risk of confidentiality, ownership\nidentity, and authenticity. In this paper, a data hiding technique for ePHI/R is proposed. The color\ninformation in the cover image is used for key generation, and stego-images are produced with\nideal case. As a result, the whole stego-system is perfectly secure. This method includes the features\nof watermarking and steganography techniques. The method is applied to radiographic images.\nFor the radiographic images, this method resembles watermarking, which is an ePHI/R data system.\nExperiments show promising results for the application of this method to radiographic images in\nePHI/R for both transmission and storage purpose....
Wireless body area networks (WBANs) are widely used in telemedicine, which can be utilized for real-time patients monitoring and\nhome health-care.Thesensor nodes inWBANs collect the client�s physiological data and transmit it to the medical center.However,\nthe clients� personal information is sensitive and there are many security threats in the extra-body communication. Therefore,\nthe security and privacy of client�s physiological data need to be ensured. Many authentication protocols for WBANs have been\nproposed in recent years.However, the existing protocols fail to consider the key update phase. In this paper, we propose an efficient\nauthenticated key agreement scheme for WBANs and add the key update phase to enhance the security of the proposed scheme.\nIn addition, session keys are generated during the registration phase and kept secretly, thus reducing computation cost in the\nauthentication phase. The performance analysis demonstrates that our scheme is more efficient than the currently popular related\nschemes....
Background. Telehealth applications have shown positive effects for people with chronic conditions and their awareness of health.\nObjective. To describe patients� and healthcare personnel�s experiences of using health coaching with online self-management\nin primary health care. Method. A pragmatic randomised controlled trial was conducted. Patients in the intervention group\nmeasured and reported medical parameters such as blood pressure, blood glucose, prothrombin complex (PK) values, and 2-\nchannel ECG. Data were collected through a questionnaire, individual interviews with patients, and focus group discussions\nwith healthcare personnel. The questionnaire was analysed using statistics; texts from interviews and focus groups were analysed\nusing content analysis. Findings. Patients were satisfied and believed that the intervention had enhanced their care and increased\naccessibility without causing concerns about privacy. Although being positive, patients commented the lack of support and feedback\nfrom healthcare personnel. Healthcare personnel regarded the intervention valuable for the patients� abilities to perform selfmanagement\nhealthcare tasks but preferred that patients did so without them supporting the patients. Conclusion. Patients expressed\nsatisfaction and acceptance regarding the use of the application. It seems that healthcare personnel are convinced about the benefits\nfor patients and the potential for the intervention but are not convinced about its benefits for healthcare organisations....
Background: Home telemonitoring is a modern and effective disease management model\nthat is able to improve medical care, quality of life, and prognosis of chronically ill patients, and to\nreduce expenditure. The objective of this study was to evaluate the efficacy, costs, and patientsâ��\nand caregiversâ�� acceptance of our model of telemedicine in a high-risk chronic heart failure (CHF)\nolder population. Methods: Patients with high risk/refractory CHF were included. In the case of\nalarm parametersâ�� modifications, a cardiologist decided to inform the emergency department (ED),\nthe patientâ��s General Practioner, or to programme a clinical ambulatory control. Results: Forty-eight\nCHF patients (28 males; 58.3%), with a mean age of 80.4 �± 7.7 years, entered this clinical experience.\nDuring the 20-months follow-up, four patients dropped out from counselling (8.3%), ambulatory\nclinical control within-24 h was planned in 18% of patients, 11% of patients were admitted to an ED,\nand 18% were hospitalized. Thirteen patients (29.5%) died a cardiac death; hospital admissions for\nheart failure decreased during the year after the enrolment when compared to the year before (from 35\nto 12 acute HF hospitalizations/year; p = 0.0001). Moreover, in these HF patients followed, accesses\nto an ED for an acute episode of HF decompensation reduced from 21/year to five/year (p = 0.0001).\nThe economic expenditure, calculated for the year before and after the enrolment, reduced from\n116.856 Euros to 40.065 Euros/year. Conclusions: A telemedicine surveillance in high-risk older\nCHF patients determines a continuous and active contact between patients/caregivers, the Heart\nFailure Clinic, and family physicians, permitting an early evaluation of signs and symptoms of\nacute decompensation...
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