Browsing by Author "Caffery, Liam J"
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- ItemDirect-to-consumer mobile teledermoscopy for skin cancer screening: Preliminary results demonstrating willingness-to-pay in Australia.(0000-00-00) Snoswell, Centaine L; Whitty, Jennifer A; Caffery, Liam J; Loescher, Lois J; Gillespie, Nicole; Janda, MonikaIntroduction Internationally teledermoscopy has been found to have clinical and economic efficacy This study aims to identify the attributes of a mobile teledermoscopy service that consumers prefer This preliminary study was set within a broader randomised control trial RCT investigating the effectiveness of direct to consumer mobile teledermoscopy Methods We undertook a discrete choice experiment DCE The DCE comprised 24 choice sets divided into in two blocks of 12 For each choice set respondents were asked to make discrete choices between two opt out choices and two skin cancer screening service options described by seven attributes A mixed logit model was used to estimate preferences for skin cancer screening services Consumer preferences weights were used to calculate marginal willingness to pay WTP for skin cancer screening services Results The DCE was completed by 113 consumer respondents Consumers preference for dermatologist involvement in their diagnosis increased accuracy and reduced excisions were all statistically significant in driving choice between service models Consumers preferred having a professional involved in their skin cancer screening rather than performing a self examination Consumers were only WTP 1 18 to change from a GP visit to mobile teledermoscopy diagnosis using a phone camera However they were WTP 43 to have their results reviewed by a dermatologist rather than a GP and 117 to increase the chance of detecting a melanoma if it was present from 65 75 to 95 Conclusion Skin cancer screening services which are delivered by health professionals rather than skin self examination are preferred by consumers Consumers were willing to pay for their preferred skin cancer screening method especially if a dermatologist was involved
- ItemHow telehealth facilitates the provision of culturally appropriate healthcare for Indigenous Australians.(0000-00-00) Caffery, Liam J; Bradford, Natalie K; Smith, Anthony C; Langbecker, DanetteIntroduction The aim of this study was to explore how telehealth facilitates or impedes the provision of culturally appropriate healthcare to Indigenous Australians from the perspective of staff at an Aboriginal Community Controlled Health Service ACCHS Methods An exploratory qualitative study was performed Semi structured interviews were conducted with nine ACCHS staff Interview transcripts were analysed using thematic analysis Results One central theme and three sub themes were identified The central theme of Care provided in a supportive environment describes how telehealth enabled specialist consultations to be conducted in the safe environment of an ACCHS instead of a mainstream health service The first sub theme described how telehealth improved affordability and convenience and brought a reduction in the stress of healthcare The second sub theme explained the importance of the presence of an Indigenous health worker to facilitate culturally appropriate healthcare The third sub theme described how telehealth supported a holistic view of health Discussion Our findings show culturally appropriate healthcare may be enhanced by the use of telehealth because it allows care to be provided in the supportive environment of an ACCHS It allows the community member to have the advocacy and assistance of an Indigenous health worker and reduces the burden of travel and dislocation from community and family
- ItemA literature review of email-based telemedicine.(2010-12-30) Caffery, Liam J; Smith, Anthony CA structured analysis of peer reviewed literature about the delivery of health services by email was undertaken for this review A total of 185 articles were included in the analysis These articles were thematically categorised for medical specialty participants sub topic study design and service delivery application It was shown that email based telemedicine can be practiced in a large number of medical specialties and has application in primary consultation second opinion consultation telediagnosis and administrative roles e g e referral Email has niche applications in low bandwidth image based specialties e g dermatology pathology wound care and ophthalmology where attached digital camera images were used for telediagnosis Diagnostic accuracy of these images was the predominant topic of research and results show email as a valid means of delivering these medical services Email is also often used in general practice as an adjunct for face to face consultation Further a number of organisations have significantly improved the efficiency of their outpatient services when using email as a triage or e referral system Email based telemedicine provides specialist medical opinion in the majority of reviewed services and is most likely to be instigated by the patient s primary care giver However email consultations between patient and primary care and patient and secondary care are not uncommon Most email services are implemented using ordinary email However a number of organisations have developed purpose written email applications to support their telemedicine service due to impediments of using ordinary email These impediments include lack of management tools for the allocation and auditing of cases for a timely response and the co ordination of effort in a multi clinician multi disciplinary service The ability to encrypt ordinary email thereby securing patient confidentiality is also regarded as difficult when using ordinary email Hence alternative web based email applications where the encryption can be implemented using the more user friendly HTTPS have become popular Much of the reviewed literature is descriptive or anecdotal and hence suffers from lack of conclusive results regarding positive patient outcomes This may account for email based telemedicine generally being regarded as underutilised However the potential is well recognised
- ItemTelemedicine--a bibliometric and content analysis of 17,932 publication records.(2014-08-27) Armfield, Nigel R; Edirippulige, Sisira; Caffery, Liam J; Bradford, Natalie K; Grey, Joanne W; Smith, Anthony CWe aimed to provide an up to date contemporary bibliometric view of the telemedicine and telehealth literature and a longitudinal analysis of changes in content themes
- ItemTelementoring for hepatitis C treatment in correctional facilities.(0000-00-00) Neuhaus, Maike; Langbecker, Danette; Caffery, Liam J; Taylor, Monica; Garner, Lisa; Williams, Gayle; Smith, Anthony C; Macdonald, Graeme AIntroduction Prevalence of hepatitis C virus HCV is substantially higher among prisoners than the general population In Australia until recently only a small proportion of prisoners with HCV received antiviral therapy The direct acting antivirals DAAs for HCV are highly effective with a low burden of side effects Since 2016 DAAs are available to all Australians with HCV However currently in Australia they can only be prescribed by or in consultation with experienced prescribers This study evaluated a telementoring service to upskill doctors and nurse practitioners working in correctional facilities Methods The telementoring service was implemented in five correctional facilities Qualitative interviews were used to examine the perceived clinical effectiveness and organisational impacts of the service Content analysis of the interviews was used to identify key themes Results In the first ten months of the service there were 16 telementoring sessions with 173 patients discussed Sixteen staff participated in qualitative interviews From these three key themes were identified access to antiviral therapy organisational impacts cost increased staff knowledge and confidence staff time and workload and adaptations of the care model and future opportunities Conclusion Telementoring is an effective method to facilitate eligible prescriber status to medical doctors and upskill other clinicians in correctional facilities to increase capacity to treat HCV
- ItemA transmission security framework for email-based telemedicine.(2010-12-30) Caffery, Liam J; Smith, Anthony CEncryption is used to convert an email message to an unreadable format thereby securing patient privacy during the transmission of the message across the Internet Two available means of encryption are public key infrastructure PKI used in conjunction with ordinary email and secure hypertext transfer protocol HTTPS used by secure web mail applications Both of these approaches have advantages and disadvantages in terms of viability cost usability and compliance The aim of this study was develop an instrument to identify the most appropriate means of encrypting email communication for telemedicine A multi method approach was used to construct the instrument Technical assessment and existing bodies of knowledge regarding the utility of PKI were analyzed along with survey results from users of Queensland Health s Child and Youth Mental Health Service secure web mail service The resultant decision support model identified that the following conditions affect the choice of encryption technology correspondent s risk perception correspondent s identification to the security afforded by encryption email client used by correspondents the tolerance to human error and the availability of technical resources A decision support model is presented as a flow chart to identify the most appropriate encryption for a specific email based telemedicine service