Browsing by Author "Demiris, George"
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- ItemAn analysis of the specialized literature in the field of telemedicine.(2005-09-19) Demiris, George; Tao, DonghuaWe studied all articles in journals specializing in telemedicine and indexed in MEDLINE Non peer reviewed journals or those that were in print for less than five years were excluded The two journals which met the inclusion criteria were the Journal of Telemedicine and Telecare JTT and the Telemedicine Journal and E Health TJE For each article we examined the Medical Subject Heading MeSH terms the country of the first author and the study type In October 2004 there were 1321 articles listed 993 in the JTT 75 and 328 in the TJE 25 The majority of papers were classified as general journal articles the number classified as clinical trials was very low 4 Based on the MeSH term teleradiology was one of the most widely studied application areas 14 The Internet was used in 137 publications 10 as a MeSH term Of all papers 24 were from the USA followed by 21 from the UK and 12 from Australia However 47 countries contributed the other one third of papers 9 country unknown The present study shows that publications in telemedicine cover a wide range both geographically and in terms of clinical disciplines This suggests that the field of telemedicine is maturing
- ItemAssessing home care agencies' readiness for telehealth.(2004-01-19) Demiris, George; Patrick, Timothy; Khatri, NareshHome healthcare is facing a set of challenging new realities in the 21st century such as funding limitations and increased life expectancy Many believe that the use of telehealth enabling patients at home to interact with nurses at the clinical site using videoconferencing technology will be a cost effective solution to providing quality care services Many agencies have adopted or are planning on implementing a telehealth solution Level of agencies readiness can lead to a lower level of risk and a more successful innovation outcome We developed a framework for assessing home care agencies readiness for telehealth consisting of 35 items This instrument can be used as a decision support tool for agencies that are about to implement a telehealth system as well as a formative or summative evaluation tool for agencies already utilizing telehealth
- ItemAssessment of patients' acceptance of and satisfaction with teledermatology.(2004-12-23) Demiris, George; Speedie, Stuart M; Hicks, Lanis LTeledermatology refers to the use of information and communication technologies such as videoconferencing or transmission of digital images to enable the practice of diagnostic dermatology between participants separated by geographic distance The objective of this study was to critically review the quality of evidence about patient satisfaction with teledermatology applications Sample size reporting of validity and reliability used instrument and its underlying constructs were determined for all studies where information was available Fourteen studies were identified five refer to store and forward applications the remaining ones describe video based systems The systematic review demonstrated that methodological deficiencies in the published research impact the generalizability of findings The two types of teledermatology video based and store and forward require different satisfaction instruments as they are based on different contexts of care delivery with video mediated communication being key in the former and patients absence from the diagnostic process in the latter mode of care delivery
- ItemAn assessment of the readiness of hospice organizations to accept technological innovation.(2004-05-28) Oliver, Debra R Parker; Demiris, GeorgeWe surveyed seven of the 62 certified hospice programmes in the state of Missouri The survey consisted of 19 questions that covered demographic information how employees received new information the current use of various forms of technology employees comfort with technology and their perceptions of the use of video phones A total of 124 surveys were returned Respondents were categorized within the following disciplines nurses 48 administrators and nurse supervisors 6 social workers 9 physicians 3 home health aids 18 chaplains 5 and other staff e g clerical and bereavement staff 12 Staff reported using several types of technological device at work but not a video phone or a Web camera There were significant differences between hospices in the degree of use of computers at work the number of devices used at work and the perceived benefits of video phone technology There were significant differences between disciplines in the degree of use of computers at work and at home the number of devices used at work and their comfort both with the use of new technology and with the idea of introducing new technology to patients and their families Because there were variations in the perceived usefulness of video phones for hospice care the introduction of such equipment would require substantial involvement of the users
- ItemCommunication patterns and technical quality of virtual visits in home care.(2003-09-03) Demiris, George; Speedie, Stuart; Finkelstein, Stanley; Harris, IleneTen patients in a home care study received virtual visits from nurses via analogue video phones in their homes They received standard home care services and two virtual visits per week The visits were video recorded and then reviewed The study involved 10 patients and 10 nurses from one urban and three rural home care agencies Six of the patients had congestive heart failure three had chronic obstructive pulmonary disease and one required diabetes related wound care The average age of the patients was 78 years SD 12 All but one lived in rural areas One hundred and twenty two virtual visits were reviewed for technical quality Their mean duration was 21 min range 5 60 The technical quality was given an average rating of 95 range 57 100 There were no technical problems in 78 visits 64 in 10 cases 8 there was difficulty establishing a connection A content analysis of 30 of the visits identified 13 themes such as assessing the patient s clinical status promotion of compliance with medication and treatment psychosocial issues general informal talk and patient education In general the technical problems were minor and did not appear to interfere with care
- ItemA comparison of communication models of traditional and video-mediated health care delivery.(2005-09-26) Demiris, George; Edison, Karen; Vijaykumar, SantoshWhile there may be benefits that accrue to the use of telemedicine technology in patient care such as decreased costs and improved access it has yet to be determined how telemedicine impacts patients ability to express themselves and accordingly how it impacts health care providers communication of instructions or expressions of empathy
- ItemDefining obtrusiveness in home telehealth technologies: a conceptual framework.(2006-07-24) Hensel, Brian K; Demiris, George; Courtney, Karen LThe literature of home telehealth technology recommends that systems be designed to minimize their obtrusiveness to end users However this term is neither explicitly defined nor consistently used This paper presents a definition of the concept of obtrusiveness Within this definition twenty two categories of what may be perceived as obtrusive in home telehealth technology are proposed based on a review of the literature These categories are grouped into eight dimensions This effort represents an initial step toward developing measures of obtrusiveness associated with home telehealth technology A validated and reliable instrument would allow for evaluation of individual applications as well as theory building across applications
- ItemDeveloping the Native People for Cancer Control Telehealth Network.(2011-02-07) Doorenbos, Ardith Z; Demiris, George; Towle, Cara; Kundu, Anjana; Revels, Laura; Colven, Roy; Norris, Thomas E; Buchwald, DedraWe aimed to develop a telehealth network to deliver postdiagnosis cancer care clinical services and education to American Indian and Alaska Native patients their families and their healthcare providers We also sought to identify the challenges and opportunities of implementing such a telehealth based application for this rural and underserved population
- ItemThe diffusion of virtual communities in health care: concepts and challenges.(2006-07-10) Demiris, GeorgeThis paper providers an overview and discussion of virtual communities in health care Furthermore we aim to discuss in this context ethical legal and technical considerations and the current status of research in this domain
- ItemE-health tools and social workers.(2005-04-27) Parker Oliver, Debra; Demiris, GeorgeSocial workers have been using telemedicine technologies since the late 1950 s The use of telemedicine has been most common in mental health practice Psychotherapy using telephones interactive video and more recently the Internet have gained in popularity with social workers in these settings However the use of e health tools in medical social work is limited and worthy of further investigation This paper will report promising projects with medical social workers and discuss the potential application of e health tools for these practitioners The purpose of the paper is to advocate for research measuring effectiveness of e health interventions in social work practice
- ItemElectronic home healthcare: concepts and challenges.(2007-11-30) Demiris, GeorgeTelemedicine in homecare also known as telehomecare THC or electronic home healthcare uses telecommunication and videoconferencing technologies to enable a healthcare provider at the clinical site to communicate with patients in their home Such an interaction is called a virtual visit Numerous applications are utilising commercially available monitoring devices and the internet to enable home based disease management and monitoring Prior to the implementation of telehomecare applications one needs to address issues of accessible design privacy and confidentiality of medical data and reimbursement The evaluation of such applications should focus on their impact on clinical processes outcomes cost of and access to care patients and providers acceptance This paper provides an overview of the concepts and challenges of electronic home healthcare
- ItemEnhancing access to cancer education for rural healthcare providers via telehealth.(2011-11-22) Doorenbos, Ardith Z; Kundu, Anjana; Eaton, Linda H; Demiris, George; Haozous, Emily A; Towle, Cara; Buchwald, DedraHealthcare providers serving rural populations face numerous barriers to accessing educational programming Difficulties accessing continuing professional education contribute to the challenges of providing comprehensive health care in the rural setting Telehealth can inform and educate rural providers about changes in medicine and evidence based practices both of which may help them provide quality care The Native People for Cancer Control Telehealth Network used telehealth technology to deliver a cancer education series in 2008 and 2009 to Washington and Alaska rural healthcare providers who treated American Indians and Alaska Native people Customizing presentation content to providers educational needs encouraged attendance Evaluation indicated videoconferencing technology was positively received for delivery of the educational sessions This series demonstrated videoconferencing was a satisfactory means of delivering real time interactive cancer educational programming to providers who might not otherwise have access to such programs
- ItemEthical considerations for the utilization of tele-health technologies in home and hospice care by the nursing profession.(2006-02-01) Demiris, George; Oliver, Debra Parker; Courtney, Karen LHome care including hospice care is a growing component of the current healthcare system and pertains to care services that are provided to individuals their family members and caregivers in their own residence Both domains face funding limitations as life expectancy and the segment of the population older than 65 years increase Tele health defined as the use of advanced telecommunication technologies to enable communication between patients and healthcare providers separated by geographic distance is perceived as a concept that can enhance both home and hospice care and address some of the current challenges This article discusses ethical challenges associated with the utilization of tele health technologies by the nursing profession in the home setting These factors form a framework for the ethical considerations that result from the introduction of these technologies in nursing practice Specifically the article discusses the issue of privacy and confidentiality of patient data informed consent equity of access promoting dependency versus independence the lack of human touch and the impact of technology on the nurse patient relationship and the medicalization of the home environment These issues constitute a road map both for nursing practitioners who are aiming to provide an efficient delivery of services in the home and for nursing administrators who are asked to make judgments about the use of tele health technology as a supplement to traditional care and as a cost saving tool
- ItemAn evaluation framework for a rural home-based telerehabilitation network.(2005-10-20) Demiris, George; Shigaki, Cheryl L; Schopp, Laura HThis study was a needs assessment to inform the design and evaluation of a home based telerehabilitation network for rural elderly patients We conducted a literature review of telerehabilitation studies and a needs assessment by interviewing 43 professionals including homecare nursing staff members of volunteer organizations and service agencies social workers discharge planners researchers and rehabilitation therapists The survey addressed perceived needs advantages and disadvantages with the use of telemedicine technologies for rehabilitation services All respondents agreed that there are unmet needs among elderly people who are discharged from hospital settings and identified several problems including medication noncompliance isolation limited access to specialists and community based services Our findings defined a framework for the development of a client oriented rural telehealth network that will be used to guide patients discharged to homecare following stroke through a complex array of health mental health and social services spanning all levels of care
- ItemEvidence-based retrieval in E-health.(2005-04-27) Patrick, Timothy B; Demiris, George; Folk, Lillian CIn this chapter we address the issue of standards for information retrieval to support decision making in e health Specifically we consider the issue of evidence based retrieval in the e health domains of the consumer healthcare practitioner healthcare researcher and genomics researcher We present the results of a preliminary study to assess the current state of evidence based retrieval in e health Within this study we reviewed articles in e health and telemedicine to determine the extent to which authors provide details of the information retrieval strategies used as well as evidence of the effectiveness of those strategies We also examined the extent to which the associated journals require authors of reviews to explicitly provide details of information retrieval strategies that they used as well as reporting any evidence for the effectiveness of those strategies
- ItemExamining health care providers' participation in telemedicine system design and implementation.(2007-01-22) Demiris, GeorgeThe study objective was to determine whether the extent of health care providers participation in the design development and implementation of a telemedicine system impacts their overall satisfaction with this system their perception of patients satisfaction and the frequency of system usage Questionnaires were mailed to 156 telemedicine providers and 68 questionnaires were returned User participation in system implementation was strongly correlated to health care providers satisfaction with the telemedicine system r 0 68 pUnder0 001 and the perceived patients satisfaction with the system r 0 72 pUnder0 001 The findings suggest that even if end users cannot be included in the definition and physical design of the system their active inclusion in the implementation stage can still lead to high levels of satisfaction and system usage
- ItemHome based E-health applications.(2005-04-27) Demiris, GeorgeHome based e health applications use telecommunication and videoconferencing technologies to enable a healthcare provider at the clinical site to conmunicate with patients at their home Such an interaction is called a virtual visit Numerous applications are utilizing commercially available monitoring devices and the Internet to enable home based disease management and monitoring The aim to meet older adults desire to remain independent at home while controlling home health care costs has also led to the development of smart home technologies A smart home is a residence equipped with technology that enhances safety of patients at home and monitors their health conditions Therefore the devices and sensors chosen to be installed and maintained in the older adults residences need to address functional limitations and social and health care needs This paper provides an overview of home based e health applications and discusses the challenges of implementing and evaluating e health applications
- ItemHospice staff attitudes towards telehospice.(2004-10-29) Demiris, George; Oliver, Debra R Parker; Fleming, David A; Edison, KarenTelemedicine defined as the use of advanced telecommunication technologies to bridge geographic distance and improve delivery of care is perceived by many as a way to eliminate barriers to quality care at the end of life The use of telemedicine in hospice known as telehospice is a novel approach to such care and few pilot studies have investigated its feasibility The purpose of this study was to assess hospice providers perceptions of telehospice A focus group session was conducted with 10 staff members from five hospice agencies in Missouri Participants included administrators nurses and social workers Overall providers had a positive perception of telehospice and found that the use of videophone technology enhanced care by enabling providers patients and family members a means to communicate However they emphasized that it was an additional tool and not a substitute for actual visits Issues of privacy and usability were also raised
- ItemInformation technology: changing nursing processes at the point-of-care.(2005-11-01) Courtney, Karen L; Demiris, George; Alexander, Greg LChanging societal demographics increasing complexity in healthcare knowledge and increasing nursing shortages have led healthcare strategists to call for a redesign of the healthcare system Embedded within most redesign recommendations is the increased use of technology to make nursing practice more efficient However information technology IT has the potential to go beyond simple efficiency increases If IT is perceived truly as a part of the redesign of healthcare delivery rather than simply the automation of existing processes then it can change nursing processes within institutions and furthermore change the point of care between nurses and patients Nursing adoption of technology within the workplace is a result of the interactions between technical skills social acceptance and workplace culture Nursing needs for information not only influence their adoption of particular technologies but also shape their design The objective of this article is to illustrate how IT can change not only nursing practice and processes but also the point of care A case study of the use of IT by nurses in telehomecare is presented and administrative implications are discussed
- ItemIntegration of telemedicine in graduate medical informatics education.(2003-08-19) Demiris, GeorgeAn essential part of health informatics is telemedicine the use of advanced telecommunications technologies to bridge distance and support health care delivery and education This report discusses the integration of telemedicine into a medical informatics curriculum and specifically a framework for a telemedicine course Within this framework the objectives and exit competencies are presented and course sections are described definitions introduction to technical aspects of telemedicine evolution of telemedicine and its impact on health care delivery success and failure factors and legal and ethical issues The emphasis is on literature review tools practical exposure to products and applications and problem based learning Given the rapid advances in the telecommunication field keeping the course material up to date becomes a challenge for the instructor who at the same time aims to equip students with the knowledge and tools they will need in their future role as decision makers to detect a need for design implement maintain or evaluate a telemedicine application