Browsing by Author "Hofmann-Wellenhof, Rainer"
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- ItemCellular phones in clinical teledermatology.(2005-10-18) Massone, Cesare; Lozzi, Gian Piero; Wurm, Elisabeth; Hofmann-Wellenhof, Rainer; Schoellnast, Renate; Zalaudek, Iris; Gabler, Gerald; Di Stefani, Alessandro; Kerl, Helmut; Soyer, H Peter
- ItemConcordance and Time Estimation of Store-and-forward Mobile Teledermatology Compared to Classical Face-to-face Consultation.(2015-01-15) Nami, Niccolò; Massone, Cesare; Rubegni, Pietro; Cevenini, Gabriele; Fimiani, Michele; Hofmann-Wellenhof, RainerSmartphones have overcome the limitations of image quality seen in older devices and opened a new field of telemedicine called mobile teledermatology Technological advances and the need to reduce health service costs will strongly promote the development of telemedicine For this reason we evaluated the concordance between store and forward mobile teledermatology and the classical face to face dermatological visit We also measured the time taken to submit a teleconsultation using a smartphone Before conventional face to face visit a final year resident of the three year course for general practitioners collected medical history took digital images of skin diseases with a smartphone and measuring the time required to complete this operation transmitted them to an expert teledermatologist In 391 patients we obtained a concordance between face to face and store and forward diagnosis of 91 05 Cohen coefficient 0 906 On average only few minutes needs to be added to a normal visit to transmit the cases to an expert teledermatologist
- ItemDesign and development of a mobile computer application to reengineer workflows in the hospital and the methodology to evaluate its effectiveness.(2011-11-29) Holzinger, Andreas; Kosec, Primoz; Schwantzer, Gerold; Debevc, Matjaz; Hofmann-Wellenhof, Rainer; Frühauf, JuliaThis paper describes a new method of collecting additional data for the purpose of skin cancer research from the patients in the hospital using the system Mobile Computing in Medicine Graz MoCoMed Graz This system departs from the traditional paper based questionnaire data collection methods and implements a new composition of evaluation methods to demonstrate its effectiveness The patients fill out a questionnaire on a Tablet PC or iPad Device and the resulting medical data is integrated into the electronic patient record for display when the patient enters the doctor s examination room Since the data is now part of the electronic patient record the doctor can discuss the data together with the patient making corrections or completions where necessary thus enhancing data quality and patient empowerment A further advantage is that all questionnaires are in the system at the end of the day and manual entry is no longer necessary consequently raising data completeness The front end was developed using a User Centered Design Process for touch tablet computers and transfers the data in XML to the SAP based enterprise hospital information system The system was evaluated at the Graz University Hospital where about 30 outpatients consult the pigmented lesion clinic each day following Bronfenbrenner s three level perspective The microlevel the mesolevel and the macrolevel On the microlevel the questions answered by 194 outpatients evaluated with the System Usability Scale SUS resulted in a median of 97 5 min 50 max 100 which showed that it is easy to use On the mesolevel the time spent by medical doctors was measured before and after the implementation of the system the medical task performance time of 20 doctors age median 43 min 29 max 50 showed a reduction of 90 On the macrolevel a cost model was developed to show how much money can be saved by the hospital management This showed that for an average of 30 patients per day on a 250 day basis per year in this single clinic the hospital management can save up to 40 000 EUR per annum proving that mobile computers can successfully contribute to workflow optimization
- ItemDiagnosis and categorization of acral melanocytic lesions using teledermoscopy.(2004-12-17) Piccolo, Domenico; Soyer, H Peter; Chimenti, Sergio; Argenziano, Giuseppe; Bartenjev, Igor; Hofmann-Wellenhof, Rainer; Marchetti, Raffaele; Oguchi, Shinji; Pagnanelli, Gianluca; Pizzichetta, Maria Antonietta; Saida, Toshiaki; Salvemini, Isabella; Tanaka, Masaru; Wolf, Ingrid H; Zgavec, Borut; Peris, KettyWe performed a multicentre study to test the validity of teledermoscopy for diagnosing acral melanoma and to evaluate inter observer agreement on the classification of acral melanocytic lesions Dermoscopic images of 77 acral melanocytic lesions 71 common melanocytic naevi and 6 melanomas were sent by email to 11 dermatologists with different degrees of experience in dermoscopy The observers analysed the images on a computer monitor to diagnose acral melanoma or atypical lesions and to categorize all lesions All 11 observers regardless of their degree of experience obtained high values for sensitivity mean 0 91 SD 0 09 and specificity mean 0 95 SD 0 04 with regard to the diagnosis of melanoma The inter observer agreement was good to excellent kappa 0 49 0 88 for the categorization of acral melanocytic lesions All six melanomas were correctly classified as atypical pattern and all observers recommended surgical excision Teledermoscopy represents a useful tool for the diagnosis of acral melanoma and for the categorization of patterns that suggest benign or potentially malignant acral melanocytic lesions
- ItemMelanoma screening with cellular phones.(2007-05-30) Massone, Cesare; Hofmann-Wellenhof, Rainer; Ahlgrimm-Siess, Verena; Gabler, Gerald; Ebner, Christoph; Soyer, H PeterBACKGROUND Mobile teledermatology has recently been shown to be suitable for teledermatology despite limitations in image definition in preliminary studies The unique aspect of mobile teledermatology is that this system represents a filtering or triage system allowing a sensitive approach for the management of patients with emergent skin diseases METHODOLOGY PRINCIPAL FINDINGS In this study we investigated the feasibility of teleconsultation using a new generation of cellular phones in pigmented skin lesions 18 patients were selected consecutively in the Pigmented Skin Lesions Clinic of the Department of Dermatology Medical University of Graz Graz Austria Clinical and dermoscopic images were acquired using a Sony Ericsson with a built in two megapixel camera Two teleconsultants reviewed the images on a specific web application http www dermahandy net default asp where images had been uploaded in JPEG format Compared to the face to face diagnoses the two teleconsultants obtained a score of correct telediagnoses of 89 and of 91 5 reporting the clinical and dermoscopic images respectively CONCLUSIONS SIGNIFICANCE The present work is the first study performing mobile teledermoscopy using cellular phones Mobile teledermatology has the potential to become an easy applicable tool for everyone and a new approach for enhanced self monitoring for skin cancer screening in the spirit of the eHealth program of the European Commission Information for Society and Media
- ItemMobile phone-based teledermatologic compliance management - preliminary results of the TELECOMP study.(2009-09-11) Hayn, Dieter; Koller, Silvia; Hofmann-Wellenhof, Rainer; Salmhofer, Wolfgang; Kastner, Peter; Schreier, GünterA mobile phone based telemonitoring system for long term psoriasis therapy is described intended to increase patients compliance by optimizing the patient physician communication Patients themselves can acquire health parameters and take photos of their psoriasis lesions The data are sent to a monitoring centre where they are provided to the patients physician who returns a feed back message The system is currently tested in a study with 20 patients Preliminary results prove the feasibility and usabililty of such a system and indicate that it is useful for optimizing psoriasis therapy
- ItemMobile teledermatology: a feasibility study of 58 subjects using mobile phones.(2008-03-05) Ebner, Christoph; Wurm, Elisabeth Mt; Binder, Barbara; Kittler, Harald; Lozzi, Gian Piero; Massone, Cesare; Gabler, Gerald; Hofmann-Wellenhof, Rainer; Soyer, H PeterWe investigated the diagnostic agreement between teledermatology based on images from a mobile phone camera and face to face FTF dermatology Diagnostic agreement was assessed for two teledermatologists TD in comparison with FTF consultations in 58 subjects In almost three quarters of the cases TD1 71 TD2 76 the telediagnosis was fully concordant with the FTF diagnosis Furthermore the diagnosed diseases were almost all in the same diagnostic category TD1 97 TD2 90 If mobile teledermatology had been used for remote triage TD1 could have treated 53 subjects remotely and 47 subjects would have had to consult a dermatologist FTF TD2 could have treated 59 subjects remotely whereas 41 subjects would have had to consult a dermatologist FTF Forty eight subjects responded to a questionnaire of whom only 10 had any concerns regarding teledermatology Thirty one subjects stated that they would be willing to pay to use a similar service in future and suggested an amount ranging from euro5 to euro50 per consultation mean euro22 euro pound0 7 US 1 4 These results are encouraging as patient acceptance and reimbursement represent potential obstacles to the implementation of telemedicine services
- ItemA mobile-phone based teledermatology system to support self-management of patients suffering from psoriasis.(2009-02-16) Schreier, Günter; Hayn, Dieter; Kastner, Peter; Koller, Silvia; Salmhofer, Wolfgang; Hofmann-Wellenhof, RainerPsoriasis is one of the most common chronic skin diseases affecting about 2 of the population world wide Continuous clinical monitoring with periodic assessment of the state of the disease is essential for long term therapy optimization We present a mobile phone based telemedical compliance management system for psoriasis patients Using special software patients can acquire health parameters such as their body weight take photos of their psoriasis lesions and report adverse effects The data are automatically sent to a monitoring centre where they are provided to the patient s physician via the use of a web browser In case of therapy relevant events email or SMS notifications can be sent to the physician If necessary the physician can send feedback messages to the patient e g for admitting the patient to the clinic for further examinations The system has been implemented and functional tests have proven its functionality Currently the system is used in the course of a medical case series
- ItemPilot study on the acceptance of mobile teledermatology for the home monitoring of high-need patients with psoriasis.(2012-02-07) Frühauf, Julia; Schwantzer, Gerold; Ambros-Rudolph, Christina M; Weger, Wolfgang; Ahlgrimm-Siess, Verena; Salmhofer, Wolfgang; Hofmann-Wellenhof, RainerBACKGROUND OBJECTIVES The willingness to be educated is one of the highest desires among patients with psoriasis Therefore a collaborative model of management would appear to be essential in enhancing patient satisfaction in this challenging condition The present study aimed at examining the applicability of a mobile teledermatology service in this regard and assessing the association between patient acceptance and perceived health related quality of life METHODS High need patients with psoriasis performed visits over 12 weeks transmitting clinical images together with some relevant clinical information via mobile phones to teledermatologists who provided treatment instructions Ten patients and two teledermatologists completed 20 item patient weeks 6 and 12 and 10 item physician at week 12 acceptance questionnaires In addition patients answered the dermatology life quality index DLQI at weeks 0 6 and 12 RESULTS Both patients and teledermatologists were pleased with the service with high acceptance rates patients 81 0 at week 6 and 82 9 at week 12 teledermatologists 74 0 In addition 80 of the patients considered the service an alternative to in person consultation and 90 felt they were in good hands but had achieved a more flexible and empowered lifestyle No significant correlations were found between patient acceptance and DLQI Both teledermatologists found the service a convenient and reliable tool for patient monitoring Neither patients nor teledermatologists thought further in person consultations necessary CONCLUSION Mobile teledermatology is a valuable tool for the home monitoring of patients with psoriasis that makes a meaningful difference in their lives It is well accepted by both patients and the physicians involved
- ItemPilot study using teledermatology to manage high-need patients with psoriasis.(2010-02-16) Frühauf, Julia; Schwantzer, Gerold; Ambros-Rudolph, Christina M; Weger, Wolfgang; Ahlgrimm-Siess, Verena; Salmhofer, Wolfgang; Hofmann-Wellenhof, Rainer
- ItemSurvey on the status of teledermatology in Austria.(0000-00-00) Eber, Elena Lucia; Janda, Monika; Arzberger, Edith; Hofmann-Wellenhof, RainerBACKGROUND The use of digital communication media is becoming increasingly important with the primary aim of improving both treatment quality and patients quality of life In an effort to optimize telemedicine in the field of dermatology we conducted a survey among dermatologists in Austria METHODS Statistical analysis of a questionnaire that was developed by a working group and sent to 769 Austrian dermatologists RESULTS Overall 243 dermatologists 132 women 111 men participated in the survey Forty seven percent of male respondents and 55 of female respondents had already received requests for teledermatology consultations Seventy three percent felt that telemedicine was able to contribute to relieving the economic burden on the health care system Telecommunication between dermatologists and experts in a given field of dermatology was deemed to be particularly useful While telemedicine was also considered to be appropriate for patient follow up it was viewed to be less useful for initial consultations Roughly 50 of respondents used telemedicine to get a second opinion one third used it for initial consultations CONCLUSIONS Our survey shows that the majority of participants consider teledermatology to be a useful supplement to the current practice of dermatology Given its particular usefulness for triage purposes teledermatology can help reduce the number of trips to the hospital and subsequent waiting times This in turn leads to cost reduction and saves time for both patients and doctors Legal regulations that include provisions for appropriate reimbursement of physicians would make using teledermatology more attractive
- Itemtelederm.org: freely available online consultations in dermatology.(2005-06-27) Soyer, H Peter; Hofmann-Wellenhof, Rainer; Massone, Cesare; Gabler, Gerald; Dong, Huiting; Ozdemir, Fezal; Argenziano, Giuseppe
- ItemTeledermatological monitoring of leg ulcers in cooperation with home care nurses.(2007-12-18) Binder, Barbara; Hofmann-Wellenhof, Rainer; Salmhofer, Wolfgang; Okcu, Aslihan; Kerl, Helmut; Soyer, H PeterTo examine the feasibility and acceptance of teledermatology for wound management for patients with leg ulcers by home care nurses and evaluate the reduction of costs and the acceptance of teledermatology by patients and home care nurses
- ItemTeledermatological monitoring of psoriasis patients on biologic therapy.(2011-10-26) Koller, Silvia; Hofmann-Wellenhof, Rainer; Hayn, Dieter; Weger, Wolfgang; Kastner, Peter; Schreier, Günter; Salmhofer, WolfgangPatients with psoriasis who are being treated with biologics require intensive monitoring However the monitoring tool teledermatology is not commonly used We investigated the applicability of a mobile phone based teledermatological system for monitoring psoriasis patients on biologic therapy Nineteen patients were given mobile phones with built in cameras in order to transmit health status data and images mobile visits weekly for a 6 month period Face to face visits were carried out at weeks 0 4 12 and 24 Image quality the Psoriasis Area and Severity Index PASI the handling of adverse events and patients feedback questionnaires were evaluated Ninety five percent of the images were of sufficient quality to enable accurate assessment of the PASI The distance between the interpolated face to face PASIs and the corresponding mobile visit PASIs was 0 46 2 15 median interquartile range All 155 adverse events were handled correctly by the system This teledermatological system represents a reliable tool for management of psoriasis patients who are on systemic treatment
- ItemTeledermatology: an update.(2008-05-19) Massone, Cesare; Wurm, Elisabeth M T; Hofmann-Wellenhof, Rainer; Soyer, H PeterDermatology is perhaps the most visual specialty in medicine making it ideally suited for modern telemedicine techniques as has been shown in a number of recent studies investigating feasibility and reliability of teledermatology It has generally demonstrated high levels of concordance in diagnosis and management plans compared with face to face consultations Teledermatology also has been used for various purposes including triage diagnostic and management services and second opinion services for primary care practitioners It has been set up in a number of ways 1 direct referral for primary care using images and clinical history sent to secondary care dermatology services for second opinion and for triage referrals and 2 facilitating community based clinics led by nurses or general practitioners Moreover in the last years new fields in teledermatology have grown up Teledermoscopy is a promising area for melanoma screening as well as for the diagnosis and management of equivocal pigmented skin lesions The feasibility of mobile teledermatology and mobile teledermoscopy recently has been proven and these new facilities have the potential to become an easy applicable tool for everyone and may open the door for a new flexible triage system for detection of skin cancer in general and melanoma in particular The implementation of virtual slide systems for teledermatopathology has allowed avoiding the limitations imposed by conventional microphotography Finally web consultations in dermatology are a rather new tool that became available in the last years and teledermatologic services through the Internet offer many possibilities including continuing medical education on line atlases and databases and specific web application suited for teledermatology ie www telederm org
- ItemTelemedicine and teledermatology: Past, present and future.(2008-02-11) Wurm, Elisabeth M T; Hofmann-Wellenhof, Rainer; Wurm, Robert; Soyer, Hans PeterTelemedicine is an emerging field within medicine with potential to revolutionize the delivery of health care It is defined as the use of telecommunication technologies to transfer medical information Teledermatology is a category of telemedicine Early experiments were already made at the beginning of the 20 th century the breakthrough happened in the nineties because of the rapid progress of telecommunication technology The latest advance is mobile telemedicine which is characterized by the use of mobile devices such as mobile phone and PDA personal digital assistant Advantages of telemedicine are the possibility of remote patient care as well as the easy and fast access to expert opinions and education This can either happen through exchange of previously stored data images store and forward method or in real time Since our society is increasingly becoming interconnected via technical advances it is essential that medicine also has an objective understanding of the topic
- ItemWound teleconsultation in patients with chronic leg ulcers.(2005-03-23) Salmhofer, Wolfgang; Hofmann-Wellenhof, Rainer; Gabler, Gerald; Rieger-Engelbogen, Karin; Gunegger, Dieter; Binder, Barbara; Kern, Thomas; Kerl, Helmut; Soyer, H PeterThe treatment of chronic leg ulcers requires frequent assessments of local wound status and adjustment of therapy The availability of reasonably priced photographic equipment and quick electronic transfer of high quality digital images should make it possible that the assessment of wound status can be made by remote experts