Browsing by Author "Loane, M A"
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- ItemA comparison of real-time and store-and-forward teledermatology: a cost-benefit study.(2001-01-31) Loane, M A; Bloomer, S E; Corbett, R; Eedy, D J; Hicks, N; Lotery, H E; Mathews, C; Paisley, J; Steele, K; Wootton, RIncreasing use of teledermatology should be based on demonstration of favourable accuracy and cost benefit analysis for the different methods of use of this technique Objectives To evaluate the clinical efficacy and cost effectiveness of real time and store and forward teledermatology
- ItemA cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care: results from a randomized controlled trial in New Zealand.(2001-08-16) Loane, M A; Oakley, A; Rademaker, M; Bradford, N; Fleischl, P; Kerr, P; Wootton, RA randomized controlled trial was carried out to measure the societal costs of realtime teledermatology compared with those of conventional hospital care in New Zealand Two rural health centres were linked to a specialist hospital via ISDN at 128 kbit s Over 10 months 203 patients were referred for a specialist dermatological consultation and 26 were followed up giving a total of 229 consultations Fifty four per cent were randomized to the teledermatology consultation and 46 to the conventional hospital consultation A cost minimization analysis was used to calculate the total costs of both types of dermatological consultation The total cost of the 123 teledermatology consultations was NZ 34 346 and the total cost of the 106 conventional hospital consultations was NZ 30 081 The average societal cost of the teledermatology consultation was therefore NZ 279 23 compared with NZ 283 79 for the conventional hospital consultation The marginal cost of seeing an additional patient was NZ 135 via teledermatology and NZ 284 via conventional hospital appointment From a societal viewpoint and assuming an equal outcome teledermatology was a more cost efficient use of resources than conventional hospital care
- ItemMulticentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis.(2000-06-08) Wootton, R; Bloomer, S E; Corbett, R; Eedy, D J; Hicks, N; Lotery, H E; Mathews, C; Paisley, J; Steele, K; Loane, M AComparison of real time teledermatology with outpatient dermatology in terms of clinical outcomes cost benefits and patient reattendance
- ItemThe potential of telemedicine for home nursing in Queensland.(2001-08-16) Black, S; Andersen, K; Loane, M A; Wootton, RThe potential for telemedicine in home nursing was examined by retrospectively reviewing the case notes relating to home visits made by nurses in Queensland The case notes of 166 clients were randomly selected from 10 domiciliary nursing centres run by the Blue Care nursing organization in south east Queensland Two experienced community registered nurses independently undertook a retrospective review of the case notes Each reviewer made an independent judgement as to whether any of the home nursing visits in the episode of care could have been conducted by telemedicine Visits requiring hands on care were deemed to be unsuitable for telemedicine A total of 12 630 home visits were reviewed The median number of visits per client was 27 range 1 722 The mean age of the clients was 72 years range 2 93 years A total of 1521 home visits 12 were judged suitable for telemedicine There was no significant difference in suitability between males 13 and females 12 Care interventions suitable for telemedicine were more likely to be those of a supportive educational or review nature Forty per cent of clients lived up to 5 km from the home nursing centre 33 lived 5 10 km from the centre and 27 lived over 10 km from the centre The results of the present study confirm the potential for telemedicine in home nursing in Australia
- ItemA randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective.(2001-05-07) Loane, M A; Bloomer, S E; Corbett, R; Eedy, D J; Evans, C; Hicks, N; Jacklin, P; Lotery, H E; Mathews, C; Paisley, J; Reid, P; Steele, K; Wootton, RA randomized controlled trial was carried out to measure the cost effectiveness of realtime teledermatology compared with conventional outpatient dermatology care for patients from urban and rural areas One urban and one rural health centre were linked to a regional hospital in Northern Ireland by ISDN at 128 kbit s Over two years 274 patients required a hospital outpatient dermatology referral 126 patients 46 were randomized to a telemedicine consultation and 148 54 to a conventional hospital outpatient consultation Of those seen by telemedicine 61 were registered with an urban practice compared with 71 of those seen conventionally The clinical outcomes of the two types of consultation were similar almost half the patients were managed after a single consultation with the dermatologist The observed marginal cost per patient of the initial realtime teledermatology consultation was 52 85 Pounds for those in urban areas and 59 93 Pounds per patient for those from rural areas The observed marginal cost of the initial conventional consultation was 47 13 Pounds for urban patients and 48 77 Pounds for rural patients The total observed costs of teledermatology were higher than the costs of conventional care in both urban and rural areas mainly because of the fixed equipment costs Sensitivity analysis using a real world scenario showed that in urban areas the average costs of the telemedicine and conventional consultations were about equal while in rural areas the average cost of the telemedicine consultation was less than that of the conventional consultation
- ItemA randomized controlled trial to assess the clinical effectiveness of both realtime and store-and-forward teledermatology compared with conventional care.(2000-05-25) Loane, M A; Bloomer, S E; Corbett, R; Eedy, D J; Hicks, N; Lotery, H E; Mathews, C; Paisley, J; Steele, K; Wootton, RThe clinical effectiveness of realtime teledermatology store and forward teledermatology and conventional outpatient dermatological care were evaluated in a randomized control trial A total of 204 patients took part 102 patients were randomized to the realtime teledermatology consultation 96 of whose cases were also referred using a store and forward technique and 102 to the conventional outpatient consultation There were no differences in the reported clinical outcomes of realtime teledermatology and conventional dermatology Of those randomized to the realtime teledermatology consultation 46 required at least one subsequent hospital appointment compared with 45 of those randomized to the conventional outpatient consultation In contrast the dermatologist requested a subsequent hospital appointment for 69 of those seen by store and forward teledermatology An analysis of costs showed that realtime teledermatology was clinically feasible but more expensive than conventional care while the store and forward teledermatology consultation was less expensive but its clinical usefulness was limited Sensitivity analysis indicated that realtime teledermatology was as economical as conventional care when less artificial assumptions were made about equipment utilization costs and travel distances to hospital
- ItemTelemedicine and cardiopulmonary resuscitation: the value of video-link and telephone instruction to a mock bystander.(2000-07-03) Atkinson, P R; Bingham, J; McNicholl, B P; Loane, M A; Wootton, RWe evaluated cardiopulmonary resuscitation CPR performed by persons with no previous experience on a resuscitation dummy Subjects were randomized into four groups one of which had no instruction The other three groups were instructed for 3 min in mock CPR by a supervisor using a telephone a video link or directly in person They were compared with a group which had had previous CPR training The main outcome measures were the number of correct ventilations chest compressions and compressions with correct hand position Video link instruction was associated with significantly higher median scores for all three outcome measurements P Under 0 05 whereas telephone instruction and previous CPR training were associated with higher scores on only one namely ventilations P Under 0 05 Video link instruction was comparable with direct observer instruction There was no significant difference between previously trained subjects and the intervention groups Video link instruction can produce significant improvements in the quality of CPR in mock resuscitations for persons with no resuscitation training