Browsing by Author "Patterson, V"
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- ItemA cohort study of early neurological consultation by telemedicine on the care of neurological inpatients.(2004-06-17) Craig, J; Chua, R; Russell, C; Wootton, R; Chant, D; Patterson, VTo find out the effect of early neurological consultation using a real time video link on the care of patients with neurological symptoms admitted to hospitals without neurologists on site
- ItemCost implications of outpatient teleneurology.(2001-09-28) Chua, R; Craig, J; Wootton, R; Patterson, VA randomized controlled trial was conducted to compare the costs of realtime teleneurology with the cost of conventional neurological care Two district hospitals in Northern Ireland were equipped with videoconferencing units and were connected to the regional neurological centre by ISDN at 384 kbit s Of 168 patients randomized to the study 141 kept their appointments 76 male 65 female Sixty five patients were randomized to a conventional consultation while 76 were randomized to a teleconsultation The average age was 44 years of those seen conventionally and 42 years of those seen by telemedicine The groups had similar diagnoses The telemedicine group required more investigations and reviews than the conventional group The average cost of the conventional consultation was 49 pounds sterling compared with 72 pounds sterling for the teleconsultation Realtime teleneurology was not as cost effective as conventional care
- ItemThe cost-effectiveness of teleneurology consultations for patients admitted to hospitals without neurologists on site. 1: A retrospective comparison of the case-mix and management at two rural hospita...(2000-05-25) Craig, J; Chua, R; Russell, C; Patterson, V; Wootton, RWe are currently evaluating the use of telemedicine for improving the care of patients admitted with neurological symptoms to hospitals that do not have specialist neurologists on site To do this we have been comparing the outcome of patients admitted to two small hospitals In one hospital all patients with neurological symptoms are seen by a neurologist at a distance using an interactive video link transmitting at 384 kbit s in the other patients with neurological problems are managed as per usual practices For the results of this study to be valid it is essential that the case mix and process of management for neurological patients are similar at the two hospitals We therefore compared the case mix process of management and outcome for all patients admitted over a four month period to either hospital who had been coded using ICD 10 as having a final diagnosis of a neurological condition No appreciable differences were noted between the two hospitals for measures of case mix or outcome Likewise most measures of process were similar although there was a significant difference for the overall length of hospital episode between the two hospitals When patients with prolonged hospital episodes were excluded or only patients with a diagnosis of headache epilepsy or transient ischaemic attack were considered who as a group made up the bulk of neurological admissions the difference in the length of hospital episode was not significant It should therefore be possible for us to estimate the effect of telemedicine on the management of patients with neurological problems
- ItemAn evaluation of the first year's experience with a low-cost telemedicine link in Bangladesh.(2001-05-10) Vassallo, D J; Hoque, F; Roberts, M F; Patterson, V; Swinfen, P; Swinfen, RIn July 1999 the Swinfen Charitable Trust in the UK established a telemedicine link in Bangladesh between the Centre for the Rehabilitation of the Paralysed CRP in Dhaka and medical consultants abroad This low cost telemedicine system used a digital camera to capture still images which were then transmitted by email During the first 12 months 27 telemedicine referrals were made The following specialties were consulted neurology 44 orthopaedics 40 rheumatology 8 nephrology 4 and paediatrics 4 Initial email replies were received at the CRP within a day of referral in 70 of cases and within thee days in 100 which shows that store and forward telemedicine can be both fast and reliable Telemedicine consultation was complete within three days in 14 cases 52 and within three weeks in 24 cases 89 Referral was judged to be beneficial in 24 cases 89 the benefits including establishment of the diagnosis the provision of reassurance to the patient and referring doctor and a change of management Four patients 15 of the total and their families were spared the considerable expense and unnecessary stress of travelling abroad for a second opinion and the savings from this alone outweighed the set up and running costs in Bangladesh The latter are limited to an email account with an Internet service provider and the local rate telephone call charges from the CRP This successful telemedicine system is a model for further telemedicine projects in the developing world
- ItemHow best to organise acute hospital services? Realtime teleneurology can help small hospitals.(2001-12-14) Patterson, V
- ItemInteractive videoconsultation is a feasible method for neurological in-patient assessment.(2001-02-08) Craig, J; Patterson, V; Russell, C; Wootton, RTo evaluate the feasibility of interactive videoconsultation IATV as a means by which neurologists might assess patients admitted with neurological symptoms to hospitals distant from a neurological centre we studied 25 unselected patients using interactive videoconsultation IATV and then validated the IATV diagnoses and management plans at a later face to face consultation IATV consultation led to an eventual diagnosis in 23 out of 25 patients with one diagnosis being changed and one remaining uncertain The IATV management plans were felt to be appropriate for all patients in study Twelve patients were able to be discharged from hospital on the same day as IATV on the advice of the neurologist It is therefore practical to assess patients admitted with neurological symptoms to distant hospitals using IATV and this may result in more efficient use of in patient resources
- ItemThe interdisciplinary management of cerebral haemorrhage using telemedicine--a case report from Nepal.(2001-09-25) Graham, L E; Flynn, P; Cooke, S; Patterson, V
- ItemA pilot study of telemedicine for new neurological outpatient referrals.(2000-10-18) Craig, J; Chua, R; Wootton, R; Patterson, VWe investigated whether new patients attending a neurological outpatient clinic could be safely managed by neurologists at a distance using a video link In Northern Ireland a video link transmitting at 384 kbit s was set up between a neurological centre and a small rural hospital 140 km away Twenty five unselected patients who had been referred by their family doctor were assessed by a neurologist using the telemedicine link and then immediately by another neurologist face to face Examiners were blinded to the results of each other s assessment In 24 cases the diagnoses made after the telemedicine and face to face examinations were identical There were minor differences between the type and number of investigations requested and the requirements for treatment and follow up between the two groups Disposal method was the same in 21 of the cases No major organizational difficulties were encountered during the study The study showed that neurologists can deliver outpatient neurological care to distant patients using telemedicine This has the potential to allow access to assessment for the large number of neurological outpatients who might otherwise be denied it
- ItemRandomised controlled trial of telemedicine for new neurological outpatient referrals.(2001-06-19) Chua, R; Craig, J; Wootton, R; Patterson, VTo test the hypothesis that telemedicine for new patient referrals to neurological outpatients is as efficient and acceptable as conventional face to face consultation
- ItemStore-and-forward teleneurology in developing countries.(2001-09-28) Patterson, V; Hoque, F; Vassallo, D; Farquharson Roberts, M; Swinfen, P; Swinfen, RWe assessed the feasibility of a store and forward email teleneurology service between a UK neurologist and a rehabilitation hospital in Bangladesh Over 12 months email advice was requested for 12 patients mean age 43 years range 15 57 years Each patient generated an average of 5 2 email messages Eight cases were considered complicated by the neurologist who would have preferred a video link consultation for these The referring doctor found the neurologist s advice beneficial in 75 of the complex cases and in all of the more straightforward cases Patient care was changed in 50 of the cases as a result of the specialist advice and one patient transfer out of the country was avoided Store and forward teleneurology is effective for delivering expert neurological advice
- ItemSuccessful management of unexplained coma by telemedicine.(2000-01-20) Patterson, V; Craig, J; Pang, K A; Wootton, R
- ItemTelemedicine--the way ahead for medicine in the developing world.(2003-02-05) Graham, L E; Zimmerman, M; Vassallo, D J; Patterson, V; Swinfen, P; Swinfen, R; Wootton, RAn e mail link with the facility to send high resolution digital images is a cheap and uncomplicated telemedicine method The Swinfen Charitable Trust helped establish such a link in Patan Hospital Kathmandu Nepal in March 2000 Over 12 months using this link 42 telemedicine referrals were sent to specialists throughout the world Referrals were 36 respiratory medicine 21 neurology 21 dermatology 14 cardiology 5 nephrology and 3 radiology 28 had digital pictures attached of which 96 were of high enough quality on which specialists were able to comment Thirty nine replies were received The average time for a specialist reply was 2 days and 45 were answered within 24 hours All replies were judged by independent assessors to be helpful or very helpful for diagnosis management and education The assessors decided that in 50 of cases the advice if acted upon would have shortened hospital stay This pilot study has shown that a low cost telemedicine link is technically feasible and can be of significant benefit for diagnosis management and education in a developing world setting
- ItemTeleneuroradiology: a case from Nepal with clinical and educational benefit.(2003-03-25) Graham, L E; Flynn, P; Patterson, V
- ItemUser satisfaction with realtime teleneurology.(2000-07-03) Craig, J; Russell, C; Patterson, V; Wootton, RUser satisfaction i e that of patients medical staff at a remote hospital and medical staff at a neurological centre with realtime teleneurology consultations was studied prospectively Twenty five patients with neurological problems admitted to a hospital without permanent neurological cover were assessed from a neurological centre by specialist neurologists using realtime video links transmitting at 384 kbit s All users reported high levels of satisfaction with the technical aspects of the consultations Patients almost universally reported confidence in teleneurology as a means of dealing with their presenting complaints Similarly medical staff at either site felt confident in managing patients using teleneurology and almost always felt that a telephone consultation would not have achieved as good an outcome No major organizational problems were identified These findings suggest overall user satisfaction with realtime teleneurology for managing patients with neurological problems admitted to hospitals that do not have resident neurologists