Browsing by Author "Rafiq, Azhar"
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- ItemAcquisition and evaluation of radiography images by digital camera.(2005-04-28) Cone, Stephen W; Carucci, Laura R; Yu, Jinxing; Rafiq, Azhar; Doarn, Charles R; Merrell, Ronald CTo determine applicability of low cost digital imaging for different radiographic modalities used in consultations from remote areas of the Ecuadorian rainforest with limited resources both medical and financial Low cost digital imaging consisting of hand held digital cameras was used for image capture at a remote location Diagnostic radiographic images were captured in Ecuador by digital camera and transmitted to a password protected File Transfer Protocol FTP server at VCU Medical Center in Richmond Virginia using standard Internet connectivity with standard security After capture and subsequent transfer of images via low bandwidth Internet connections attending radiologists in the United States compared diagnoses to those from Ecuador to evaluate quality of image transfer Corroborative diagnoses were obtained with the digital camera images for greater than 90 of the plain film and computed tomography studies Ultrasound U S studies demonstrated only 56 corroboration Images of radiographs captured utilizing commercially available digital cameras can provide quality sufficient for expert consultation for many plain film studies for remote underserved areas without access to advanced modalities
- ItemCase report of remote anesthetic monitoring using telemedicine.(2004-01-26) Cone, Stephen W; Gehr, Lynne; Hummel, Russell; Rafiq, Azhar; Doarn, Charles R; Merrell, Ronald CWe report a case supporting the use of telecommunications technology from a remote location to monitor anesthetic events Vital signs data and video were transmitted from surgery conducted in the remote Amazonian rainforests of Ecuador to Richmond VA This application of telemedicine technologies makes available expert advice from remote locations during surgical procedures
- ItemDigital video capture and synchronous consultation in open surgery.(2004-03-16) Rafiq, Azhar; Moore, James A; Zhao, Xiaoming; Doarn, Charles R; Merrell, Ronald CTo achieve real time or simultaneous surgical consultation and education to students in distant locations we report the successful integration of robotics video teleconferencing and intranet transmission using currently available hardware and Internet capabilities
- ItemIntegration of information technology, wireless networks, and personal digital assistants for triage and casualty.(2006-08-31) Zhao, Xiaoming; Rafiq, Azhar; Hummel, Russel; Fei, Ding-Yu; Merrell, Ronald CThe purpose of this study was to evaluate a portable tool for use by first responders in documenting triage of victims in a mass casualty incident MCI more effectively The tool presented in this study allows first responders to gather patients vital signs injuries and triage status in a prompt and accurate way and enables first responders to wirelessly communicate vital health information throughout the entire care continuum The architecture infrastructure for the portable device is called Triage and Casualty Informatics Technology TACIT and can expedite triage transport and treatment procedures within an MCI TACIT was developed by integrating handheld devices wireless networks global positioning system GPS digital cameras and bar code scanners with customized triage software Two MCI initial field trials verified that the TACIT software battery life data accuracy and wireless transmission met the emergency response system requirements Initial field trials also demonstrated robustness of operation reduced triage collection time and improved collection accuracy The TACIT system could work as an efficient prehospital response tool and platform
- ItemRemote video management for intraoperative consultation and surgical telepresence.(2007-11-16) Boanca, Cosmin; Rafiq, Azhar; Tamariz, Francisco; Lavrentyev, Vladimir; Onisor, Daniel; Flerov, Evgeniy; Popescu, Irinel; Merrell, Ronald CTelemedicine applications can connect surgeons from one operating room OR to a distant consultant The additional capacity of telepresence provides remote consultants the ability to control their own view of the surgical field using robotic management of a network camera The goal of this study was to compare access to surgical field by robotic camera versus image controlled by the surgeon using a camera mounted to the table A Stryker laparoscopic camera was attached to the OR table using a Mediflex arm and video image was transmitted with a Polycom Transfer Control Protocol TCP Internet Protocol IP connection A network Sony camera was mounted on a tripod connected over the Internet using a parallel TCP IP connection A Web interface allowed control of the camera angle and zoom In 22 consultations effective bandwidth was 800 Kbps for the network camera and 1024 Kbps for the Stryker camera The operation was thyroidectomy and the consultant was either in Moscow Russia or Bucharest Romania The quality of the image in both methods was indiscernible The ability to identify critical surgical anatomy was also indiscernible No transmission session failed or had an interruption The robotic camera can be a powerful tool for surgical collaboration
- ItemA surgical telemedicine clinic in a correctional setting.(2008-06-23) Lavrentyev, Vladimir; Seay, Arden; Rafiq, Azhar; Justis, Deborah; Merrell, Ronald CThe telemedicine network between Virginia Commonwealth University Health System VCUHS and the Department of Corrections in Virginia has seen a steady increase in the number of disciplines involved in consultation Hardware integration and methodologies between VCUHS and correctional facilities were supported by Polycom videoconferencing technology During consults a VCUHS based surgeon was provided with patient records picture archiving and communication system images and laboratory data or text reports sent by fax A registered nurse at the correctional site assisted the surgeon at VCUHS Electronic stethoscope and dermascope were also used for physical examination of inmates Preoperative encounters included physical examination and informed consent from video Electronic scheduling and preoperative orders were issued at the time of consultation Of the 55 consultations completed this past year 27 were followed by surgical procedures In one case the referral diagnosis was corrected and one case required minor change in diagnosis at an in person examination on the day of surgery Twenty patients had postoperative examination by telemedicine and five of these required a second follow up telemedicine visit All patients confirmed their informed consent and acknowledged their surgeon upon first meeting face to face at the hospital Telemedicine consultation for general surgery is an effective asset and can limit patient transfer
- ItemTelemedicine for access to quality care on medical practice and continuing medical education in a global arena.(2005-08-04) Rafiq, Azhar; Merrell, Ronald CHealth care practices continue to evolve with technological advances integrating computer applications and patient information management into telemedicine systems Telemedicine can be broadly defined as the use of information technology to provide patient care and share clinical information from one geographic location to another Telemedicine can lower costs and increase access to health care especially for those who live in remote or underserved areas The mechanism of telemedicine raises some difficult legal and regulatory issues as well since technology provides remote diagnosis and treatment across state lines resulting in unclear definitions for liability coverage Physician licensing becomes an issue because telemedicine facilitates consultations without respect to state or national borders With the increased access to current information and resources continuing medical education becomes more feasible with synchronous or asynchronous access to educational content The challenge in implementation of these unique educational tools is the inclusion for standards of practice and appropriate regulatory mechanisms to cover the audiences
- ItemTelemedicine in extreme conditions: disasters, war, remote sites.(2008-02-28) Merrell, Ronald C; Cone, Stephen W; Rafiq, AzharTelemedicine has developed around certain assumptions about connectivity and format From the pioneer work of Kenneth Bird in the 1970 s medical events separated by distance were connected for videoconference interaction 1 The connection implied well developed telecommunications tools at both ends of the interaction Telemedicine in its most common manifestations relies upon electronic and professional familiarity plus training with proper technical support This is true even with Internet telemedicine at the low end of bandwidth A workable Internet service provider and intact telecommunication services are required at both ends The assumption of intact robust telecommunications fails when there is any significant disruption of services power or trained people to initiate a telemedicine request The very nature of disasters whether made by nature made by fellow humans or in war declarations implies a rupture of the social fabric a failure of infrastructure This loss of infrastructure and connection happens at a cruel time when the need for services in health matters is generally very much exacerbated Extreme remote sites have never had infrastructure and therefore fit into this chapter Is telemedicine incompatible with support and relief in disasters of remote places Certainly not However telemedicine must adapt to the situation in ways not generally associated with standard telemedicine New solutions can meet the expectation of being wherever services are need whenever the need arises This chapter looks at the experiences successes and failures of telemedicine in natural disaster war and extreme remote sites The presentation is concluded with recommendations to make telemedicine integral to any disaster response and a natural tool for any human endeavor that requires sending people to remote and hostile environments
- ItemTelemedicine licensure in the United States: the need for a cooperative regional approach.(2007-05-10) Cwiek, Mark A; Rafiq, Azhar; Qamar, Aamna; Tobey, Charles; Merrell, Ronald CThe extraordinary successes and refinement of modern telemedicine applications in recent years have been diminished somewhat by the anachronistic licensure laws of the 50 state jurisdictions that limit the practice of medicine to specific state geographic boundaries This approach is deficient when applied to telemedicine because with the advent of the Internet and modern technological advances differences in space and time are rendered nearly meaningless It is recommended in this paper that the practice of telemedicine be handled differently than the practice of face to face medicine as related to licensure Although it may be argued persuasively that a national licensure model for telemedicine should be advanced the political and constitutional hurdles may be too great to overcome It is therefore recommended that a voluntary regional geographic approach be instituted by jurisdictions already demonstrating a commonality of interests such as through the Southern Governors Association or the Western Governors Association The benefits to be derived from this approach would include improving access to healthcare and medical specialists enhancing the quality and timeliness of care cutting medical costs by moving information instead of people securing patients access to medical records and information and facilitating commercial export of American telemedicine services