Browsing by Author "Ruddick-Bracken, H"
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- ItemThe development of a pilot telemedicine network in Scotland: lessons learned.(2001-12-18) Brebner, J A; Brebner, E M; Ruddick-Bracken, H; Wootton, RA pilot telemedicine network was established in 11 sites using funding provided by the Department of Trade and Industry in the UK The main purpose of the project was to develop and evaluate clinical and educational links between central and peripheral sites in Scotland The results were very encouraging and clinical services were established in accident and emergency medicine tele ultrasound and clinical psychology An undergraduate medical teaching service was also successfully established All of these services are to be continued after the completion of the project Many lessons were learned during the establishment of this network which will be useful in future projects These included the importance of training for telemedicine users the importance of identifying a telemedicine champion the pitfall of health economics and the fact that services must be needs driven
- ItemThe diagnostic acceptability of low-bandwidth transmission for tele-ultrasound.(2001-03-26) Brebner, J A; Ruddick-Bracken, H; Brebner, E M; Smith, A P; Duncan, K A; Mcleod, A J; McClelland, S; Gilbert, F J; Thompson, A; Maclean, J R; Ritchie, L DUltrasound recordings were made of 100 consecutive patients attending for obstetric examination in Peterhead and 100 patients attending for non obstetric examination in Aberdeen Two identical video conferencing machines were used to transmit and receive the original ultrasound images at data rates of 384 kbit s and 128 kbit s thus producing a total of three tapes for each case Four experienced observers who were blinded to the transmission bandwidth each viewed 300 examinations and decided whether the images were acceptable or not for diagnosis Almost 100 of the obstetric ultrasound images on the original recordings were considered diagnostically acceptable compared with 93 of the 384 kbit s transmissions and 44 of the 128 kbit s transmissions Similarly 99 of the non obstetric ultrasound images were considered acceptable compared with 87 of the 384 kbit s transmissions and 21 of the 128 kbit s transmissions For the obstetric ultrasound images the intra observer diagnostic agreement was 93 kappa 0 89 between the original and the 384 kbit s transmissions and 78 kappa 0 63 between the original and the 128 kbit s transmissions For the non obstetric ultrasound images the respective intra observer diagnostic agreements were 77 kappa 0 62 and 78 kappa 0 63 The quality of dynamic ultrasound images transmitted at 384 kbit s was diagnostically acceptable but was unsatisfactory at 128 kbit s
- ItemEvaluation of a pilot telemedicine network for accident and emergency work.(2002-09-09) Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, JA pilot accident and emergency teleconsulting service was established in Scotland It was based at the accident and emergency department of the main hospital in Aberdeen There were three peripheral sites in rural Grampian Peterhead Turriff and Huntly and one in the Shetland Isles The videoconferencing equipment used was connected by ISDN at 384 kbit s During the 15 months of the study 1998 videoconference calls were made of which 402 20 calls were made to the accident and emergency department for clinical consultations The majority of the clinical calls 95 were made between 09 00 and 17 00 and more than 90 were completed within 20 min During the majority of calls 87 one or more X ray images were transmitted The majority of patients 89 received treatment without transportation to the main centre in Aberdeen The present study demonstrated that accident and emergency teleconsultations can be technically reliable effective in reducing the number of patient transfers and acceptable to the referring clinicians As a result approximately 1 5 million has been made available by the government to develop a national system for Scotland
- ItemEvaluation of an accident and emergency teleconsultation service for north-east Scotland.(2004-03-09) Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, J; Palombo, A; Pedley, D; Rowlands, A; Fraser, SWe evaluated an accident and emergency teleconsultation service provided to 14 community hospitals in north east Scotland Each community hospital was equipped with a videoconferencing system and a document camera to allow transmission of radiographs The network used 384 kbit s ISDN connections A total of 1392 teleconsultations were recorded during a 12 month study period Seventy seven per cent of patients n 1072 were managed locally and 23 n 320 were transferred to Aberdeen The majority 95 of teleconsultations were conducted on weekdays and 90 of these occurred between the hours of 09 00 and 16 00 The mean delay in contacting a doctor was 9 min and the mean consultation time was 10 min The majority of patients were suffering from fractures or suspected fractures of the limbs Radiograph transmission was used in 75 of all teleconsultations A high degree of satisfaction was recorded by all users of the service
- ItemExperience-based guidelines for the implementation of telemedicine services.(2005-07-22) Brebner, J A; Brebner, E M; Ruddick-Bracken, HMany telemedicine projects fail to survive beyond the funded research phase A review of seven Scottish telemedicine services was conducted to identify successes and failures Qualitative interviews were conducted with key individuals in each project All projects were partly successful The main reasons associated with partial failure were the service was not needs driven there was no commitment to provide the service there was no suitable exit strategy after research funding expired there was poor communication there was a lack of training there were technical problems work practices were not updated the protocols for use were poor or non existent Based on this guidelines that might improve the chances of success in future projects were drawn up
- ItemThe importance of setting and evaluating standards of telemedicine training.(2003-09-03) Brebner, E M; Brebner, J A; Ruddick-Bracken, H; Wootton, R; Ferguson, JThe importance of appropriate training in the use of videoconferencing equipment for clinical purposes is often underestimated when telemedicine projects are established We developed a user training programme which was delivered via videoconferencing to a group of 130 nurses Training was delivered on a one to one basis A questionnaire was developed to evaluate user satisfaction and the effectiveness of training One hundred and two fully completed questionnaires were returned a 79 response rate High levels of satisfaction were obtained but the level of user competence reached 100 only when training was supported by a training manual and at least weekly practice Before establishing a telemedicine service the following steps appear to be important identify the required training competencies deliver a hands on training programme based on the required training competencies back up the training programme with an instruction booklet ensure that trainees have at least weekly practice measure the level of user competence