Browsing by Author "Scott, Richard E"
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- ItemCategorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy.(2004-04-23) Varghese, Sunil; Scott, Richard EDeveloping countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services However this process faces disparities and no complementarity in telehealth policy development Telehealth has the potential to transcend geopolitical boundaries yet telehealth policy developed in one jurisdiction may hamper applications in another Understanding such policy complexities is essential for telehealth to realize its full global potential This study investigated 12 East Asian countries that may represent a microcosm of the world to determine if the telehealth policy response of countries could be categorized and whether any implications could be identified for the development of complementary telehealth policy The countries were Cambodia China Hong Kong Indonesia Japan Malaysia Myanmar Singapore South Korea Taiwan Thailand and Vietnam Three categories of country response were identified in regard to national policy support and development The first category was None Cambodia Myanmar and Vietnam where international partners driven by humanitarian concerns lead telehealth activity The second category was Proactive China Indonesia Malaysia Singapore South Korea Taiwan and Thailand where national policies were designed with the view that telehealth initiatives are a component of larger development objectives The third was Reactive Hong Kong and Japan where policies were only proffered after telehealth activities were sustainable It is concluded that although complementarity of telehealth policy development is not occurring increased interjurisdictional telehealth activity regional clusters and concerted and coordinated effort amongst researchers practitioners and policy makers may alter this trend
- ItemChallenges of telehealth research in clinical settings.(2007-12-14) Araki, Yuriko; Scott, Richard E; Lear, Scott
- ItemConsidering the socio-cultural impact of e-health.(2010-12-30) Hunter, Jolene; Scott, Richard Ee Health projects are being implemented globally in low income countries as a response to the identified inequality and inequity of access to health services for poor populations with a great burden of disease These projects are seen to offer solutions that provide quality care at a low cost Limited research is done on the sustainability of these projects Even less addresses the socio cultural impact on the host communities Based on experience of living with a remote community in Ghana this paper explores the needs of one community and how e Health has the ability to meet those needs using different solutions Also examined are the potential positive and negative impacts that e Health might yield on the people and their surroundings were e health solutions to be introduced
- ItemDeveloping needs-assessment tools for e-learning initiatives in preventive medicine in Pakistan.(2007-01-17) Khoja, Shariq; Scott, Richard E
- ItemE-health and the Universitas 21 organization: 3. Global policy.(2005-07-22) Scott, Richard E; Lee, AnnaThere is an urgent need to develop global e health policy in order both to facilitate and to manage the potential of e health As part of the Universitas 21 U21 project in e health an evaluation of the status of global e health policy was performed using a SWOT analysis strengths weaknesses opportunities and threats The analysis showed that the greatest threat to global e health policy is the autonomous nature of domestic health care systems The greatest opportunity may be the prospect for nations and individuals to work together in establishing mechanisms necessary to offer health care access through global e health a new global public good Full integration of e health into existing health care systems could be achieved in both a practical and a policy sense through global e health policy initiatives that facilitate integration across jurisdictions There is a pressing need to resolve a range of e health policy issues and a concomitant need for research that will inform and support the process A process that adopts a global approach is recommended
- ItemAn e-health needs assessment of medical residents in Cameroon.(2005-12-26) Scott, Richard E; Ndumbe, Peter; Wootton, RichardMedical residents from Yaounde I University in Cameroon are required to spend periods of time in rural or remote locations to complete their training To determine if e health might lessen their isolation and enhance patient care a needs assessment of the residents was performed using a brief questionnaire five items about the situation in which residents found themselves outside their medical school environment We gave the questionnaires to 45 residents Seventeen questionnaires had been returned at the time of the site visit a response rate of 38 Most residents indicated that the ability to contact a mentor would have either made them feel more confident 16 or 94 or altered their handling of recent cases 15 or 88 All residents had access to a mobile phone and many 11 or 65 had used it to contact a medical colleague for guidance A low cost and technologically simple telemedicine solution that maximized use of mobile phone capability provided access to medical and health care information and permitted exchange of images would be an appropriate response to the identified needs
- Iteme-Health readiness assessment tools for healthcare institutions in developing countries.(2007-09-12) Khoja, Shariq; Scott, Richard E; Casebeer, Ann L; Mohsin, M; Ishaq, A F M; Gilani, Salmane Health Readiness refers to the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to Information and Communications Technology ICT This paper presents e Health Readiness assessment tools developed for healthcare institutions in developing countries The objectives of the overall study were to develop e health readiness assessment tools for public and private healthcare institutions in developing countries and to test these tools in Pakistan Tools were developed using participatory action research to capture partners opinions reviewing existing tools and developing a conceptual framework based on available literature on the determinants of access to e health Separate tools were developed for managers and for healthcare providers to assess e health readiness within their institutions The tools for managers and healthcare providers contained 54 and 50 items respectively Each tool contained four categories of readiness The items in each category were distributed into sections which either represented a determinant of access to e health or an important aspect of planning The conceptual framework and the validity and reliability testing of these tools are presented in separate papers e Health readiness assessment tools for healthcare providers and managers have been developed for healthcare institutions in developing countries
- ItemFoundations in global e-health: a global capacity building course.(2010-12-30) Scott, Richard E; Palacios, Moné; Saeed, AyidaThe Foundations in Global e Health is a capacity building initiative designed for providers managers and ICT professionals in the healthcare sector Currently being trialled through PANACeA a pan Asian e health research network it is intended to offer the course in other developing regions from 2011 Using adult education principles this on line self paced course is offered in a modular fashion comprising 12 modules the workload of each module is in the range of 20 24 hrs with modules 2 to 12 requiring 1 month for completion The evidence based curriculum is designed to provide an introduction to e Health such that graduates of the program have a solid and standardised baseline awareness and understanding a common foundation from which they are better able to collaboratively communicate and independently develop and assess e Health initiatives within their respective settings and countries
- ItemHealthy e-health? Think 'environmental e-health'!(2010-12-30) Scott, Richard E; Saunders, Chad; Palacios, Moné; Nguyen, Duyen Thi Kim; Ali, SajidThe Environmental e Health Research and Training Program has completed its scoping study to understand the breadth of a new field of research Environmental e Health Nearly every aspect of modern life is associated directly or indirectly with application of technology from a cup of coffee through transportation to and from work to appliances in the home and industrial activities In recent decades the rapidly increasing application of information and communications technologies ICT has added to the cacophony of technological noise around us Research has shown that technology use including ICTs has impact upon the environment Studying environmental impact in such a complex global setting is daunting e Health is now being used as a convenient microcosm of ICT application within which to study these impacts and is particularly poignant given that e Health s environmental harms conflict with its noble goals of doing no harm The study has identified impacts both benefits and harms in all three life cycle phases for e Health up stream materials extraction manufacturing packaging distribution mid stream use period and down stream end of life processes disposal recycling In addition the literature shows that a holistic Life Cycle Assessment approach is essential to understand the complexity of the setting and determine the true balance between total harms and total benefits and for whom
- ItemInstant Messaging in Dermatology: A Literature Review.(0000-00-00) Morris, Christopher; Scott, Richard E; Mars, MauriceThe use of smartphones and IM has the potential to transform the delivery of health services by providing an easy to use cost effective tool for remote doctor to doctor and patient to doctor consultation and diagnosis Whilst the introduction of new technologies has improved access to healthcare it has also created new challenges The aim of this paper was to review the literature on the use of Instant Messaging IM and IM applications apps in dermatology METHOD PubMed Scopus and Science Direct were searched for multiple terms for 20 individual IM apps linked to the terms telehealth telemedicine ehealth e health mhealth or m health After title and abstract review 31 papers met the inclusion criteria of IM use in dermatology RESULTS Three papers all from the developing world reported the benefits of using IM in a clinical dermatology service Other uses included behavioural change disease management diagnosis triage screening diagnoses home monitoring education and administrative Little mention was made of medico legal issues such as consent confidentiality privacy and data security and storage CONCLUSION Currently there is little use of IM in clinical dermatology services but its potential is great There is need to address ethical and medico legal concerns and develop guidelines for its use IM is a simple cheap and effective solution for the developing world
- ItemMoving research into practice: A decision framework for integrating home telehealth into chronic illness care.(2006-11-19) Hebert, Marilynne A; Korabek, Barbara; Scott, Richard EHome telehealth is an effective alternative for some aspects of traditional care in chronic illnesses such as diabetes congestive heart failure and asthma However in spite of evidence to support use of home telehealth technologies they have not been adopted as predicted A significant challenge for decision makers is applying results from multiple small studies to the care of large numbers of clients in a health region Aside from the technology this complex decision must also include expected client outcomes variations in nursing resources and their deployment in service delivery This paper presents research evidence supporting the effectiveness of home telehealth for diabetes care with attention to the range of technologies and outcome measures reported It also discusses implications of a recently released national study on Homecare Indicators that reported resource allocation and outcomes in home care The burden of illness evidence of technology effectiveness and proposed home care outcome indicators are considered together in a decision framework to demonstrate an approach for decision makers and practitioners to transfer home telehealth research into practice The resulting decision framework is applied to diabetes care within one large health region in Canada to illustrate its utility as a research transfer strategy
- ItemAn online method for diagnosis of difficult TB cases for developing countries.(2011-02-21) Marcelo, Alvin; Fatmi, Zafar; Firaza, Paul Nimrod; Shaikh, Shiraz; Dandan, Alvin Joseph; Irfan, Muhammad; Bari, Vaqar; Scott, Richard EOptimal use of limited human technical and financial resources is a major concern for tuberculosis TB control in developing nations Further impediments include a lack of trained physicians and logistical difficulties in arranging face to face f 2 f TB Diagnostic Committee TBDC consultations Use of e Health for virtual TBDCs Internet and iPath to address such issues is being studied in the Philippines and Pakistan In Pakistan radiological diagnosis of 88 sputum smear negative but suspected TB patients has been compared with the gold standards TB culture and 2 month clinical follow up Of 88 diagnostic decisions made by primary physicians at the spoke site and electronic TBDC e TBDC at hub site there was agreement in 71 cases and disagreement on 17 cases The turn around time TAT patient registration at spoke site for f 2 f diagnosis to receiving the electronic diagnosis averaged 34 6 hours ranging 9 minutes to 289 2 hours Average TAT at the rural site 59 15 hours was more than the urban site 15 9 hours Comparison of e TBDC and f 2 f diagnosis with the gold standards showed only slight differences Using culture as the gold standard e TBDC decisions showed greater accuracy sensitivity 32 4 as compared to f 2 f 27 6 using 2 month clinical follow up as the gold standard f 2 f diagnosis showed slightly better improvement in patient symptoms and weight as compared to e TBDC In Philippines iPath was trialed and demonstrated that e TBDCs have potential Such groups could review cases diagnose and write comments remotely reducing the diagnosis and treatment delay compared to usual care
- ItemReducing your carbon footprint: How telemedicine helps.(2007-11-23) Smith, Anthony C; Patterson, Victor; Scott, Richard E
- ItemSecurity and Other Ethical Concerns of Instant Messaging in Healthcare.(0000-00-00) Morris, Christopher; Scott, Richard E; Mars, MauriceThere is a growing body of evidence highlighting the benefits of mobile health in terms of cost effectiveness efficiency and patient satisfaction These benefits have been further enhanced through the development of Instant Messaging IM applications apps that enable the transmission of images and text messages The aim of this paper is to review the use of IM in clinical services and to understand the medico legal concerns with regard to the security and management of protected health information on doctors phones METHOD PubMed was searched using the various IM apps as a search term Inclusion criteria were that the paper was in English and described the use of IM in a clinical service RESULTS 39 papers met the inclusion criteria Data are at risk at several levels including during transmission storage on servers en route and on the sender s and receiver s phones Consent is seldom obtained for instant messaging and confidentiality privacy data security and record keeping remain areas of concern CONCLUSION The use of IM and in particular WhatsApp is now commonplace amongst clinicians and used extensively across different clinical services Security concerns have created barriers preventing the global adoption of IM in healthcare Guidelines in the management and use of IM need to be developed in order to prevent the unwanted consequences of non compliance by uninformed clinicians With improved security IM has proven to be a viable option in the developing world
- ItemSelfie Telemedicine - What Are the Legal and Regulatory Issues?(0000-00-00) Mars, Maurice; Morris, Christopher; Scott, Richard ESelfies self taken photographs using mobile phones or tablet computers have become a way of life People are now sending selfies to health professionals for medical advice or dermatology triage or postoperative wound assessment These selfies may be unsolicited and sent to clinicians with whom the patient may or may not have a prior doctor patient relationship or on the instruction of the attending doctor or even to social media groups They may be sent by email or by mobile phone and instant messaging applications or sent to Websites or telemedicine specific application sites These photographs and accompanying information are legal documents should form part of the patient s record and should be securely transmitted and stored to maintain patient confidentiality and privacy This paper reviews the legal ethical and regulatory issues associated with the different forms of selfie telemedicine METHOD A scoping literature review was undertaken using PubMed Scopus Science Direct Ebsco Host and Google Scholar which were searched for Selfie and any of medicine telemedicine telehealth eHealth or mHealth Inclusion criteria were that the paper was in English and described the use of a selfie in relation to healthcare These were then reviewed for reference to legal ethical issues and regulatory issues RESULTS 68 papers met the inclusion criteria Legal and ethical issues identified were consent confidentiality privacy the doctor patient relationship data security responsibility record keeping licensure continuity of care quality of care image quality concordance phone stewardship and patient satisfaction CONCLUSION The literature provides little guidance on how legal and ethical issues and shortcomings of selfie telemedicine should be addressed especially the responsibilities of the patient and physician for unsolicited requests Nor does it provide advice on how records are to be kept or how images and information stored and sent to and from mobile phones or computers are to be managed The new issues that arise need to be addressed
- ItemThe spectrum of needed e-Health capacity building--towards a conceptual framework for e-Health 'training'.(2014-11-04) Scott, Richard E; Mars, MauriceTo ensure the benefits of e Health are maximised e Health capacity building requires a formal and logical structure that describes broad areas that must be addressed In this paper a Conceptual Framework for e Health Training is derived that could guide well thought out and consistent development of future capacity building efforts Consideration of e health education needs is the mandate of the International Society for Telemedicine and eHealth ISfTeH Education Working Group Through this Group a structured but generic 2 3 day telehealth training programme for healthcare professionals was developed and trialed and the Group has been asked to develop a telehealth curriculum Ongoing debate and feedback has made it clear that this is insufficient In an effort to establish an Conceptual Framework for e Health Training four aspects or levels of instruction are considered necessary at this time education of a small number of personnel leading to an academic graduate qualification MSc PhD instruction of a slightly larger number of personnel e g to provide proficient network managers teaching of a still larger number of personnel in terms of the use of specific technologies devices and services and awareness of the general populace Collectively this is referred to as e health training If implemented in a coordinated and structured manner such an approach would stimulate e health growth and application globally It would generate demand awareness allow that demand to be filled teaching and guided instruction with the focus on technologically appropriate and needs based solutions education The Education Working Group intends to develop outlines of recommended instructional and informational content for training at each level Here the four levels are highlighted and the terms hierarchy and descriptions of the Education Working Group s proposed approach to its Conceptual Framework for e Health Training are formalised
- ItemStriving for evidence in e-health evaluation: lessons from health technology assessment.(2005-12-26) Gagnon, Marie-Pierre; Scott, Richard EEvaluation is crucial to the integration of e health applications into the health care system and their ultimate sustainability However e health evaluation is often criticized for the poor quality of research design the lack of common outcome indicators and the absence of an agreed theory Health technology assessment HTA could offer a sound methodological basis for e health evaluation However there have been major concerns about the applicability of the HTA approach to the evaluation of e health initiatives Evaluators and decision makers must accept that telehealth evaluation may serve different purposes for different stakeholders and therefore concede that no single evaluation framework or methodology even the randomized controlled trial is totally objective To address the complex environment of telehealth evaluation a participatory strategy is useful whereby stakeholders are involved in the study design and definition of evaluation questions at each phase This will also build confidence between the evaluation team and the stakeholders facilitating informed decision making through an integrated knowledge mobilization activity
- ItemTelehealth outcomes: a synthesis of the literature and recommendations for outcome indicators.(2007-11-16) Scott, Richard E; McCarthy, Frank G; Jennett, Penny A; Perverseff, Tara; Lorenzetti, Diane; Saeed, Ayida; Rush, Bonnie; Yeo, Maryann
- ItemTelehealth policy: looking for global complementarity.(2003-03-28) Scott, Richard E; Chowdhury, M Faruq U; Varghese, SunilTelehealth is gaining acceptance as a tool for bridging the local and global health care divides However integrating telehealth into existing health infrastructures presents a daunting challenge for governments policy makers telehealth advocates and health care workers The development of specific inter jurisdictional telehealth policies will significantly improve the ability to meet this challenge In the policy context one success is the increasing number of jurisdictions addressing policy issues However policy decisions have largely been taken in isolation within individual health institutions regions provinces states or countries This represents a failure of the current approach Telehealth by its very nature has the ability to transgress existing geo political boundaries As a consequence policy in any single jurisdiction may hamper or even cripple the ability of telehealth to fulfil its potential Commonality or at least complementarity of approach to telehealth policy must be encouraged To achieve this it is essential to understand the current or anticipated regulatory constraints that may affect telehealth We have begun a preliminary study of country specific policy issues