Browsing by Author "Wootton, R"
Now showing 1 - 20 of 51
Results Per Page
Sort Options
- ItemAvoiding artificiality in teleconsultations.(2001-09-28) Tachakra, S; Newson, R; Wootton, R; Stinson, AThe ideal videoconferencing environment would produce the minimum feeling of artificiality for its users We assessed nurse and patient perceptions of artificiality by varying the technical and operational procedures for telemedicine in a minor injuries unit Twenty five patients and eight emergency nurse practitioners ENPs participated in simulated teleconsultations under a variety of different conditions and completed a Likert scale survey There was a close correlation between the ENPs ratings and the patients ratings for the various factors r 0 99 In relation to technical factors a flicker free television screen and the user being seated close to the screen were preferred Similarly in relation to operational procedures an initial explanation of telemedicine introductions and adequate preparation were also preferred The study suggests that careful attention to technical specifications and operational procedures can reduce the perceived artificiality of teleconsultations
- ItemCan telemedicine be used to promote sexual health?(2001-09-20) Wootton, R; Bourne, C
- ItemCan the Internet be used as a medium to evaluate knee angle?(2003-10-15) Russell, T G; Jull, G A; Wootton, RTelemedicine promises to revolutionize medical care delivery in rural and remote areas The ability to accurately evaluate physical impairment via the Internet is important to the possible future provision of Internet based physiotherapy This study evaluated the reliability and validity of assessing knee range of motion via the Internet Two therapists evaluated knee angle on a single subject via two methods of assessment the Internet and the traditional method face to face Nine random positions of the knee were chosen with the principal examiner performing 20 face to face and two sets of 20 Internet measures in each position n 540 The secondary therapist performed Internet assessments only The Internet connection was established at a readily available speed of 17 kbit s The Internet based goniometer was found to be a valid tool for measuring both knee flexion and extension angles It was shown to possess both high intra and inter rater reliability Difference average plots of the scores verified the consistency of measurement between both modes of assessment The successful evaluation of the physical outcome measure of knee range of motion via the Internet assists the further development of Internet based physiotherapy applications
- 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
- 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
- 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
- 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
- ItemCould a low-cost audio-visual link be useful in rheumatology?(2000-05-25) Graham, L E; McGimpsey, S; Wright, S; McClean, G; Carser, J; Stevenson, M; Wootton, R; Taggart, A JWe have investigated prospectively the diagnostic accuracy specialist satisfaction and patient specialist rapport of a low cost audio visual link between a junior doctor with a patient and a consultant rheumatologist Using a telephone link and subsequently a video phone link 20 patients with various rheumatological problems were presented by a junior doctor to the consultant rheumatologist for provisional diagnosis All patients were then seen face to face by the consultant when a final diagnosis was made An independent consultant rheumatologist made a gold standard diagnosis Thirty five per cent of diagnoses were made correctly over the telephone and 40 over the video phone there was no significant difference in the diagnostic accuracy between these two methods of communication Rapport over the video phone was universally poor Where it was important clinical signs could not be visualized over the video phone and in more than 85 of cases small joint swellings could not be seen clearly
- 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 effect of videoconferencing on the depth perception of observers.(2001-05-07) Wootton, R; Collins, M; Loughridge, J; Loane, MThe ability of the human eye to perceive depth was measured using a specially designed instrument Visual acuity and both monocular and binocular stereoacuity were measured when viewing the instrument directly and via a videoconferencing link Ten subjects with an average age of 32 5 years range 24 50 took part in the study The group mean visual acuity using both eyes under normal test conditions was 0 04 logMAR Snellen 6 5 compared with 0 18 logMAR Snellen 6 10 for the video link The mean stereoacuity using both eyes was 37 SD 18 under normal test conditions When a videoconferencing link was used the mean stereoacuity fell to 1218 SD 1203 using one eye and to 1651 SD 1419 using both eyes The ability to perceive depth remotely via a video link was significantly decreased compared with normal test conditions
- ItemEffective diagnosis of spinal cord compression using telemedicine.(2001-02-22) Patterson, V H; Craig, J J; Wootton, RWe report the case of a man with an acute cervical cord lesion which was diagnosed after a teleconsultation with a neurologist at a distant neurological centre We show that the ability to assess patients clinically using real time videolinks is also of use in detecting those patients who would benefit from specialist neurosurgical intervention but who might otherwise be denied it because of their location
- ItemEquipment for minor injuries telemedicine.(2000-02-02) Wootton, RA telemedicine system for minor injuries work comprises two main components 1 a face to face videoconferencing system often including a second camera at the patient end for close up pictures and 2 a system for the transmission and display of radiographic images i e teleradiology There is a wide variety of equipment being used for minor injuries telemedicine in the UK For videoconferencing low cost systems including those based on PCs and medium cost systems are in use For teleradiology high resolution system i e those complying with the standard set by the American College of Radiology and low resolution systems i e those which do not are in use The quality of the telemedicine interaction for minor injuries work therefore appears to be less dependent on the sophistication of the equipment used than on other factors including human ones Equipment choice has implications for costs
- 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 with a low-cost telemedicine system in three developing countries.(2001-09-28) Vassallo, D J; Swinfen, P; Swinfen, R; Wootton, RThe Swinfen Charitable Trust was established in 1998 with the aim of helping the poor sick and disabled in the developing world It does this by setting up simple telemedicine links based on email to support doctors in isolated hospitals The first telemedicine link was established to support the lone orthopaedic surgeon at the Centre for the Rehabilitation of the Paralysed CRP in Savar near Dhaka in Bangladesh in July 1999 An evaluation of the 27 referrals made during the first year of operation showed that the telemedical advice had been useful and cost effective Based on the success of the Bangladesh project the Swinfen Charitable Trust supplied digital cameras and tripods to more hospitals in other developing countries These are Patan Hospital in Nepal March 2000 Gizo Hospital in the Solomon Islands March 2000 Helena Goldie Hospital on New Georgia in the Solomon Islands September 2000 and LAMB Hospital in Bangladesh September 2000
- 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
- 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
- ItemMinimum acceptable standards for digital compression of a fetal ultrasound video-clip.(2001-12-18) Begg, L; Chan, F Y; Edie, G; Hockey, R; Wootton, RIf the Internet could be used as a method of transmitting ultrasound images taken in the field quickly and effectively it would bring tertiary consultation to even extremely remote centres The aim of the study was to evaluate the maximum degree of compression of fetal ultrasound video recordings that would not compromise signal quality A digital fetal ultrasound videorecording of 90 s was produced resulting in a file size of 512 MByte The file was compressed to 2 5 and 10 MByte The recordings were viewed by a panel of four experienced observers who were blinded to the compression ratio used Using a simple seven point scoring system the observers rated the quality of the clip on 17 items The maximum compression ratio that was considered clinically acceptable was found to be 1 50 1 100 This produced final file sizes of 5 10 MByte corresponding to a screen size of 320x240 pixels running at 15 frames s This study expands the possibilities for providing tertiary perinatal services to the wider community
- ItemMinor injuries telemedicine: introduction.(2000-02-02) Wootton, R; Benger, J
- «
- 1 (current)
- 2
- 3
- »